If you’re in the process of healing from OCD, you’re already doing incredibly hard and brave work. Facing fears, resisting compulsions, and sitting with discomfort day after day is no small task and it deserves to be honored.
But before we talk about what happens when things don’t go perfectly (and they won’t!), let’s back up and talk about what OCD treatment actually looks like and how I approach it with clients.
How I Approach OCD Treatment with ERP
When I work with clients who have OCD, we focus on reclaiming their lives from the grip of fear, avoidance, and compulsions. My approach is rooted in Exposure and Response Prevention (ERP) the gold standard in OCD treatment but always applied with compassion, collaboration, and flexibility.
Together, we identify the obsessions and compulsions that are interfering with your life and create a roadmap to face those fears. That might mean resisting a compulsion after an intrusive thought, tolerating uncertainty instead of seeking reassurance, or leaning into discomfort when OCD says “don’t.”
We go at your pace. We celebrate wins. We laugh, we problem-solve, and we find ways to keep moving forward even when OCD tries to convince you otherwise.
What Is ERP?
Exposure and Response Prevention (ERP) is an evidence-based treatment for OCD. It involves:
- Exposure: Gradually and intentionally confronting the thoughts, situations, or feelings that trigger your OCD fears.
- Response Prevention: Resisting the compulsions or rituals that OCD demands in response to that trigger.
The goal of ERP isn’t to eliminate intrusive thoughts (which we all have), but to change how you relate to them, learning that you don’t have to respond to anxiety with action. With repeated practice, your brain learns that feared outcomes don’t need to be avoided or “neutralized,” and the urge to ritualize becomes less intense over time.
ERP is challenging work. It asks you to step into uncertainty and tolerate discomfort but it also offers freedom on the other side.
So What Happens When You Slip Up?
Now that you know what ERP is, let’s talk about something that everyone in OCD recovery encounters: slip-ups. You might give in to a compulsion after weeks of resisting. You might avoid a trigger when you mean to face it. You might ask for reassurance without realizing it until later. Here’s what I want you to know: Slip-ups are normal. They are expected. And they are not the end of your recovery.
OCD recovery isn’t about perfection it’s about practice. You’re rewiring your brain, not trying to ace a test. And that means there will be moments that don’t go according to plan. OCD thrives on perfectionism. It tells you that “messing up” means you’re back at square one. But healing doesn’t move in straight lines, and one moment doesn’t undo your progress.
What To Do When a Slip-Up Happens
When my clients experience a slip-up, we don’t shame or spiral, we recover. I offer a simple, 7-step approach to guide this process, which is also included on a tool I designed, give to my clients, and I love using in sessions: the ERP Slip-Up Recovery Card.
Here’s the process:
- Pause, Breathe, No Shame
Relapse is part of healing. You don’t owe OCD perfection. - Name What Happened
Avoidance? Compulsion? Reassurance? Say it clearly and without judgment. - Undo It (When You Can)
Can you go back and redo the exposure or prevent the ritual this time? - Don’t Let OCD Rewrite the Rules
A slip-up isn’t a failure. It’s a chance to practice again. - Reflect, Not Ruminate
What made this hard? What might help next time? Learn, don’t spiral. - Reconnect with Your Why
Freedom > temporary relief. You’re stronger than OCD says you are. - Reach Out for Support
Talk with your therapist. You don’t have to figure it out alone.
What I Love About This Work
One of my favorite parts of supporting people with OCD is watching them undo a slip-up and (what I like to call) “boss back” at their OCD. That moment when a client turns a misstep into momentum is powerful. It’s not perfection that brings healing, but persistence.
If you’re in the thick of recovery and have slipped, take heart: this is part of it. You’re still on track. You’re still doing the work. And you’re absolutely still capable of healing. By Alexis Leechford, LMSW