I’ve been doing a lot of acceptance and exposures lately, which has been scary (to say the least) but ultimately effective. The trouble is, once you do exposures and realise, after a spike in anxiety then habituation, that you’re going to be okay because you really do have a choice about things, the temptation (and habit) is to cling onto this and stop doing exposures. Why would you want to keep telling yourself horrible stuff when you’ve had a few moments of clarity that it’s all just anxiety and you don’t have to believe your thoughts?
There comes a point in OCD treatment where you have to make a choice: remain a slave to your illness and continue in the endless cycle of compulsions, or choose to take what, at the time, feels to be a huge risk, and stop the behaviour that you think is keeping you safe. And then keep taking this risk, and keep accepting, and keep exposing yourself to your fears, over and over again. The typical duration of therapy for OCD takes between three months and one year. In the case of ‘pure-O’, where the compulsions are mostly internal (rumination, checking, reassuring, etc) it is a little more difficult to just stop doing compulsions as these mental processes go on automatically. So I am struggling with this somewhat: I can’t just stop thinking. If I could, all my problems would be solved…
It’s also difficult to do exposures in a consistent way. I can’t force myself to have genuine intrusive thoughts, and sometimes this actually becomes a compulsion in itself: think this, have these feelings, then don’t ruminate, and you’ll feel better. My brain becomes a bit of a scrambled knot when I get into this way of thinking, and it’s difficult to let it go and just relax. I’ve read about this in OCD literature, where doing ERP becomes a kind of OCD cycle in itself.
Anyway, this is where I’m at now. Making progress, slowly, bit by bit.