Do you sometimes repeatedly check whether the doors, windows or appliances are closed? Do you sometimes repeatedly think about unnecessary things? In fact, everyone has some compulsive symptoms at one time or another. When the above performance affects your life or work, it may be OCD. What is OCD? Recurring thoughts, impulses, and imagery that cannot be controlled are called obsessive-compulsive thinking. Compulsive thinking causes anxiety, which leads to repetitive, meaningless or ritualistic behaviors called compulsive behaviors. Compulsive behaviors usually relieve anxiety at the time, and compulsive behaviors can affect the patient’s life and work or cause pain or even serious disability in the long term. Such obsessive thoughts and or compulsive behaviors are collectively known as OCD, and obsessive thoughts and compulsive behaviors can occur separately or together. To illustrate the above, for example, Zhang is always afraid of getting dirty and being infected with a disease, which is his compulsive thinking. This kind of thinking causes him to be nervous and anxious, and then he rushes to wash his hands, repeatedly many times, washing his hands is his compulsive behavior. After washing his hands, the patient is not so worried about being infected with the disease and feels much more relaxed. The act of washing his hands relieved his anxiety for a short period of time, and because this relieving effect reinforced Zhang’s behavior, he repeatedly washed his hands. When he washes his hands too many times a day, for too long each time, and after spending more than an hour a day washing his hands, it has a serious impact on his life and work. He may even be unable to live and work as a result, causing disability. This is obsessive-compulsive disorder. What treatments are available for OCD? OCD can be treated with exposure response blocking therapy (ERP, hereafter referred to as exposure therapy), a form of cognitive behavioral therapy, and medication or a combination of both. We will mainly talk about exposure therapy. Exposure therapy is a form of cognitive-behavioral therapy that focuses on behavior, and it is currently recognized as one of the most effective treatments for OCD. The essence is to expose the patient to situations that will cause distress and thus anxiety, while preventing the patient from doing the compulsive behavior and experiencing a natural decline in their anxiety habituation process. There are two forms of exposure: real exposure, such as having Zhang sit on the floor or touch something dirty; and imaginal exposure, such as asking Zhang to imagine himself sitting on the floor. Then comes response blocking, which is the key to the therapy’s treatment of OCD. This is because the exposed patient may experience compulsive thinking, such as fear of infection, which leads to anxiety; and response blocking is stopping the patient from compulsive behavior (including ritualistic actions and avoidance behaviors) when he or she is anxious about wanting to appear, such as wanting to get off the floor or wanting to go clean. By allowing the patient to remain in the exposed situation until the seemingly unbreakable pain and anxiety naturally decays, the anxiety does not rise endlessly, but will naturally decline over time, which is habituation. Patients who experience success with habituation are able to successfully overcome this level of anxiety in the situation. Exposure practice generally begins with moderately distressing situation stimuli or imagery and ramps up to the most distressing situation. This level is best chosen as an intermediate level of anxiety that will allow the patient to successfully complete the exposure exercise while still being challenging. Step by step, the patient overcomes the situation and object he was afraid of until the situation with the highest level of anxiety. Habituation of the experience is the key to healing OCD, and continued exposure thereafter can prevent relapse. Patients can be exposed under the guidance of a therapist or they can do self-directed exposure, but it is important to have a diagnosis and treatment plan from a regular psychiatrist beforehand. However, despite the perception that psychotherapy has no side effects, exposure therapy has the unpleasant side effect of making you feel distressed when confronted with the situations that give rise to obsessive-compulsive thoughts. Exposure therapy requires a lot of effort on your part, with the patient doing most of the work themselves. The rewards of this treatment depend greatly on the amount of time and effort you put into the process. A standard course of exposure therapy for OCD consists of 13-20 weeks of weekly therapy or 3 weeks of intensive therapy, including 5 sessions per week (Monday through Friday). And the above acute phase of treatment is followed by 3-6 months of regular consolidation psychotherapy. It is hoped that patients with OCD will achieve maximum healing with this advanced approach.