Hey! I’m a POCD sufferer and I was wondering if anyone who is doing ERP has any good suggestions for exposure heirarchies that I could take inspiration from? I’m starting CBT soon but I can only get it in a group and I don’t feel super comfortable talking about the details of POCD yet cos it feels really embarrassing. So far I’ve thought of going to the pool/park, or writing down my thoughts and looking at them, but my OCD really goes wild if I try to masturbate or if I feel aroused at all...at the moment I’m avoiding anything like that because it’s so distressing, but is that something I should do exposures for in the future?

Than you for your question. I am not at all worried about such a thing, I am going to explain why. 1) Neuroplasticity usually refers to 'procedural knowledge' - That is 'practicing' something. I could think about the word 'elephant' a million times and even imagine myself as one and in no way I am training my brain for me to become an elephant' but I am training my brain to "think about being an elephant" - That is, in no way I will turn into one; however, my brain will learn to obsess about anything related to turning into one. That is what neuroplasticity is - the one you mention is called magical thinking. 2) I could repeat millions of times that I am a serial killer and in no way that will make me commit any atrocities since I have a value system that is impenetrable unless I change my beliefs (which takes cognitive reestructuring which is very difficult to attain). Think of the people who prepare for movie roles - None of them become what they portray forever. Their mind might be vulnerable to suggestion but nothing beyond that. 3) The fact that you have 'panic' about the related fears shows your value system. With ERP we are not trying to bend your value system but only trying to train the mind to become more resilient "against' those thoughts and feeling. Think about lifting weights - The pain is horrible and in no way people enjoy pain but the muscles grow and eventually that weight does not cause pain anymore. Does that mean that I like pain? No it just means I am stronger.

I saw many therapist who were not OCD specialists who just made it worse. Then at my lowest I joined an intensive outpatient program at a behavioural clinic (every day for three hours for six weeks). That was enough for me - I learned a lot to do the rest on my own. Right now I have an outpatient provider whom I only see about once a month to check in.

You can start with writing down thoughts and then repeating them in your mind only once without compulsions. For me, for example, the words: "monster", "perpetrator", etc. Triggered me a lot - so I started with those. Then I added longer sentences such as "I want to x my daughter" (the therapist recommended it and she was so right). Then you can start reading written real stories of child abuse. Then you can write a worry script where your worst fear comes true.

i think so, but definitely leave that for a long time in the future. part of my exposure includes reading and writing kidfic (something which i really enjoyed before the ocd came and punched me in the face) and watching family vlogs if that might be useful to you?

ah thank you so much! that helps a lot!! (ive actually experimented with the technique a little since you mentioned it this morning, although apparently i can already dismiss thoughts like that pretty easily...which brings its own level of panic, but i guess that's the thing that ive gotta resist!)

Ah thank you those are really helpful! I’ll start off with some of the easier ones and see how it goes this week :)

question for FernandoV: when it comes to that aren't you worried that repeating the thoughts will rewire your brain in a way that makes them true? ive been reading up on neuroplasticity and knowing about it makes me really worried about doing that kind of exposure

FernandoV how long have you been working with a therapist about your OCD?

That’s great, well done! :)

I specifically had a fear of being close enough to children as to touch them and not visually based obsessions. For me, my hierarchy began with first sitting in the parking lot of a store with children (ex department store, toy store), then the next day I had to go inside, then I had to go inside and walk down one aisle, then I had to walk all the aisles, then I had to all of that without performing reassuring actions like holding things in my hands or avoidance of aisles with children or looking at their faces.

I cant do groups i left a DBT Group stupid patients causing problems.