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OCD - Obsessive Compulsive Disorder/Some questions about exposure...

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Question
Hi... I have three related questions about exposure if you don't mind.
I've read about it on wikipedia, but some things are still not clear to me.


Can I do exposure on my own... without a therapist?
How do I know exposure is working?
Would meds be easier?

Answer
Hi Jeff,

thanks for your question.

You asked: "Can I do exposure on my own... without a therapist?"

I'm going to assume you mean exposure as applied to ERP or Exposure & Response Prevention - a commonly applied treatment process in OCD. Exposure can be a long process and takes a lot of determination and commitment. A therapist qualified to guide you through ERP would probably be optimal. Doing it by yourself often leaves you unmotivated or feeling helpless. A therapist will give you greater guidance and greater accountability to stay on track!

However, that is not to say you cannot do exposure on your own (or with the help of family members). If you've got the determination and discipline, then it can (and has) been done. But you'll want to arm yourself with as much knowledge as you can first - this may mean consulting a therapist initially, reading books on OCD and ERP (especially self-directed ERP), or finding helpful websites (like this one, of course). And don't forget that the "Response Prevention" part in ERP is equally as important as the "Exposure" part. Exposure will be useful to you in treatment, but alone it is not much effective in OCD if you're simply ritualizing while doing it, (or indeed, after it).


You asked: "How do I know exposure is working?"

Exposure is based on the proven principle of habituation. This means that if we get used to something that is anxiety-provoking enough, we will steadily get used to it (in most cases). You will often feel the decline, and indeed you are aiming for the decline, of the anxiety during an exposure session (not by ritualizing, but just adjusting to it). This may take 30 mins to an hour or more, and it may depend on the individual. Make sure you do exposure gradually, and don't do something too anxiety-provoking to begin with - it's easier and smoother if you work your way up. Try to be as patient as possible because it may take many attempts.

Additionally, another sure way to know it's working, is to record your progress. In order to do this, you will need to make an anxiety scale of your particular obsessions. There's a few ways to structure this, but a basic way is just to make a score out of 1-100 (or 1-10), as to how anxiety provoking you think the exposure stimulus is, and write it down so you can review it. Rate it before and after exposure sessions, and monitor whether your anxiety begins descending over the coming days/weeks/months. If all is going smoothly, you will begin to notice that it causes you less anxiety and for less amounts of time.

You asked: "Would meds be easier?"

Medications can be effective, but they're typically considered inferior to ERP (and other more efficacious OCD treatments), when taken on their own. Medications may require less effort on your part, but they also have side-effects and may not treat your problem as successfully in the long-term, particularly when you decide that you want to discontinue them. Your body may also become less responsive to medication as time wears on, reducing its effectiveess.

ERP is a great treatment for OCD and is typically worth the effort necessary to reduce your anxieties on a much broader scale, and ultimately lead to a healthier & happier life.

I wish you luck in your endeavor.


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OCD - Obsessive Compulsive Disorder

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Alan Baker

Expertise

I can answer questions relating to OCD, such as:

*Washing
*Checking
*Order & Symmetry
*Contamination
*Health
*Harm
*Sexuality/sexual
*Gender Identity
*Magical thinking/superstitions

Please note: I can not give you a diagnosis or give you medical advice. I also do not offer therapy or counselling. I advise you to see a doctor or mental-health professional for appropriate treatment of OCD.

Experience

I've been a research associate in clinical psychology, written numerous essays on OCD diagnosis & treatment, and been quite active in the local OCD community (as we do group-therapy and workshops). I also consider myself an ex-sufferer of OCD.

Education/Credentials
B.A Science
PGDip Applied Psychology
Social Work

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