ERP Mechanisms of Action
Three mechanisms are thought to be involved in the reduction of obsessions and compulsions during ERP; a behavioural mechanism, a cognitive mechanism, and changes in self- efficacy. From a behavioural perspective, ERP is effective because it provides an opportunity for the extinction of condi- tioned fear responses. Specifically, repeated and uninter- rupted exposure to feared stimuli produces habituation—an inevitable natural decrease in conditioned fear. Response pre- vention fosters habituation by blocking the performance of anxiety-reducing rituals that would foil the habituation pro- cess. Extinction of conditioned anxiety occurs when the once-feared obsessional stimulus is repeatedly paired with the nonoccurrence of feared consequences and the eventual reduction of anxiety.