3 Everyday Locations To Practice ERP Therapy in San Francisco
Exposure and Response Prevention (ERP) therapy is one of the most effective treatments for Obsessive-Compulsive Disorder (OCD). It also works well for other disorders like generalized anxiety, social anxiety, phobias, panic disorder, etc. ERP therapy involves gradually exposing yourself to feared situations while resisting compulsions or other safety behaviors. OCD and anxiety tend to overmagnify catastrophes and underestimate your ability to cope with emotionally challenging situations. ERP will gradually teach you that perhaps these catastrophes aren’t as likely. And that you are more capable of coping than you think (even if your worst-case scenario does occur.)
An important part of ERP therapy is practicing exposure exercises between sessions in your day-to-day life. Below are 3 everyday locations where you can practice ERP within San Francisco, and some exposure ideas based on OCD type. These are just examples - working with an OCD specialist can help ensure that exposure exercises are tailored to target your specific fears and help you identify your particular compulsions.
Libraries and Bookstores
So many OCD fears can be targeted by going to a library or bookstore. These are public places filled with all kinds of reading material that can address an endless number of OCD fears. The great thing about libraries and bookstores is that most of us will find something we can enjoy or learn about while browsing through reading material. So you can work on your OCD while doing something meaningful.
Contamination OCD- Handle books in high-traffic areas (i.e., Best Seller’s table or children’s section), touch surfaces others have touched, or use the public restroom. Resist compulsions like hand washing or decontamination rituals, mental checking, etc.
Religious or Moral Scrupulosity OCD- Browse books about religion, faith, or spirituality, or read a book on a taboo subject in front of others. Resist compulsions like mentally reviewing, comparing, praying, etc.
Existential OCD- Browse books about philosophy, near-death experiences, the afterlife, simulation theory, parallel universes, or science fiction. Resist engaging in compulsions like reality testing, researching, or mentally “figuring things out.”
Relationship OCD (ROCD)- Browse books about infidelity, breakups, wedding planning, or anything that triggers relationship doubts. Resist compulsions like mental reviewing, comparing, and seeking reassurance.
Harm OCD- Browse murder mystery books, crime novels, or biographies of serial killers or mass murderers. Resist compulsions like comparing, mentally reviewing, etc.
Pedophilia OCD (POCD)- Walk around the children’s section or plan your visit when there will be an increased number of children around (i.e. when story time is going on.) Resist compulsions like neutralization, mental justification, checking for arousal, etc.
Library/Bookstore suggestions in the San Francisco area:
San Francisco Public Library (Main Branch) 100 Larkin St, San Francisco, CA 94102
Bird and Beckett Books & Records 653 Chenery St, San Francisco, CA 94131
Green Apple Books 506 Clement St, San Francisco, CA 94118
City Lights Bookstore 261 Columbus Ave, San Francisco, CA 94133
Borderlands Books 1740 Haight St, San Francisco, CA 94117
Dog Eared Books 900 Valencia St, San Francisco, CA 94110
Parks and Green Spaces
Outdoor spaces can be a great way to get some sunlight and time with nature while working on your OCD recovery. Again, the goal is to resist rituals and compulsions, (whether physical or mental compulsions) and connect to the activity you are doing in the same way you would if OCD wasn’t in the picture.
Contamination OCD- Sit on a public park bench, use the public restroom, touch playground equipment, use the water fountain, or have a picnic on the grass. Resist compulsions like excessive hand washing, decontamination, avoidance, etc.
Existential OCD- Observe nature (trees, plants, animals), pay attention to sensations and sounds (the warmth of the sun, wind blowing, birds chirping, dogs barking), lay on the grass and watch the clouds in the sky, etc. Resist engaging in compulsions like reality testing, mentally analyzing, answering what-if questions, etc.
Harm OCD- Take a walk in a high-traffic area while holding a “dangerous” object (ball, rock, branch, etc.), ride a bicycle near walking pedestrians, play catch or a sport that involves throwing, hang out in a location that could trigger the fear of losing control and acting out on an unwanted urge (edge of a lake, hill, bridge), etc. Resist compulsions like monitoring body movements, self-reassurance, etc.
Pedophilia OCD (POCD)- Walk near or around a playground, station your picnic blanket near families with children, people watch (observe family interactions, children playing, etc.) Resist compulsions like comparing, mentally analyzing, body scanning, etc.
Perfectionism “Just Right” OCD- Do things imperfectly with the way you walk, the way you’re dressed, how you set up your picnic area, the way you eat, etc. Resist compulsions like repeating actions until they feel “right” or complete and challenge yourself to do things the “wrong way.”
Relationship OCD (ROCD)- Go with your partner and engage in a conversation you’ve been avoiding, walk with your partner holding hands or showing natural affection, people watch and notice other couples, etc. Resist compulsions like comparing, checking feelings, analyzing your partner’s reactions or behaviors, reassurance seeking, etc.
Parks/Green space suggestions in the San Francisco area:
Golden Gate Park 501 Stanyan St, San Francisco, CA 94117
Dolores Park Dolores St & 19th St, San Francisco, CA 94114
The Presidio 210 Lincoln Blvd, San Francisco, CA 94129
Alamo Square Park Hayes & Steiner St, San Francisco, CA 94117
Lands End 680 Point Lobos Ave, San Francisco, CA 94121
Crissy Field 1199 E Beach, San Francisco, CA 94129
Buena Vista Park Buena Vista Ave & Haight St, San Francisco, CA 94117
Supermarkets and Grocery Stores
Public places with food and people are excellent for ERP practice. You likely have to make trips to these places anyway - and perhaps you’ve been avoiding them. Maybe you could motivate yourself by going to a high-end grocery store and treating yourself to a little something fancy. These are great opportunities for exposure practice while engaging in daily living tasks.
Contamination OCD- Go during a high traffic time (like a weekend or after work), touch different food packages, handle shopping carts/baskets, get food from the bulk stations, order from the deli counter, purchase from the salad bar, etc. Resist compulsions like decontamination, physical inspecting, mental checking, avoidance, etc.
Perfectionism “Just Right” OCD- Get the first item on the shelf, make quick decisions about item selections, place items in the cart or bags in random order, etc. Resist compulsions like excessively reviewing or checking items/labels, analyzing, fixing things in a “just right” way, etc.
Harm OCD- Handle items in the cutlery aisle, stand near others while waiting in line and unloading items from your cart, drive and park closer to the store where there is more people traffic, etc. Resist compulsions like staying far from others, neutralizing, self-reassurance, etc.
Relationship OCD (ROCD)- Go shopping with your partner, hold hands while walking in the store together, notice other couples in the store, shop alone and purchase something for your partner, notice other attractive individuals, etc. Resist engaging in compulsions like comparing, figuring out compatibility, emotion checking, overanalyzing interactions, reassurance seeking, etc.
Supermarket/Grocery Store suggestions in the San Francisco area:
Trader Joe’s 555 9th St, San Francisco, CA 94103
Whole Foods 2001 Market St, San Francisco, CA 94114
Rainbow Grocery Cooperative 1745 Folsom St, San Francisco, CA 94103
Other Avenues Grocery Cooperative 3930 Judah St, San Francisco, CA 94122
Falletti Foods 308 Broderick Street, San Francisco, CA 94117
I hope some of these suggestions are helpful in your OCD recovery! Remember that certain activities could be a good exposure idea for some, but compulsive for others. An OCD therapist can properly guide you with ERP exposure ideas catered to you.
