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I want to ask about exposure exercises in OCD treatment, specifically when some exposures feel unsafe or inappropriate. For example, sometimes I’m asked to say things aloud that are socially unacceptable in front of my family, or actions that could create real problems. My mind says this is impossible or crazy, and it definitely raises my anxiety. I asked ChatGPT, and it suggested doing exposures gradually, but I’m still unsure how to handle exposures that are truly unsafe. My imagination no longer worries me, but I really want advice specifically about handling unsafe exposures safely. Thank you!

Kdmaw

User type: OCD Conqueror

Date posted: 22h

IMO, what you deem unacceptable and unsafe should be defined by your core values and not your OCD. Defining your core values is hard (especially when trying to differentiate it from your OCD) but I think it’s useful. In general I use like the Kantian categorical imperative approach for if I hold something to be a value. If I hold something highly enough that it could be held evenly across all people then that is something I consider a value of mine. A specific example is service, I think all can be asked to provide for others within the limits of their capabilities and their ability to provide for themselves. So service to me is a value and I align some of the things I do in life to that value. I had contamination OCD that prevented me from doing service to others, eg I was afraid I’d get sick and pass that sickness to others as a result I didn’t do any volunteering within my community. I also have a finite amount of energy money and time so I could beat myself up on not doing enough service for others, but that’s not my value because I don’t think I should be able to force people, including myself, to live their whole in service to others. All of this to say, when you say an exposure could cause real problems are they OCD real problems or value real problems? OCD real problems you can work towards exposing yourself to, value problems are a boundary. Like an exposure for harm ocd could be murder but that’s not something any of our values, or law, will support. I had a specific issue with driving during traffic because I thought if I’m part of traffic and then an ambulance needs to get by and they’re blocked then I could’ve caused someone to die. I wouldn’t universally will that no one can drive their car except for emergency situations or everyone had to live within 10 miles of work, so I can’t really float that as a value. So I target doing things that got me used to doing that behavior and I’ve been able to drive in rush hour traffic again when needed. So a novel of a reply to basically say, if doing something violates your values it’s not an exposure but if it violates your ocd it is. For the scary OCD exposures you can do some smaller exposures around them maybe? So like instead of the full socially unacceptable things in front of family you could talk about those things with your family maybe as a half way point?

R🌷.

Date posted: 20h

Exactly, but there is a feeling that if I don’t do it, I will remain unwell, and I don’t want that. However, my parents have a difficult temperament, so I think my mind tells me it’s impossible for me to say it. This is because I was once punished by someone for saying a curse. I believe some of the OCD thoughts may be silly, but I think some of them stem from my incorrect upbringing.

Kdmaw

User type: OCD Conqueror

Date posted: 20h

@R🌷. Yeah so it sounds like something you want to tackle and not something incongruent to who you are as a person. In terms of curse is it like something profane to social norms or something profane to religious norms? And when you have these distressing thoughts, like saying something inappropriate in front of family, is the fear like “I’m worried I’m going to do this thing even thought I don’t want to,” or is it like “do I feel the need to have to tell someone about this bad thing I’m thinking,” or something else?

Freddy327

Date posted: 25w

Fear of not doing exposure and upsetting therapist

Hi! I was given exposure HW that I chose to do by my therapist but lately I’ve been feeling overwhelmed by it and thinking that maybe I need to start with an easier exposure. However I can only see my therapist every other week due to her schedule and I’m really having a hard time feeling like I’m not following the “rules” of therapy. I feel like she’s not going to help me if I don’t do the exposures and that I’m gonna be all alone again and have no where to turn. So, part of me was gonna just force myself to do the exposure to avoid feeling bad. I don’t want to let OCD run the show also by not doing the exposure…but also feeling like doing the exposure is not quite right either. Please if anyone can relate I could really use some help.

anxietypoops

Date posted: 24w

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.

thatusername...

Date posted: 24w

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)?

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