Module 2 — Who created ERP? | ERP Course
- Jun 5
- 6 min read
Updated: Jun 7
Free Course by Everything IFS Academy | Therapeutic Modalities Series
Module 2 — Who created ERP?
Every powerful treatment has an origin, and ERP's is more dramatic than most. It begins with a condition that doctors had all but given up on, and a psychologist willing to try something nobody else would. Knowing this story is not trivia. It explains why ERP looks the way it does, why it asks what it asks, and why it has earned the trust it now holds. This lesson tells that story honestly, including the fact that ERP was not the invention of a single person but the work of several, each handing the method to the next.
The Problem Nobody Could Solve
For most of the twentieth century, obsessive-compulsive disorder was considered close to untreatable. It was seen as one of the most stubborn problems in all of mental health, and the prevailing mood among clinicians was something near hopelessness. Talking therapies of the day made little dent in it. People could spend years in treatment while their rituals only tightened their grip. So entrenched was the pessimism that researchers of the era barely bothered to distinguish between people who improved on their own and people who improved because of treatment, since so few seemed to improve from treatment at all.
That is the backdrop worth holding in mind. ERP did not arrive as a small refinement to an already-working system. It arrived as a breakthrough into a condition the field had mostly written off.
Victor Meyer and the First Breakthrough, 1966
The turning point came from a British psychologist named Victor Meyer, working at the Middlesex Hospital in London. Meyer had an unusual history for a scientist. He had been a fighter pilot in the Second World War, was shot down over France, and survived as a prisoner of war. Colleagues later described him as exactly the kind of person willing to take a risk that others would not.
Meyer knew something from the animal research of his time: when frightened animals were exposed to what scared them for a prolonged stretch and prevented from fleeing, their fear eventually faded. The principle was sound in the laboratory. The bold question was whether it would hold for human beings caught in severe obsessions and compulsions. In 1966, Meyer tried it. He worked with two patients whose OCD was so disabling they were hospitalized, and he applied the same logic: bring them into sustained contact with what triggered their distress, and ensure the compulsive rituals were not carried out.
It worked. The improvement these patients showed was the first real crack of light into a condition that had defeated everyone before. A later follow-up of a larger group treated this way found that the gains held over years, not weeks. The treatment that would eventually be named exposure and response prevention had been born, even though it did not yet carry that name.
Jack Rachman and the Maudsley Group
A first success is not yet a treatment. For Meyer's discovery to become something other clinicians could rely on, it had to be developed, tested, and understood. Much of that work happened at another London institution, the Maudsley Hospital, where Stanley Rachman, known to colleagues as Jack, was a central figure.
Through the early 1970s, Rachman and his collaborators ran a series of careful studies that put the behavioral approach to OCD on scientific footing. They were not simply repeating Meyer's procedure; they were probing how and why it worked, separating which ingredients mattered, and demonstrating its effects across more than a handful of cases. Rachman became one of the great chroniclers and champions of the method, and decades later he was still speaking about its history and crediting Meyer's early courage. It was this body of work that moved ERP from a striking one-off into a method the field could take seriously.
Edna Foa and the Rise to Gold Standard
If Meyer lit the spark and Rachman's group tended the flame, it was the American psychologist Edna Foa who built ERP into the standard it is today. From the late 1970s onward, Foa refined the procedure, formalized how it should be carried out, and subjected it to the kind of rigorous, repeated testing that earns a treatment its reputation. Her work is the reason ERP is now described, without much argument, as the gold-standard psychological treatment for OCD.
Foa's influence reached beyond OCD as well. She took the core insight of exposure, that approaching what is feared, rather than avoiding it, is what heals, and applied it to the treatment of trauma, developing an approach known as Prolonged Exposure, now one of the leading treatments for post-traumatic stress disorder and widely used, including in programs for combat veterans and other trauma survivors. In other words, the same principle Meyer tested on two hospitalized patients eventually grew into a family of treatments touching some of the most painful conditions in mental health.
The Deeper Roots: Mowrer, Wolpe, and Lazarus
ERP did not appear from nothing. Its pioneers were standing on ideas worked out by others. Two roots are worth naming.
The first is the learning theory of O. Hobart Mowrer, who described how fears are first learned and then kept alive over time. That account gave the behavioral pioneers their rationale: if a fear is learned and maintained by certain patterns, then it can be unlearned by changing those patterns. The second is the work of Joseph Wolpe and Arnold Lazarus, who created a simple scale for rating how much distress a person feels in a given moment. That distress scale became a basic instrument of exposure work, and ERP still uses it today. These ideas are taught in their own right later in the course; here they matter as the foundation the founders built upon.
From Meyer's Method to Modern ERP
The method that Meyer began did not stay frozen in its original form. His version was intensive and hospital-based, carried out under close supervision, with the compulsive rituals blocked quite directly. Modern ERP is a gentler thing. It is collaborative and gradual, something a person works through in partnership and at a pace they can manage, with their own consent and understanding at the center rather than imposed from the outside. In spirit it is the same method Meyer pioneered, approaching the fear and holding back the ritual; in style it has softened and matured. The understanding of why exposure works has been refined over the decades as well, which has sharpened how the work is done, even as the founding insight has held steady.
Why This History Matters
It would be easy to treat the origin story as background and move on, but it carries a point that genuinely matters for anyone learning ERP. This is a method that was forged on the hardest cases, the people for whom nothing else had worked, and it earned its standing not through marketing or fashion but through decades of testing by skeptical researchers. When a treatment survives that kind of scrutiny and keeps proving itself across generations of study, its credibility is hard-won rather than assumed. It is also why ERP still sits at the top today: decades on, it remains the first-line psychological treatment for OCD in current clinical guidance, and most people who engage with it well see meaningful improvement. The confidence people can place in ERP is rooted in exactly this history, a brave experiment that worked, followed by close to sixty years of careful proof.
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