Over-control of details in the environment, schedule, or in one’s person, is a compulsion. This compulsion is a defense response from a fear of being unsafe. These people are labeled by those in their inner circle as “micro-managers” or “very particular.” In OCD treatment, we let go of one thing at a time, until many things float outside the circle of management/control.

For most of us, OCD is far more entrenched than we even realize when we begin treatment.  Exposure homework gets avoided week after week, and our clients’ progress is slow.  Regular repetition of therapy exposures is the quickest path to healing!  At-home exposure coaching basically helps adults and children actualize the goals of therapy between sessions.  

While I encourage everyone experiencing OCD to match with an Exposure Response Prevention (ERP) Coach and Therapist to begin their healing journey, some may benefit from trying out some self-directed exposures to understand the basic principles of ERP.

A common homework challenge for Exposure Response Challenge is compulsion breaking around cell phone use. While most modern humans have some over-checking with their phones, those of us with OCD can have critical anxiety behavior that revolves around this otherwise enjoyable device.

Many folks with OCD struggle with any potential for lateness. Some are chronically late due to compulsions needed to leave the house, but most deeply fear the shame of arriving somewhere even a minute or two late. Exposure Response Prevention can help.

Exposure therapy originated in the treatment of simple or specific phobias, which means a marked fear around a certain object or situation, such as a needle, an animal, or flying. When confronted with these feared objects or situations, clients tend to experience panic.

In treatment for Obsessive Compulsive Disorder, we explore many avenues for exposures to reduce distress around our client’s fears. One interesting technique is known as a “loop tape.” This exposure is basically an audio immersion to your greatest fears.

For treatment of Obsessive Compulsive Disorder (OCD), exposure treatment can come in many creative forms. In some cases the OCD fear is based on an imagined outcome, and an in vivo (live in the therapy room) exposure is not possible. This is especially the case with dangerous or horrific intrusive thoughts. In this case, we may use a written exposure to desensitize our client to their terrible thoughts.

Sometimes a therapist cannot set up in vivo exposures either in the therapy room or as homework. Sometimes an in vivo exposure would be too dangerous, too extreme, or simply not viable. In these cases, an imaginal exposure is the next best option.

OCD (Obsessive Compulsive Disorder) can be understood as inflammation of our amygdala – the part of our brains that responds to threat. When we suffer from OCD, many safe things can feel like dangers. Part of us can shut down to the outside world to avoid our triggers. So, what if the world demands vulnerability and our OCD fights back to mitigate uncertainty?