OCD is a really manipulative teacher. It’s taught you to perceive things certain ways and to attribute comfort and safety with behaviors that are either a) useless or b) way too extreme. We’re here to shake things up! Exposure and Response Prevention is just doing things that run counter to what OCD has taught you. OCD says these thoughts are dangerous? Well, let’s purposely bring them up! OCD tells you to avoid those objects or people? Get closer to them! OCD’s convinced you that you’re going to do something terrible? Let’s do things to make that scary scenario more likely.
You can go slow and steady here— as long as you’re going! Think small chunks— if an action feels too challenging, what can you do to make it easier?
Here are some examples:
Big Goal: Cooking a meal using sharp knives
1. Stand in the kitchen without touching anything
2. Stare at knives in the kitchen
3. Place butter knife on table in front of you
4. Hold butter knife
5. Hold sharp kitchen knife
6. Hold butter knife while someone is in the room
7. Hold kitchen knife while someone is in the room
8. Chop something using a butter knife while alone
9. Chop something using a kitchen knife while alone
10. Chop something using knife while someone is in the same room
See how exposures 1-9 are all leading up to the 10th exposure? These steps are all ways to build that confidence, experience mastery, and completely eviscerate what OCD has convinced you is the gospel truth.
And we’re going to do this all while tearing down OCD’s goon squad AKA compulsions and safety behaviors. If you’re able to outright resist compulsions completely while doing an exposure, then fabulous! Keep going! If the urge feels way too strong at first, then keep reading!
Here are ways to approach response prevention with some examples of compulsions:
- I want to check my emotions and thoughts to make sure that I’m not feeling urges to hurt others. I will delay this process of checking until 3 hours from now, and when that time comes, I’ll take that opportunity to see what actually happened when I didn’t check.
- I realized that I’ve been trying to figure out if I’m a violent person for the last couple of hours. I can remind myself that I can’t have 100% certainty about the future, even if I spent the rest of my life thinking about this.
- I usually wash my hands in a very specific way. I’m going to skip a step in this compulsion so I still feel contaminated.
- I asked my partner for reassurance, and they gave it to me. I can remind myself that they don’t actually know any more than I do.
This sounds super counterintuitive, but remember— OCD wants to win, at the cost of your life. Achieving recovery from OCD can feel daunting, but step by step, I believe you can get there!