Graded exposure (ERP) for ROCD

Hi all, I am looking for suggestions, tips, and experiences with what works in terms of graded exposure for relationship OCD. I've suffered with OCD for I think around two years now (prior to this I had anxiety but not OCD, this was triggered by surgery and long years of being unwell and other things happening in life), but it went undiagnosed until around 9-12 months ago. This is when the theme of my anxiety and intrusive thoughts turned from my health to my relationship with my partner and to a certain extent others around me as well. Even though we've been together happily married for 10 years, having to rely on someone to help you when you are so sick, combined with covid and lockdowns, and death and illness in the family was a perfect storm of triggers for me. Even so, I have improved quite a lot because I was also diagnosed with severe depression around the same time, and that and my anxiety levels have improved. A lot of this is no doubt that I was doing a PhD while all of this was going on and have begun to heal from too. But I also think I managed to improve using a mindfulness approach to triggers (accepting but not engaging as much as possible). But I do believe that to improve further I need to begin some graded exposure therapy with my psychologist. The trouble I have, is, I get very confused about my triggers, although there are some definite themes I do not know how to write these down to begin a graded exposure, because they are thoughts I have, a line in a movie I watch, something my partner says etc. But I'm to the point now where these triggers are not so strong all of the time and it almost feels like a "mood" when I'm more susceptible to the trigger. Other days those things don't trigger but something else might. It feels like the less thought I give them, the better I get so starting this therapy feels counter intuitive to me. Is anyone willing to share examples of the kinds of triggers they started with? Or help as to how to start? Any help or advice would be appreciated.

PenguinOCD

Date posted: 2y

I can definitely relate. I have used some triggers like “planning a vacation together” and “write a story about breaking up with him” and “listen to a playlist of romantic songs and focus on the lyrics” but that last one isn’t always triggering and the others are sometimes too triggering. I also try to take advantage of triggers that happen during my day, like when a thought pops into my head like “I’m supposed to see him later and I’m not sure if I want to. Must mean I deep down want to break up”, I feel anxiety and want to google things to avoid it, but try to treat that as an exposure and just sit with the thought and anxiety without judging until it passes. That said, I can’t do that for every single obsessive thought in a day - either because I’m in public or at work or because it’d just be too much. I know ultimately an ERP hierarchy has to be based on our own individual triggers but I’m interested in others’ ideas

LaraW

Date posted: 2y

This is so helpful thankyou! I have thought of using my triggers as exposures too, but like you said it isn't feasible for every time, but even the way you phrase it, makes practical sense to me. I also definitely think I will try my own versions of your triggers, mine are similar. I relate to much to your thought too, I get the " I feel anxious about going home, it must be because he is there, that must mean I don't like him etc". Boy it is exhausting! Thanks for sharing!

UUCM

Date posted: 22w

How to do ERP for Harm & ROCD regarding my spouse?

My spouse is my best friend. A few months ago I basically worshipped the ground he walked on. He’s the best partner in the world so no “maybe he’s not the right person” commentary. Lately my fear of going psychotic has brought back my intrusive thoughts about harming my husband. Now, whether it be from emotional dissociation or medications, I can’t feel any emotions so I’ve developed ROCD. This is ruining my life and has been a month from hell since my spouse/comfort zone makes me feel nothing. My therapist hasn’t given me any info on how to do anything about this other than reading a book (didn’t help). Any ERP suggestions? I haven’t done ERP before for these types of OCD

anxietypoops

Date posted: 22w

The RP in ERP

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.

Monkeybrain842

Date posted: 12w

How does one activl 'practice' exposure therapy ?

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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Graded exposure (ERP) for ROCD

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