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Help with exposure therapy ideas - fear of being harmed


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Hi everyone,

Without going into detail I have a long history of OCD involving mainly mental compulsions and some reassurance seeking and a lot of avoidance.    I'm working with my CBT therapist on my fear of being assaulted (specifically during the night whilst I'm in bed).  From a cognitive side I understand where this fear comes from but need help with ideas on exposures.    

My therapist thinks I have aspects of PTSD (which remain untreated) but we don't have much therapy time left so we are trying an OCD approach as I'm sure this is playing a part.  I'm determined to do what I can so have a couple of questions and welcome any suggestions.

I recognise I mentally assess any noises I hear at night (which trigger a spike in anxiety) I think this a compulsion and happens automatically in a split second until I catch it.  Instead of getting out of bed to check, or think it through I'm trying to accept the thought "yes maybe someone is breaking in".  This is to provide uncertainty.  I'm also reading an exposure script as often as I can which goes into graphic detail about my feared situation happening.

So, does anyone have any suggestions of other exposures?

Also any ideas on how to tackle a belief I have which I think is keeping this going.  'Thinking about these things somehow protects me', (even though I know it flippin well doesn't)!!

 

Thanks

 

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Hey OB1, sorry to hear about your struggles.

Exposure therapy can be very helpful, but can definitely be tricky when it involves harmful situations.  It sounds like you are already doing what I was going to suggest, which is exposure through imagination, or in your case a script.  Other variations you could try are recording it (or having someone you trust record it) and listening to it in a loop on audio, since that will give a different sensory input than reading it.  You might also try watching videos, such as from movies or tv shows, that contain your feared situation, or something similar.

Best of luck!

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Hi OBI. You say in your openning paragraph you know where your ideas come from but you say in your concluding paragraph that you want help in dealing with your belief. It is up to you, but the circumstances of the origins of the belief need to be mentioned. If not to us then to your therapist.

A book CBT for OCD deals with the origins of core beliefs. It is written by the authors of Break Free From OCD. In Break Free the authors say that establishing the reasons for the core belief is not important. In CBT for OCD they change their recommendation. (There is one substitution in the writers). I cite these books because they are written by the leading experts in OCD in the UK. 

I had a fear of being killed or injured at night. I live in a flat. My fear revolved around my neighbours not securely locking the  communal front door. I have experienced unwelcome guests before and there was and is a series of break ins in my road.  I have made as secure as possible the door to my individual flat following the advice of my local police force who leafletted advice in my area after a peak of break ins. I no longer check the front door. Reasonable security - I stress reasonable - along with the things that you are doing should solve the problem.

 

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3 hours ago, Angst said:

Hi OBI. You say in your openning paragraph you know where your ideas come from but you say in your concluding paragraph that you want help in dealing with your belief. It is up to you, but the circumstances of the origins of the belief need to be mentioned. If not to us then to your therapist.

A book CBT for OCD deals with the origins of core beliefs. It is written by the authors of Break Free From OCD. In Break Free the authors say that establishing the reasons for the core belief is not important. In CBT for OCD they change their recommendation. (There is one substitution in the writers). I cite these books because they are written by the leading experts in OCD in the UK. 

I had a fear of being killed or injured at night. I live in a flat. My fear revolved around my neighbours not securely locking the  communal front door. I have experienced unwelcome guests before and there was and is a series of break ins in my road.  I have made as secure as possible the door to my individual flat following the advice of my local police force who leafletted advice in my area after a peak of break ins. I no longer check the front door. Reasonable security - I stress reasonable - along with the things that you are doing should solve the problem.

 

Hi Angst,

Thanks for replying and it's good to hear you have dealt with this in the end. 

My therapist knows where the fear comes from, happy to share it hear too.  I was physically assaulted as a teenager which still haunts me 27 years later.  A few years later, one night I caught someone in the act of crowbarring my patio door at home and that also caused a lot of fear.  There are a few other things, I went to quite a rough school where I witnessed more than enough violence or fear of it.  It's only now I appreciate how this has lasting consequences if it isn't dealt with.

I'm not entirely sure where my belief about protection comes from but I do think it's something to do with spending decades ruminating (a compulsion).

So is that 2 books by the same authors that contradict one another?  I'm not trying to understand where the belief comes from though, just ways to challenge it. 

Thanks 

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