Taylor Newendorp

How can someone get their anxiety down enough to do exposures without medication? . . . There’s no one-size-fits-all approach to this, but therapists will often work with their clients to design exposures that are achievable before gradually ramping up the intensity. Exposures themselves actually increase anxiety before it decreases over time. But if someone is already so anxious that they can’t begin to do exposures, they may want to consider revising their treatment plan with their therapist (or starting to work with an OCD therapist if they haven’t already). Working with an OCD therapist can help you better understand the long-term benefits of facing your fears through systematic exposures. It will also provide added motivation to endure the increased anxiety that initially comes when you are actively resisting your compulsions.

How do I stop reacting to my thoughts? I feel helpless because I have a constant need to reassure myself. . . . I realize that your thoughts can be so overwhelming that you would do anything to stop them. The cycle of obsession-anxiety-reassurance is exhausting and can pull us away from the things we truly care about. Remember though that these thoughts are just your OCD and aren’t a reflection of who you are. But reassurance-seeking is a compulsion, and there are ways to unlearn our compulsive behaviors. One strategy is “doing nothing.” Don’t even take a moment to acknowledge the thought (or feeling or sensation) has occurred, and simply persist through the activity you’re in. Ignoring thoughts is similar to one of the main goals of OCD treatment: becoming able to experience thoughts without reacting to them. But, in and of itself, it’s a very difficult thing to do; and if it comes in the form of avoidance, it might be counterproductive. Similarly, you could take the exposure-based approach of purposely thinking the thought and “welcoming” the thought while resolving not to check. If you’ve worked with an OCD therapist, you might be familiar with the concept of exposure and response prevention (ERP). This means you’re not using any compulsions when you feel anxiety kicking in. Developing strategies for response prevention takes time, and there are no simple answers. Although ERP is the most effective type of therapy for OCD, it can’t work without the response prevention part. If we’re not preventing ourselves from temporarily escaping anxiety, we can’t learn how to do anything else. In general, once they’ve designed some response prevention strategies together, therapists may ask their clients to deliberately intensify their anxiety when they’re in specific situations and it kicks in. Making an exposure out of these difficult situations can help us be more deliberate in our responses and grow from the moment of anxiety, rather than just suffering through it or spending time and energy on compulsions. So, again, working with an OCD therapist is the best way to learn how to create exposures and respond to anxiety without falling back into the same old compulsive cycle.

How do I stop reacting to my thoughts? I feel helpless because I have a constant need to reassure myself. . . . I realize that your thoughts can be so overwhelming that you would do anything to stop them. The cycle of obsession-anxiety-reassurance is exhausting and can pull us away from the things we truly care about. Remember though that these thoughts are just your OCD and aren’t a reflection of who you are. But reassurance-seeking is a compulsion, and there are ways to unlearn our compulsive behaviors. One strategy is “doing nothing.” Don’t even take a moment to acknowledge the thought (or feeling or sensation) has occurred, and simply persist through the activity you’re in. Ignoring thoughts is similar to one of the main goals of OCD treatment: becoming able to experience thoughts without reacting to them. But, in and of itself, it’s a very difficult thing to do; and if it comes in the form of avoidance, it might be counterproductive. Similarly, you could take the exposure-based approach of purposely thinking the thought and “welcoming” the thought while resolving not to check. If you’ve worked with an OCD therapist, you might be familiar with the concept of exposure and response prevention (ERP). This means you’re not using any compulsions when you feel anxiety kicking in. Developing strategies for response prevention takes time, and there are no simple answers. Although ERP is the most effective type of therapy for OCD, it can’t work without the response prevention part. If we’re not preventing ourselves from temporarily escaping anxiety, we can’t learn how to do anything else. In general, once they’ve designed some response prevention strategies together, therapists may ask their clients to deliberately intensify their anxiety when they’re in specific situations and it kicks in. Making an exposure out of these difficult situations can help us be more deliberate in our responses and grow from the moment of anxiety, rather than just suffering through it or spending time and energy on compulsions. So, again, working with an OCD therapist is the best way to learn how to create exposures and respond to anxiety without falling back into the same old compulsive cycle.