Here’s how it generally works:

• Exposure: Under the guidance of a therapist, individuals are carefully and safely exposed to their feared stimuli. This can be done in various ways:
• In vivo exposure: Directly confronting the feared situation in real life (e.g., a person with social anxiety attending a small gathering).
• Imaginal exposure: Vividly imagining a feared situation or thought (e.g., someone with PTSD recalling a traumatic memory).
• Virtual reality exposure: Using VR technology to simulate feared scenarios.
• Interoceptive exposure: Deliberately bringing on harmless physical sensations (like a racing heart) that are feared (common in panic disorder).
• Response Prevention: This is the crucial “prevention” part. As anxiety arises during exposure, the individual is guided to resist the urge to perform their typical anxiety-reducing behaviors (e.g., for OCD, not washing hands after touching a “contaminated” object; for social anxiety, not leaving a social situation early)

The core principle of ERP is to gradually and systematically expose individuals to the situations, objects, thoughts, or sensations that trigger their anxiety, while simultaneously preventing them from engaging in their usual “response” – the compulsive behaviors, rituals, or avoidance strategies they use to reduce that anxiety.