I don’t know what to do. I have the most specialized therapist in my area and they basically said they couldn’t help me.

Construct a hierarchy of fears: Here, the therapist and client collaborate over what things are least feared, to those most feared. For example, one may find it possible to carry a napkin that has touched the floor, but cannot bear the thought of directly touching the floor without washing. This can be applied to other feared items (such as public doorknobs, toilet seats, subway straphandles, etc.). Self-monitoring: Maintaining a record of frequency of hand washing (by keeping a log, or self-monitoring sheet) individuals often experience some reduction of symptoms. As treatment progresses (by inclusion of exposure with response prevention), self-monitoring can be extended to successful completion of behavioral exercises. The value of this stems from the ability to objectively evaluate progress over time. Further, in discussing weekly progress, it is then possible to recall more accurately how and under what circumstances improvement took place. For example, someone may do very well the first three days following a session, and then struggle a bit just before the next session. Without the objective data, someone could say they ‘are doing terribly.’ However, that is not entirely true. Instead, there was some variation in success, as noted in the self-monitoring forms. Exposure with response prevention: Once a hierarchy of fears has been established, the therapist and client ‘climb the hierarchy’ by exposure to low items on the list. The important portion associated with this approach involves not washing after the activity. As part of this experience, it is important to introduce items that are contaminated into the individuals’ contamination free zones. That is, the most effective treatment involves ‘spreading’ the contamination, which (a) prevents keeping track of what is dirty or clean and (b) promotes more rapid treatment response. An additional feature of this spreading of the contaminant prevents ‘contrast effects.’ This may be most painful by individuals establishing strong safe zones in close proximity to contaminated zones. Re-Exposure: Once the person actually washes (which therapists acknowledge is completely necessary for hygiene, of course), it is most important for the person to engage in re-expose to a feared contaminant. This is sometimes the most difficult thing to do in therapy, but also fosters rapid treatment gains. The rationale behind this involves fostering a sense that one can never be completely clean, and that contaminants are pervasive. It also addresses the concern over intolerance of uncertainty. That is, one can be clean yet still be contaminated. Contractual matters: A final important aspect. Treatment, and progress through the hierarchy, is akin to a contractual agreement. However, in actual practice, people encounter feared items that are not part of the contract. We would encourage washing after contact with these items, but immediate re-exposure to contracted items. For example, it may be contracted that exposure takes place with doorknobs, but not for the bathroom doorknob (yet). If contact is made with the bathroom doorknob, wash but immediately touch a different doorknob.

It's a very hard ocd to treat but there are some ideas. It's usually hard to find a therapist. Try just talking to ppl with the same things going on.

I would go through my day and see what things about your ocd cause the most anxiety. It might help figure out what it is you're afraid of. I'm not to experienced in this type of ocd , but I'm here to chat if you need to talk about it.

What are you looking for help with?

Contamination OCD

The problem is i don’t know what I’m afraid of. And I don’t have any 1s to start with. Everything’s a 5-10. If I do one exposure it creates more things I find dirty