How can someone get their anxiety down enough to do exposures without medication? . . . There’s no one-size-fits-all approach to this, but therapists will often work with their clients to design exposures that are achievable before gradually ramping up the intensity. Exposures themselves actually increase anxiety before it decreases over time. But if someone is already so anxious that they can’t begin to do exposures, they may want to consider revising their treatment plan with their therapist (or starting to work with an OCD therapist if they haven’t already). Working with an OCD therapist can help you better understand the long-term benefits of facing your fears through systematic exposures. It will also provide added motivation to endure the increased anxiety that initially comes when you are actively resisting your compulsions.

I find while doing exposures, rarely does my anxiety lessen. It usually amps up and stays that way for the remainder of the day. I could be having a fairly decent day, but dutifully do my exposures and then the rest of my day is anxiety filled. I guess that’s just how it is now? Also, I’m wondering if my therapist even believes I have OCD. I totally understand my therapist cannot provide reassurance. But it’s to the point it seems my therapist acts like I actually did the thing I fear. I feel so isolated.

This is my first time posting - I have a fear of throw up and I’ve been told it is cause from my OCD (repetitive thoughts) which makes sense because if someone gets sick it replays over and over again and I can’t get it out of my head. It’s gotten a lot worse in the past maybe two years. I’m always on edge that someone is going to get sick around me. I’ve heard the “best or most common” way to help with this is exposure therapy and OBVIOUSLY I don’t want to do that. Anyone have any tips or anything for this (or maybe have done the exposure therapy)?

So I've been working to address my OCD for about a month now. So far, I haven't been working on it with a therapist and have instead been trying to create my own exposure exercises. The primary obsession I'm working on is the fear that I'm somehow flawed or invalid on a fundamental level. The best way I can describe it it is that its similar to the feeling you get when you have germ OCD and you feel contaminated, except my whole existence and being feels contaminated, so to speak. I've identified a list of triggers, and a list of compulsions (pretty much all mental) that I've noticed myself performing. I started out by doing imaginal exposures and scripts where I'd write out triggering fictional scenarios and read them over and over, combined with mindfulness techniques to focus on my breath and bring myself back to the present when I noticed myself performing compulsions mentally. At first it worked to some extent, but eventually I started to feel like the stories I was writing about this obsession weren't triggering any anxiety anymore or a very low level. So I stopped reading them and focused solely on improving my ability to stay present and identifying compulsions as I perform them, and disengaging. Now, I'm at the point where it seems like my general anxiety levels throughout the day are lower, and the triggers I've identified are producing noticeably less anxiety. But that makes me wonder if somehow I'm just secretly doing mental compulsions without knowing it? Is only a month of rather disorganized and unstructured ERP enough to produce this much improvement? To avoid giving me re-assurance, I'd appreciate if you guys don't directly answer those questions, maybe just provide some possibilities or your own experiences so I can get a better idea of where I'm at. Any info would be appreciated. Thanks!