Exposure and Response Prevention (ERP) Therapy

At Bread and Roses Therapy,  we offer Exposure and Response Prevention (ExRP) Therapy to support folks who experience symptoms of Obsessive Compulsive Disorder (OCD) and Anxiety Disorders.

Exposure and response prevention (ExRP) is the evidence-based treatment of choice for learning to manage obsessive compulsive disorder (OCD). In this treatment, individuals with OCD are “exposed” to their fears (thoughts, feelings, sensations) and they learn to tolerate them without engaging in their typical response (checking, asking for reassurance, engaging in a compulsion or ritual, ruminating, worrying).

• Increase your ability to tolerate distress and anxiety related to obsessions and compulsions
• Practice exposure to anxiety-provoking thoughts without engaging in compulsive behaviors
• Live a value guided life without feeling  

At Bread and Roses Therapy,  we offer Inference Based Cognitive Behavioral Therapy (I-CBT) Therapy to support folks who experience symptoms of Obsessive Compulsive Disorder (OCD).

Rather than focusing on anxiety or the need to tolerate uncertainty, I-CBT helps people understand how obsessional doubts are created in the first place — through a reasoning process that disconnects them from reality.

In OCD, the problem is not uncertainty itself, but a false doubt created by the imagination. I-CBT shows how this false doubt arises and teaches you how to return to the direct, trustworthy experience of reality.

I-CBT is a structured, collaborative form of psychotherapy that helps you understand how obsessional doubts are created, maintained, and resolved.
Rather than provoking anxiety, it focuses on the reasoning process—the inferential confusion described earlier—that gives rise to false doubt.

To make this concrete, I-CBT highlights the OCD Trifecta—which are the obsessional reasoning processes that form the first stage of the Inner Wheel and drive the crossover into imagination:

1. Distrust of the senses and self
2. Boundless imagination
3. Misapplied logic and artificial relevance

Together, they generate a convincing but entirely hypothetical story that gives rise to obsessional doubt.

Step by step, therapy helps you:

• Identify the obsessional story and its reasoning chain.
• See exactly where imagination replaced reality and how the doubt was constructed.
• Understand the personal themes and feared possible self that give the doubt meaning.
• Build a reality-based narrative grounded in sensory evidence and self-trust.
• Strengthen perceptual confidence, cognitive flexibility, and resistance to future doubt through Reality Sensing.

You come to recognize that obsessional doubts are not genuine uncertainties but false inferences disconnected from reality. Once the faulty reasoning is corrected, the doubt loses power—and with it, the anxiety and compulsions it once produced.