Exposure Scripts For OCD
"Exposure Therapy, in a phrase, is the systematic and intentional triggering of fear while minimizing- and ideally eliminating- all pathological responses.
Imaginal Exposure accomplishes this with thoughts and ideas. It is done in the context of addressing unhelpful/pathological responses to fear." The first thing we do besides offering good education is gaining a strong assessment data- it must underlie good exposure.
Know what you’re working with. Make a list of your obsessions or bothersome thoughts. See a specialist. Get educated. Get to know your symptoms, your motivations for getting better, and start a running log (monitoring) daily.
Once you have a tally of key examples, placing them on a hierarchy really helps to get a road map and be realistic and also to monitor progress (like the one above for arachnophobia). Once you’ve got your hierarchy, we consider conceptualizing the core fear behind an uncomfortable thought or action.
Start simple; don’t overthink it. Once a person can tolerate facing their fear at a lower level with scripting (or exposure in general), they can then move up the hierarchy and face higher and higher ones. Don't worry if you run into issues- that's what specialists are for! But also don't hold out from facing fears that you have a good reason to face.
How to write an exposure script for ocd
Exposure story for OCD
How To Stop Compulsions with OCD
How many things do we do in our life because “just in case”. Our brain comes up with an idea of “something bad” happening and we tend to follow it up with….well just in case, I’ll do this behavior. I want to talk about the traps we can fall into when we use “just in case” when it comes to OCD and anxiety.
So if you really think about it, this just in case mentality is the root of a lot of anxiety and OCD. Most people are not doing certain compulsions because they know a hundred percent no doubt in their mind that the thing they're scared of is going to happen. They are doing these behaviors because they want to prevent something that they don’t know could happen.
For instance, those who may struggle with contamination OCD wash their hands just in case there are germs or contaminants.
Those who struggle with sexual orientation OCD might ask for reassurance again just in case the person didn’t understand them correctly.
Someone who struggles with relationship OCD may just end the relationship just in case it was never meant to go anywhere.
Someone with real event or false memory OCD may spend a lot of time ruminating, their thinking through all these different types of scenarios just in case they find some new evidence to what they’re thinking.
These just in case behaviors keep people trapped in their OCD. And what I want is for people to turn this all away around and say just in case my theory is wrong I’m willing to risk it. Risking it means they are using exposure and response prevention. This is something to think about when you are going through your OCD topics or themes. You think about your motivation for why you are doing whatever you are doing. You can follow it up with I’m doing this just in case ….. -- if there is even a just in case there and you know it’s part of your OCD this is a moment to step back and say I am purposely not going to do this behavior or this compulsion.
Because what the brain needs to learn is that you are saying I’m going to fix this before there’s ever a problem. The problem that doesn’t happen in all the brain knows is that you had a lot of control over the outcome. This can be completely false because in reality, you may have not had any control. The brain doesn’t know this, this is your job to teach it. The only way for it to learn is for you to not do the compulsion to respond differently to the thoughts and fears.
Because what happens is that when your brain says This thing five times or a family member will die. You choose not to. You see that the outcome most likely doesn’t happen. When it doesn’t happen it starts correcting the brain and retraining it to say, hey you completely lied to me. You said I had to tap five times, and nothing happened. Maybe it’s time for you to stop lying to me.
Your brain congratulates you for taking care of the just in case moments. Of course, we can never be 100% sure that these bad things will never happen in your life. But that’s not the point, the point is that you may need to risk that the fear in your mind may happen but it’s not because of any compulsion were not doing a compulsion.
So the next time your brain says just in case. Look around you, if you don’t see immediate danger then you may choose to make a different choice, you may learn to sit through the anxiety, not ruminate through it, not do any other compulsion…. And see what the outcome is. You may be surprised.
So here’s my question for you, what just in case things do you do?
Stop What if with ocd
Just In Case with OCD
How To Stop Ruminating with OCD
Rumination and OCD
This video is a long time coming. Let’s talk about rumination. Do you know what rumination is? I would say most, If not all individuals who struggle with OCD ruminate. The official definition of rumination is “the action of chewing the cud”……
Wait, that’s not it. How about this. “a deep or considered thought about something.” That’s better. We can all be in deep thought from time to time. It can whisk us away from the present moment. It can distract us from noticing the surroundings around us. Some have said that rumination is often considered to be a silent mental health issue. No one can see what’s going on except the person. They often don’t know the harm they may be causing themselves because of this rumination.
But why would thinking something very deeply be an issue? Well, it only tends to be an issue when it actually starts interfering in a person’s life. When it comes to anxiety, rumination is essentially a way for the individual to gain answers and problem solve whatever they’re feeling anxious about. It’s trying to problem solve the future. Trying to problem solve the “what if’s”.
If you think about yourself, are you ever able to actually come up with a good answer to the things you are ruminating about. I would guess the answer is no. Because we think we have a good answer, we react as if we have a good answer, we do behaviors assuming we have a good answer, and in the end it ends up being different than what you thought.
Rumination is a huge part of obsessive-compulsive disorder. Individuals who struggle with this often are looking for certainty. They want to know for sure what they are experiencing is true or not. If there really that type of person or not. If they would really do that thing or not. If that catastrophe in the future is going to happen or not. Rumination is thinking about all these things. Thinking about your specific topic or fear when it comes to your anxiety and OCD. Often rumination is just trying to figure out if what you are experiencing is OCD related or not. It’s problem-solving through what your brain says is a potential problem.
Here is an example: somebody you may experience contamination OCD may attach to door handle. Their brain has attached meaning to this. Here’s the rumination and what my sound like: “ I can’t believe you just touch the door handle. Do you have any people touch the door handle? What if somebody was sick that touched it? Do if you touched your face or no after you touch the door handle? No is probably okay to touch it. But if it’s not okay then I’ll get sick. I get Sick, then I won’t be able to go to work. If I can’t go to work, then how am I going to support my family. You know even though it’s probably fine, you should probably wash your hands just in case.
The person goes to wash their hands.
I know you washed your hands, did you know if you touched your pants afterwards? I know you trust your phone is a something you probably need to wash? How about you just change her clothes just in case. Well I know now you just kept yourself safe, but did you see that your child just touched the door handle. What things did they touch. Maybe need to go ask them, wash their hands change their clothes washed the door handle.
As you can see, this person is problem-solving they are doing just in case behaviors. There trying to think through it and prevent whatever the fear is from happening. Often I see rumination as very automatic. It will throw out these threats to you as quick as it can. If you go down this road and problem solve or think through the situation. You are doing a compulsion.
The compulsions are the things that are keeping you trapped. All your brain knows is that you may have saved yourself from whatever fear it says was going to come your way. It is a liar. You cannot think your way through your fear.
I say don’t engage with rumination. Do not give it any power whatsoever. This is a very tough task. But here are some tips you can use. Making sure you give your brain the same answer every single time it threatens you. It says you hit someone with your car are you thinking through this whole situation. Your answer is maybe I did maybe I didn’t. Some choose to agree with the threat to take the power away. They may say, sure I totally have someone of my car.
I can only imagine the OCD screaming you just gave it that answer, that you agreed with it. Are you sure you actually love your partner? Maybe I do maybe I don’t. Are you attracted to somebody of your same gender? Maybe I am maybe I’m not. Will I harm my child? Maybe I will maybe I won’t.
There is not a topic or theme you cannot use this phrase with. Everybody thinks their special and that their specific topic or fear does not apply. To help you not ruminate, it’s committing to not engage by giving it the same answer every single time. Even if it feels real, even if you feel like this one’s different.
Some choose have different catchphrases. That’s not my thing. Sure man totally. Thank you for your opinion.
These statements need to be followed up with not engaging in the compulsions. The individuals that do the compulsions are not really committed to the maybe maybe not’s that they are saying. Because you cannot say maybe maybe not, and then go wash your hands because you’re just not sure. Or avoid the knife because you’re just not sure. Or go back and check to make sure you did hit a pedestrian because you’re just not sure. Ask for reassurance again because you’re not sure. That is the whole point. You need to be unsure. Being unsure on purpose as a way to stop the rumination.
One of the first parts is recognizing that you’re even ruminating in the first place. You might think about what is my reasoning for thinking through this right now. Am I just genuinely curious, or do I feel this urge for this need to figure out this answer right now. If it’s the urge, you’re not gonna do it, you choose not do it. Is actually your choice. The thoughts will start coming in that’s the automatic part, but you engaging with them is completely your choice. Give yourself that power.
Did you know that I created a very specific course for OCD. It takes you through understanding yourself, the treatment and a way to maintain your progress. We talk about rumination, hierarchies, exposures, writing scripts so much more. There are over 41 videos in this thing. I’ll link it in the description. You can preview you it for free.
Do you ruminate? What do you ruminate about?
Overthinking and OCD
Nathan Peterson, LCSW
OCD can be tricky! I want to provide useful information for your OCD, anxiety, tics, tourette's, BFRBs, and many other anxiety related disorders.