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ERP Therapy for OCD | A Complete Guide |
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- Äas pĆidĂĄn 14. 08. 2024
- Exposure Response Prevention Therapy ERP is the gold standard when it comes to treatment for OCD.
DO YOU NEED MORE HELP WITH OCD & ERP?
đđŒ If you are tired of your OCD and need help treating it with ERP so that you can feel better, I can help you.
Find out more about my course for OCD here:
paigepradko.co....
đđŒ Here is a link to a FREE SELF ASSESSMENT for OCD:
www.paigepradk...
đđŒ Here is a GIFT for you. A PDF for The Top 10 Things to Know to Practice ERP for OCD, Phobias & Anxiety:
www.paigepradk...
OCD is a doubting disorder that can completely take over oneâs life. ERP is one of the most effective methods to fight back.
If ERP is considered the gold standard treatment, why is it not utilized more? The simple answer is because it is CHALLENGING, both for the client and the therapist. But, with DETERMINATION, you can learn how to do ERP and find healing on the other side.
ERP effectively trains oneâs brain that a triggering thought, image or event can be tolerated without responding with anxiety or a ritualistic, compulsive behavior.
To begin ERP, identify your triggers and create a hierarchy of thoughts, actions or events that cause anxiety. Most people begin ERP with an exposure that is relatively easy to successfully complete, while not engaging in compulsive behaviors or rituals. It is not advisable to calm yourself or escape the negative feelings during the exposure. By staying in this anxious feeling and exposure, your brain learns that nothing bad happens. New neuropathways are formed that do not include the need for compulsive behaviors to relieve anxious thoughts.
**** Occasionally research comes along that advances our field. The work of Michelle Craske and Inhibitory Learning Theory has advanced and changed the way we treat OCD. After I made this video, I made several changes in my treatment of OCD including no longer using Cognitive Therapy techniques like working on cognitive distortions or Examine the Evidence or Check the Facts with ERP. I also no longer use hierarchies or SUDS scores, and the goal of the exposures are safety learning when exposed to fear triggers and learning that anxiety and uncertainty can be tolerated.
If you wish to learn more about ERP for OCD, watch this video, and if you find this information helpful, consider liking the video.If you wish to learn more about some of the most effective methods for learning to live with other common mental health challenges, consider subscribing to my channel.
#PaigePradko, #OCDwithPaige, #OCD, #ERPforOCD, #OCDhelp, #OCDTreatment, #ERP, #OCDExposures, #Exposuretherapy, #ExposuresforOCD, #howtodoexposuretherapy, #howtodoERP, #howtodoERPforOCD, #ERPforOCD, #treatmentforOCD, #OCDTherapist, #CalmseriesforAnxiety
Please feel free to follow me at the social media sites below:
/ paigepradkotherapy
/ paige.pradko.therapy
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www.paigepradk...
I would love to hear your comments and questions below. If you would like your question considered on an upcoming Q & A video, please let me know. Thank you for helping me spread mental health help and education.
Until next time...I will see you in session,
Paige
DO YOU NEED MORE HELP WITH OCD & ERP?
đđŒ If you are tired of your OCD and need help treating it with ERP so that you can feel better, I can help you.
Find out more about my course for OCD here:
paigepradko.com/ocd.
đđŒ Here is a link to a FREE SELF ASSESSMENT for OCD:
www.paigepradko.com/ocdquiz
đđŒ Here is a GIFT for you. A PDF for The Top 10 Things to Know to Practice ERP for OCD, Phobias & Anxiety:
www.paigepradko.com/erp
0:54
Steps for ERP
1) Identify your triggers
2) Assign each trigger a SUDS score ('Subjective Unit of Discomfort'-Scale)
3) List your triggers in order from the lowest to highest score
4) Practice ONE exposure from the list, start from the bottom
5) Refrain from doing compulsions. Stay until anxiety decreases 50%
6) Practice that exposure daily
7) When it no longer triggers you notably anymore, start the next exposure from your list
Maximum efficacy
1) Work with a therapist
2) Combine ERP with Cognitive Therapy (challenging the actual thoughts)
3) Cognitive Bias Modification (Cognitive Bias in OCD = interpreting benign situations as dangerous, percieving yourself as more responsible for things than what is true)
4) Be completely committed (Remind yourself that even though it's really hard, it will be worth it)
5) Watch for avoidance and escape behaviors
6) Watch for secondary gain (Is your brain getting benefits from you having OCD? For example people helping you more than necessary)
7) Consider medication - consult with a physician. (Be aware that Benzodiazepines renders ERP completely ineffective)
8) Watch for safety behaviors (Compulsions to try to 'take the edge off' the exposure)
Important notes
- Your brain must remain highly anxious (Until anxiety decreases on its own)
- Relaxation techniques make ERP less effective
- You must be highly challenged
WowâŠ.this took a lot of work. Thank you for doing this. You did a great job! I have evolved my practice of ERP slightly since making this video to incorporate the latest research on inhibitory learning theory. The changes include no longer assigning a SUDS score and adding more variety to the exposures, and focusing on learning experiences and tolerating anxiety during the exposures. đđ
Thank you so much for this comment I really needed this in Written form so I can copy it up to my notes. It makes it a lot more easier to have these bullet points at hand
Tried it myself for a week. Its one of the hardest things that I have ever done in my life.
Yes, ERP is difficult, but it works. You have to be determined and having a therapist or support group to help you stay accountable helps. It is like facing your worst fears ...I get it. The first week is the hardest. It gets easier after your brain begins to respond. I wish you the best.
How did it go after the week? How was your progress?
Yes how did this work out for you? Iâm needing to try it but nervous.
First few weeks was extremely difficult. During after the 1st week of therapy is when I experienced the highest level of anxiety. It was so debilitating for me that it greatly affected productivity, because I was doing some important projects at work during the time. There were times when I felt that there is utterly no hope, and I can't even do the simplest task. I was questioning if this was all worth it. I was reduced to a point where all I can do is summon the willpower to resist the compulsions, while clinging to my therapists promise that 'it will eventually subside because that is how the brain works'. I noticed that after the first month my anxiety did subside, a little, as I no longer experience the same debilating anxiety, and the strong urge to 'get out' by doing a compulsion like I did in the first week. After a few months I can't say that it is completely gone but I could say that I have come to a point that the anxieties I experience are manageable as they come and go. If you are looking for relief to your obsessions by doing ERP, it's not going to give you that. I never really experienced 'relief', but what I think it will do is help you desensitize to the same triggers. If you keep at it, one day you'll wake up and notice that your obessions does not have their effect on you like they used to. One other thing, If you are going thru a tough time, like say, if you are working on a difficult project, or you are having a financial difficulty or just lost a loved one, I don't think this would be the best time for you to start the therapy. But in any case if you are going to go through it, make sure that you are extremely committed and prepared to go though hell.
nothing1more thank you for your honest response!
This topic was very well presented. I appreciate your videos and channel. I am a grad student doing my clinical internship, and I needed to understand ERP better.
Thank you very much. I am so touched when another therapist comments on my videos. I wish you the best in your future.
Woah, that secondary gain statement just blew my mind.
The statement that my brain could be seeing benefit in the OCD was an angle I was blind to. The revelation from that statement was realising Iâve built much of my social circle, job, and daily life around enabling my OCD. Iâm glad I found this, it may have just changed my life.
OCD can be very tricky. It can convince us to avoid and accommodate our OCD in more ways than compulsions and rituals.
Just don't trade in OCD control for your therapist's agenda. I'd rather so not have "treatment" than to have a therapist control me.
Love the video, it really helps put things in perspective. Iâm a compulsive checker and let me tell ya doing the exposure is torture, but if you can power through it, itâs very worth it.
Thank you, Justin. Keep up the good work!
Thank you so much, Paige. I've improved drastically a couple times using ERP but I've always fallen back into OCD. It's very difficult to maintain an OCD-free state of mind because it can sneak in when you think you are cured and have your guard down in my experience. This video gave me a better understanding of how ERP works and how to do it correctly. I will continue trying even though it is extremely difficult and can feel hopeless at times.
Yes, continue to treat it. I cover a few more techniques and nuances of ERP that may help you in other videos, Here is a playlist you can look through:
czcams.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html. And, here are more resources for help with OCD:
The Top 10 Things you Need to Know to Practice ERP: Exposure and Response Prevention for OCD, Phobias and Anxiety
www.paigepradko.com/erp
OCD Self Assessment Quiz
www.paigepradko.com/ocdquiz
OCD course
www.paigepradko.com/ocd
Thank you very much! It is true not many specialist know very well about OCD. I didnât think about secondary gain, I will be aware of it.
A relative has OCD so I decided to learn about ERP. The background music is super annoying but the information was very helpful.
Iâm sorry about the music. I have eliminated music in my more current videos. Here is an ocd playlist that you can look through to understand more:
czcams.com/play/PL1lUhuKpYUYqRtx-_xbr5gofDxBYIBdq0.html
Thank you for your great efforts. I have pure O and I am not sure how to challenge myself when the thought is just humiliating me telling me I am a failure and they keep repeating all day long. I also have noticed the thoughts keep changing their theme according to the most important thing i have at the time.
Yes, obsessive thoughts will change the theme. It helps if you can remember that the theme does not matter, because the treatment is the same. We treat our thoughts as just thoughts not truths. The more that you can do that, the less anxiety you feel when you have a thought. Your job is to tolerate the unknowing of the truth of any thought.
Hey! I have pure O as well. I have the exact same thoughts and they can be brutal. Iâve been telling myself when they pop up, out loud âNOPE, not engaging with youâ and throw myself completely into my activity. Or I laugh at the thought, or I let it just drift by. ANYTHING other than engaging with it. The thoughts themselves are harmless but they can make you feel like dirt. So I understand you completely.
Also, my compulsion after these thoughts come is to seek reassurance that âam I going to be okay?â So Iâve asked my support system to extremely limit reassurance with the goal of removing it all together. The goal is to be able to reassure ourselves. Easier said than done but we can do it.
Hi Paige, thank you for all the information and the helpful techniques you share. I've been struggling with different types of OCD for almost 7 years and I was feeling desperate since I can't afford a therapy. So, I can't thank you enough for your videos. I tried to do ERP on my own but I didn't know if I were doing it right or how to do it correctly. Thanks to this video, I've just wrote down the list of strategies you give and I'm starting to do them gradually right now :)
Thank you for your comments, Selin. It makes the work worth it to hear that it helps. Working with a therapist is best, but, therapists trained in ERP are hard to find and afford. I do not want to overwhelm you, because too much information at once is not good. But, as you become more curious, here is a playlist of videos on the treatment of OCD.czcams.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html
@@PaigePradkoTherapy Iâll be watching and practicing other methods, as well.Thank you, again.
How are u feeling now? What type of OCD did u have? â@@selinderin_karaoke
I keep doing exposure and it really pays off in the long run. I now get excited about challenging myself because Iâve experienced the results.
Would really like a video on CBM havenât been able to find much but sounds like a great subject.
Keep up the good work đ
Thatâs great. I love your attitude. CBM seems promising in the labs for research, but, has not transferred over much into therapy. It is an interesting subject matter for a video.
Thank you so much for this wonderful video. With research and self-observation, I think I have HOCD - itâs been a bit debilitating, to be honest. Recently, my main concern has been whether this might lead me to develop another [more severe] mental condition - or in typical parlance - whether it may make me âgo crazyâ in the long run. Ironically, the thought of this possibility drives me nuts (LOL), I still deal with it every single day. There are moments that are quite overwhelming when the anxiety hits me: I lose focus, feel a bit dissociated from myself, become irritable (so I hate it when anyone from my family talks to me while all this is happening, because their mere voice becomes unbearable for me), and then in a matter of a few hours, I am able to bounce back. As compared to other [more severe] cases, I think Iâm relatively doing well -- and perhaps this is all just to say that hey, I chanced upon your video. These have been my symptoms for the past several weeks. They can get shitty, to be honest, but your words have given me love and light. Two lovely things I learned today: (1) I am not alone - my HOCD is a shared experience (and then, of course, that thoughts are just thoughts); and (2) I HAVE the power to reclaim myself despite these difficulties. This may sound trite, but by all means I CAN decide to live the truth of a healthy, happy, and fulfilling life because I CHOOSE how to react (or not react!) to my own thoughts!
I love your comments, because so many people are experiencing these intrusive thoughts, and your message is intuitive and hopeful. I have a new video on intrusive thoughts coming out later this week that I hope will help you. It talks about all of these second level of fearful thoughts like...am I going crazy. They are all just thoughts.
Hello. I want to sincerely thank you for what you are doing. It's true that there are not so many therapist around who can help patients with their OCD. Even in Slovakia I could not find someone who is specialized in this area. I've been suffering OCD for 15 years. It started since I was child, when I experienced my first obsession (harmful thoughts). I did not solve those thoughts properly at that time. After 10 years (OCD was sleeping in my subconsciousness), it started getting worse. Each day my mind found new problem that caused obsession and then I've done compulsive reactions. Everything was contamined for me, I thought I may harm anybody everywhere, or be extremely careful, which resulted on trying to stop those thoughts intensively or checking the people or the place I've visited). Two months ago, I realized that I have OCD. I immediately visited doctor, started to administrate an SSRIs and listen to the online therapists like you. Personally, I've found ERP as the one of the most useful methods. In the beginning, when I was exposing to the uncomfortable situations, I felt like devil in the hell. Bad thoughts was trying to stop me from doing anything. But I won. Now, the little monster called OCD is hidden somewhere in my brain and I am the dominant one. I feel very happy and my life started to get sense. And I forgot to mention one thing - I told about my OCD to almost every real friend or family member. I think noone should be afraid to talk about it. People will understand us.
You are incredible. I am sorry that you suffered so long not knowing what the condition was even called. I am so glad the videos have been helpful. Keep up with ERP anytime it resurfaces. And I am glad that you are educating people around you. There is no shame in having OCD, it is a condition that is treatable and it is very common and most people inherit the condition genetically. Thank you for sharing.
@@PaigePradkoTherapy Hi Paige! Just and little update. Itâs been year since I started ERP therapy. The results are amazing!!! Now I am still very happy, enjoying my life. I almost forgot or erased all bad thoughts. When they come to my mind (happens very rarely) I can fully control them and forget them in a seconds! Wow. Thank you for your incredible videos. Youâre the angel. Believe me :) sending a huge hug and regards from Slovakia.
@@robes2883 your comment gave me hope, thank you â€ïž
@@robes2883 do you still take SSRI? do you feel like the SSRI is needed during ERP therapy?
@@naomio.7503 thank you â€ïž I am glad that we can share our experience and motivate each other. Feel free to write me in fb (Nick Ro Bes) if you want to talk to someone about it.
Thank you for posting this video. I am following this amazing doable outline.
Iâm Finding therapists who can help me expose myself to my triggers to reclaim my life & try NAC to support my process.đ
Thatâs great news, Judith. If you ever need more support, here is my ocd course that can also be used to supplement your therapy:
OCD course
www.paigepradko.com/ocd
hi Paige thank you for posting this videos because they have helped me so much in overcoming my ocd,thank you
I'm so glad that the video helps. Keep going with the daily exposures. It gets easier.
How is it now Amby Jay??
@@naomio.7503 feels so good to be compulsion free thank you very much â€ïžâ€ïž
@@ambyjay2199 really? You did it on your own and it worked? This gives me so much hope as I was worrying doing it on your own might not be helpful.
@@ionela-roxana4566 yes,just try and everything will be okay.....
The way you explained everything so smoothly thankyousomuch đđđ
My pleasure đ
Thanks Paige, this is the best explanation of ERP I have come across, it has been very helpful, thanks again.
Glad it was helpful! â€ïž
Hi! Im really grateful for your videos I've learned so much!! I've been dealing with ocd thoughts from my past (21 yrs ago) The situation that happened is not really the problem its what my thoughts tell me about it. Its a constant battle with shame and guilt and not being deserving of anything thats good for me. Never did that situation bother me until my anxiety started a few months ago with the pandemic. During a very anxious day I heard a song that talks about my situation and after that moment its been the scariest thought in my life. Its been like 4 months of a constant battle with shame and guilt and " not deserving of good things in life" Thank you for your advice ive been putting them to practice! Its super hard but I know i can do this.
I am sorry that you are having to deal with this, Maggie. Perhaps doing exposures on the thought 3 times a day will help. Thank you for your comment.
@@PaigePradkoTherapy
Thank you Paige for your helpful response. I will definitely do that. đ€
How are you doing now?
Hi Paige,i think all your videos,and information is very helpfull to many people,keep all of them coming and more because it"s hard to get this kind of information for help just anywhere, and it all kind of shows what it"s all about thank you,love Dennyđđ
Thank you, Denny. I really appreciate it and am happy to hear that you find them helpful. Keep up the good work. đâ€ïž
wow thank you so much for this. I am just out of ideas of how to deal with my trigger, and I really appreciate the details on how this could work and help.
Hello, i have pure o and my main compulsion is rumination. Doing erp for me requires imaginal thinking of my fears but i ended in just ruminating the thoughts. :(
Me too I've been trying for two years now but I couldn't do erp đąđą I am going for medicine give me ur contact I can tell u about my progress
Thank you so much mam for the explanation. I was desperately searching for a vedio that clearly narrating about ERP. Definitely i m gonna put this into practice. Thanking you once again for the effortâ€.
this is excellent! God Bless You!
Thank you. And you as well đâ€ïž
Thank you soo much Paige! You're simply amazing at explaining things. I wish i had a therapist like you here in India. I really appreciate your efforts for making this informative video. đ
You are so kind. Thank you so much for your kindness and your encouragement. I appreciate you.
@@PaigePradkoTherapy thanks! You too :)
Interesting video. For a very helpful narration on when ERP will fail at mitigating OCD and how Response Prevention can still succeed please click on the attached hyperlink.
czcams.com/video/i-wY-nGD0zo/video.html
So strange I just stumbled upon this video - I started taking NAC about a week ago to help with my anxiety and I think it's actually helping me deal with my checking OCD ERP. So glad to see it validated by a professional!
are you still taking NAC?
@@ThinkPositiveDude hi - no I'm not - I can't remember why I stopped tbh but I have recently started taking L-theanine and finding it helpful
Loved it looking for erp therapist in the Okanagan British Columbia
Hi Meighen. If you would like help with ERP, I have a wonderful course that will take you through step by step on what to do. Here is more information on my course Free from Pure O and OCD: www.paigepradko.com/ocd.
Madam, why is CZcams not allowing me to post comments under your videos specifically? Do you have any idea why .. if so please reply madam .. I post a lengthy comment under your videos and after a couple of minutes return back to view my comments and it's gone .. This comment got posted , thank god and did not vanish after a couple of minutes .. Please reply madam ..
Hi Arjun. CZcams seems to not allow the posting of longer comments. I have noticed that when someone leaves a long comment, I will see the comment, as CZcams sends me an email. But, it will not post and I will not be able to reply to the comment if it is too long. It is unfortunate.
@@PaigePradkoTherapy wow madam, you replied sooo fast thank you .. I wanted to whole heartedly thank you for answering my query 4 days back wrt more explanation from your side on DBT TECHNIQUES .. THANK YOU MADAM SOOO MUCH .. I am compelled to keep my comments short here ..
You are more than welcome. I appreciate you as well.đ
@@PaigePradkoTherapy THANK YOU SOO MUCH MADAM .. OCD & ANXIETY elimination has changed transformed me as a human being, I feel I am a totally new reborn individual now .. feel soo light headed, clear minded .. emotionally balanced .. Thank You soo much madam .. Arjun ..
This was interesting. How can you do ERP exposures for fear of harming family members (violence) and sexual intrusive thoughts against others? How to expose yourself to these routinely?
I recommend using a strategic approach on these thoughts. Label them as OCD, and then do not interact or argue or give the thoughts attention. It is OCD, so you cannot dispute with something that is made up by your brain. Tolerate the anxiety associated with the thoughts. And let time pass. Do this repeatedly when the thoughts arise. Identify and label the ocd thought, tolerate and float through the anxiety, the anxiety and thought will die down on itâs own.
Thank you for this wonderful video. I am enrolling in training for Exp/RT and excited to learn more about this and help in this area.
Glad it was helpful! I have more recent research and techniques included that incorporate inhibitory learning in more recent videos. Good luck in your training.
Thank you â€
You're welcome đ
Iâm doing my best. Though I canât help, but have a massive headache. đ
May Allah cure you
First of all, thanks a lot for your work. I'm struggling with a problem that is not properly classified as OCD but has a lot in common with it. Retroactive jealousy. I'm suffering a lot and I'd like to apply ERP to this problem. Do you think it could work? how can I do the exposure with a PURE O-like problem?
I have pure-o too
Wow thank you mam it literally helps a lot ....hoping this kind of therapist in india......
Brilliant. Great explanation especially secondary gains and keeping an anxious brain, once I discovered meditation I have used that to calm myself, I suppose I should stop for certain periods to get the full âDoseâ of fear.
Thanks
Yes, there is strong evidence that taking certain medications like benzodiazepines lessen the effectiveness of therapy including ERP because your amygdala is basically numb and not activated. But, those medications can be very difficult to go off of and if you are taking them, please do not withdrawal without consulting your physician. It takes some people several months, even a year to withdrawal. There is no evidence that I am aware that suggests antidepressants make ERP less effective.
I have started with it since a week and it is extremely difficult and emotionally draining
Yes, ERP is draining and difficult. I want to encourage you to keep working at it. Every time you practice ERP you are making progress, every exposure is good. It does take time, and you have to be willing to be uncomfortable. If you can remember that you are willing to be uncomfortable in ERP in order to have improved wellbeing overall.
@@PaigePradkoTherapy hello mam
Is it ok to cry heavily after erp therapy,actually i was dealing with intrisive blasphemous thoughts.SO finally i gave that thought a intentional way and what followed was Heavy cry.Is it normal
Very helpful, thank you.
Youâre welcome đâ€ïž
What about existential ocd, where there isnât anything physical for us to touch for example to make us anxious. I think over the years my anxiety has now become existential ocd. I ruminate a lot about the meaning of happiness, I ruminate about whether or not a selfless act truly exists, etc⊠I also ruminate about everything else also like if Iâm in a new city Iâll ruminate about the landscape like where is this like this, who decided that this building was going here, how do they organise the infrastructure, etc⊠Iâve also ruminated about things like a tv show. I once ruminated about a show because the good guy in it lost a fight even tho he was a lot tougher than the bad guy and I couldnât stop ruminating about it. Itâs sounds all crazy but whenever Iâm uncertain about something Iâll ruminate about it even tho I donât want to. When it comes to existential topics obviously there no definite answer but when theyâre questions about reality or philosophical things it makes me feel very disconnected and that reality isnât how I think it is
Good information and very nice.
Great!!!-thanksđ
I have OCD about death and children, I fear death and other death and i get this fear first thing in the morning and during the day. At night I can sleep well without any problems but when I awake death comes in my mind. I think death as a fearful and assume one day I will have to visit the hospital and watch my parents die. This put fear into me. Also, fear of getting old too and having many illnesses too. Its a shame we cant live forever
Our brains are very good at choosing obsessive thoughts that frighten us. We can do ERP and Strategic exposures on those obsessive thoughts, regardless of the content of the thoughts.
@@PaigePradkoTherapy Thanks, do you have these videos on your channel
Great summation of ERP strategies.đđœ
Thank you. I have made a few updates to ERP treatment that are summarized here czcams.com/video/0xpDmuIe53E/video.html.
Thanks for the link to your updateđđœ
This content is amazing thank you for sharing this!!!
Youâre welcome and glad you found it helpful.
Thanks again!!
Youâre welcome, Larry.đ
awesome facts explained.
Thank you. Iâm glad you liked it. đ
You're a God send
Thank you đâ€ïž
God bless you Maâam
Thank you đâ€ïž
I am a father who has OCD and my son also has OCD, this video has given my wife and I some ideas to try with our son. He is currently being medicated but is not seeing a therapist
@Merz thank you
You are a loving father to be searching for help for your son. I highly recommend finding a trained therapist, although it is difficult to find OCD therapists that are accepting new clients at the moment. The IOCDF.org has many resources and a listing of trained therapists. You want to make sure that the therapist is trained in ERP. However, when therapists are unavailable, it is completely possible to âdo it yourselfâ, especially if your son is willing. The more he understands about OCD, the better. I wish you and your son the best.
thanks a lot for putting so much effort into your videos and into helping people! do you have any advice on physical symptoms and on like social interactions? i feel like interacting with other people is super hard for me at the moment, my symptoms (like pressure on the chest) get worse and i feel like i'm not really able to have a regular conversation, do the physical symptoms decrease over the period of recovery just by accepting them and doing exposures or are there certain methods especially for the physical symptoms? :)
Thank you for your comment. Yes, there are specific techniques if your anxiety is exacerbated by physical symptoms and social environments. First, I advise all of my clients with anxiety to practice square breathing and breath focused meditation daily. You can find those videos in my series on Calm the Body. Second, if your anxiety gets revved up by body sensations like a rapid heart beat, I recommend doing Interoceptive Exposure Therapy. You will find my video on this type of exposure on my video page. It is even proven to be more effective than CBT techniques like cognitive restructuring. And finally, if your anxiety is tied to social interactions, than, exposure therapy is going to be important. Many people make the mistake of not doing exposures in enough variety of situations and environments. I also have struggled with social anxiety and made a video on what I learned and what has helped me. I hope you check that video out too. I relate personally to your question and I look forward to hearing from you after you have experimented with some of these techniques. I personally look at social anxiety and many anxiety disorders as lifelong challenges. We can make incredible progress, but we have to keep challenging ourselves. Thank you again for your comment đ
Very well explained. Thank you!
THANKYOU FOR YOUR WORKâ€â€â€
Youâre welcome. Thank you for your appreciation đâ€ïž
I can do anything. Use public restrooms, Go into a Dr.'s office as long as I don't come home. If I sleep in a hotel I'm ok. However when I come home then begins the decontamination rituals. Showers, laundry, car cleaning, can't sit anywhere till I shower. ( which means no drinks at the movies or local restaurants) This goes for any one who went with me which causes tears and arguments. I'm ok as long as I don't come home. Why do you think this is? When I'm on vacation I feel free till I come home then I feel filthy, contaminated. What's so special about me entering my home?
OCD does not make logical senseâŠbut your brain can send you the urgent messages to compulse anyway. If you would like helpâŠI have a program that would be great for you. I walk you through exactly what to do to give you your freedom back when you walk into your house. If you are interested, you can find out more here: www.paigepradko.com/ocd
Thank you đ
I wish I had done ERP when my OCD was contamination focused. Now my OCD is focused on something that doesn't lend itself to real world exposure too well
Yes, mental compulsions can be challenging. Here is a playlist to help you: czcams.com/play/PL1lUhuKpYUYqKvEwlGXoRPDu_8blhbaq-.html
It helps alot. i was searching for something like this. Thanks
Hi Zubair. I am glad you found it helpful đâ€ïž
Looking forward towards more.
Thank you sooo much !! This was so helpful
Thank you, Liz. I am so glad it was helpful. I have a playlist for OCD and for Pure O if you are interested.
I exposed myself and did my fear. It wasn't that bad but i still did it and now i am more scared (:
Hi Gabe. Good job. Itâs ok to feel scared or anxious. If you felt like it was more than you can tolerate, they ease up the exposure. But, often people can feel anxious for hours afterwards. But, I do recommend doing your exposure with an attitude like you are determined versus white-knuckling it the whole way through. I hope you feel proud of yourself for your courage to face your fear.
@@PaigePradkoTherapy i thank you so much. It's kinda funny my anxiety is strong but i don't fear anything. Like i don't fear the thing i feared
OCD comes and goes. I realized it comes immediately anytime l try to read a book. I keep re reading the same sentences anytime I mess up a word. My chest and throat gets tight like in knots and I feel tingling through out my body.
Iâm sorry you go through that. What you experience is a common OCD theme. It is related to perfectionism and redoing. The fear is often that you may be afraid you missed something or didnât quite comprehend it all, and the rereading occurs. I cover that one in my course. You have to allow the uncertainty that you may have missed something to be there on purpose and keep going. đ
@@PaigePradkoTherapy Thank you so much for this reply! I am definitely going to follow you and check it out!
We also need erp therapy for hocd and harm ocd
Yes, absolutely. Thank you.
Subscribed. I have horrible OCD. Please do a video on toileting contamination OCD. It's near debilitating for me just to use the bathroom. I can't even shower unless the bathroom is clean. I have Medicaid and have a prescribing psychiatrist. However, getting erp and cognitive therapy hasn't happened. I need it desperately. There is a months long waiting list.
I am so sorry you there is such a long wait list. I will add this to my list of topics to cover. I do have an OCD playlist that may help you, but have not made a video yet specifically on your topic although it is covered in my OCD course.
Nice job presenting this topic. I am an ocd contamination person and I donât think I can do erp. Iâm trying to use the motivation of not having to go through it and medication to try and relax my standards of cleanliness. Iâm not sure how well itâs working but Iâm trying. Iâve been through a number of different phases of compulsions and this is the worst. I hope I can get my ocd more under control without erp.
Thank you, Richard. Yes, motivation and determination has to be very strong to do ERP. But, medication can make ERP more âdoableâ for some. I want you to know that you are not alone and I wish you well.
Hello mam. ..
To see this video I can Do ERP therapy to my sister who is suffering from OCD..
But plzz help me to do this therapy step by step so that she feels comfortable by this ERP therapy...
Omg this video help me so much thank you
Glad it was helpful đ
Thank you very much watching here in Philippines. A big help..
Thank you, Polly. Shout out to the Philippines! One of my best friends on the planet is Filipino â€ïž
Great information.
what if the client is too exhausted because of many years of trying to overcome the OCD before coming for therapy, and does not want to make the hierarchies. which therapy would work then? Basically, a resistant client.
There are a few different options with a resistant client. And, this video is a few years old and I no longer use hierarchies, but encourage people to mix up exposures and intensities of the exposures. But, with a resistant client, I would work for awhile on why they want to get better, and what they have missed out on in life due to their ocd. I would work on establishing well identified motivation and values and reasons to want to get better. Then, I would investigate how they did ERP in the past. Many people do not do response prevention after exposures are over or set specific rules as they work their way up to response prevention. And if they absolutely do not want to do ERP, I might suggest that they do a therapy called I-CBT (Inferential Based Cognitive Therapy).
Thankyou so much for helping me Mam I've beated my RELIGIOUS OCD,just a question Can't a mentally strong person prevent further relapses or different OCD themes in future,if he practiced ERP well???
OCD may pop up here and there. Identifying it when it pops up and practicing ERP, especially the response prevention part, can keep it in check.
@@PaigePradkoTherapy Thankyou Mam :)
Or N - Acetyl cysteine .
I have read several research articles and have had clients prescribed NAC by their psychiatrists. To be honest, I have not seen any break through, impressive results in my clients. But, the research is positive. This is an area that needs more study.
@@PaigePradkoTherapy
Thank you. I never had OCD until it showed its head when I was about 35 yrs old. Been taking NAC for a few months as well as Maca root powder. Something is helping because my stress level as gone down and not as fearful of situations.
That is so encouraging to hear. Thank you for sharing.
Very informative video
Glad you think so!
Dear Dr. Paige Pradko,
My name is Hung, I have watched your videos on CZcams on OCD and anxiety treatment, I found that they are so helpful to me. Now, I am suffering Somatic/Sensorimotor OCD and need your help. There are no therapists specialized in OCD at my location, so I am doing ERP by myself. Below is summary of my OCD symptoms:
1. Obssesions:
- Intrusive sense on awareness of where my eyes looking at (the most anxious) and awareness when moving legs and hands.
- Intrusive thoughts come after intrusive senses, there are 2 types:
+ Type 1: Thoughts about my movements with reason such as: I am looking at...because..., I look at this thing, not that thing because...).
+ Type 2: Thoughts that my movements have no reasons, so my movements are abnormal.
They come again and again all day, repetitively, whenever I do something. I feel anxious and distress whenever intrusive senses come, the intrusive feeling of paying attention excessively where my eyes looking at is so terrible, very anxious. But the intrusive thoughts are less anxious.
2. Compulsions:
- Try not to think the thoughts.
- Think more about thoughts.
- Analyze thoughts whether they are compulsion or not? Need to remove them?
3. ERP actions:
- Not avoid anything, I deliberately join in actions, not avoiding any situation although I feel so anxious.
- Allow senses and thoughts come, not get rid of them, not analyzing.
I am trying implement ERP, but the frequency of senses and thoughts come more and more, then I have to tolerate discomfortable feelings all day, the anxiety and distress feeling not subsided by their own. Please help to give advices what I need to do more?
Note: I am taking Seroquel XR 50mg and Fluoxetine 20mg per day as prescripted by doctor.
Hung.
Now I am trying to agree with all thoughts, let them come, let then go. But they come more and more, specially intrusive sense of where my eyes looking at, the sense come fast, bring anxiety, thoughts and go fast. My anxiety come and go quickly, I feel so distressed now
ThĂĄi HÆ°ng HoĂ ng, it sounds like you are on the right track for treatment. You do not what to analyze your thoughts...just let them be, let them float there. No avoidance or mental compulsions. If you are more anxious and more thoughts come, let them come. This is common when one begins ERP. Anxiety will go up, before it drops. Stay with it.
If a person has multiple OCD like harm and contamination and both goes hand on hand how to make ERP Strategy and also how to make response prevention in harm OCD where ritual is mental compulsion
Yes i am live at last corner...here we have not ha such therapest...Your videos are helping me a lot.
I am happy that you found my channel and that my videos are helping you. Here is an ocd playlist that may help. czcams.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html
Respect and love
@@PaigePradkoTherapy in harm ocd when we absses our mind creat assocotion...how can they be solved?
I might have given my friend erp therapy by accident growing up
That must be a good story đ
it was a great explication! I would like that youtalk about ocd reading or if you could to share information about it. I have problems with reading. I can't remenber the text so I repeat it more times. It is stressing and I have problems with University.
Thank you Doctor ERP works.
Youâre welcome âșïž
Enjoy watching the video. It really has good information. I suffer with harm OCD, what Triggers my Thought is a person I life with is there a way we can connect in a more private way to discuss steps on how in over come this.
MTB_Hulk cash Rolie, unfortunately, I am unable to work privately at this time. My only means of support are the videos. Harm OCD seems to occur in people that would never harm anyone. When you have the obsessive thoughts, identify them as OCD and allow the thoughts. Do not argue with or analyze the thoughts. Just allow them to float there. Do not do any compulsive behaviors in an attempt to not have the thoughts. Eventually, your brain will learn that you can tolerate the anxiety associated with the thoughts and they will go away.
Paige Pradko LPC NCC thank you for responding well follow your advice.
Thanks for putting together this video :) I was just wondering why antidepressants are ok with ERP, but benzos are not recommended.
Great question. There are research studies documenting the evidence that antidepressants, specifically SSRIâs help people with OCD. What I notice in my clients that choose to take them is that it cuts down the rumination considerably and they are more easily able to resist their compulsions. Benzodiazepines suppress the nervous system and can have long term harmful side effects if taken daily. Research points to difficulties storing new learned information and consolidating it into long term memory when taking a benzodiazepine. However, there are times when someone might use a benzodiazepine on occasion (not daily) when doing an exposure for the first time. That may help them get through the exposure and then be able to redo the exposure without the medication soon after.
Thanks again for explaining all of this Paige :) Do you know by what mechanisms SSRIs are able to decrease the ruminating thoughts?
No, I donât. I have also witnessed a similar result with people taking the supplement NAC for OCD.
Thanks again for the info - I'll have to do a bit of research and check out NAC, too! :)
Wonderful video
đâ€ïž
Paige I'm so grateful to you for loving my comment. You are Amazing
13:00 Exposures don't work if we make ourselves less anxious .. so going by your explanation .. _should we stop meditating regularly since that makes us less anxious and more calm .. please explain madam_ .. great video madam . . Thank You .. please elaborate on my above doubt ..
Meditation is a wonderful practice for everyone. Exposures require a certain amount of anxiety or discomfort, at least at the beginning of the exposure. If there is no anxiety, then you may not be challenging your core fear, or you do not need exposure therapy or have possibly habituated to your fear. The anxiety does not have to be extremely high. Please keep meditating, but not during your exposures.
@@PaigePradkoTherapy yes madam correct you are right .. meditation should be done when there is no exposure or trigger around. . we should not meditate during an exposure .. Meditation as far as I have observed tends to reduce the intensity of an exposure (deliberate exposure or sudden unplanned exposure) or trigger ... .
If friend is asking 100s of compulsive questions per day what can I say instead of repeating answers? Ocd triggers are many different words and themes related to insecurity and jealousy. Should I stop all answers (impossible) or 1 hour per day no answers or some other progressive change?
It is important to be compassionate and kind, but it is not helpful to give repeated reassurance. You can say something like, âIt seems like your ocd is really triggered today. I know this is difficult for you, but giving you reassurance is not helpful for your ocd. I care about you and do not want to support your OCD.â
the problem is that one of my biggest triggers recently is going to sleep - since I've been having trouble sleeping. then, if I don't do the deep breathing techniques, I'll have trouble sleeping (because I'll be too anxious), even though apparently if I don't do it, it will help with ocd. it's like a loop :(
I understand because I have a type of ocd called somatic awareness ocd. It can be triggered by becoming aware of my breathing when I am trying to fall asleep. Breathing can become a compulsion even though breathing exercises can reduce anxiety in the short run. However, they reinforce the anxiety and ocd in the long run. I recommend allowing the anxiety to be there in a kind and accepting way. Almost like you have given up all of your defenses and you just sayâŠokay anxiety, you win. You are allowed to stay as long as you wish. Even if I donât sleep, I suppose my body will find a way to catch up on sleep eventually. This kind of attitude will help. đ
@@PaigePradkoTherapy that was so kind of you, thank you!!
Thankyou mam. Im suffering for relationship OCD although I'm only 16. I want to stay with my partner but my OCD keeps giving me anxiety if i think about him or be with him or talk to him at all but i want to have a future with him and im very serious. At one point we also had to break up but i went back to him but im having the OCD and anxiety again i want to learn how to do erp i discussed this with him he told me i will get better but im scared to loose him. I don't know what to do im just very scared
If ones OCD revolves around more thoughts (intrusive thoughts) about other people, would we do ERP in the form of âthinkingâ those bad intrusive thoughts? Like allowing ourselves to think those scary thoughts and allowing them to come in and accepting them or saying them out loud? Instead of trying to resist?
Yes, that is exactly what you do. You allow the thoughts and do not resist them or argue with them or try to figure out if they are true or false. Youâve got it!
Paige Pradko LPC NCC Thank you so so much!!!!!! This is going to be a great help. Thank you for all that you are doing.
Please doctor I started doing medication and spending time with family and friends going out eating walking and shipping and taking care of my body
Does this make my ocd stronger because It knows I'm trying to escape it
Or is this okay? Like can I do things that make me happy?
Yes, do things that make you happy whether OCD is there or not. đ
Mam i was having ocd 2 yrs back ..and your videos really helped me to eliminate them but suddenly i got suicidal ocd and it was out of the bule now i am not able to take out them out of my brain and again i will do your ERP Theapy
Hi Partha. I am glad the videos helped you before and will hopefully help you again. OCD likes to create doubtâŠif you are doubting and asking yourselfâŠâwhat if I do this or thatâ you know it is your OCD imagination at work and not you. If you need more help with harm OCD, I have a course that walks you through exactly what to do to feel better: www.paigepradko.com/ocd.
@@PaigePradkoTherapy ok sure i will check that out
Thank you ..
Youâre welcome âșïž
I do not have trigger its just feeling which keep coming without trigger. Any advice how to deal?
Seems they are always in the background sometimes coming automatically.
There is no emotional pain but they are painless feeling which are not stopping
Yes, OCD obsessions can include more than just thoughts. They can include feelings or emotions, images, urges or sensations you feel in your body. Response prevention is important for treatment. Do your best to not respond to what you are sensing or feeling.
@@PaigePradkoTherapy really appreciate your reply. Thank u so much
Thank you so much for this video!! đđ
Youâre welcome. Thank you for watching and commenting đâ€ïž
Can I do anything that makes me happy like listen to music or write? Or dance or talk to friends
Yes, do all of those things. đ
Tks so much Paige for these great explanations that u give to enlighten us on OCD. Wouldn't the I AM method be like having a safety behaviour?
Thatâs a great question. The I. A.M. method is an incidental ERP exposure combined with mindfulness. We are identifying the thought, we are not trying to avoid or push it away or analyze it, we are actually doing the opposite. We are Allowing the thought. This is a form of non reactive exposure. Then, we are connecting mindfully with the moment we are living and moving on. An incidental exposure is different than a planned ERP exposure. I like my clients to have a plan of what to do with the thoughts when they are not in an ERP exposure. A safety behavior might be avoiding a situation because it might trigger you. There is no avoidance here. You allow the thought to be there, then mindfully connect to the moment you are living. The thought can stay in the background as long as it wants to stay. đâ€ïž
I have been trying ERP on my own and your video was extremely helpful for what I am doing wrong! Thank you so much! This is not my first time practicing ERP but before I was very young and diddnt even realize I was doing erp I just know my ocd calmed down no barely bothersome until now.
My contamination OCD is led by my very real and deathly allergy to Strawberries and walnuts and I am struggling with how to find a common ground between being safe but not being completely careless. I did ask a few people who have severe food allergies what they do for cleaning and what they do to keep cross contamination to allergens down but answers were not very clear other than keeping those allergens out of the home. Any advice?
I can understand how your ocd could be exacerbated by your allergies. I would read ingredients before eating a new food, and then purchase an epi pen to have on hand just in case I ate something I was allergic to by accident. I would then make sure that I was not compulsing by excessive washing and cleaning.
@@PaigePradkoTherapy ah yes. I have already stopped the compulsive handwashing. I started wearing gloves when cleaning things (that I should be wearing gloves like the litter box) and I got accustomed to only washing my hands when appropriate and it was not again and again and again. I feel like I am making progress because my IT that would lead me to compulsions come and go just as fast without any reassurance from myself (which I learned from your video last night that telling myself it's okay and that it is safe is wrong!) Unfortunetely I cant use many medications because of another allergy to some unknown possible binding agent? and drs have never been able to figure out if it is even safe for me to have an epi pen.. It is a Rollercoaster but I am grateful how far I have come and I have all the motivation not to give up.
You have really done an incredible job, Sasha. Congratulations for making so much progress.
Your way of explanation of therapy is great . Can we use relaxation therapy at initial stage of erp if we are using ERP for first time . I m a big fan of yours .
Relaxation techniques are not recommended, but if this is the only way that you can do ERP, than it is better to use them than to not do ERP. You can possibly use them at first, and then let them go later when you have learned that you can do ERP. I am glad that you are benefiting from the videos.
Hi Paige
My son (15) feels that he has to do hours of rituals so that he doesn't lose something good. So how would I do ERP on that?
Sera
Hi Sera.
This is an ocd theme that I only see occasionally, but it can still create suffering. Jonathan Graysonâs book, âFreedom from OCDâ has a chapter on this type of OCD. I would begin with scripts and have him write and record several scripts that target his fear of losing things that he cares about. It would be helpful if your son could work with an ocd specialist. If this is not available, your son will have to want to work on it and want to do ERP. Here is my latest video on how to prepare scripts for ERP. czcams.com/video/HrjM091rcXc/video.html
This one is Great , thank you madam
So glad you found it helpful. Thank you
Wondering why benzos are bad for OCD.The doc gave them to me to help with it???
This is a great question. There has been quite a bit of research on this in the past 10 or so years. Researches like Catherine Pittman and others noticed that exposures and ERP were not effective on those patients taking benzodiazepines. They believe it is because the medications interfere with the brainâs process of storing new information into long term memory. The psychiatrists that work in university hospitals and specialize in treating OCD patients know this research well. Unfortunately, not all physicians are familiar with this research.
Thanks!
You bet! đ
How long should a typical ERP session be? And how many days/weeks/ months does it take to recover if your consistent everyday?
A typical ERP session is going to be very different for each person and it depends at what stage of treatment one is at as well. Your goal in each ERP session is to feel like your brain learned something and your anxiety went down a bit before you stop. Sometimes people can feel their anxiety go down in 15-20 minutes, while other people do not feel any decrease in anxiety until 1-2 hours of ERP. When you first begin, it might take longer than a few weeks into treatment.
Should I try anything that gives me anxiety and obsession? For example licking dirty toilet floor get me super anxious and it has about SUDS 100 but is it healthy to do that? s there a limit for exposures? How should I know the difference between my obsessions and unhealthy behavior?
Hi Ali. I understand what you are asking. Your exposures will depend on what your core fear is. If you are afraid of getting sick and dying, then you will have to exposures to âfeelâ contaminated. Of course you will not do something that is literally life threateningâŠ..but you do need to trigger your fear. I am creating a therapy course for contamination ocd that will be available soon, and in the course I walk you through step by step what to do. I have included updated information in the course on how to do contamination ocd exposure and response prevention. If you think you might be interested in my therapy course for OCD, please send a message on PaigePradko.com and I will send you more information when it is available.
Hi Mrs Paige.
My name is Chibuzo and am 16 years old.
I dont know whether I'm suffering form OCD but I feel like I am having these symptoms of OCD. Some of these symptoms include tightness in the chest, Awareness of my breath.
And I try as much as possible to help myself to get relief of these symptoms. I also get scared a lot.
So please Mrs paige, Can you help me please?
Hi Chibuzo. I am sorry that you are being bothered by those symptoms. It sounds like a type of OCD that I have as well. It is called Sensorimotor or Somatic Awareness OCD. It happens when an unconscious body process or sensation becomes conscious. Like you, my breathing comes into my awareness and feels like I somehow have to consciously breathe. Just like any other type of OCD, ERP is helpful. In my case, I prefer the I. A.M. technique. Here is a link to the technique czcams.com/video/9nEC8yIgFKg/video.html. However, if it hits when I am trying to sleep, I just try my best to be non reactive and allow it to be there as long as it wants to be in my awareness. But, I do my best to not go checking on it. The compulsion here is checking to see if we are aware ⊠and if we check for it, of course we will find it. I hope this helps.
why do I always read over and over when I can only read something around that I can see? Is it OCD? Please answer my question. đ„ș
Yes, this is a common subtype of OCD. People can reread over and over. They are often have doubt that they understood it correctly or they are trying to get a certain feeling. But, yes, it is OCD. Here is a self assessment www.paigepradko.com/ocdquiz