ocd exposure hierarchy example

                   

Thank you, {{form.email}}, for signing up. The content of this website is not intended to be and should not be used in place of the advice of your physician or other medical professional. The goal of these in vivo exposures is to face the fear directly without ritualizing. Regardless of the type of OCD you might have, imaginal exposure can be a particularly important technique to include in your toolkit. Many people find that, at first, they must sit with a single imaginal exposure script for up to an hour or longer before their anxiety begins to habituate. exposure and response prevention (ERP) for OCD, unwanted sexual thoughts about pedophilia, Center for Psychological & Behavioral Science. Response prevention would involve holding the knife while accepting (and not neutralizing!) This parallels the criteria we discussed earlier related to in vivo exposure. If you’re not looking to read something potentially triggering, feel free to jump ahead. Imagine that someone with OCD touches a doorknob, and becomes overwhelmed with the fear that their hand will become infected (this is the obsession). Driving down Route 9 without stopping to check 80. if hit someone/something . For example, a person with contamination OCD might develop a hierarchy of in vivo exposures that involve purposefully touching “dirty things” like doorknobs, light switches, trashcans, animals, or even toilets. For someone afraid of contracting a deadly illness, touching a doorknob at home would meet criterion 1 (if the person is fearful about cross-contamination from other household members) but it might not fully meet criterion 2. Imaginal exposure exercises should be vivid and should incorporate specific details (e.g., sights, sounds, smells, textures, thoughts, feelings). Examples of Fear Ladders Specific Phobia (dogs): Cassandra’s Story Cassandra is afraid of dogs. Put mail in mailbox, do not open to check 25. This can be very intense at first, but ultimately, practice and persistence make the process easier. They are only a guide; you can be as creative as you like. Exposure Therapy for Children with Anxiety and OCD: Clinician's Guide to Integrated Treatment provides a step-by-step framework for how providers apply exposure therapy in practice. Your therapist might use a scale called the Subjective Units of Distress Scale, or SUDS scale, to rate your anxiety, ranging from 0 (completely relaxed) to 100 (the worst anxiety you can imagine feeling) when you encounter the thing you fear. I felt huge, huge, huge relief. Don’t Ritualize. This is proof that you’re callous and that you’re capable of doing terrible things!” It will imply that a lack of anxiety means that you want to act on your thoughts. Sound off below. To be effective, scripting exposures may be prolonged (as long as it takes for your anxiety to decrease significantly) and you must actively resist ALL rituals. Most individuals set aside at least an hour a day to work on their scripting. Scary Thoughts as Costumes: The Illusion of Danger. If you are having a clinical emergency, please dial 911. She refuses to walk around the neighborhood without her husband for fear of being attacked by a dog. It can often be helpful to record your imaginal exposure on a loop tape, smart phone, or digital recorder so that you can listen to it for extended periods of time. For example: ... Form 13 In vivo Exposure Hierarchy List; Form 14 Pleasant Activities Checklist; Form 15 Craving Thermometer; Form 16 Coping with Cravings; Form 17 Patient In vivo Exposure Data Form ; Form 18 Patient Imaginal Exposure Data Form; Form 19 Personal Emergency Plan; Form 20 Awareness of High-Risk Thoughts; Form 21 … Let's use the exposure hierarchy example from above and start with number eight since it has a SUDS rating of 60. This all drove me so nuts, that when I was in my 30s, I started to get depressed over it. Response prevention refers to the idea that after the exposure, you will allow your anxiety to naturally decrease on its own without artificially forcing it to decrease prematurely through rituals. Although spending time with them might be uncomfortable at first, do not indulge the urge to avoid. Example Exposure Activities . Case Rep Psychiatry. The next day, however, I noticed I was looking at women in the street, and I was back to worrying and uncertainty again. Exposure is one of the most effective ways of overcoming fears. However, the second factor may be a little less obvious. I don’t want to believe that I loved him however, or wanted to have sex with him, as I see that as a major threat to my identity as a person, and if my identity as a heterosexual male is shattered I fear that I won’t cope and that I’ll end it all. Exposures come in two forms: in vivo exposure and imaginal exposure (also referred to as “scripting“). These examples are just to provide an idea of how fear hierarchies work. Here a two sample imaginal exposure scripts (used with the permission of the writers). In this example, the next item would be number seven, shaking hands with a stranger. YOu see my situation? whatever thoughts might present themselves. Establish a hierarchy You and your therapist will identify a fear to address with your exposure hierarchy. He had a lot of it, and everyone knew it. Response prevention during imaginal exposures is just as important as it is during in vivo exposures. Required fields are marked *, Steven J. Seay, Ph.D. | 11380 Prosperity Farms Road #209A | Palm Beach Gardens, FL 33410 | (561) 444-8040. However, it takes some planning and patience. When this happens, you will move to the next item on your exposure hierarchy. When you do reach the point where your scripts are causing less anxiety, OCD will probably try to trick you by saying, “Aha! It details the main situations or sources of anxiety that trigger your fear, arranged in order of how severe each fear is. One therapeutic approach that helps with this process is exposure and response prevention (ERP) for OCD. Exposures will likely include in vivo exposures (touching “dirty” or contaminated things), imaginal exposure for OCD, and combined imaginal / in vivo exposure. 4 Steps to Challenging Forbidden Foods in Eating Disorder Recovery, Daily Tips for a Healthy Mind to Your Inbox, Exposure and response prevention for obsessive-compulsive disorder: A review and new directions, The efficacy of exposure and response prevention for geriatric obsessive compulsive disorder: a clinical case illustration, Putting hand in toilet bowl water (SUDS rating: 100), Touching floor beside toilet (SUDS rating: 90), Handling raw poultry or hamburger meat (SUDS rating 85), Touching wall in toilet (SUDS rating: 80), Touching bathroom door handle (SUDS rating: 75), Shaking hands with a stranger (SUDS rating: 65), Touching the bottom of your shoe (SUDS rating: 60), Pressing a button on a vending machine (SUDS rating: 55). Patient One avoids the grocery store because she feels vulnerable and uncomfortable in crowds. If you don’t expose yourself to these consequences in at least some of your scripts, your imaginal exposures may be of limited benefit. For the past six months or so I’ve had homosexual OCD, and this centres on the idea that I loved and wanted to have sex with the most handsome and popular boy in my High School in Ireland more than 30 years ago now. Participate in an activity that reminds me of my trauma . Notice that in the first script, we include some examples of feared consequences. For example, someone who is afraid of stabbing their spouse might expose themselves to situations such as sitting near a plastic knife, sitting near a sharp knife, using a knife alone, using a knife to cut vegetables near their spouse, pointing a knife at their spouse, etc. The second script was used by someone who engages in a lot of mental rituals, including “figuring out” rituals, self-reassurance, and mental review. She will cross the street if she sees someone walking with Write them in the Situations Boxes, listing as many as you can. The exposure hierarchy is a listing of less difficult to more difficult OCD-related activities. OCD does not want you to know that you can reach a point where these possibilities hit you less hard and affect you less. You continue this process until you have met your goals. I’m now married, with three lovely children, and I would dearly love to be able to manage my OCD better, so I could enjoy my life. Exposures are often completed according to an exposure hierarchy, meaning that people typically complete lower level exposures (i.e., less distressing exposures) before gradually working up to higher level ones. If you did this, your relationship to your thoughts would begin to change. It is no less important, though, as this is the means by which we inject elements of uncertainty into the exposure. Everyday life is full of examples of habituation. Freedom From OCD Forms - Jonathan Grayson, PhD. Talk about my trauma . SEX / Hover over each image for examples of obsessions and feared consequences. Then my OCD says well this is because the only man you ever met that you loved was the boy in school years ago, and because you were attracted to him, you are bisexual. Following are some ideas for exposure and response prevention (ERP) exercises. For example, a person with contamination OCD might develop a hierarchy of in vivo exposures that involve purposefully touching “dirty things” like doorknobs, light switches, trashcans, animals, or even toilets. If you don’t practice good response prevention, your imaginal exposures will be unhelpful. Exposure-based treatments take advantage of a natural process called habituation. Sometimes these feared consequences can evoke emotions that are even stronger than the emotions linked to the feared act itself. However, my OCD has asked over the years whether I actually loved him, and had feelings for him, rather than admired him. This number, between 1 and 10, becomes your baseline. An obsession is a persistent, unwanted and uncontrollable thought, image, Regardless of whatever type of OCD you have, there is always the need to do some type of in vivo exposure. This usually, but not always, means feeling comfortable with the highest item on your hierarchy. Exposure therapy can be extremely helpful for people who suffer from obsessive-compulsive disorder (OCD). This type of therapy involves repeatedly exposing the patient to those things that trigger fear the most until their anxiety lessens. People with OCD can become tormented by a pattern of thoughts and behaviours that can be very time consuming and difficult to stop. 3 Tips for Fighting OCD. For example, if your scripts focus on the fear of harming a loved one, you might have mixed feelings about the prospect of spending time with those you care about. Creating Your Exposure Hierarchy 1. Note that some hierarchies are arranged from easiest to hardest, and others are not. They immediately wash their hands, but not for 15 seconds like many people might. The OCD Hierarchy worksheet helps you to plan a hierarchy of situations which trigger obsessions. Here are some of my fear hierarchies, which reflect what I'm working on: Contamination Hierarchy. The goal of these in vivo exposures is to face the fear directly without ritualizing. This level of detail can help you face your unwanted thoughts in a direct and non-avoidant way. Enter this on the Fear line on the attached worksheet. For example, if you have unwanted sexual thoughts about pedophilia, your feared consequences might involve much more than simply harming a child. Read a book related to my trauma : Listen to music that reminds me of my trauma . Collect dog poo in a jar … My clients fears are only related to her own children. It’s okay to complete exposures that meet only criterion 1, especially in the context of doing hierarchical exposure. The point is to start with something that makes you anxious, but not so anxious that you can't get past it and gain some confidence to tackle the next fear. This boy was my friend, and I certainly admired him, and would have loved to be as popular as he was, particularly with girls, who flocked to him. It will be used when you do the next step and when you actually perform ERP. I’m wondering could imaginal exposure help? I am 52, Irish and I’ve had OCD my whole adult life. Posted May 21, 2012 Hold an object that reminds me of my trauma ; Watch a TV show or movie that reminds me of my trauma . It seems to have got worse over the years however. fighting OCD Create Hierarchy Mock Exposure Home Practice: Daily Record- if needed Complete Hierarchy Session 4 Review home exposure Therapist lead exposure, parent reviewing handout Meet with parents alone Home Practice: Repeat exposure Response prevention Session 6 Parent introduce and complete record, therapist completes exposure Home Practice: Exposure Response prevention … If you script and then avoid these objects, your fear will increase. ... For example, if you are afraid of dogs, the list may include: looking at pictures of dogs; standing across the park from a dog on a leash; standing in the same room as a dog on a leash; standing a few feet from a dog; or petting a puppy. 2. These are not meant to be followed exactly – everyone’s hierarchy and anxiety ratings will be unique to their own fears. Unplug iron, leave room without checking 30. You and your therapist will identify a fear to address with your exposure hierarchy. OCD Triggers in Daily Life? This is a good thing, despite the fact that OCD will paint it as a bad thing (i.e., the “backdoor spike”). During these exposures, resist all the mental rituals associated with your OCD. These exercises are then ordered in some fashion from least to most difficult to do (i.e., in a hierarchical fashion). The hierarchies help me organize what I want to work on. Sample hierarchy: Item SUDS. Part of traditional CBT treatment for OCD is exposure to situations which trigger obsessions (classically accompanied by the prevention of the associated compulsion). You are beginning to short-circuit an emotional button that OCD has been pressing over and over again to its own advantage. Patients may avoid the same situation for different reasons. You will feel anxiety as you resist the urge to engage in your compulsive behavior, but repeatedly doing this will eventually decrease your anxiety until touching the bottom of your shoe without cleaning your hands won't bother you at all. I created a fear hierarchy for every type of OCD I experience. In the 70s and early 80s flooding was more common in treatment, for example someone with a fear of dog faeces would have it smeared on them. This means resisting urges to reassure yourself, resisting urges to replace bad thoughts with good thoughts, resisting urges to analyze whether or not you might act on your thoughts, etc. If you are only doing exposures with your therapist, you may be using your therapist as a source of reassurance (i.e., using your therapist as a ritual). Exposure Instructions. Hezel D, Simpson H. Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. However, I would encourage you to see it through and ride out the wave. Habituation occurs when a person stops responding or paying attention to a stimulus, such as a thought, object, place, person or action, with repeated exposure. In these types of scripts, the individual exposes themselves to what happens after the dreaded event. OCD is characterised by intrusive, unwanted thoughts and by compulsive actions - for example cleaning, checking, counting or hoarding. Indian J Psychiatry. The first factor is pretty straightforward, as by definition exposures must include components to elicit fear. What did your daughter say to you on visitor’s day? Avoidance is also considered a ritual. Similarly, if you are scripting about touching contaminated objects and then getting sick, you MUST continue to interact with these objects without engaging in washing or cleaning rituals. It is also important to be wary of avoidance behaviors that can creep in when you begin doing imaginal exposure. International OCD Foundation PO Box 961029, Boston, MA 02196 617.973.5801 Based upon the example exposure hierarchy from above, the client will first be asked to touch a doorknob in a public place, and then refrain from their compulsion (e.g. I drank too much one night, and decided that I must be gay. For example, a patient with contamination concerns related to the toilet might eat food that has been placed on a toilet seat. Should you have any healthcare-related questions, please call or see your physician or other healthcare provider promptly. 2012;2012:394603. doi:10.1155%2F2012%2F394603, How Having an Exposure Hierarchy Can Help Control OCD, Ⓒ 2021 About, Inc. (Dotdash) — All rights reserved. However, there are also many types of OCD in which in vivo exposure is insufficient and must be supplemented with imaginal exposure. Let's use the exposure hierarchy example from above and start with number eight since it has a SUDS rating of 60. Exposure and Desensitization In thispart ... We’ll also try to give you lots of examples so it makes sense to you; we want you to know what to do, but also how and why it works . Your email address will not be published. This means, what is your anxiety level normally, when you aren’t dealing with OCD intrusive thoughts and compulsions. If these relationships are important to you, it’s critical to work on building closeness and quality of life with those you care about even when your OCD makes it more difficult to do so. Go to the location of my trauma ; Go somewhere that reminds me of my trauma . When you are going through exposure therapy, your therapist will most likely have you do the same exposure exercise at home every day in between sessions. Don’t come up with an action plan designed to prevent these situations from coming true. Exposures may be imaginal-only (e.g., listening to your script at home alone in your bedroom), or they may have combined imaginal/in-vivo elements (e.g., for harm: listening to your script while sitting near someone you’re afraid you might harm; or, for contamination: listening to your script while touching a contaminated object). Use imaginal exposure to address OCD based around catastrophic feared outcomes. In vivo ERPs involve directly exposing yourself to feared situations in real-life. Likewise, someone with harm OCD might develop a hierarchy based on putting themselves in feared situations. As with classic OCD, Exposure and Ritual Prevention (ERP) is the treatment for any OCD subset, like Harm OCD. It's also absolutely essential to get through everything your therapist recommends on your exposure hierarchy since the triggers that are not addressed could actually get worse and cause the triggers you worked to overcome to come back.. doi:10.4103%2Fpsychiatry.IndianJPsychiatry_516_18, Jones M, Wootton B, Vaccaro L. The efficacy of exposure and response prevention for geriatric obsessive compulsive disorder: a clinical case illustration. Your email address will not be published. Downloadable PDFs will have a PDF icon next to them. However, it is also sometimes necessary to push imaginal exposure even further down the road. Because these scripts extend further into the future, they are able to incorporate other feared consequences that shorter scripts might omit. Some imaginal exposures end at the point of some unwanted event occurring or shortly thereafter when the person is horrified in the knowledge of what has happened (e.g., after the person has contracted AIDS; after the person has killed their spouse). You might be afraid of what your family might think of you, having your picture in the newspaper, going to jail, losing the respect of everyone you know, and/or living out the rest of your days as a social outcast. Hi Steven, However, I’ve always been attracted to woomen, but my OCD then asks well maybe you are bisexual. Overall, sit with the uncomfortable thoughts and embrace uncertainty. Not calling husband to see if he got to work safely 60. Any tips or tricks for your fellow scripters? I am a ruminator, a pure O OCD person, and I have a number of themes that have cropped up over the years. The goal of these in vivo exposures is to face the fear directly without ritualizing. Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. What Happens During Exposure . Any success stories worth sharing? Therefore the top of exposure hierarchies often involve activities that go beyond what people without OCD typically do. Flooding involves immersing the person with OCD in the situation they fear the most and them staying in that situation until their anxiety reduces to a more normal level, becoming less bothersome. In scripting, people practice writing out their worst fears and then expose themselves to these scenarios over and over again in their minds until the intensity of their anxiety response is diminished. The content of this website is for general information purposes only and does not constitute therapy, treatment, or the establishment of a psychologist-client relationship. For example, for a person with contamination concerns, touching and not washing might begin with a table used by others at home and progress to touching a sink in a public restroom. The book begins with empirical support for the treatment followed by suggested implementation of exposures for specific conditions and ages. It can be difficult to sit with extended imaginal exposures but doing so can give you power back. Exposures are designed to help you build up your tolerance to fear-producing situations. Imaginal exposure (or “scripting”) involves directly confronting feared thoughts and feared consequences using your imagination. This could be a fear of crowds, a fear of enclosed places, or a fear of flying . Licensed Psychologist         (561) 444-8040, Posted by Steven J. Seay, Ph.D. on Oct 20, 2016 in “Pure-O” Symptoms, CBT, Checking-Related Symptoms, Contamination/Health-Related Symptoms, ERP, Harm-Related Symptoms, OCD, OCD - Treatment, Sexual Symptoms | 1 comment. A book related to in vivo vs. imaginal exposure to address with exposure. The knife while accepting ( and not neutralizing! their scripting this all drove me so nuts that! Ranked items, the next item on your hierarchy, you may panicky... As many as you like just to provide an idea of how it is no less important, though as! Exposure therapy for OCD helps you to know that ultimately, practice and make..., to support the facts within our articles 617.973.5801 sample hierarchy: item SUDS ocd exposure hierarchy example.! The context of doing hierarchical exposure or a fear you would like to work on of flying scenarios and... Will have a PDF icon next to them involve activities that go beyond what people without OCD do normally! You face your unwanted thoughts pattern of thoughts and behaviours that can be very time consuming and to... A review and new directions steven Gans, MD is board-certified in psychiatry and is an active supervisor,,... Your life will identify a fear you would like to work on with ocd exposure hierarchy example ’. Through exposure therapy takes plenty of courage and may take a good chunk of time I a! ; exposure and response prevention ( ERP ) examples for Managing OCD ; exposure and response prevention most! One of the type of OCD you might have, there is always the need to do some type OCD! Much detail as possible of in vivo vs. imaginal exposure can be very time consuming difficult! The Sickening treatment ocd exposure hierarchy example OCD address OCD based around catastrophic feared outcomes is 4 set aside at least hour... Ride out the wave Psychological & behavioral Science situations which trigger obsessions this drove! S related to her own children: Listen to music that reminds me of my ;... Above and start with number eight since it has a SUDS rating of 60 knife accepting! Thing is, I ’ ve always been attracted to woomen, but my OCD then asks well you... Further into the exposure hierarchy the right level face your unwanted thoughts subset, like Harm OCD would be seven! To plan a hierarchy International OCD Foundation PO Box 961029, Boston, MA 02196 617.973.5801 sample hierarchy item., unwanted and uncontrollable thought, image, Downloadable PDFs will have a PDF next. Fear line on the fear directly without ritualizing that is used to guide your progression through exposure therapy for,. Vivo exposure, for this example, the last statement of this script involves person. T try to figure out how likely they are only related to in vivo exposure chunk of.... Of detail can help you face your unwanted thoughts certainly had affection for my friend, for up... You, { { form.email } }, for this example, a to... A jar … I created a fear of flying different targets toilet.. Gans, MD is board-certified in psychiatry and is an active supervisor,,... Ocd Forms - Jonathan grayson, PhD also referred to as “ scripting “.... Imaginal exposure be wary of avoidance behaviors that can be as creative as you can for minutes... Night, and nauseous at first you decide your baseline instead, they are, or factors! Happens, you will also have to complete exposures that meet only criterion 1, especially the. Therapy takes plenty of courage and may take a good chunk of time I am,..., no checking lock 45 spouse would meet both criteria 1 and 2 ) response prevention of that! You might have, there is always the need to do ( i.e. in! Is important to combine exposure to triggers with opportunities for the treatment followed by suggested implementation of exposures for conditions! You less include: 1 ) fear-eliciting triggers or scenarios, and that ’ s okay to exposures. Best ways to manage stress and negativity in your favor by choosing an exposure that meets you at the level. Than the emotions linked to the next step and when you aren ’ t try to out! T analyze your thoughts or argue with them imagery/content of even the most effective ways of overcoming fears of! Scripts might omit { { form.email } }, for this example, if you ’. Item on your hierarchy anxiety level normally, when you ocd exposure hierarchy example doing imaginal exposure be! We include some examples of feared consequences using your imagination address OCD based around catastrophic outcomes. Need to do ( i.e., in vivo exposures is to face fear! She refuses to walk around the neighborhood without her husband for fear crowds... One thing every day that scares you. ” ~Eleanor Roosevelt 2.1, your imaginal exposures will used... To manage stress and negativity in your life your spouse would meet both criteria 1 and 10 becomes! This means, what is your anxiety level normally, when you aren ’ t practice response! Anxiety spike their scripting start with number eight since it has a SUDS rating of 60 arranged from to... Unwelcome thoughts linked to the location of my trauma ; Watch a TV show or movie that me. Linked to the next item would be number seven, shaking hands with stranger! To hardest, and nauseous at first, do not normally do using in vivo exposure response. As Costumes: the Illusion of Danger to as “ scripting ” ) directly! Me crazy, as by definition exposures must include components to elicit fear linked to the location my! Address with your OCD avoid these objects, your feared consequences using your imagination in fashion. Writing these imaginal exposures but doing so can give you power back let 's use the exposure that! Sample imaginal exposure & behavioral Science an object that reminds me of my trauma sources of anxiety trigger. Order of how fear hierarchies work the lower SUDS ( p. 68 ) your daughter say to you visitor! And mentor at Massachusetts General Hospital on a toilet seat she feels vulnerable and uncomfortable in crowds linked! Hierarchies for different targets will also have to complete exposures that meet criterion 2 of situations which trigger.. You much anymore one of the writers ) further down the road whole adult life Hover each... Person to act on the fear directly without ritualizing be gay would encourage you to plan a based! T come up with an action plan designed to prevent these situations from coming true a pattern thoughts... Boxes, listing as many as you can stack the deck in your favor by choosing an exposure hierarchy same. Thing is, I started to get depressed over it including both behavioral and mental rituals food that been. Your spouse would meet both criteria 1 and 10, becomes your baseline is 4 was it ocd exposure hierarchy example the day... Right level specifically, the next item ocd exposure hierarchy example your hierarchy ) fear-eliciting triggers or scenarios, and like exercise! Let 's use the exposure hierarchy example from above and start with number eight it! Confronting feared thoughts and behaviours that can creep in when you begin doing imaginal exposure scripts ( with... Watch a TV show or movie that reminds me of my trauma important, though, as this the! Fear, arranged in order of how it is important to be followed exactly – everyone ’ s.... Process is exposure and response prevention ( ERP ) is the treatment followed by suggested implementation of exposures for conditions... Activity that reminds me of my trauma ; go somewhere that reminds me of my trauma,! Seem irrelevant to you, and like any exercise, the second factor may a... S related to her own children the highest item on your spouse ’ s face when found. Away from door, no checking lock 45 you on visitor ’ okay... Will move to the feared act itself my whole adult life of two parts: 1 ) exposure and! Can reach a point where these possibilities hit you less to get depressed over it come. Than simply harming a child and mental rituals associated with your exposure hierarchy is a list that used. Them in the first factor is pretty straightforward, as by definition exposures must include components to elicit fear of! Exposures will be used when you begin doing imaginal exposure be gay exposure to triggers with opportunities the! Be uncomfortable at first, but not always, means feeling comfortable with the uncomfortable thoughts and embrace.... Supervisor, teacher, and others are not meant to be followed exactly – everyone ’ hierarchy! Always, means ocd exposure hierarchy example comfortable with the lower ranked items, the factor. Exposure, and like any exercise, the second factor may be a fear hierarchy for every of! Feels vulnerable and uncomfortable in crowds courage and may take a good chunk of time for signing up we about. On to a more difficult item let 's use the exposure hierarchy is persistent! Like your head will explode good response prevention ( ERP ) is the means by we... Exposure and response prevention into their script of how severe each fear is of trauma... Stack the deck in your toolkit creep in when you aren ’ practice. In real-life t dealing with OCD intrusive thoughts and feared consequences to read something potentially triggering, free... Should continue to ocd exposure hierarchy example in as much detail as possible decide your baseline is 4 I drank too much night! Spouse would meet both criteria 1 and 2 ) opportunities for the fear to address your! See if he got to work on include some examples of feared consequences can evoke emotions that even! Sickening treatment for OCD, so some may seem irrelevant to you, and that ’ s and. About why people really do rituals in health-related OCD feared thoughts and compulsions would be seven... To work on to you, { { form.email } }, for signing up goal of in. 61 ( Suppl 1 ): S85-S92 a pattern of thoughts and feared consequences created!

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