Exposure and Response Prevention (ERP) Therapy

Dr. Anna Breytman

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Dr. Anna Breytman

Request a Consultation

Exposure and Response Prevention

Exposure therapy is a set of behavioral techniques and the most effective therapeutic treatment designed to address elevated anxiety. It is based on the premise that fear and the accompanying distressing physical sensations are extinguished when confronted. Anxiety can be similar to a false alarm system in which hypervigilance and hyper-awareness result in exaggerated responses to even the smallest of triggers for risk and danger. Consequently, feelings of danger and threat become continuously magnified.

Within a behavioral framework, individuals learn to become anxious in response to certain stimuli, including objects, situations, and thoughts. In ERP, with the guidance of a therapist, a person gradually and systematically faces one’s fears. Over time and with repeated practice, distress subsides and there is an opportunity for new learning to be assimilated into the experience. The mechanisms of habituation, becoming adjusted to anxiety, and ultimately extinction are responsible for this progression. Through this process, individuals develop the understanding that anxiety is temporary and that everyday risk and uncertainty can be tolerated. Furthermore, the ability to think and behave more adaptively, to cope effectively, and to manage distress also improves through ERP. With new learning opportunities, people can be more rational and flexible in their responses. ERP also addresses avoidance and escape behaviors which likewise maintain fears. By practicing approaching, in real or imagined ways, feared situations, anxiety is diminished in the long term.

ERP is involved in the treatment of:

Phobias – fear of specific objects, places, or situations

Panic attacks – fear of bodily sensations and catastrophic worries

PTSD – anxiety associated with memories of traumatic experiences

OCD – fear of certain stimuli, situations, and thoughts such as contamination

BDD – anxiety about some aspect of one’s physical appearance

In OCD treatment, for example, an anxiety hierarchy, or a list of feared experiences is constructed along with ratings of the intensity of the anxiety. With therapist guidance, an individual is exposed to the feared stimuli and instructed to resist engaging in compulsive rituals. For instance, a person with contamination fears would be instructed to touch a doorknob and then refrain from washing their hands. Once this goal in the hierarchy is established, the patient and therapist transition to the next item on their hierarchy.

In conjunction with cognitive therapy, therapist guidance, and between-session practice, individuals can significantly reduce their symptoms and regain functionality.

Call today for an in-person or teletherapy appointment:

Phone: 201.694.2129
Please leave a message or email:
online form

Two Office Locations:

New Jersey office location:
194 North Harrison Street
Princeton, NJ 08540

New York City, Manhattan,
Upper West Side:

27 West 86 Street, Suite 1B
NYC, NY 10024


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Call today for an appointment:
Phone: 201.694.2129

Please leave a message
or email:
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