How do you do ERP? I'm not asking generally, but rather how do you, the person reading this, do ERP? I'm at the point where I'm trying to work out how to do ERP for myself (largely self-directed as I don't see my psychologist more than once every few weeks), and I'm trying to get an idea of what it looks like on a practical level. Do you try and do ERP every day? Multiple times a day? How long do you spend on each exposure/session? Do you do ERP at the same time every day, or do you change it up? What do you do after you've done an exposure, do you do any self-care once the exposure is finished? I see things online saying that it can take upwards of an hour for distress to decrease when doing an exposure, and I'm wondering what are you allowed to do during that time? If the goal of ERP is to sit with the distress, do you literally just sit there for an hour doing nothing until the anxiety goes down? That's a long time to sit doing nothing but feel anxious, especially if the goal is to do this every day. Right now I'm struggling with implementing ERP into my routine. I currently do ERP sporadically, and not on any kind of schedule. I'm struggling to find exposures that distress me sufficiently, and when I do find something I'll still find myself feeling anxious hours later even after I thought I'd acclimatized. I'd really appreciate hearing from other people so that I can get an idea of what good ERP looks like in practice.

I started treatment in August. I actually did ERP on my own before my counselor had a chance to teach me. I did a couple of exposures with my therapist. I have found that I usually have to do the exposure 3 or 4 times in a row before my anxiety got low enough. When I first started treatment, I had a lot of intrusive thoughts involving knives. As a result, it got to the point where I was afraid to hold a knife for more than a few seconds. So my counselor had me wash and dry some knives. Starting with a small knife then working my way up. The smallest one didn't give me hardly any anxiety. The medium one made me nervous. The biggest one sent my anxiety through the roof. The hardest part is when your anxiety is going crazy. It feels like an eternity. But it lasts at most a few minutes. I can now handle large knives with no problem. The next exposure I did (again with my counselor) I watched a slasher movie in 5 minute increments. I watched Scream because the killer attacks people with a knife. I did a total of 5 five minute segments The first two were brutal. I almost had a massive panic attack after the second one. I don't scare easily, but I was trembling. My counselor could see what was going on and gave me a couple minutes before going on to the next segment. With the next 3, my anxiety got less. My homework was to watch the rest of the movie. I watched the rest of the movie with almost no anxiety. My counselor told me the point of planned exposures is to learn ERP so you can use it in real life situations as they come up. So I no longer do planned exposures. ERP has become also automatic. I don't have to think about it as much anymore. I have made so much progress. The great thing about ERP is that it works for any OCD theme.

Thank you so much for taking the time to reply! That’s helpful to hear

Hi! I am someone who went through the NOCD program, and I found that doing real life exposures were the most helpful for my journey. Anytime that I would start to get anxious from my thoughts, instead of actively searching for answers, I would sit and allow myself to be anxious. I often used to worry that if I sat with my anxiety, I would end up dying, because the symptoms were very scary! I always thought I had to get out of the sensations. Instead, I learned to sit with them when they start happening. I take a big deep breath and say "ok, here we go" and sit through the anxiety. It is for sure not always fun, but it is the best exposure because I am teaching myself that the anxiety will pass. Sometimes reading articles or writing out worst case scenarios help me out too. I also try not to avoid things that scare me as much.

Hi Oth, I try to practice ERP whenever a real life opportunity comes up much like @Jesse Miller, which is usually at least few times a day thanks to my OCD bully. The length of time of the actual ERP exercise varies depending on whether it is a major or minor obsession and whether this is a new subject of ERP or something I’ve repeatedly faced before. Anxiety is going to go through the roof as you first start a new ERP as the OCD starts fighting back, but the more you repeat that ERP (or something similar) overtime the less the anxiety tends to peak. Try to always start with one of your minor themes/obsessions first so you can ease into the anxiety spikes from doing ERP. I typically try to sit with the uncomfortableness/anxiety as long as I can, but not so long as to forcing myself to have an anxiety attack or anything. Each time aiming to go a little further into the sitting with it zone, until eventually I almost seem to do it on autopilot. I still will sometimes have slip-ups or fall back on old ways, but the key is to remember that I’m not losing all my progress up that point and slip-ups will happen. Even if you go just a little bit further sitting with it each time, you should treat it as a victory and tell yourself “great job” and do not be hard on yourself if it takes longer than you like or if you have a slip. Sometimes depending on the particular theme I do have to give myself a pep talk and say “ c’mon you got this…” before I get started. It will be hard in the beginning, but ERP will get easier overtime. Stay strong in your recovery and best wishes.