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ERP ‘failure’


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Hi all,

First time poster here. I was diagnosed with OCD a few months ago, and have been in therapy for about a month. My OCD is harm-based and primarily focuses on my children, and has been specifically around knives.

My therapy has actually being going pretty well, and we’ve quite quickly graduated up to doing some fairly scary ERP exercises, such as holding a knife for 15 minutes whilst holding to my son too etc. There have been a variety of exercises like this, of varying types and length of time, without any of my worries/thoughts etc coming true. I’ve done approximately 50 of these since starting therapy. So, progress you’d have thought. My therapist has pinpointed that my OCD seems to revolve around a fear of losing control and doing something terrible, despite having no desire to do so. She therefore wanted me to test out the principle of ‘losing control’ in general, not specifically around knives.

So, after I bathed my son last night I had him on my lap as usual as I was putting his pyjamas on. I had this sudden thought that I could put my hands around his neck, so I tried to make myself lose control and I was horrified to find out that I could make myself put my hand around his neck. I instantly felt absolutely terrible and then made myself do it again to see how I felt. It has absolutely haunted me ever since, and really made me lose confidence in the other exercises that I’ve done. If I can make myself lose control in that way, then why not with a knife too?!

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Hi @BF2020,

I'm really sorry that you're struggling like this, but I have to admit that I felt a bit of relief reading your post because it's similar to what I experienced with ERP and haven't really had a chance to talk to anyone about it.

My main worries are about harm with knives too, although mainly towards myself. So in a similar way to you, my ERP exercises involved holding a knife to my wrist...and wow was it hard, I think that it was one of the hardest things I've ever had to do. So well done to you for doing these exercises! You should be proud for stepping up and challenging yourself!!

I then went through exactly what you are going through right now, questioning if I could do this, what would stop me from going a step further and acting out on my fears. For a while, I was really worried that the ERP was going to make things worse because it made me feel so bad.

But the point is to see that you can "lose control" as you practiced doing and that still you wouldn't do anything bad. I also realised that the anxiety can't just be limited to the session where you do the ERP exercise, you are going to have to carry it with you for a while. That is part of the process. I was hoping that I'd just hold the knife to my wrist, feel terrified while doing it, see nothing would happen and forget about it and get on with my day. But it doesn't work that way, you feel it for a while, and that is okay.

So I think that this extended period of worry is part of your ERP. Now you have practiced this, your next step is to work on the compulsions that you are doing to deal with the anxiety that stems from it. I am guessing that you are ruminating quite a bit about this, for example. The anxiety is going to be there, you are going to worry that you're going to lose control with a knife, and that is all part of the ERP exercise. I think the best way is to accept that these worries will be there and try to avoid doing compulsions and get on with your life.

I hope this helps. I think you're very brave!

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16 minutes ago, BF2020 said:

Thanks very much for your reply. I think more what’s bothering me now is bizarrely not the knives, but actually the fact that I wasn’t able to stop myself putting my hand around the neck! 

I get you, but it's really all the same thing. Besides, you're meant to be bothered by it, the exercise would be meaningless if you weren't. So just go with it and try to learn to manage this in a constructive way.

 

Edited by malina
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Yeah, that makes sense. I guess what’s bothering me is that this wasn’t a specific exercise directed by my therapist. She just told me to try and come up with ways to ‘lose control’ and see if I would. And I was able to, which is I guess the opposite of what should have happened? I should have been able to resist doing it. 

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I think this questioning is part of the compulsion. You didn't lose control, I think that you did exactly what you were meant to - you showed yourself that you could put your hand around his neck and not hurt him. Now the OCD is causing you to doubt yourself, your actions, your intentions and whatever. Your next step is to prevent yourself from going down this path.

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18 hours ago, BF2020 said:

Any further thoughts on this one from anyone? 

A couple comments.

First, I agree with Malina, the real takeaway from this situation is that yes you CAN choose to put your hands around your sons neck, but not because you "lost control".  You made a conscious choice AND stopped there.  The evidence is proving the opposite of what you are afraid of, but OCD is making you feel like its proving your fear.  Thats one of the problems with OCD, it distorts our thinking, and we have to be aware of that and work against it.

Second, consider that by asking for further thoughts you are engaging in a bit of a compulsion, reassurance seeking.  Malina already gave you a good answer.  Absent OCD that should be ok, you should move on after that.  But, because you have OCD, you unfortunately continue to feel doubt, so you want another answer that agrees, and then another, and then another :)  Normally, seeking out some additional confirmation might not be so bad, people do it in real life all the time, but OCD makes us vulnerable to taking that to extremes.  Just something to keep in mind.  Its a good idea to avoid repeating the same question to multiple people when you are dealing with OCD related fears.  But don't worry, it takes time and effort to break these kind of "bad" habits.  You are just getting started in your recovery journey and it sounds like you are making great progress so far.  Overcoming OCD is a marathon, not a sprint, so keep up the good work!

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6 hours ago, dksea said:

A couple comments.

First, I agree with Malina, the real takeaway from this situation is that yes you CAN choose to put your hands around your sons neck, but not because you "lost control".  You made a conscious choice AND stopped there.  The evidence is proving the opposite of what you are afraid of, but OCD is making you feel like its proving your fear.  Thats one of the problems with OCD, it distorts our thinking, and we have to be aware of that and work against it.

Second, consider that by asking for further thoughts you are engaging in a bit of a compulsion, reassurance seeking.  Malina already gave you a good answer.  Absent OCD that should be ok, you should move on after that.  But, because you have OCD, you unfortunately continue to feel doubt, so you want another answer that agrees, and then another, and then another :)  Normally, seeking out some additional confirmation might not be so bad, people do it in real life all the time, but OCD makes us vulnerable to taking that to extremes.  Just something to keep in mind.  Its a good idea to avoid repeating the same question to multiple people when you are dealing with OCD related fears.  But don't worry, it takes time and effort to break these kind of "bad" habits.  You are just getting started in your recovery journey and it sounds like you are making great progress so far.  Overcoming OCD is a marathon, not a sprint, so keep up the good work!

Thanks so much for your reply, I totally agree with all of it! Part of me certainly knew even at the time that it was definitely some sort of reassurance/compulsion. Really annoyed with myself to a degree, because it’s the first time since starting ERP that I’ve cracked and done anything on the internet or self help books related to OCD. I think it’s because for some reason it felt like a backwards step, so I cracked and needed some reassurance. I’m going to be working hard from now on again not to get involved with any Googling etc. 

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