Exposure therapy, or Exposure and Response Prevention (ERP), is a well-established treatment intervention for anxiety and related disorders. In their comprehensive case study series, Folke, Von Bahr, Assadi-Talaremi, and Ramnerö (2012) offer not only an excellent review of their treatment for Body Dysmorphic Disorder, but also a thoughtful discussion of the importance and impact of ERP in these cases. Our commentary addresses the concerns the authors raise in their discussion of patient reactions to the exposure component of the therapy intervention. Using examples from the authors’ case studies, along with relevant research and clinical anecdotes, we offer suggestions on overcoming some of the factors that may prevent the optimal implementation and application of exposure therapy.