ERP?

[sim123]

Hi Guys

I was hoping for some advice because I am a bit confused!

So I have been feeling a lot better for the last week or so, having intrusive thoughts but not dwelling on them and not having a constant feeling of anxiety.

However my therapist told me I should keep up my work even though I have been feeling fine. So this afternoon I sat and forced myself to think of situations that had previously caused me the most anxiety, tell myself negative things etc. This seems to have caused me to start thinking again about an issue I had not worried about in over a week. The anxiety is not as bad as before but it is definitely on my mind again and hadn't been before doing this ERP. It isn't even so much anxiety, it is just thoughts regarding this issue keep popping into my head now and that had completely stopped for a week before this.

Is there a point after you have been feeling better for a while that you should stop doing ERP as it is bringing back old issues or does my mind focusing on this issue again mean that it probably would have started bothering me again at some point and I wasn't really 'over it'?

Any help would really be appreciated.

[Gemma7]

If the issue still causes you stress it is likely that it would have popped into your brain itself. Doing the exposure meant you took control so aim to not compulse on this at all and your anxiety will go down. Doing regular exposures even when you feel better will help to keep OCD away.

[sim123]

Thanks Gemma7. That makes sense, maybe it is a good thing I bought this thought forward again myself instead of letting OCD throw it back at me later! It is on my mind but not causing me a lot of distress, kind of more a little discomfort, I'm more frustrated that I was feeling a lot better and this thought, in fact thoughts in general, hadn't been bothering me before this and I did think I was finally beating the OCD!

[Gemma7]

Just try to see this as part of the process. You don't want to leave anything not dealt with when it comes to ocd. If you don't act on this the thoughts will have no importance to you and won't impact on you at all.

[gingerbreadgirl]

I would add just be very careful you're not carrying out any covert compulsions during erp - rumination is a killer x

[sim123]

Gingerbreadgirl, can I ask what covert compulsions you mean? I don't know if I'm doing them! I tend to force myself to repeat negative things in my mind and imagine scenarios situations the past that cause me anxiety but make them seem even worse.

[gingerbreadgirl]

What you're doing sounds perfect. All I meant was, make sure you're not accidentally trying to make the anxiety go down by, for example, reassuring yourself or trying to 'analyse the problem away'. Compulsions like this can be really sneaky (at least in my experience!)

I'll be really honest though - and feel free to ignore this as I don't want to confuse things. BUT...

Although I am a big fan of ERP (it has worked for a lot of my fears and I know it has a good track record with lots of people here), I have found that for some obsessions I've had - mainly the more 'mental' ones - ERP has actually made it worse in the way you describe. I have had much more success simply dropping all my compulsions and not actively trying to expose myself (but at the same time not actively avoiding anything either). By doing this I was able to get over a false memory obsession that had tortured me for a long time and it hasn't bothered me since. But when I tried to do active ERP (eg. actively thinking about it, ramping up the anxiety and so on) it just focused my attention on it.

I hope that doesn't confused matters! Obviously your therapist knows a lot more than I do! Just wanted to share my experience

[Steven_in_the_clouds]

I had the same gbg. I find that just continuing my day and refocusing is the most useful with mental obsessions and worries about the future or past. I tried the exposure therapy to those by doing loop tapes with a therapist in the past and I actually think I felt worse. I am certainly best when I am not actively avoiding but not going out of my way to think more about whatever I'm worrying about either. Then my worries tend to become less intrusive and I can focus on real life instead!

[gingerbreadgirl]

I had the same gbg. I find that just continuing my day and refocusing is the most useful with mental obsessions and worries about the future or past. I tried the exposure therapy to those by doing loop tapes with a therapist in the past and I actually think I felt worse. I am certainly best when I am not actively avoiding but not going out of my way to think more about whatever I'm worrying about either. Then my worries tend to become less intrusive and I can focus on real life instead!

Yes this was exactly what I experienced! - good to know I'm not the only one x

[sim123]

Thanks so much for the advice. Since doing the exposure this morning I have had feeling of unease that I hadn't had in about a week and it does seem to have knocked me back a little. I guess everyone is different, maybe my mental compulsions just don't sit well with that treatment. Can I ask what you do instead to work at it?

[gingerbreadgirl]

Personally - with this particular false memory obsession I had - I simply refused to engage with it in any way at all and just focused on other things. I didn't avoid anything - I watched the news and did everything exactly the way I would have done pre-obsession. But I didn't deliberately expose myself to it. I focused on all the other things in my life and every time my mind started wandering in that direction I was like 'nope, not today'. I know not everyone agrees with this approach (and like I say, I have done graded exposure for other things and it worked really well).

[sim123]

Thanks, with this particular memory I will give it a try

[Markie1974]

Personally - with this particular false memory obsession I had - I simply refused to engage with it in any way at all and just focused on other things. I didn't avoid anything - I watched the news and did everything exactly the way I would have done pre-obsession. But I didn't deliberately expose myself to it. I focused on all the other things in my life and every time my mind started wandering in that direction I was like 'nope, not today'. I know not everyone agrees with this approach (and like I say, I have done graded exposure for other things and it worked really well).

That's right way to do it !!! That's what I say, in addition to STOP and eff off !