How to Design and Implement an Exposure for Anxiety or OCD Treatment
While it is ideal to work with a dedicated therapist for your OCD and Anxiety treatment, some people need to begin or continue the process outside of formal therapy. Fortunately, the design of an exposure can be a learned skill.
The first step is to isolate a trigger, and the compulsions that you wish to target.
A trigger can be a situation, a person, or an event, such as a first date. The compulsions are unhealthy behaviors or thoughts in reaction to that trigger. It is important to remember that OCD compulsions can be both physical and mental. The most common compulsion is avoidance.
If we continue with the example of social anxiety for a first date, the trigger is the date, but the compulsions can be multiple including, but not limited to: rumination, canceling, reassurance seeking, checking, over-preparing, etc. It is important to isolate the rituals being done, because exposure to a trigger without ritual prevention (the RP in ERP) is not going to provide results.
Once you understand what your fear-blocking behaviors and reactive rituals are, you can practice imagining the trigger and then refraining from the compulsions.
For example, we can picture a first date, or even write out a script of a first date, and allow ourselves to sit with the anxiety being generated by our thought experiment.
In clinical terms, this is called an imaginal exposure, and can be quite a powerful first step up the fear ladder.
Next, we bring the fear/trigger into reality. We actually arrange a first date and rather than try to neutralize the fear inspired by the date, we lean in. Remember anxiety can be utilized for healing – if we can bring up the anxiety, then train ourselves not to fear this reaction, we slowly reprogram our brains.
As we are implementing our exposure, we must ask ourselves some check-in questions. While a typical exposure evaluation may ask 1-10 or 1-100, how strong is the anxiety, a more nuanced approach asks open ended questions like the following:
Where in my body am I experiencing the anxiety?
Am I able to sit with this anxiety without trying to neutralize it?
How can I lean into this anxious feeling and not work to escape it?
The key to a successful exposure is to not try to prevent this anxiety, but to, in fact, embrace the anxiety!
Truly, so many unnecessary limitations in our lives come from trying to avoid anxiety.
As modern humans, we have become masterful evaders of anxiety, and the post-exposure experience of simply being with anxiety is a priceless learning tool. Anxiety does not equal harm.
As we sit with our anxiety, the temptation will be to then do mental self-soothing. The key is to notice which of our mental “tricks” are healthy, adaptive techniques, and which are mental compulsions.
Remember everything can become a compulsion if we feel a “need” to do it, even something as nourishing as a bath, or as wholesome as praying.
The final important point to remember as a self-exposing client, is that you do not have to do this alone! Many people who formally suffered from OCD are now thriving and paying it forward! Do not hesitate to reach out to others with OCD through support groups, coaching partnerships, and therapy.
To find out more about the groups, events, and individual OCD treatment we offer at Kairos Wellness Collective, please inquire today!
