Is this a compulsion or a trigger? LF: ERP advice

I've got a smart watch that tracks my sleep. It gives data like heart rate, heart rate variability (HRV), respiratory rate, sleep cycles, restfullness, etc etc etc. Well, since the health OCD has gotten to its peak, I am noticing a false patterning coming from it. For context; I was sick 2 times in recent memory where sleeping heart rate and HRV became metrics that I could use to sort of track the illness. In the days leading up to it, I'd notice my heart rate going up and HRV going down (higher hrv is better.) Then when I was fully sick, my HRV would be up to 15ms less than normal. So now, when I look over my sleep data (because I like to look at data like that, it is interesting to me) and notice my HRV is lower than normal, it triggers intrusive thoughts of "am i getting sick again?" despite no other symptoms. Ruminating begins as I try to "figure out" the cause, despite knowing that stress can lower sleeping HRV. My question is; is it a compulsion to be looking at my sleep data? Should I avoid it altogether? Or is this exactly what ERP is; exposing myself to a triggering event and preventing the response? I look at the data either way and it is only alarming when I see something out of the ordinary. So, do I stop tracking my sleep, or is this a good small step for ERP?

User type: Therapist

Date posted: 9w

Hello rightfulmcool, You bring up a great question. In ERP exposure is a key part of the process, as it is intentionally triggering the distress, related to the intrusive thought, "What if I am getting sick?" Compulsions are what is done to alleviate the distress caused by the intrusive thought, as in your example this would be "checking the watch". The goal in ERP is not to trigger distress and not engage in compulsions. Simply triggering and following the same pattern, is just OCD being triggered. So are you engaging in a compulsion or resisting the compulsion? Are you able to reintroduce uncertainty, when you do compuls? At NOCD we are trained experts in the diagnosis and treatment of OCD and related conditions using Exposure and Response Prevention (ERP). ERP is the gold standard of treatment for OCD and related conditions, with the better part of the past century's research backing the efficacy of ERP. If you would like more information on OCD and ERP, please visit our website at www.treatmyocd.com. If you are seeking to begin/resume your journey of recovery, you may reach out to our member advocate team at care@nocdhelp.com. I hope this message reaches you well and know that at NOCD, we are always here to help! Take care, Ian Reeder

rightfulmcool

Date posted: 9w

Good question. It usually goes something like: I wake up, look at the sleep data, and only if something is abnormal there do the intrusive thoughts happen. I then become compelled to Google or ruminate to figure it out. I do fight these compulsions when they come up. Given that if there's no abnormal metrics in the sleep data I don't get any intrusive thoughts, and I don't get any compulsions, it leads me to believe it is more of a trigger; especially because looking at the data always happens first? I've had a smart watch for years, long before OCD started up for me (at least I think) and looking at my sleep has almost always been the first thing I do.

littlecreek24

Date posted: 22w

Compulsion vs ERP

I'm thinking of trying some ERP on my own while I wait for treatment, but I'm having some trouble knowing what is a compulsion and what would be good exposure. For example, I have huge fears of being a narcissist and/or a generally bad person. So whenever I watch a movie or read something that has an evil character in it I automatically compare myself to that character and stress over if I'm like that person. A couple of things I do when this happens is Google other people's experiences, seek reassurance, rumination, etc. Sometimes I'll also google different symptoms of narcissism, freak out over things that I relate to, then get relief over things I don't. So my confusion is, would researching people who have narcissism be an exposure, or a compulsion since it's something I sometimes do during a spiral? Or, would the exposure be watching movies/living life hearing these stories, and refraining from the spiral of rumination and no Googling at all?

Nova2025

Date posted: 14w

OCD with the news

Curious.... the news has been terribly distressing for me and has stirred up OCD. Compulsive rumination and checking (news stories) are my go-to when OCD is triggered. Today, I purposely did not listen to my news podcast as I do every morning. I feel better-ish. Is this avoidance, or is this self care? Would continuing to listen to a podcast be exposure with response prevention applied to the compulsions that go with it? Thanks in advance!

baukje

Date posted: 11w

Erp for insomnia ?

I have, alongside my other OCD themes, an intense fear of insomnia. Although this has been improving somewhat — partly thanks to medication and The sleep school on YouTube — I still find myself ruminating about it throughout the day when I have something important the next day, I get stuck in the fear that everything will be ruined — for both myself and others — because my mind is so preoccupied with sleep. + a fear of depression coming back. It honestly feels like a form of sleep OCD. I'm not sure if that’s an official thing, but that’s how it feels to me. A form of erp is the idea of befriending wakefulness. That works great tbh. Things like sleep hygiene, meditation, etc. — tend to backfire because my OCD latches onto them and becomes too obsessive about “doing them right.” I’m genuinely wondering whether ERP — for example in the form of a worst-case-scenario audio loop (imaginal exposure) — could be helpful in this case. I’m hesitant to start unless I know it can actually help. Is there anyone who has experience with this or thoughts about it? I’m not looking for reassurance or tips to fall asleep — only for ideas on how ERP might be applied in this situation.

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Is this a compulsion or a trigger? LF: ERP advice

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