What I Learned in Bergen, Norway about ERP, OCD, and Living Life Fully
Recently, I traveled to Bergen, Norway, to meet the team who developed the Bergen 4-Day Treatment for OCD (B4DT)—a program that has quietly reshaped how exposure therapy is practiced and understood. I had the privilege of serving as the “first opponent” for Kay Morton Hjelle’s PhD thesis defense and speaking at length with the architect of the B4DT, Professor Bjarne Hansen. In my view, the folks in Bergen are world leaders in exposure therapy and have truly “cracked the code” on how to squeeze every last drop of effectiveness out of an already powerful approach.
It was a wonderful trip—and a clarifying one. As I was leaving, I jotted down some notes to capture what stood out most. What stayed with me wasn’t a new “technique,” but a shift in how anxiety and OCD are understood—and, crucially, why we ask people to face their fears at all.
The core idea is surprisingly simple: recovery isn’t really about fighting anxiety, controlling thoughts, or even “doing exposure” in the way many people imagine. It’s about reconnecting—with your life, your values, and your willingness to experience the full range of human emotions that come with being fully alive.
Detecting Threats
Anxiety and intrusive thoughts are not signs that something is broken in you—or that you’re doing recovery wrong. They’re signs of a normal brain doing what it evolved to do: detect threat. As I’ve said elsewhere, your brain is not broken! The problem isn’t the thoughts or feelings themselves, but what we naturally do next. We avoid, suppress, check, distract, seek reassurance, and so on. These safety behaviors make sense—but they backfire, and understanding why is key to understanding anxiety.
Safety behaviors send a powerful message to your body: I am in danger. When your body receives that message, it does exactly what it’s designed to do—it sounds the alarm. What really matters, then, is not what you know rationally, but what your behavior communicates. If you act as if you are in danger, you trigger your body’s alarm system. The flip side is also true: acting as if you are not in danger prevents the alarm from going off.
This principle is simple to grasp but hard to live by. How can you act as if you are not in danger when you feel like you are? The answer from the experts in Bergen is this: by intending to lean into anxiety. What really matters in ERP is the mindset you bring into it. The ideal agenda is a willingness to fully experience anxiety—deliberately bringing it on, leaning into it, and refraining from safety behaviors meant to make it go away. And why adopt this agenda? To get your life back!
Exposure is not about forcing yourself to endure fear in the hope that it eventually fades, or about proving to yourself that a feared outcome won’t happen. Those things may—and probably will—occur, but they are not the reason for doing the work. The deeper reason is this: to take your life back from OCD.
When OCD is in charge, life gets smaller. Choices are made to reduce anxiety rather than to move toward what matters. ERP, done with intention, is a way of choosing your life again—choosing relationships, meaning, freedom, and values—even when anxiety shows up. Anxiety may rise. It may fall. That’s not the point. The bigger question is this: What kind of life do you want to live, and what are you willing to feel in order to live it?
How, why and the deeper purpose of ERP
What the experts in Bergen have done is bring together the how, the why, and the deeper purpose of ERP into a single, compelling approach. Technique is what you do. Theory is why it helps. Philosophy is why you should bother doing it at all. Most anxious people know that facing their fears would probably help. But knowledge alone rarely leads to action—or to full engagement. Just as knowing we should eat vegetables or exercise isn’t enough to change behavior, knowing about ERP isn’t enough either. What’s needed is a compelling why.
Why touch a dirty object you fear is contaminated? Why stay present with an intrusive thought you fear says something terrible about you? Why leave the house without checking the oven one more time? The best answer is this: to take your life back from OCD, so you—not anxiety—are in charge, and your choices are guided by your values. Only then do you have the chance to live a rich, full, and meaningful life, and to reconnect with the whole of your inner experience—thoughts, feelings, uncertainty, fear, joy, desire, doubt, and more. Avoiding these experiences doesn’t make you safer; it makes you less alive. Facing fear, then, isn’t about fixing yourself. It’s about allowing yourself to be fully human again.
This is the why the experts in Bergen emphasize. The how is approaching exposure tasks with a clear, intentional agenda: leaning into anxiety and acting as if you are not in danger. Done this way, ERP helps people with OCD adopt a fundamentally different way of living—one that can be truly transformative.
From this perspective, ERP isn’t something done to the client by the therapist. It’s something the patient actively chooses. That’s the empowering implication. In ERP, clients are not told what to do; they are put in charge. The central question becomes, “Will you choose this—and why?” When applied to an exposure task, the question becomes, “What would it look like, in your mindset and actions, to approach this task will full intention?” When people reconnect with their reasons, their values, and their agency, something important shifts. ERP stops being a technique for managing anxiety and becomes a way of living more honestly and fully. Not a life without fear—but a life no longer organized around avoiding it.
