How do you perform a proper exposure? How do you handle the thoughts that pops while you do a exposure, do you maybe label the thoughts? It would be helpful for me if someone can explain me the DO's and DONT's of doing exposures
This might not work for everyone but this is the framework I follow: Recognise - I recognise the thought as intrusive and maybe say something to myself like ‘okay OCD I see you’ or ‘this thought is an unwanted intrusive thought’. Just a thought - My compulsions are completely rumination and reassurance seeking based, so once I recognise it’s OCD I then remind myself that it’s just a thought and not worth exploring or getting involved with. Accept and allow - this is the hardest stage for me (!) but here I just accept that I have the thought and accept any anxiety or discomfort that comes along with it, and I allow it all to be there. I don’t get entangled with it by doing compulsions I literally just let it sit. It’s discomfort, not danger and I know that by allowing anxiety and accepting the thoughts I’m not agreeing with them, just letting them be there. If I feel myself getting tempted to explore them or I start ruminating I try to say something to myself like ‘that’s not worth exploring, stay in the present’ and I try to bring my attention back. This stage takes a lot of practice! Let time pass - this is another pretty crucial stage for me as the key here is to feel anxiety for as long as it takes for the body to calm down. If you try to hurry the process or you think ‘urgh I’m accepting the thoughts why am I still anxious?!’ you’re only gonna cause the anxiety to stay around even longer. If you try to check where the thought has gone or if it still upsets you anymore it’s going to have the opposite affect of what you want. So you have to really just wait and be patient with yourself. Proceed - finally it’s really important to do two things: carry on with your life and exactly what you were doing when you first had the thought and don’t avoid situations that trigger the thoughts, even though that feels like the most natural thing to do. You want to show OCD that it’s meaningless and that means doing things even when you’re anxious. It also means doing things that might have been the cause of your anxiety in the past. The part of the bran that learns to be fearful only unlearns fear when that anxiety is activated so you really need to feel the anxiety and push through to reduce triggers in the future. Sorry this is super long and this model might not help everyone but this has really worked for me - I don’t have therapy but practice ERP myself and have found a big improvement in the last 6 months or so. But it took my a lot of attempts to really master sitting with anxiety and I still definitely have relapses. Good luck!
@birdee_ also for anyone wanting to learn more I forgot to say that this framework comes from the (amazing!) book Overcoming Unwanted Intrusive Thoughts by Sally M Winston
@birdee_ This is so great
I have been doing the things you listed here on my own too and it has helped me a lot but i have never gone to an ERP therapy before so I don't know what to do and what not to do while doing exposures, basically the DO's and DONT's of doing an exposure and it would help me if you or anyone here can tell me how to do exposures and by exposure I mean things that triggers us and we expose ourselves to it and things like how long should an exposure be? What time of the day should one do exposures? Are you allowed to label thoughts that pops up during an exposure? How do you avoid rumination after an exposure? And things like that.. It would be really great if someone could explain this to me in detail and thanks for replying to post!
Hi! I've been on my OCD healing journey for about half a year and I have seen a lot of success. I'm reaching out for advice, I am very willing to do exposures because I know the more I do them, the more I get better, but I struggle with the response prevention part. I don't know how to control my brain when it comes to facing the fears especially since most of my compulsions are mental. I can tell myself the typical things "I am okay with the uncertainty of this happening", etc. but its like my brain doesn't believe them. I've been stuck in this disconnect for a while and would love advice you have heard from a therapist or learned that has really help you.
My NOCD therapist (who has been awesome) and I are both struggling to identify ways in which I can practice exposure therapy while in-session, because the vast majority of my OCD symptoms are mental compulsions. For example: indecision and inability to commit to a choice; seeking reassurance on decisions from friends and family; mental review of things that have just happened / social situations; over-thinking and catastrophizing. I also have some other hallmark symptoms (contamination fears, moral scrupulosity, etc) but those tend to be inconsistent too. It’s hard to really practice these during my sessions because so many are in the moment and fleeting. By the time I join my session they are no longer active. How can we establish exposure responses during my sessions, if most of my OCD involves mental rumination and overthinking patterns/thought loops that only occur “in the moments - rather than specific or consistent compulsions (such as hand washing)?
One problem - Various themes This is my first post. I had a relapse a few months ago. Life was amazing and then boom, I got triggered by something and started spiralling about my sexuality (having finally been at peace for two years, entered a healthy new relationship and come out of the closet as an older women). How do you, when you're not triggered practice ERP? I'm able to try and accept the thoughts every time I see a man. What should I be doing when I don't encounter these triggers. I was to say as well that I also am starting to get real event OCD about some of the sexual things I did in the past when I was married and in an unhealthy toxic relationship with my ex husband. I am shamed and disgusted and I'm working on it but there's a certain subsection of the LGBTQ community that trigger these thoughts, groinals and thing for me... I feel like I'm beginning to realise I need to maybe be a little more active in my recovery instead of waiting for triggers... But I don't know how
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