Ew! Yuck! Ick!: Addressing the Disgust Response in Exposure Response Prevention (ERP)

While fear is widely acknowledged as a core emotion driving OCD, anxiety, and ARFID, the role of disgust is often overlooked—perhaps because it evokes reactions that even clinicians find uncomfortable or taboo to explore.

Emerging research suggests that the visceral experience of disgust can be even more potent and resistant to treatment than fear. Disgust serves an important protective function by helping individuals avoid contamination or harm; however, when it is experienced with heightened intensity and frequency, it can lead to excessive avoidance, emotional distress, and interference with daily functioning. This interactive workshop will examine the impact of both sensory-based disgust and self-disgust in individuals with OCD, anxiety, and ARFID, offering practical strategies for recognizing and addressing disgust as a treatment target. Case examples will be utilized to demonstrate strategies for effective intervention and treatment.

CE credit(s) available for clinical professionals, psychologists, therapists, counselors, and social workers. See below for details.

Learning Objectives

Define and give two examples of sensory disgust that can lead to experiential avoidance.
Describe how ERP can be adapted to effectively address disgust responses in clinical practice.
Develop an exposure hierarchy that targets the disgust response using a case example.

Presenters

Melanie Smith, PhD, LMHC, CEDS-C

Psychotherapist, CBT of Central & South Florida

Dr. Melanie Smith (she/her) is a therapist in private practice at CBT of Central & South Florida. She is a Licensed Mental Health Counselor and Qualified Supervisor in the State of Florida. Additionally, she is a Certified Eating Disorders Specialist and Approved Consultant (CEDS-C) and is a Certified Therapist & Trainer of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP). Special treatment interests include Avoidant Restrictive Food Intake Disorder (ARFID), Disorders of Gut-Brain Interaction such as Rumination Syndrome, OCD, phobias including emetophobia, health-related anxiety, and coping with chronic illness.

Dr. Smith is passionate about the dissemination and implementation of evidence-based treatments, clinical supervision and clinical training and has presented numerous lectures, workshops and Keynote presentations at academic and professional conferences nationally and internationally. She has co-authored publications in peer-reviewed journals and is co-author of the peer-reviewed treatment manual and patient workbook, The Renfrew Unified Treatment Model for Eating Disorders and Comorbidity published by Oxford University Press.

Rebecca Berman, LCSW, MLSP, CEDS-C

Clinical Director, Anxiety Institute

BS, University of Delaware // MSS, MLSP, Bryn Mawr College

For over two decades, Rebecca Berman has treated adolescents and adults with anxiety-related issues and eating disorders in outpatient, intensive outpatient, day treatment, residential, and inpatient settings. Rebecca earned a dual Master’s Degree in Social Service / Law and Social Policy from Bryn Mawr College Graduate School of Social Work and Social Research. Rebecca joins Anxiety Institute after fourteen years with the prestigious Renfrew Center where she served most recently as a Clinical Training Specialist. In that role, Rebecca was responsible for supervision, training, treatment, program development, and led Renfrew’s Trauma Informed Care initiative. Rebecca co-authored the groundbreaking treatment manual The Renfrew Unified Treatment for Eating Disorders and Comorbidity – An Adaptation of the Unified Protocol, published by Oxford University Press in 2021. Rebecca specializes in anxiety, trauma, eating disorders, and neurodiversity and has a special interest in working with the transgender population. Rebecca is a nationally recognized speaker in Trauma, Eating Disorders, Avoidant/Restrictive Food Intake Disorder (ARFID), Self-Injury, Neurodivergence, and Transdiagnostic Treatments.

In recent years, Rebecca has witnessed first-hand the overlap of anxiety, trauma and eating disorders in the adolescent, young adult, and adult populations. She is passionate about treating multiple disorders at once by understanding their maintaining mechanisms and the role of experiential avoidance. Rebecca has been motivated to research, develop, and implement cutting-edge transdiagnostic treatment practices using the unified protocol and cognitive processing therapy.

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Co-Hosted By

Questions regarding this course?

Kyrsten Bravo, Director of Outreach

Email: [email protected]
Phone: (203) 570-9623

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