Guides
Practising ERP on your own.
Most people who want to do this cannot get to somebody trained, or cannot get there this month. This is the practice written as something you can actually run: what one rep is made of, how to build the ladder, and the question almost every guide skips, which is how you know when a rung is finished.
The whole thing, before the parts.
Exposure and response prevention is the practice published clinical guidance recommends first for obsessive-compulsive disorder NICE CG31. None of it was invented here and none of it needs an app. This is how the pieces fit, and the rest of the page walks them in order.
One rep is two halves.
The name is the instruction. Exposure is meeting the thing that sets the feeling off. Response prevention is not doing the thing you normally do about it afterwards IOCDF. Both halves, or it is not a rep.
The second half is the one people skip, because it does not look like anything. You touch the handle, which feels brave and countable, and then you wash twenty minutes later and the twenty minutes felt like coping rather than like the compulsion. It was the compulsion. The washing is what tells your brain the handle mattered.
The compulsion is not always a hand under a tap. Asking somebody whether it is fine, googling one more phrasing, going back over the conversation to check what you said: all of them do the same job NOCD. So do the ones entirely inside your head, where there is nothing to see from outside and hours going into settling something NOCD. If it is aimed at making the feeling go down, it is the half you are practising against.
What you are practising instead is willingness: letting the feeling be there without doing anything about it Twohig 2018. Not gritting through it until it stops. Having it, and getting on with your evening while you do.
Build the ladder.
Graded means chosen. You write a handful of steps, order them from noticeable to hard, and start at the bottom IOCDF. Nothing is sprung on you and nothing gets decided by anybody else. Three to eight rungs is plenty; a ladder you keep rewriting is a ladder you are not climbing.
The test of a rung is whether somebody else could watch you do it. A feeling is not a step. An action is.
Sit with the anxiety.
Touch the door handle on the way in and leave my hands unwashed until dinner.
Stop needing to be sure.
Write the sentence I am most afraid is true, once, and leave it on the note without rereading it.
Be less anxious on the way out.
Leave the house without going back, and let my partner get on with their evening without being asked.
Two things go on the rung with the action. The compulsion you will not do afterwards, named out loud, and the words you will use when the question arrives mid-step. Pick those words in advance, because the moment is a bad time to write them. “Maybe, maybe not.” “I don’t know, and I’m not finding out tonight.” Never the soothing ones. “I’ll be fine” is the compulsion said in a calm voice.
Aim the ladder at something. A rung is worth doing because it gets you back the thing the loop has been taking: the washing-up left until midnight, the application not sent, the room you go round rather than through. That is the reason to practise, and it is never evidence about the thought.
Knowing when to move up.
This is where people stall. Most guides tell you to build a hierarchy and stop there, so you end up on rung one for four months, either because it still feels hard and that seems like a reason to wait, or because nothing ever said what finished looks like.
The old answer was to repeat a step until the fear dropped by half, and then move. There is a problem with running that on yourself: it makes you the person taking the measurement. Checking whether the fear has come down yet is checking, and it turns the practice into one more thing to audit. You end up doing the rung in order to pass it.
Use a coarser signal instead, asked once, after the rep, and never during it: was that easier than I expected, about what I expected, or harder? One word, written down, no number.
Three easy ones
Three reps in a row that came out easier than expected, and the rung has done its job. Next one.
Two that did not happen
A rung you have skipped twice is too big. Shrink it until it is something you would do today, and shrinking it is not losing ground.
A hard one
Changes nothing. Hard reps are ordinary and they are not a setback. Do it again rather than moving down.
Note what is missing: any rule that requires the feeling to have gone. It never has to. The rung is finished when you can do the thing and leave the compulsion alone, not when it stops being uncomfortable.
The reps you did not plan.
A ladder covers the practice you arranged. Most of any week is the other kind: the urge that turns up on its own, at the bus stop, at 2am, in the middle of something else. Those are reps too, and there are far more of them.
Keep it simple enough to actually do. Name what it is pulling you to do, in your own words rather than a category. Not “checking”, which is a shape, but “going back to try the handle” or “texting mum to ask again”. Then sit with it, and afterwards write down one thing: whether you held off or did it.
Three things worth leaving out of that log, all for the same reason. No rating of how bad it was, because repeated self-rating is monitoring. No timer, because counting how long until it eased is checking whether it worked. No streak or total, because a score makes the honest entry the expensive one, and a log you lie to is worth nothing.
How it goes wrong.
- The rep happens and the compulsion happens too, an hour later. That is the compulsion winning slowly, and it undoes the rep. Plan the hour after, not just the step.
- You keep the step but drop the wording. Saying "it's probably fine" while you do it is reassurance in your own voice, and it teaches the same lesson as asking somebody.
- You wait to feel ready. Waiting is the pattern, not the preparation. Make the first rung small enough to do today.
- You do the biggest thing first, once, and never again. Repeatable beats impressive.
- You measure whether it worked. Rating the fear afterwards turns the practice into one more thing to monitor.
When it comes back.
It will, and a bad fortnight is not the practice failing. Write the plan for it while things are steady, because the middle of a setback is the worst time to think one up. Three lines is enough: what the early signs looked like last time, what actually helped, and the one thing you will want to do that you are not going to do.
Then the first small step back, written now, in advance. Not a plan to start again properly on Monday. One rung you know you can do.
What doing it alone cannot do.
Being straight about this matters more than the rest of the page. Practising on your own means nobody is checking the ladder you built, nobody notices when you quietly stop, and you are the one deciding how hard a step should be, which is the decision the loop has the strongest opinion about. Most people set the rungs too low.
Some things want a trained person in the room. Steps anywhere near real risk, and fears that would be wrong to act out, are designed with a professional rather than alone IOCDF. If you can get to somebody who treats this, do, and treat this page as what you use while you wait rather than instead.
If things are worse than this page is pitched for, the safety page lists real people you can reach today.
Where to go next.
If any of the vocabulary here was new, the ERP guide starts from scratch. The one on reassurance goes deeper on the half people skip, and imaginal exposure covers the fears with no door handle to touch.
Maybe is this practice with the structure already built, and how it works walks the same diagram from the product side. We are honest on the evidence page about what is and is not established, including about this app.
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