I have a fear of my therapist not responding to my question before I go to sleep. I have harm and false memory ocd. My fear is over taking brain meds or supplements, being in a state of confusion, and acting on my harm fear or religious scrupulosity fear (basically something that prevents me from being saved). Yesterday I messaged my therapist about a new wave of thoughts I was getting. If-then thoughts. Example) if you stand next to this smoker you will act on your fear. Therapist told me to ignore those thoughts but didn’t answer my question of: if I get a thought that says if you send that text you will act on your fear then do I send the text anyway? I know the therapist would say yes and send my texts anyway, but the fact that I did not get a response makes me feel like something has happened because I had a “if the therapist doesn’t respond then you will do your fears”. I feel like it’s different when you are intentionally doing what ocd tells you not to do vs. not being able to get a response from the therapist and not really having a choice to choose to do the opposite of what ocd says to do. I feel like this could mean that something has happened and that I am ruined. I feel so hopeless. I am not sure what to do but I feel like giving up.

Hi alittleapple, Thank you for reaching out--it sounds like this is really causing you a lot of distress. If I'm understanding correctly, it sounds like there are two obsessions going on here: an intrusive thought that says "if I send this text I will act on my fear" and an intrusive thought that says "if my therapist doesn't reply to the text something bad will happen." (I'm not sure if it's the same bad thing or not, but from what you wrote I'm guessing it's different.) So treating the first thought as an exposure, by sending the text and sitting with your anxiety that maybe doing that means you will now act on your fear, also means there's a chance you'll have to do the second exposure whether you like it or not. It's definitely a tangle. I would agree that the best thing to do is send the texts anyway. Not sending the texts because you're scared that it might mean your therapist might not reply, which might mean something bad will happen, a) is an avoidance compulsion that will make both those fears worse b) risks cutting you off from a much-needed avenue of support. It sucks to have to cope with two exposures at once, but in the long run, it's less painful than always having to cope with both those fears at once. Exposure therapy-wise, there actually isn't much difference between an exposure you do intentionally and an exposure that is out of your control. Once I had something happen where there was no way to be sure whether or not my worst fear had come to pass for several days. Of course, I spent that whole time panicking. I asked my therapist what exposures I should do to cope with my anxiety, and she said "none, because the exposure already happened. Now you do the response prevention." I didn't have a choice but to do the opposite of what OCD wanted, because what OCD wanted was for me to go back in time. And it was really hard. But doing my response prevention meant even though I hadn't chosen to do that exposure, it got easier. Sometimes life is going to throw you exposures that you have no control over. And part of OCD recovery is moving from planned exposures in therapy to the exposures we encounter in daily life, the ones that aren't intentional. There will always be situations where we don't get a choice. But we still have a choice in how we respond. I hope this helps. I know you said you feel like giving up, but you didn't. You came here. You got this. <3