I think Dr. Michael Greenberg is spot on with OCD treatment. It makes more sense to me than anything else. https://drmichaeljgreenberg.com/articles/

I was just thinking about how OCD tries to be tricky and switches themes on us!! The amount of times I have said to myself in the past, IF ONLY I HAD THE OLDER THEME I USE TO WORRY ABOUT BECAUSE THIS NEW ONE IS SO MUCH WORSE!!! Has anyone ever experienced this before? Once I started ERP therapy, I began to really start understanding what mental/physical compulsions I was doing to really keep my OCD alive! While I did this, I would also tap into my self-compassion bucket, even when it felt like it was dry at times, because it was SO easy to judge myself for because of the sheer presence of my thoughts. I would also have the most self-compassion for myself for those taboo intrusive thoughts that really felt so strong, ego-dystonic and real!!! My OCD would hop around from theme to theme and just when I thought I figured it out (compulsion) it would hop again and make me discouraged! I noticed for me that once I really understood my compulsions, it didn't matter when the theme switched as I could tackle it at its core. If I was able to stay steadfast and resist compulsions the best I could, I started to notice that my CONFIDENCE increased in the long run! I also noticed that some of the core fears were the same for different OCD subtypes. OCD treatment is hard BUT living with OCD is harder. I have experienced subtypes including Harm OCD, ROCD, Moral Scrupulosity, Sensorimotor, Contamination, Perfectionism/Just Right, Hit and Run, Magical Thinking, Real Event/False Memory. ERP therapy allowed me to really work on stopping these compulsions and switching from theme to theme. I was fed up with what OCD took from me and I needed to do something about it. I talked to an ERP therapist and it was one of the best decisions of my life. If you are struggling, keep pushing and get the help you deserve!! You got this!!!

I realize this may not work for everyone, particularly those who are struggling with moral or existential forms of OCD, but as someone struggling with relationship OCD, here’s my proposition and what’s worked- 1. ERP and resisting compulsions involves intentionally exposing yourself to distress and not trying to do anything about it, but just sit with it. It is a fundamentally ascetic and meditative practice. 2. Resisting compulsions also means overcoming your bodily desire (because more than anything OCD is a nervous system response, not a rational one) for relief from distress, and instead aligning yourself with a higher principle that overcomes your temporal state. 3. OCD also operates similarly to addiction, and recovery outcomes for addicts are significantly improved through belief in a higher power. Higher power is actually one of the core elements of AA programs because it makes self discipline a lot easier. 4. ERP/CBD is effective, in part, because it already fits within the psychology of someone with OCD. What I mean by this is that it involves homework, specific procedures done at regular intervals, intense self discipline, and is overall pretty formulaic/ritualistic/somatic in nature. And we know that it works, and this method of addressing OCD tends to really excite and appeal to those who suffer with it. We act like the totality of OCD psychology is bad, but it also seems to be the key to reversing OCD, and may be a kind of superpower when properly utilized. 5. We have countless religious traditions that are thousands and thousands of years old which have developed techniques and rituals precisely for what OCD recovery needs- Getting out of a reactive state, getting into a state of gratitude and meditation, developing ascetic skills to overcome temptation (compulsions), being okay with uncertainty, creating a place of inner peace and compassion, having a system of accountability and reminders which keep you from slipping back into compulsive patterns, and doing all of this in community with people who experience the same struggle. So far, religion has been *the most* helpful thing I’ve done for my OCD. Here’s how this has played out in my own life: -Hesychastic prayer. This is an Eastern Orthodox tradition where you project the Jesus prayer, in repetition, channeling it not just from the mind or mouth but from the heart. It is deeply psychosomatic, with the goal of creating ego death and achieving a state of seeing God in all things. It creates a calm, warm feeling in my chest that feels identical to a psychedelic afterglow. It takes me out of my head and into my body, and the first time I tried it, with a prayer candle lit beside me, I experienced very rapid relief and was able to sleep for the first time without having any nightmares. I now do this consistently, along with other kinds of prayer and hymn recitation, and gratitude before meals, and it’s something I genuinely enjoy and look forward to. Since doing it, my compulsions have gone done by like 70%. Every time I feel myself slipping into compulsions, instead of doing them, I pause and pray. Prayer fills me with warmth, gratitude, and comfort. I feel connected to something greater than myself, my body becomes calm, my heart stops racing, and afterwards, I no longer feel compelled to perform my compulsions, because I know that it is harmful to myself and those around me, and that God is watching over me guiding me to act in a more thoughtful and wise way. This has single-handedly brought me more long term relief than any other OCD technique or treatment has. Not only has it relieved my OCD, but I have so much more energy, motivation, and self discipline in other areas of my life. It’s like I can feel my neurochemistry balance itself in real time. I’m eating healthier, my relationships are richer, I’m a better student, I feel more creatively inspired, and I have so much more self discipline to resist habits that are bad for me. I hope this may be helpful to anyone else who might be struggling. I’ve searched online and there’s really no information out there that I could find on religious ritual being an effective OCD treatment, but it’s been completely revolutionary in my life.

I had just posted a summary of ERP for a group member, and I thought it might be useful for everybody. Here it is below (with a little extra added)…. ERP therapy is researched-based. Most other therapies don’t work. There have been people who have been literally stuck in their houses (from their OCD) who gained their lives back through ERP therapy. NOCD does ERP therapy exclusively. You can find it in other places too, but you have to ask around. There are two tenants of ERP therapy: The first one has to do with the repetitive thoughts inside our heads. These thoughts are actually defined as “obsessions”. You are not supposed to do anything with the obsessions. You are supposed to let them run through your head freely, without trying to fix them or stop them. Imagine a tree planted by a river. The leaves fall off and float down the river. You can see the leaves falling, but you don’t try to stop them or pick them up. You don’t try to fix them. You just let them float away. This is really important to do with your obsessive thoughts. The more you try to fight them off, the worse they get. I used to have blasphemous sentences running in my head 24/7. I felt like I had to put a “not” next to each sentence in order to “fix” it. But this just took hours of my time every day, and it was very scary, because I was worried that if I messed up, that I would go to hell. It was very freeing to learn later that I could just let those sentences run freely through my head without trying to fix them. The second part of ERP therapy is all about “denying your compulsions.” Every time OCD tells you that if you don’t do things a certain way that something really bad will happen, that is a compulsion. Once you recognize what your compulsions are, ERP therapy will have you practice stopping doing all of those things. For some people, that will mean stopping washing their hands or touching lights switches or, in my case, putting “fixing” words in their head. Compulsions are safety behaviors. During ERP therapy, you will practice stopping engaging with safety behaviors. All this is very hard to do and scary, so during therapy you will be given tools to help you deal with the fear. Often ERP therapy will take people from being non-functional to functional. I highly recommend it. ————————————————- PITFALL #1: After you have been doing ERP for a while and become somewhat successful, the OCD will try subtle little tricks to bring you down again. The first one is to tell you that your thoughts are REAL and not OCD, and therefore you can’t apply ERP therapy. Don’t fall for this trick! All thoughts are just thoughts. They are all meaningless. Don’t try to figure out what is real and what is OCD. Just treat all thoughts with ERP therapy. PITFALL #2: The second pitfall is that OCD will tell you that you can’t move forward unless you have absolute certainty that you will be safe. Hate to tell you this, folks, but there is no certainty in life. You will never know for SURE that you or your loved ones will be “safe” from the OCD rules. Therefore, you have to move forward in the uncertainty. It’s hard, but it gets easier with time and practice. We got this, guys !!!!!!