SUDS Ratings

Hi ElenaMarceline 👋 I understand the impulse here—you want to get accurate readings without letting OCD steal the show and obsess about them. I had a similar string of concerns when I first started using the purple SOS button. Tying symptoms to physiology helped for me. Here is a rubric I use: 7-10: my heart is pounding and I feel very scared. 8 or higher starts to feel unbearable after a few minutes (sweating, heightened senses and breathing). 10 usually means I dove in too deep. 4-7: I’m not completely struggling, but I’m also quite uncomfortable. I can feel anxiety gripping me and my body tightening. 2-3: I can feel an underlying hum of anxiety, but nothing I couldn’t live with indefinitely. With some of my symptoms, they have simply stayed around a 2-3 regardless of exposures. 1: this is usually reserved for whether I felt a reduction in symptoms to near-zero. If I end at a 1, that’s often a great sign. If I start at a 1, I’m likely wasting my time and could move on to a different or more intense exposure. Another way to think of this: imagine your stress during ERP as if you were weight-lifting. What would be “too much” to lift for more than 30 seconds? What would be “too little”? Use those as benchmarks for your 10 and your 1 placements. Keep putting in the practice—what matter is that you are getting in tune with your body, symptoms, and what reduction and (eventually) homeostasis feels like. Once you get there, it is much easier to identify when OCD is kicking in to hijack your senses. Hope this helped 💛

J vv has great advice above. I remember being unsure and confused about this as well. I had to embrace “close enough” or “accurate enough” data points. It did feel like at first I was approximating and guessing, especially since I didn’t have a good sense yet of what all my feelings felt like (I’d been running away from them for a while). In terms of other negative feelings, I would guess the same applies? I imagine you want to track whatever feeling you’re trying to avoid with compulsions — and the goal is to get to a point where you can tolerate that feeling without doing compulsions. For me, it’s almost always fear. But I’ve heard disgust can also be a common one. I’d ask your therapist what they recommend.