Many people wonder about where to draw the line with exposures. This conundrum has become particularly muddy in our current situation, as we are faced with new and uncertain risks. Some of my former colleagues at McLean Hospital’s OCD Institute recently wrote an article, detailing many of the considerations affecting how we deliver ERP during a pandemic. The article is featured in the Association for Behavioral and Cognitive Therapies’ newsletter, the Behavior Therapist and is called “Adapting Exposure and Response Prevention in the Age of COVID-19”.
In short, the article suggests that we can adjust by: doubling down on response prevention (given the limits on actual exposure), focusing on function over form (am I washing my hands to follow the recommended guidelines or to reduce distress?), and by leaning into inhibitory learning rather than habituation-focused exposures (changing our relationship to anxiety and uncertainty rather than trying to eliminate it).