How to Practice Mindfulness In ERP Therapy for OCD

By now, you may have heard of exposure and response prevention (ERP) therapy, the gold-standard treatment for obsessive-compulsive disorder (OCD). What you may not have heard is that integrating mindfulness techniques into ERP therapy can be beneficial for people with OCD.

Practicing mindfulness often involves observing your thoughts and feelings without judgment, which can be useful for anyone who struggles with intrusive thoughts and feels a need to engage with them, suppress them, or avoid them. Mindfulness can enhance ERP by helping people with OCD learn that uncomfortable thoughts and emotions will pass without any action being required.

Find out what these two modalities have in common, why they can work well together, and how you can implement your own mindfulness practice alongside ERP therapy in 3 steps.

Why ERP therapy and mindfulness can work well together

The primary function of ERP therapy is to help people struggling with OCD develop a different relationship with the intrusive thoughts, images, or urges they’re experiencing. Mindfulness serves a similar purpose, making it a useful skill to complement specialized treatment.

ERP also aims to reduce compulsions, the physical or mental behaviors that people with OCD perform to neutralize the distress that they’re feeling. Mindfulness practices often involve allowing your thoughts to exist without judging or engaging with them, which can help people resist urges to do compulsions.

Mindfulness and ERP also share several other objectives:

1. Accepting uncertainty

Feeling uncomfortable with uncertainty is a core feature of OCD. Mindfulness encourages people to be present in the current moment instead of getting caught up in the search for certainty regarding their intrusive thoughts. Learning to approach these thoughts, as distressing and upsetting as they may be, with an attitude of curiosity rather than judgment can play a crucial role in treatment. When someone is able to take a step back and see their thoughts not as part of their identity, but rather as a natural part of human existence, they can become less and less ensnared by their thoughts.

2. Understanding thoughts and behaviors

Like ERP, mindfulness can also help people with OCD become more aware of their intrusive thoughts, images, and urges. They can see all of the different ways in which they experience the distress and anxiety associated with obsessions. This increased awareness and understanding can also help people approach their obsessions non-judgmentally during ERP exercises.

3. Tolerating discomfort

By practicing mindfulness during ERP exercises, individuals with OCD can learn that they’re able to “sit with” anxiety and discomfort, allowing these feelings to pass without engaging in compulsions. It’s important to recognize that mindfulness itself has the potential to become a compulsion. To ensure it isn’t being utilized compulsively, seeking the guidance of a qualified OCD specialist is recommended.

3 steps for practicing mindfulness in OCD treatment

Step 1: Be aware.

The first step to practicing mindfulness in OCD treatment is to observe the thoughts and feelings you’re experiencing. We can refer to this as becoming aware of them. Awareness in this sense means simply noticing that you are having an obsessive thought. 

This awareness extends to being aware that if you have OCD, you have a tendency to become fixated or “stuck” on thoughts that make you feel uncomfortable. OCD can make it seem like intrusive thoughts have to mean something, but engaging with these thoughts or trying to make sense of them will only keep you stuck.

Step 2: Observe without judging.

Once you’ve recognized you’re dealing with a disorder that wants you to attach meaning to these unwanted thoughts, you have the power to fight back by choosing not to internalize these thoughts or the feelings they bring. The meanings we tend to attach to intrusive thoughts are never beneficial to our well-being. Instead, you can observe your thoughts and move on, knowing they don’t require any action on your part.

You can continue living life based on your values and give yourself compassion, knowing that everyone has thoughts they feel uncomfortable with from time to time. Obsessions are not signs that you are overlooking some important truth about yourself. Having a thought of an action is not the same as doing the action.

Step 3: Be present in the moment you are in.

While OCD might tell you that you need to “figure it out,” that you should stop everything and go down its rabbit holes in search of certainty, the truth is that you get to decide. What OCD doesn’t tell you is that you have more power than you may think. You can choose not to play its game. This is easier said than done, of course, but I’ve learned from my own experience that it’s possible with time and practice.

I always say that OCD thoughts can “hang out” if they want to, but they won’t stop me from doing what I need to do. If I’m doing dishes, I continue doing dishes. If I’m watching a television show, I continue watching. No matter what I’m doing at that particular moment, it is important that I continue that activity. This doesn’t mean the thoughts will suddenly go away, or that I won’t still have distressing feelings. What it means is that I will not put my life on hold for OCD and its antics. I will continue to live life on my terms.

As you try incorporating mindfulness into your own treatment journey, please remember that they call it practicing mindfulness for a reason. It’s normal to find it difficult at first, but the more we practice, the stronger we get. Every time we choose to continue living our lives in the present moment and not let OCD’s what-ifs and worries drag us down, we reduce OCD’s power to make us feel ashamed or distressed. We remind ourselves that our thoughts do not define us.

The best way to incorporate mindfulness into your treatment

If you’re struggling with OCD and mindfulness feels challenging, working with a qualified OCD specialist, like our therapists at NOCD, can help. NOCD Therapists deeply understand OCD and are specialty-trained in treating OCD with ERP therapy. They’ll work with you to incorporate mindfulness into your treatment plan, helping you build your skillset and ensuring mindfulness techniques are practiced in a non-compulsive way.

Your NOCD Therapy experience will be a highly personalized journey that’s thoughtfully crafted to meet you exactly where you are. We go above and beyond standard, “one-size-fits-all” therapy, tailoring each stage of treatment to your needs to help you conquer OCD. You can book a free 15-minute call with our team to learn more about getting matched with a therapist and starting OCD treatment.