How did you end up in the world of ERP?
I stumbled into the world of ERP without even looking for it. I was working at a large psychiatric hospital where one of the few residential treatment centers for OCD is located. Initially I worked as a substitute therapist, similar to a substitute teacher, across all units of the hospital. Over time, I found I really enjoyed the days I was working in the OCD residential programs. A full time job opened that split time between the adult and adolescent OCD programs and I was hired. Prior to this experience, I did not have any exposure to OCD or its treatment, soI feel fortunate that I found my path when I easily could have gone my entire career without an understanding of OCD. This is part of the reason I’m now passionate about increasing awareness about OCD among early career therapists.
How does Art Therapy influence your practice?
Sometimes the influence is indirect. My training as an art therapist is always part of how I work even if I am not actively engaged in an artistic process with a client. I am a creative problem solver and drawn to working experientially with people (as opposed to just verbally), which comes in very handy in developing exposures. In more direct ways, art therapy can be an effective way to communicate one’s experience of OCD to others/as a form of advocacy, as part of ERP, and to address common challenges that co-occur with OCD such as perfectionism or difficulty expressing and sitting with uncomfortable emotions.
Do you ever use art in your exposures?
Yes. Depending on a person’s OCD there may be certain colors that provoke anxiety,contamination concerns evoked by various art materials, and/or imagery that is used to confront intrusive thoughts.
Where would you like to see the field of psychology go?
So many directions! First, I would like to see more acknowledgement of the past (and current) harms our field has perpetuated. In doing so, I think we could be less myopic in how we treat patients and understand our role in activism and racial justice.I would also like to see a smaller gap between research and clinical practice. Too often amazing research is being done but the results or implications do not trickle down to therapists or people with OCD where the research findings would have the most impact. Addressing this may include more collaboration between researchers and people with OCD and more clinicians engaged in research to address issues of critical importance for OCD sufferers. Specifically, with OCD, I would like to see more public and clinician awareness of the various presentations of OCD and a true understanding of the suffering it brings. I hope to see more early career therapists pursue a specialty in OCD and reduce barriers to accessing treatment.
How do you get people to do things they do not want to do?
Well, sometimes I don’t. I acknowledge that not everyone benefits from ERP, or it may not be the right time, or I may not be the right fit. But, when someone is successful at facing something challenging there are generally two factors involved. One, we have developed a relationship with enough trust and rapport to face hard things. Secondly, I really try to focus on someone’s values. What do they really care about? It may be having deeper relationships with loved ones, pursuing education or career goals, or feeling more contentment with their spirituality/faith. Whatever it may be, living a life that is more congruent with one’s values often involves facing discomfort. It helps to keep the bigger picture in mind and gain perspective on why it may be worth it to do hard things.
What books/podcasts/blogs do you frequently recommend to folks you treat?
I often find myself recommending materials to family members more than my clients. Many of my clients have already encountered a myriad of sources, many times in an effort to seek reassurance, so I can be hesitant to recommend resources about OCD. Some books I frequently recommend include Self-Compassion (Kristen Neff), Loving Someone with OCD (Landsman, Rupertus, and Pedrick), Buddha’s Brain (Rick Hanson), The Gifts of Imperfection (Brené Brown), Intuitive Eating (Tribole & Resch), to name a few. I have utilized countless articles from the IOCDF website–such an amazing resource. I also highly recommend the short documentary Unstuck: An OCD Kids Movie about pediatric OCD. Those kids are so inspiring!
How do you stay fresh? What do you do when you need a recharge? What are your favorite rewards?
From a professional perspective, staying engaged in the OCD community through conferences, reading, research, and supervising new therapists helps me to stay fresh in my work. On a personal level, I try to maintain good boundaries and limits around how much I work per week so I can be in this work for the long haul. I try to practice what I preach in living my life in accordance with my values. I love and value my work but I also really value my relationships, creative and introspective time (art making, baking, piano playing, meditation, exercise) and seeing new things through traveling. Giving myself permission to say no can be one of my favorite ways to reward myself. That and a good massage!
When new clinicians ask you for tips, what do you find yourself saying most often?
You’re not alone and you don’t need to go it alone. It’s often an overwhelming time as a new clinician and it’s easy to put a lot of pressure on ourselves to know everything or do everything well. Practicing acceptance that this is not possible, or necessary, and understanding that so many new clinicians feel this way can be useful. It can also be an isolating time so I always encourage new clinicians to find good supervision and a good network of peers. I find this helpful even at my stage of my career.
What has ERP taught you about teaching?
Teaching is not necessarily in my comfort zone; I have no formal training or education on being an educator. But, I try to embrace uncomfortable things and give myself permission to mess up. I think it has also helped in supporting my students in facing hard things. As a therapist in training, you are bombarded with uncomfortable situations. Guiding my students in becoming comfortable with the uncomfortable is a big part of my framework as a teacher.
Dr. Erin Headley is a Licensed Professional Counselor and Board Certified Art Art Therapist in Portland, Oregon. Dr. Headley is a seasoned lecturer and advocate for increasing visibility of OCD. Check out her professional websites at: