How do I practice exposure for mental compulsions?

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 By the time I join my session they are no longer active.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)?

Warmtea

User type: OCD Conqueror

Date posted: 22w

I understand this— I have started using silly phrases like “not my circus not my monkeys” “f**k it we ball” “I’ll burn that bridge when I get to it” “if it floats it floats if it sinks I dive” stuff like that. I try to come up with new ones to make myself laugh and break myself out of the loop I get stuck in. Gotta inject some humour into an otherwise messy and terrifying disorder.

Smolbean

Date posted: 22w

Not sure if this is helping yet, but I’ve started writing out a script while in sessions to return to during exposures or episodes.

NotMyStick

Date posted: 21w

You can try to think of silly or Witty ways to beat a bully at its own game without any indication of self assurance in the mental statements you use. Any evidence of self assurance can turn into a compulsion.

thatusername...

Date posted: 21w

@NotMyStick Can you give an example of this?

NotMyStick

Date posted: 21w

@thatusernamehasalreadybeentaken Ok I’m not the best at witty comeback on the spot or I wouldn’t be here with you. I asked grok(Ai) for help with responses related to my HOCD/SOOCD. Hopefully you can get some kind of idea out of all this. Here it goes… Intrusive thought: “Wow, that guy at Costco is sexy.” Witty response: “Yeah, and so’s the discount rotisserie chicken—guess I’m marrying a bird next.” Intrusive thought: “I’m gay.” Silly comeback: “Cool, tell that to my girlfriend’s shampoo I’ve been stealing for years.” don’t argue, just sidestep with absurdity. It’s not about proving it wrong; it’s about making it less of a dictator in your head. Is anxiety giving you that dreadful chest squeeze? How about: “Oh, great, my heart’s a drama queen now, where’s the Oscar?” Intrusive thought: “That guy’s sexy, I must be gay.” Comeback: “Sure, and I’m also in love with my toaster—guess I’m toast-sexual now.” Intrusive thought: “I’m gay, it’s true.”Response: “Oh, fantastic, I’ll RSVP to the rainbow parade right after I finish lusting over this pizza.” Intrusive thought: “What if I’ve always been gay?” Quip: “Then I’ve also secretly been a ninja—explains why I’m so bad at sneaking snacks.” Intrusive thought: (Chest squeeze)“Yes you are.” Retort: “Thanks, Captain Obvious, my lungs are just practicing for the squeezebox audition.” These examples may not be the greatest, but the point is to break the intrusive thoughts hold over your state of mind in the moment with a lighthearted, silly and absurd comeback.

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

Anonymouus

Date posted: 11w

How to avoid mental compulsions

My biggest is ruminating, i talk and talk and over share with myself and others Like what are some exposures?

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How do I practice exposure for mental compulsions?

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