ERP for magical thinking OCD

Yes, thank you

@stpap - Happy to share! Deciding to start ERP and actually sitting down to build the hierarchy takes real courage. One thing worth knowing before you click: when the compulsion is always the same act, a hierarchy usually isn't organized by location or activity — it's organized by how hard response prevention is in each situation, so "repeating the action" can show up at several different levels of the same list. Two things tend to make that ranking easier: how serious the feared consequence attached to that particular thought feels, and how much of the ritual you'd be giving up. Delaying the repeat, doing only part of it, doing it deliberately "wrong" or incompletely, and skipping it entirely are all separate rungs on the same ladder, which means you can build a full hierarchy out of one compulsion. It's also worth watching for the quieter compulsions that ride along with undoing — avoiding certain words, sounds or rooms, or mentally replaying the action instead of physically repeating it — because those need response prevention too. "What Are Magical Thinking OCD Exposures? Explanation and Examples" https://www.treatmyocd.com/blog/magical-thinking-exposures-explanation-examples-ocd-treatment Written by Dr. Keara Valentine, this walks through what exposures actually look like for magical thinking specifically and how the undoing ritual gets targeted, which should give you concrete material to turn into hierarchy items. "What Happens in ERP Therapy? ERP Examples & Exercises" https://www.treatmyocd.com/blog/erp-examples Clinically reviewed by April Kilduff, this covers how an exposure hierarchy is put together and ranked by distress, with examples of how exercises progress over time — the exact piece you said is tripping you up. "Can you do ERP therapy at home? Understanding OCD treatment options" https://www.treatmyocd.com/blog/should-i-first-try-erp-on-my-own Since you're building this yourself, this one covers what's realistic to do on your own and where self-guided ERP tends to go sideways without a specialist's input. That last point matters here, because hierarchy design is one of the parts of ERP that's genuinely hard to do alone — it's easy to accidentally build in avoidance or set the first rung too high and conclude ERP doesn't work. Are you working with a therapist who specializes in OCD and ERP specifically, or is this something you've been navigating on your own so far? 💬 Was this response helpful? Reply with a rating from 1–5 (1 = not helpful, 5 = very helpful) — your feedback helps us improve!

Just saw your reply, thank you a lot for sharing your story and for your suggestions, they are really helpful! I'm glad that someone gets what I mean by saying I feel confused about the hierarchy because that's something that I can't find a lot of information about. And to answer your question, yes, there are intrusive thoughts and consequences that are more distressing. And now that I'm thinking that, based on your answer I've realised that in our case probably the best idea is to create the hierarchy based on the severity of the intrusive thoughts/ consequences and not the compulsions. You have difficulty creating your hierarchy because you have so many triggers. And I could say the same, I have a few intrusive thoughts, one compulsion (repeating the action) and an infinite number of triggers because everytime I'm having an intrusive thought I feel the urge to repeat the action I just did. Or isn't what I've described a trigger? See, that's maybe the point that confuses me the most lol. Thank you once again for your recommendations, appreciate it!