Does anyone have any input about the concept of extreme exposures? I understand why it’d be necessary for recovery but wouldn’t some of them be genuinely dangerous? Like especially for contamination?

As a therapist I would never put a client in harm’s way when it comes to actual exposures. When you are doing self exposures you can weight the benefits against actual risk! I risk dying in a car accident everyday that I drive, but this risk doesn’t keep me from going where I need to go! If an exposure could cause actual harm, move on to something different. Try an exposure that would elicit the same amount of high anxiety but actually doesn’t risk harm. When it comes to contamination get creative! And, you could also consult an expert (doctor, infectious disease worker, etc) to get a go ahead or actual data on risk! But…….don’t ask them more than once! 😉

I’ve wondered this as well. Like I’ve heard of people touching public toilet seats and not being allowed to wash their hands.

Mine were never that extreme but sometimes I felt like I was going against common hygiene practices. Like not washing my hands before taking my pills. Like you’re supposed to wash your hands before you put something in your mouth.

Another approach that you might like better than extreme exposures is to try to slowly reduce your OCD behaviors until they get down to a normal level. This way, you don’t need to do any extreme purposeful exposures. If you’re not sure if something is extreme or not, ask yourself what someone close to you without OCD would do. If you’re still not sure, you could always ask someone if it’s reasonable or not. Also, if you think something might be OCD, it probably is.

An extreme exposure would be on the higher end of the hierarchical ladder of your fears. When starting out with ERP, generally you would start with the easier things first and work your way up the hierarchy until you reach what bothers you the most. Although I am not a therapist, I am confident in saying that a therapist would not give someone anything that would be considered dangerous - the OCD is likely to consider it dangerous because it is a fear of ours. Hope that helps.

Germs are everywhere. For example, I had Covid but I have followed the cdc guidelines. The purpose of the exposure is to help us sit with uncertainty. I know it is uncomfortable but it teaches us how to live with the uncertainty that we may or may not get sick.