Exposure Response Prevention Therapy (extinction)

Printer-friendly version

strong armA few techniques exist that lessen cravings when exposed to a trigger or cue. This thread on YBR - Ultimate method of urge control - discusses the pros and cons of a couple of approaches.


This man explained how he used this approach to rewire his brain:

The ERP technique that has been helpful for me is quite extreme. I think is best to remind you first just what ERP is trying to achieve and then detail exactly what I do.

ERP is Exposure and Response Prevention. We create a 'exposure (to porn)' and then 'prevent the response (to masturbate)'. But why?

The example I have read that best sums this up is of a snowboarder at the top of a hill. Fresh snow everywhere and off he goes. Finding the perfect way down the hill, he goes this way and that. In defining his chosen path he has optimised his enjpyment and proven that this ride was a thrill.
He boards the chairlift and returns to the top.

Next run is a repeat of the first. He again captures the moment and reaching the bottom he confirms once more that his chosen path offers the best thrill, the optimised route, the most efficient way to have fun on a snowboard and he returns to the top. He stands on top and looks down and sees only his singel track. For him there is only one track. A well defined and optimum path and off he goes again.

He now has difficulty conceiving any other way down the hill.

Every time we view porn and link it to the chemical high that masturbation produces in us, we are creating a path in the brain that, just like the snowboarder, we follow over and over again. It's like we wrote a computer program and we hit the start button. It's like a song that we start and sing the same verses each time. This neural pathway is optimised and refined over many acting out sessions to maximise the thrill or high. We are experts and why gets up off and and we strengthen that part of our brain with unbelievably strong wiring that we seem to never be able to break free.

The male brain, internet porn and the sexual chemestry we manufacture into a cocktail of acting out actually blinds us and this is why our will power is never enough to stop.

Wouldn't it be great if our snowboarder could go to the top of the hill and ski a new and completely different path. He would not be retracing his old steps but he would have to make a very concious effort to change direction to do so.

Exposure and Response Prevention is a technique that helps us reprogram the brain. It is useful to disconnect the porn from the high. It permits our brain to be expose to the thought of porn and be totally and abruptly denied the high. Exposing to the thought of porn and having no acting out actually makes the brain go "What the f? just happened? The neural pathway that was so well accustom to associating porn with the high doesn't get it any more. The more you do ERP, the more confused and broken that circuit becomes.

It starts to break down over time. The brain startes to learn that it doesnt get a sexual high when you see a sexy girl. Your brain startes to stop begging you for porn because it is denied the benefit of it. The brain is really very smart. ERP works because our brains are plastic and the massive neural pathway that was our snowboarders only option becomes a network of broken segment in time, taken over by other paths, other activities.

Porn and masturbation addiction is then taken over by new healthier activities and after all this is what we are all desiring.

OK now you understand you have a massive neural circuit that is predisposed to keep you acting out and your brain will rewire that circuit automatically with healthier activities if you can break it. Here's where ERP comes in.

We must never never actually look at porn. This is what we are trying to overcome and looking simply strengthens the neural wiring. We have to use the thing that is our target for change. Our memory, our brain itself. What we do is replay the first part of the circuit then smash the second half to pieces.

Here's what I do.

I find a quite place where I won't be disturbed for 10 minutes. I have an interval timer set to 3 x 3 minute intervals.

  • 0-3 Minutes - I close my eyes and imagine the most explicit porn I can think of. Using the circuits in my brain I use my memory to recreate the first part of the porn / acting out cycle. I want my brain to think its the real thing happening. The stronger the better. Inside my scull, my brain does not know any different. My pulse goes high and my breathing shortens as I "go for it". Fully clothed and with no hand stimuation at all. Eyes closed and no actual porn anywhere. I even imagine climaxing and contract my body just as I used to in the real situaton. I fool my brain completely. It thinks I am actually looking at stuff and actually masturnbating. The circuit is alight! On fire. Building for a shot of sex hormone! Anticipating the thrill. Receptors are on high alert. Incoming sexual high!......
  • 3-6 Minutes - Complete and utter stop! As sharp a stop the better. Abrupt. Savage. Images held a few seconds ago are gone. Just the quiet blackness of my closed eyes. Breathing is regulated and deepened. Breath in for 5 seconds, hold for 5 seconds, out for 5 seconds. Repeat. Thinking of nothing. Keeping blank. My brain has absolutely no idea what just happened. It has hit a brick wall! It is totally denied any of the chemicals that would have come from acting out. It is competely denied a response and its absolutely pissed! The only reason that circuit exists is because of the response acting out gives it. The brain circuit is begining to lose purpose as I relax and I fill my blood and brain with increased fresh oxygen. Still, quite, blank.
  • 6 - 9 Minutes - I spend the last 3 miuntes mostly looking at images of another woman. My wife! I have photos on my iPhone of us out to dinner, or on holiday. Of her when I first met her and more recent ones. I have a favourite love some playing as the slide show flicks though. I reflect on what I gain by beating this addiction and what it might cost me if I don't. I review some written statements I wrote that reinforce that fact and generally bask in the often teary moments when I realise what a stinking sh1t I hade been and how grateful I am to have happiness in my life. Having denied the circuit it thrill and now feed some goodness into it.

It has no alternative other than to change!

So dear friends....the take homes are these.

  1. Zero Porn Policy - Absoutely don't feed the bad wolf. This will never work if you sneek some soft porn or follow that short skirt along the mall.
  2. Practice ERP 2 or 3 times per day. It is the most wonderful experience actually fighting back. I was taking the sucker punch for so many years and simple retaliation is a refreshing expereince.
  3. This is not all about you on the inside. Go and be of use to some one in this world. Join a volunteer organisation. Distribute blankets to street people. Train for a marathon. Embark of new studies. Give the brain new a worthy places to change into. Fill the void with good stuff.
  4. Journal and support your friends here. You know, the time I have spent writing to you here has actually strengthened my resolve and simply telling you my story give me and other strength to go on.

My update

On Oct 16, I am celebrating 6 month of freedom. I have not accessed any porn during that time. I have not masturbated in that time.
I am a bit older than you but I struggled with this problem for 40 years. My life change have been remarkable and freedom tastes sweet.
ERP for me is getting hard for me because the images I am now imagining are so faded and my circuit is so broken that I can hardly recall anyting explixit at all. I have little trouble with the stromg urges to act out that plagued me. Anytime that I get a bit worked up, I can easily break it because I am not feeding the problem. The bad wolf is lying exhaused and starving in the corner over there and I am at the moment much stronge than him...as long as I dont feed him that is.....

I do have to continually work on my visuals though and my need to keep my eyes away from the ladies is a continual reminder to me how strict I must remain. I am presented with tempttion and opportunty regularly but I am delighted that my decision framework is sufficiently changed that, for example, being home alone or having no internet filtering is no real problem to me any longer.

This man has experimented too:

[3 March] As an internet porn addict of over 20 years (an addict since dial-up) I have tried numerous methods of quitting and only now have I gotten relief, and it started with your Ted talk and this website.

I am now over 30 days porn free with only 3 "edging" type relapses. Yet, my daily journaling shows that I've spent an estimated time of 5 hours total this month relapsing verse over 3000 waking hours of healing. For the first time in 20 years I'm experiencing days and weeks without cravings.

The reason I'm writing is because I want to share a resource and method that I believe has greatly reduced my cravings and spearheaded a quicker and more productive recovery for myself. My hopes is that this will work for others as it worked for me, and although I know it may not work for everyone it has worked like magic for myself. The comfort of the knowledge that I've found a solution that works consistently and over time is worth the effort of quitting.

The site was written by a bio-chemist and deals directly with the problems of brain chemistry and the healing of the dopamine receptors damaged during addictions. The site is: http://gettingstronger.org/2010/10/change-your-setpoint/

It's a simple plan involving dieting and exercise that I feel greatly decreased my recovery time and healed my dopamine reception. Life seems brighter now and the natural dopamine hits I get from exercise and intermediate fasting is greater than any internet porn sessions could ever produce. Not to mention the I've lost 10 lbs. in 30 days and gained more confidence as a result!

Also, I used the information on the psycology link on the page to create a deconditioning plan using Pavlovian methods. I identified my triggers, the times and situations that set off my cravings and I planned ahead of time to purposefully decondition myself. I would wait for the time (usually late at night, alone, in my bedroom, with my laptop and internet or iphone and flicker.) and I would begin my normal session of typing in my normal sites or keyword searches (note, this is not "edging" but reconditioning) Once I hit the enter button I felt that rush of excitement in my body, but I expected it. So, the X button on the top of that browser has been my best friend...I hit the button before the page even started loading, and with a wrapped chocolate truffle nearby, I immediately turned off the wi-fi, turned off the computer, or i phone, escorted it to my car like a bouncer does a drunk clubber, and toss the chocolate in my mouth to positively reinforce my little injured rat brain. After ten or more sessions, some of them coming with unexpected triggers and cravings, which thorough a cravings log helped me fend these off as well, I noticed a gradual reduction of cravings. This, along with the short, hard exercise, diet and what I call neo-cognative processes: meeting with friends, planning my goals, writing in my journal, counseling, doing research and watching science programs (anything involving learning, and language) has truly changed my life.

I hope you will share these finding with others in the community as I truly believe that they enforce everything in YBoP and even take things a step further in advancing recovery. Thanks again for all your help, work and support given.

P.S. - I also did all this while going through a break-up and slowly reuniting now with my ex. WOW!

[March 26] Yes, it's still working for me. I'm using extinction method now more readily but even this morning with cravings hitting I new tabbed links that triggered me and then exited out of my browser. It's not perfect, of course, and had a couple of bad days, but I'm now 53 days w/o. :)

Another guy - age 16

Every time I was on pc I would open a porn website and once the site opened I would turn it off so I could see how much of will power I had. Those first 2 weeks were the hardest by far, and I still don't know how I was able to do it. After 30 days clean, I was still thinking about porn and masturbating, but I could tell I was forgetting it as the time was going by.

So, today I've been clean for 90 days now and I barely think about porn. Yes, during this 3 months I masturbated a few times (like 5), but I never watched porn. It's just something that every teenager needs to do, even if it was not that often. Now, after 3 months, I feel like I'm a new person.

 


FRC: Face it, Replace it, Connect

Face-it phase

Choose one of the categories that contains the first sexual outlet or behavior you want to work on.

pick a behavior

  • Pornography/Fantasizing—This includes photos/video of people or sexual acts, portrayed in some type of media, including: magazines, movies, Internet, lingerie catalogs, etc.—and visualizing these images in your mind. This category also includes fantasizing about "real" people you see in public such as the shopping mall, airport or swimming pool, and fantasies about past relationships and sexual encounters.
  • Masturbation—This includes any self-stimulation for sexual pleasure. It is often performed in conjunction with pornographic images or fantasizing.
  • Virtual Sex—This includes any sexual outlet that involves another "real" person in the encounter, but there is no physical touch, such as: cyber sex, chatting, sexting, singles hook-up websites. This often includes or is followed by masturbation.

Triggers Can be:

Environmental triggers:

a/ person
b/ situation
c/ behavior

Emotional triggers:

a/ feeling depressed
b/ feeling rejected
c/ feeling burned out, etc

Choose trigger

  • example - Lying in Bed
  • Trigger: I'm lying in bed trying to go to sleep and I feel the urge to masturbate. You have a sudden urge to engage in behavior. Instead of fighting it off, you boldly face it and challenge it. It is bold, truthful and very detailed description of negative consequences that always take place if you follow the old script

Ask: Is this truly what I want or is there something better?

The more emotions you put into your statement the more powerful the calming effect.

  1. State the behavior that your brain has been trained to want
  2. Described the short term benefits and old beliefs that justify acting out your sexual behaviour
  3. State the real life consequences that follow when you give in to the urge. Describe the negative emotions that your feel as a result

This is a script with Triggers and Face-it statement: Title: Lying in Bed

  • Face-It (I) Masturbating to get to sleep is just my Responder using old circuitry. It feels good for a second, but leaves me feeling out of control after. Climax is not the only way to go to sleep -- I'm just living on autopilot. This I not how I want to live my life.
  • Than goes replace-it (II) statement: Bold, specific description of what you want instead of your old sexual behavior. Very details description of how you will feel when you will replace the old way with a new, healthy behavior

Every time you replace your old way of thinking with a new healthy alternative, you shrink old circutry and expand the new circuitry. The more powerful emotions and feelings you attach to it the quicker your new brain pathways expand.

Sequence:

  1. state boldly and specifically the new behavior
  2. boldly and specifically declare you new beliefs about your sexuality
  3. describe in detail how this new healthy choice makes you feel
  • Connect (III) – act of connecting to other human being (ie: call to a friend, mother – and have a meaningful conversation), to yourself (ie. meditate) or healthy outlet/behavior (go out and run few miles)

Whole trick is that connecting in a healthy way releases dopamine also. And that you feel good afterwards.

It's also recommended, that after playing out trigger (again – NOT PORN!), you breathe few times deeply to slow down the heart rate. You hold your last breath longer and releasing it you think about something positive that you are proud of. Some achievement possibly

I hope it explains it a bit. If you want to know more about candeo you will have to sign up and check for yourself. It's not free so I don't try to push you into this direction.