ERP not working, been doing it for 8 months

@Susan4444 Unfortunately ICBT is not evidence-based like people claim it is and it’s a form of talk therapy- which involves doing compulsions. So that often makes OCD sufferers worse ❤️‍🩹 ERP is the golden-standard OCD treatment

@Wolfram I can handle exposures just fine. I’ve got to the point where exposures don’t give me much anxiety, just discomfort but I always sit with it and resists doing compulsions. My doctor prescribed me Prozac but I don’t want to take it because it can increase these thoughts and it’s hard to ween off on your own.

@Cherno Maybe change your diet slightly and do activities to boost seratonin? Basically natural SSRIs without side effects.

@Wolfram Brother my problem is the intensity of the thoughts. I just want a few moments of the day where I can have a peace of mind and clarity. Where I’m not being bombarded by intrusive thoughts. I don’t expect the thoughts to go completely away but I do want them to lessen.

@Cherno The should be reducing if Erp is done properly 🤔 How do you feel when you do your exposures?

@Wolfram When I do my exposures I feel just fine. When doing them I try to avoid compulsions and focus on sitting with the anxiety.

@Cherno I don't understand how you feel fine if it's an exposure. What runs through your head when you avoid the compulsions?

@Wolfram My compulsions are googling SI and going Reddit forms to compare my condition with other people who are actually SI. I typically avoid sad music like Radiohead, sometimes I’ll ask myself am I actually you know? And yeah just hours of research. I typically resort to compulsions when I feel like my OCD is getting really overwhelming.

@Cherno So do you find it easy to do the exposures in therapy because you know you can resort to the compulsions after?

@Wolfram No, not really. Doing exposures with a therapist reduce anxiety in general. But I’ve done pretty tough exposures for this theme, I’ve pretty much worked up through my hierarchy. The intensity of the thoughts won’t lessen at all. My problem isn’t exposures. It’s the intensity of the thoughts. Every minute the throughout the day. It’s not just fleeting thoughts they are relentless. I’ve even done loop tapes for an hour. And that hasn’t really helped if I’m being honest. I think I might be a lost cause. Like this is going to be my life until the day I die.

@Cherno In what form do the thoughts take?

@Wolfram The thoughts more often than not show up as commands. “End yourself”, “I’m gonna end myself”, “what if I end myself?”, and this continues nonstop. These loops carry on nonstop. It makes it hard to do everything. And I’m someone who lives in their head. My whole life I’ve always maladaptive daydream so I struggle with being present. It’s difficult to get a thought and comebacks to the present.

@Cherno Maybe the Erp you're trying doesn't work for you and you need a different approach.

@Wolfram What would be the different approach?

@Cherno Have you tried any aggressive approaches to Erp? Challenging them to a point where you near enough have a panic attack? Literally poking that sleeping bear until you feel overwhelmed by it, and then resisting the compulsions by letting all of that pent up energy wash over you like a dark cloud until it fades? Potentially the side effects could also amp up the exposures for Erp 🤷 Alternatively a different type of therapy might be better.

@Wolfram What alternative form of therapy would help me? ERP is the gold standard if this doesn’t work then there is nothing that will work.

@Wolfram I’ve done the most aggressive forms of ERP, and I still experience this intensity. I think I have to accept I have the worst form of OCD and nothing will ever get better for me.

@Cherno Gold standard is a loose term. I find Erp to be the hammer on the psychology toolbox for ocd. Cbt therapy may be good, also EMDR has shown signs of helping. Alternatively, speak with your therapist and bring up the possibility psilocybin use. That, in some cases has wiped out symptoms of ocd. It's frontier stuff but it looks promising

@Wolfram Yeah it’s over for me

@Cherno How did you come to that conclusion based on what I said?

@OneDayAtATimee I do a lot of research and scrolling on Reddit forums when I’m not doing ERP

@Cherno Ah that makes a lot of sense! Thank you for being honest :) Those are common compulsions that most people with OCD do. Those compulsions include ruminating, reassurance-seeking, checking, etc. Doing compulsions on Reddit in your free-time is the reason why ERP isn’t working for you. Because you are only doing the exposure portion of ERP and you are not doing the response prevention portion (which is the even more important than doing the exposures). So you are one foot in and one foot out of doing ERP. You have to fully commit to both portions of ERP for it to work. When you consistently decrease that researching compulsion, you will slowly start to feel better 🙏🫶 Extra points if you cut it out completely!

@OneDayAtATimee Okay I’ll try to stop. I get overwhelmed with OCD then start researching all these different forums.

@Cherno Totally understandable :) You got this! 👏💪

@OneDayAtATimee But even when I wasn’t on Reddit I still had a hard time. I remember driving back from NYC the day after the 4th of July. For like two hours straight I was getting slammed with intrusive thoughts.