I need a bit of advice. I struggle with really vivid thoughts (mental images, sounds, sensations) that just feel horrible in and of themselves. It goes to weird, surreal, disturbing places. So I’ve been trying mindfulness sessions where I just let my mind run wherever whether it be beautiful, strange, violent, sexual, blasphemous, boring, funny, cringe, interesting, ridiculous, plausible, etc. and just describing them neutrally. It’s hard to use standard ERP messaging with these because there’s no truth claims to these thoughts, and therefore no uncertainty, except occasionally when one feels like it’s true in the real world. In addition I do use the ERP message “There is a possibility that these thoughts will make me feel bad (anxious, disgusted, ashamed, etc.).” The idea is that I don’t push the thought away or fixate on it. I am also very sensitive to images and have been doing exposures with genitalia themed memes and just today with movie gore. I feel this might have been a mistake because it affected this mindfulness session and the thoughts were more violent than usual and I had a moment where a harm theme came back. I didn’t compulse, but I feel really off. Is there anything about this that is inadvisable or should I keep doing the exposures and the mindfulness sessions?

And I don’t think this idea contradicts with your mindfulness approach. In meditation guides, I have heard them say “let your thoughts go past you like they are cars and you are on the side of the road watching traffic, let them float by like clouds in the sky but your focus is the empty sky.” I like to picture that I’m in a rowboat and there’s stuff in the water that passes me but I just keep on rowing. I don’t necessarily let myself indulge in focusing on the stuff that’s passing and think whatever I want about it, but I don’t try to make it go away either. I say oh look there it is, and let it be there and let it pass by without needing to look at it too much. (Obviously this is really hard and I am not very good at it yet, just to be clear lol)

The “this might be true” statements can only apply to things which actually claim truth (like the harm obsession), but I struggle additionally with being afraid of thoughts as thoughts. The vivid imagery I experience is not solely an analytical process that I use to solve a problem, it’s also free associative. The thoughts get really weird and uncomfortable, but not because I am even tempted to think that they are true but because I am sensitive to images (which I think interacts with OCD but is independent of it). They can be as bizarre and disconnected as a pterodactyl with an erection biting a person’s head off. I am afraid of seeing these things rather than the things being true if that makes sense. ERP does apply here in the form of “this might make me feel horrible or off,” but not in the form of “a pterodactyl with an erection has bitten, is biting, or will bite off someone’s head.” Because of this “It’s just a thought” isn’t much help here, because it’s having the thought that I am afraid of. Does this make sense? My concern is just that I’m mixing obsessions during the exposure and that might make it harder to make any progress. I am trying to focus on overcoming my fear of my graphic thoughts and I feel I might be ramping it up too soon, making for thoughts that touch reality in the way that intrusive thoughts normally do, such as the harm obsession. I really really don’t want those to return.

@CaptainKierkegaard That sounds really scary and hard, I’m sorry you have to deal with that :( I think the “just a thought” response is similar to “thoughts are not facts” in that the important thing is “thoughts can’t hurt me.” It’s really hard sometimes to figure out what exactly you’re doing in response that’s making the thought sticky and keeping it from just going away. But it seems like the idea at least is that there’s always something you’re probably doing that’s compulsive and keeping the thoughts coming or feeling distressing. The goal is that you’re like “oh that’s a weird thought” but not distressed, and supposedly it’s the approach of trying to get away from or protect yourself from the thoughts that keeps you from getting there. Because you teach yourself that they *are* scary. So I know that’s a really hard thing to figure out, but I guess some examples could be like, when you feel scared, do you do anything to comfort the scared feelings? Do you try to shift your focus to thinking about happy things? Do you get mad at yourself for always thinking weird thoughts? Any reaction that you do to try to counteract the fear, feel ashamed, or pay lots of attention to the scary thought could maybe be compulsive, so maybe pay attention to that. And I actually agree with you about it being really hard to capture those sorts of things in the actual ERP session—I’m not an expert but maybe talk to your therapist about that. Personally I find that my obsessions just come up during the day and it was impossible to recreate them during a therapy session, so it was really hard for me to do ERP and it didn’t seem to work. But I also think that might be partially because my depression is severe but my OCD isn’t severe, so I wouldn’t recommend everybody here do the same as me.

@jello86 When you told me that depression kind of takes over for you on another post, I definitely relate. There are behavioral structures in my life that seem very much like OCD, but depression is often what steals the show. Very very recently I have considered that there are some things that just aren’t OCD and have to be approached differently. There are matters in my life where I have felt lasting relief from reassurance and never had to ask it again and matters where it was clearly a compulsion. There are some things which have gotten worse in the time which I have done ERP. I’m not even early on in the process despite feeling like I haven’t made a ton of progress. I’m about 10 weeks in. But there are also things which have gotten better. Ultimately, I don’t feel like ERP is the complete solution for me. It’s something I still need and should do diligently, but I need to be sensitive to what needs to be approached this way and what doesn’t especially because I think the way I have been engaging with treatment is actually compulsive (it’s a little complicated but I think I’m able to explain this if you’d like).