What Are Some Good Exposures for ____ OCD/Anxiety?

One of the most common questions I get is “what are some good exposures for ___ OCD?” People really resonate with the subtypes of OCD, like contamination OCD, relationship OCD, sexual orientation OCD, pure O, and the list goes on and on. While subtypes exist to provide basic clinical information and to establish a sense of community for those who have this condition, identifying too strongly with the subtypes can lead to oversimplification of this disorder and its treatment.

As cliche as it sounds, every single person comes with their own uniqueness and nuances that cannot be simply explained away by identification of a subtype of OCD theme. The fact of the matter is that two people could very much resonate with a term like relationship OCD, yet have completely different triggers, rituals, obsessions, and therefore, completely different sets of exposures, different styles of response prevention that will be needed, and therefore, a different treatment plan.

Think of it this way: someone with relationship OCD could struggle with the nagging and ego-dystonic intrusive thought that their partner is not attractive enough. This person may engage in compulsions like checking photos, reassurance seeking, and avoidance in order to feel perfect, just right, or 100% certain about how attractive they find their partner. Someone else may also resonate with the concept of relationship OCD but struggle in a completely different way. This person may struggle with intrusive doubts and obsessions about the integrity of the relationship itself, rather than the person. This person may struggle with obsessions like whether they spend enough quality time together, whether they are the right “fit” as a couple, and so on. Rituals in this situation may include comparing to other couples and rumination. One person may want to avoid their partner, whereas the other person may want to compulsively spend more time with their partner in an effort to alleviate the doubt and anxiety.

This is all to say that we, especially when OCD is involved, are way more complicated than these subtypes could ever demonstrate. We have to look beyond just the subtypes and ask ourselves, what is it that we’re fearful of? What is it that we avoid on a day to day basis? In what ways are my compulsions, mentally or physically, getting in the way of what it is that I want to do? Instead of asking what good exposures are for contamination OCD, pedophilic OCD, hit and run OCD, or any other kind of OCD that resonates with you, think about your own individual triggers, the things you avoid, and the things you would do or not do if OCD and anxiety weren’t in the picture. Those are the exposures you should start with, and they might be completely different from someone else with the same subtype as you.

I wish there was a complete book where all of the best exposures could be categorized and classified by subtypes. If that exists, or ever does exist, it might be superficially helpful in sparking some ideas. But at the end of the day, you will know yourself best. You know what you avoid. You know what scares you. You know the day to day, or even hour to hour or minute to minute things that make you feel compelled to do these compulsions you don’t want to do. Find small, challenging, and manageable ways to do those things, while reducing safety behaviors and rituals, and your exposures will be far more meaningful and impactful than any superficially created list online could tell you.

Keep on doing all the hard things. 

-Jenna