Exposure Is About Learning, Not Habituation

Please note that this is an older article. Thinking about exposure in terms of learning was a conceptual stepping stone between thinking in terms of habituation (the classical model) and thinking in terms of restoring agency (my current model). Rumination-Focused ERP: Turning Exposure On Its Head and Targets and Rationales for RF-ERP Exposures offer the most […]

ERP Exercises for Compulsive Rumination

I use the series of exercises in this article to help patients practice eliminating compulsive rumination.   Per Targets and Rationales for RF-ERP Exposures, the goal of these exercises is not to make the patient anxious.  Rather, the goal is for them to learn that they can control rumination, even when they encounter a trigger. Some […]

It Matters How We Talk About OCD: The Importance of Using Language of Agency

OCD isn’t random or illogical.  It is a comprehensible, logical strategy (avoidance and compulsion) aimed at preventing the Core Fear.  Recovering from OCD requires recognizing that you are employing a strategy that doesn’t work, and learning that you have the ability to make different choices that lead to feeling better. Put another way, recovering from OCD […]

Using Imaginal Exposure When Practicing ERP from the Perspective of Learning

I approach exposure from the perspective of learning as opposed to habituation (For further discussion, see Exposure Is About Learning, Not Habituation).  From this perspective, the point of exposure isn’t to habituate to a stimulus but rather to learn something. It’s easy to conceptualize how this might work for an ‘in vivo exposure,’ in which you […]

Rethinking the Process and Treatment of Compulsive Rumination

The below is the first article I wrote on this topic a few years ago. These ideas have evolved significantly since that time.  Rumination-Focused ERP: Turning Exposure On Its Head and Targets and Rationales for RF-ERP Exposures offer the most current version of my approach to exposure. I believe that the issue of compulsive thinking, or […]