I still havent had my first therapy session but I have been writing down my fears and triggers and at first that felt good because I was finally organizing the chaos in my brain, but I am still having episodes usually before I go to sleep and when I wake up my thoughts race the most. My obsessions have had many themes one of the themes that scares me the most is existential. I have kind of suffered with that theme since I was little, I just didn't know what it was. Before bed in middle school I had these rituals of I had to say good night and i love you multiple times and I had to be the last one to say it to my family in case when I woke up they died that way I could fall asleep knowing that I was the last one to say I love you and I would have no "regrets". Now that I have moved back home for the second time (once at 23) and now again at the age of 28 all of those fears and other obsessions have come flooding back into my head with an intensity I haven't ever experienced before or at least since I was a tween/teen. I guess for me lately just being alone with my thoughts in the morning and night is a big trigger. I start to wonder about what I will do the day I die what that experience will be like and how I won't be able to handle it and that when I cry out for my mom to make death stop that I will just have to allow it to happen to me to wash over me and accept it without anyone by my side to help me through it. If this thought gets intense enough my heart beats loudly, my head feels like its pounding, and I start crying and even shaking sometimes. Because of my magical thinking I am too scared to even write down some of my other thoughts and fears because I feel like that will make them more true but also because of shame. If the episodes get really bad I start crying and shaking and I run to my mom for reassurance, or I try to suppress the thoughts by listening to a video of someone saying it is going to be okay. So yeah I guess avoidance and reassurance have been my biggest compulsions in my life with a bit of magical thinking (knocking on wood, praying, saying words in my head to self sooth, deep breathing, or even trying to physically shake off the feeling or thought if it has been bad enough, wishing on 11:11 for good luck and a better future, or saying oh god out loud or repeating to myself "I can't" as a signal to my brain that I can't do this right now brain please stop). I was wondering if anyone else experiences intrusive thoughts with very little physical triggers and more just intrusive thoughts that you feel you have to fight at random, but especially when alone like at night and early in the morning. It's hard for me to know what to expose myself to, in order to help me with my existential themes about death because the thoughts happen on their own, and death is inevitable so I can't tell myself this fear is something I will never have to deal with in reality but I also don't see death everyday the triggers feel more like when my mind is trying to be still or forced to be still my OCD floods my brain with all my fears so I can't "just be". What have people found helps with existential and death obsessions? In terms of erp and cbt?

"Pure" OCD

Fathomable

Date posted: 5y

Well, the biggest ERP I know is to deliberately imagine your own death, not the circumstances in particular, just the fact of it happening and not being able to do anything about it. It makes your adrenaline go up, but you're supposed to stick with it and keep imagining the same thing, and accept it layer by layer as all kinds of anger and grief and feelings of helplessness come up. The key here for you would be RESPONSE PREVENTION. You HAVE to be experienced with deliberately, mindfully refusing to start obsessing when triggered, and redirecting your attention away from your obsession if it has started already. The death rehearsal meditation is designed to help you come to terms with your own death as a part of you and reduce anxiety about it, but you need to be able to focus your attention on the physical sensations of your emotions and accepting that they're happening. For example, you're doing it and a thought pops up about how devastated your family would be, so your job is to let the feelings of despair caused by that thought, just happen, without trying to do anything like imagine different scenarios or think of ways to prevent that from happening. In fact, this is what you need to do with existential/death OCD anyway. Less allowing your brain to go off on these runaway trails of imagination which are all designed to alleviate the discomfort you feel about not knowing how or when or if you're going to die. When you find yourself imagining situations and looking for something to help you feel better whenever you're reminded about death, you need to deliberately stop doing it. Identify your mental compulsions and do not so them. Every single one of us is 100% capable of doing this, and the more often you do it, the easier it becomes, like strengthening a muscle. You let the fear be there, both physically and as an unanswered question, without doing a single mental thing to attempt to get rid of the anxiety or answer your fears through imagining ways out or potential futures. Eventually the physical part goes away, and all of a sudden the unanswered fear question is a lot less tempting to start looking for answers and solutions to, so you can get back to doing normal things with your life and thinking-time. You've already got plenty of exposure going on, you're triggered all the time. Any time you start thinking about it, it's because you've been triggered and that IS the exposure. If you're obsessing, that meant the exposure part is already done. All you have to concentrate on is response prevention, which is VASTLY more important than the specific methods or exposures used to trigger you.

Anonymously

Date posted: 5y

thanks so much for unpacking that for me, i definitely will try this tonight when im alone with my thoughts 🙏

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