Refraining from compulsive rituals (response prevention) is a
vital component of treatment because the performance of such
rituals to reduce obsessional anxiety would prematurely discontinue
exposure and rob the patient of learning, first, that
the obsessional situation is not truly dangerous and, second,
that anxiety subsides on its own even if the ritual is not performed.
Thus successful ERP requires the patient to remain in
the exposure situation until the obsessional distress decreases
spontaneously, without attempting to reduce the distress by
withdrawing from the situation or by performing compulsive
rituals or neutralizing strategies.