Question about ERP. So, if the goal is to habituate to whatever we are exposed to, how does that work logically on some exposures. For example, put your hand in a toilet & habituate to the discomfort. Or even, lick the bottom of your shoe & habituate to the discomfort. Make a picture crooked on the wall & habituate to the discomfort. My concern arises because even outside of OCD, I wouldn't completely habituate to these things as a person. #1, i don't have contamination OCD & I think sticking my hand in a toilet is icky. Licking the bottom of my shoe is icky too. Yeah, I can handle a picture crooked on the wall, but I prefer my pictures to hang straight. Get what I'm saying? Sometimes I wonder if I went through ERP, it wouldn't work anyway because outside of it, I'm not going to 100% habituate to these things. Not sure alot of people would completely.

Its kind of difficult to explain. Basically you need to think of the thoughts as random bits of information your brain is throwing at you. Its not no idea what its sending you. It can’t differentiate between you freaking out over a grizzly bear and you freaking out over touching a toilet seat, it only recognises a signal for danger. When the brain recognises danger, it sends you more of the thought to keep you focused on the task at hand, and allowing you to engage in a flight or fight response. When you show the brain, through gradual habituation, that putting your hand on a toilet seat isn’t dangerous, it’ll downgrade that train of thought to unimportant, and it won’t send it to you as frequently. You’ll still get it every so often, but you’ll be in a position to dismiss the thought and stop the cycle before it starts. Hope that made sense :)

No, I don't have contamination OCD. You can guarantee though that if I touch a toilet seat, I'm going to wash my hands before I eat food... I don't understand why people can't see that that's nasty, even for someone with OCD! Yet, sufferers are asked to do this AND habituate. It's just weird & doesn't line up with logic.

You’re not going to be 100% comfortable with anything; especially in the beginning the anxiety level rises higher. It’s supposed to make you uncomfortable but the thing about habituation is we realize that our perceived thoughts/fear isn’t a dire thing. If you’re 100% comfortable then there’s no ERP and no habituation. This can be done when you’re facing your fear. And just because you have OCD, if you don’t have contamination fear, you’re worrying over something you don’t have to do. Watch Katie d’ath on YouTube. She can explain better.

I’m sensing that your problems aren’t fear based.

Okay I think I understand better. I don’t think you have OCD. ERP is used for OCD fears where you expose yourself to your fears, the underlying reason of things you do (compulsions). But if you like things a certain way, there’s absolutely nothing wrong-unless it interferes with your life-and if it does, ERP is not the right treatment as there are no “fears” to expose yourself to and “habituated” to.

I think when you say “just let things be” you are saying accepting the thought and be okay with it. It’s about letting the thought be there and not engage in the ritual. The “let things be” is not targeted towards your compulsions. It’s targeted toward your thoughts/images. I’ve asked my doctors “how can I let go?”, “how can I accept my thoughts”. They recommended DBT. Thoughts randomly pop up and there’s nothing you can do. Some are minute and some loud. Some are pleasant and some scary. It’s what we do and how we react to these thoughts. When we react to our intrusive thoughts/images that’s when things get intense. You give it “life”. We can’t fight or get rid of it. When we do give in, it comes back stronger. That’s where the mindfulness, “just let the thoughts be” help with out compulsing (like reassuring yourself or checking) ERP specifically targets the compulsions whether it’s mental or physical. I read somewhere to think ERP as removing cancer cells. Do you want the surgeon to take some or all. Does this make sense? I hope I’m not confusing you.

If you “just let things be” with your compulsions then it will definitely get worse.

You don’t have to put your hand in the toilet. It’s an example. There are other exposures to face contamination fear. Also I have an impression that you think you have to do it. That particular exposure is for people with contamination fear, so if you don’t have it you don’t have to. You need to expose yourself to things that causes you distress. If I didn’t have contamination fear and only checking compulsions then I wouldn’t do that exposure either.

Well no one can make you do things. A good therapist will work with you to do something that’s easier to manage. With that said there are things a therapist would never have you do. Like putting your hands in a public restroom toilet. It’s always done at home and is clean. As an OCD sufferer with contamination fear even if the toilet is clean it’s still dirty. So it still works even if it’s bleached. Another exposure for contamination fear would be maybe go to a hospital and sitting in the waiting area. The place is “contaminated” and it makes sense but a therapist would never have you touch blood. Of course you will be anxious. ERP doesn’t tell you you shouldn’t be anxious at all. If you’re not that’s great but the purpose is to reduce that anxiety level to where it’s tolerable and manageable where you can make healthy decisions. It’s being able to tolerate the anxiety without ritualizing. It’s to learn that you can handle these thoughts and not use the compulsions to cope. I forgot another point I was going to make but that’s the idea.

Because preferences are not fear based. OCD and the compulsions we do are fear based. ERP only works with fear based. That’s why ERP doesn’t work on preferences. Honestly I don’t know how else I can explain. ERP doesn’t work on people’s preferences, interests, likes, values because there’s no “fear” to attack. What do you need to habituated to for a personal preference? Like if I decide my preference in color is blue, what “habituation” has to occur? Nothing. Because it doesn’t bother us. Because there’s no fear attached to it. I’m not performing any ritual. I’m not choosing blue because if I don’t I’m going to die. Your preferences are not OCD. It’s a preference. Honestly I don’t know how else I can explain.

Habituate*

Do you have a contamination fear? I have contamination fear and fear of chocolate. So I was instructed by my ERP specialist to put chocolate on the toilet seat, wait for fifteen minutes and then to eat it and not wash my hands. I had to repeat that three times a day. Maybe you can do the same? Touch the toilet, don’t wash your hands and touch all over yourself, touch everything in your house. In a YouTube video, I saw someone was asked to eat with her hands after touching the toilet.

Without*

Even outside of OCD, I'm not going to habituate to my hand on/in a toilet, so im still confused.

Seems like that wouldn’t be the target of erp then. What is your obsession/feared outcome?

My feared outcome is that if I'm not 100% comfortable with my hand in a toilet or being dirty, then i havent done therapy right, haven't habituated, am going to be sick forever, don't deserve a life where I prefer to be clean & not dirty. I don't even have contamination OCD. What im trying to get at is that I don't prefer to have my hand in a toilet. Take the disorder away and let's just acknowledge everyone for human beings for a second. Because I prefer not to be filthy, I'm never going to get better. Because I prefer my pictures to hang straight on walls, I'm never going to get better. Because I prefer to eat my pizza off a dinner plate & not the raw floor beneath my feet, I'm never going to get better. Because I prefer to watch my television quality in high definition instead of standard definition, I'm never going to get better. Because I prefer the pillow I'm sleeping on right now, instead of a lumpy one, I'm never going to get better. This goes on with everything in life really. It's hell.

No one is understanding what I'm saying.

Crazy.Cat.Lady, go make your pictures crooked on the wall & keep that way right now.

Keep them that way right now*

Umm. I don’t know if you’re trying to be hostile but I’m just trying to help. If you want me to back off, fine. If we’re not understanding what you’re saying then go see a therapist.

Crazy.Cat.Lady would you go make your pictures crooked on the wall & leave them that way?

I did

Are they still crooked?

Yes

Why? Because you like them crooked?

You told me to keep it that way. Are your “obsessions” fear based? You might have OCPD.

No, I'm asking you do you , crazy.cat.lady. prefer your p pictures to hang straight or crooked on the wall?

Simple question. Do you prefer straight to or crooked pictures?

Do you prefer straight or crooked pictures?*

Straight

THIS is what I'm trying to get at. I don't understand why I'm not allowed to hang my pictures straight on the wall, leave it like that & get on with my life. ERP is awful.

Both you & I should be allowed to prefer pictures hanging straight on the wall, no?

It shouldn't mean we are awful people because we like our pictures hanging straight.

“Preferring” something is not the same as “it has to be that way”. Now the “it has to be that way” can be because 1. You have to have it that way. It can’t be any other way. 2. It has to be “that way” or else my mother is going to die. Do you see the difference. The first one is not done because of fear. It’s simply because it looks better or it doesn’t seem right.

No, I agree with you. Where I get confused is that we are supposed to habituate to a crooked picture. This is an actual exposure that it done. My issue comes in that this is not entirely habituable anyway, for I prefer my pictures to be hanging straight. Therefore, if I haven't completely habituated to a crooked picture like I'm asked to, then I'm doing ERP wrong according to how it's process is supposed to work, sit & habituate to the crooked picture, but wait, what if I like my pictures to hang straight? It is confusing.

This is a sensitive topic. Have you been officially diagnosed with OCD? I was talking to someone earlier and I suggested she may have OCPD(which I think that’s what you have) and she identified with the latter. I’m not a therapist so I can’t diagnose you but from my experience that’s what I think. Are you able to see a therapist?

I've been diagnosed with OCD yes.

I've seen multiple therapists. I've actually been able to overcome most OCD themes. Checking for money on the ground, checking the stove, checking my car windows, messing with my television equipment. I'm been able to overcome all of those by stopping the compulsions.

It's when ERP came into my life that s*** really hit the fan.

I’ve been thinking about the frame on the wall. I understand you want to fix it so it’s not crooked. If there’s no fear attached to you fixing it then yes it becomes a preference. ERP is to disconnect your actions from your thoughts. I’ve had checking the stove symptoms and I would do it out of fear that there may be an accident. I used to check, recheck and check some more. I even took pictures to reassure myself. When I applied the ERP I stopped checking altogether after using the stove. Once I detached the fear of something bad happening if I left it on left, I now check the way people without OCD check. I’m curious when you stopped your compulsions the first time, how did you feel? Were you anxious? Was it easy or very difficult?

It was difficult. I didnt really overthink it though. If I could guess, my mindset became "Oh well, maybe the stove is on, whatever." Or "maybe I did drop money, whatever " and I'd move on and the anxiety would decrease when I stopped the checking compulsions. The problem I'm having now is ERP says to drop money on the ground, ERP says to make pictures crooked on the wall. ERP says to leave the stove on & look it for a bit. The thing is, as a person, I really don't want to habituate to these things. I truly, don't wish to, because they go against everything I stand for, but I feel like in order to get better, I have to, like ERP says. Really all I want to do is stop the compulsions. I agree with that. But to make things backwards on purpose and get used to, I refuse to habituate to that, because I am a human being who deserves to live life according to my values.

People say all ERP really is about is stopping compulsions. Experiencing the anxiety & doing nothing, letting it dissipate on it's on. However, the practice of ERP tells a much different, sinister story.

That conflicts with just letting things be . You now must do things backwards in order to get better ... It's very confusing for my mind to comprehend.

I absolutely agree with you. The physical exposure exercises are what confuse me, like making a picture crooked on purpose. Licking the bottom of your shoe. Putting your hand in a toilet & being asked to habituate to all of those things. Even with OCD/anxiety, I wouldn't fully habituate to those things anyway. Does that make sense?

Yeah, I absolutely agree with stopping compulsions. But to habituate to backwards things goes over my head.

It’s not backwards really. When we preform compulsions we don’t allow ourselves to see (that our perceived fear that’s attached to the compulsion) doesn’t happen. So for example, I’m afraid of losing things. I have to make a list of things that I take in my bag. So my goal is to be able to take out my bag without checking. At one point I avoided by not taking anything with me. So I started with what I was able to manage-take my phone only. Then onto the next level. ERP works when you do the opposite of what OCD wants you to do. It’s a paradox. It’s illogical. But it works. I understand it confuses you but maybe you should try “let it be” with your thought of why ERP seems backwards to you. I’ve heard of putting hand in the toilet but not licking the bottom of your shoe. ERP seems extreme but it’s always done in a safe way.

I agree with not performing compulsions to retrain our brain, to make it see that there really is no danger.

I can't agree with ERP though. Putting my hand in a toilet is extreme. I don't even have contamination OCD fears, so why would I put my hand in a toilet?

Putting your hand in a toilet is icky, for anyone.

Right, yet everyone is still expected to habituate to that exposure. (Anxiety goes from a 10, down to a 4, and then eventually disappears altogether). That's what the theory is about. Yet, if I were to go put my hand in a public restroom toilet right now, my anxiety would probably be about a 3 on a scale of 1-10. This is where ERP fails to make logical sense. I should deserve to be a bit anxious about putting my hand in a toilet, because that's icky, yet ERP says I shouldn't be at all.

Same with a crooked picture on the wall. Yeah, nothing horrific is going to happen if the picture is crooked, but I prefer my pictures to hang straight. So, if I were to make my picture crooked on the wall right now, my discomfort level would be a 2 on a scale of 1-10 & my OCD isn't even centered around that. But, according to ERP, making a picture crooked should cause be absolutely no discomfort at all, yet, it would make me a bit uncomfortable to just make my picture crooked for no reason.

& I'm assuming it would you too considering you prefer straight pictures hanging on the wall too.

I agree with you mostly. I just think therapy should be focused on attacking the obsessions & compulsions to help the sufferer recover. Not habituating to things that go against their character/things they wouldnt habituate to outside of OCD.

You need to realize what your intentions are. If you are straightening it because you like it then you’re not performing a ritual. But if you have an intrusive thought and try to reduce that anxiety by straightening then yes. When you said “nothing horrific is going to happen”, did you say it without the fear or despite having intrusive thoughts you’re rationalizing and know it’s illogical.

And unfortunately, exposure puts patients in a box where they can't be individual people with different likes, interests, preferences, etc.

I'll always be for resisting the compulsions though. Compulsions absolutely fuel the fire for OCD.

& in my opinion, in order to really recover, we have to drop our compulsions.

It’s fine if that’s how you feel. You’re entitled to how you feel. But obsessions are thoughts/images which can’t be attacked. You can’t fight and get rid of it. It’s to ignore or just let it be. Accepting the thoughts as thoughts and nothing more and if you can accept the intrusive thoughts and see it as just a thought and therefore control yourself not to do the compulsions then that’s great.

"It's to ignore or just let it be." So, you agree that the only way out is to sit with the anxiety&thoughts & let them be?

I agree with that.

Exposure is not that.

I agree that obsessions can't be fought against. It'll only make things worse.

But not fighting against obsessions is not exposure. I prefer to have my pictures hanging straight on the wall. I prefer my house to be tidy. I prefer horror movies over comedy movies

As long as you don’t attach any meaning to what you do. Like if it’s purely because you want your house tidy and not clean to the point where you yourself are covered in bleach. If pictures hung straight is aesthetically pleasing and not because “something bad would” happen then it’s completely fine. You’re not doing it for hours and hours.

Meanings*

I agree with you . This is where ERP fails to make sense to me though.

ERP doesn't take people's preferences/interests/likes/values into account. It tosses them out the window like that person isn't allowed to be human. Sit with a crooked picture on the wall until you habituate? Ok, but what if we find it aesthetically pleasing for a picture to be hung straight. It's over and done with, move on. But ERP doesn't allow us to hang our pictures straight

Thanks for talking with me though, even if we aren't seeing eye to eye. Sorry if I sound frustrated. I am in a way, but I know that isn't your fault. Thanks for your advice. Good luck in your recovery :)

I understand your frustration. I’m sorry I couldn’t explain better. Thank you, and I hope you find your answer :)