DO YOU NEED MORE HELP WITH OCD & ERP? 👉🏼 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. 👉🏼 Here is a link to a FREE SELF ASSESSMENT for OCD: www.paigepradko.com/ocdquiz 👉🏼 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
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
Wow….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. 🙏😊
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
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.
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 I’ve built much of my social circle, job, and daily life around enabling my OCD. I’m glad I found this, it may have just changed my life.
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: th-cam.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
Love the video, it really helps put things in perspective. I’m a compulsive checker and let me tell ya doing the exposure is torture, but if you can power through it, it’s very worth it.
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.
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.
I’m 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: th-cam.com/play/PL1lUhuKpYUYqRtx-_xbr5gofDxBYIBdq0.html
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.th-cam.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.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. I’ve been telling myself when they pop up, out loud “NOPE, not engaging with you” 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 “am I going to be okay?” So I’ve 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.
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. It’s 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. You’re the angel. Believe me :) sending a huge hug and regards from Slovakia.
@@naomio.7503 thank you ❤️ 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. I’m Finding therapists who can help me expose myself to my triggers to reclaim my life & try NAC to support my process.👍
That’s 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
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.
Thanks for the guidance! I'm a therapist and am working with OCD clients with contamination-bodily excretions focus. This is never an example in trainings, and I would greatly appreciate some examples of how to do exposures with them.
@@lilag2290 yes, this is a much, much needed topic. I cover it in detail in my course, but on youtube…it would likely be censored. Feel free to drop me a line at paigepradko.com and I will try to give you some pointers. 😊
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. :(
Thank you so much for this wonderful video. With research and self-observation, I think I have HOCD - it’s 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 “go crazy” 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 I’m 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.
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 Denny😘🙏
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.
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 ... .
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.
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???
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.
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?
Great question. There are research studies documenting the evidence that antidepressants, specifically SSRI’s 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.
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 effort❤.
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!
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 “Dose” 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 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
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 “do it yourself”, 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 😊
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 it’s own.
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.
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.
I’m 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 didn’t 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. 😊
I keep doing exposure and it really pays off in the long run. I now get excited about challenging myself because I’ve experienced the results. Would really like a video on CBM haven’t been able to find much but sounds like a great subject. Keep up the good work 👍
That’s 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.
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
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.
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
How much time usually does it take to feel high improvement? (I mean for a really severe ocd) cause i use medications for about 10 years and did anterior capsulotomy & limbic leucotomy but they were totally useless & i wanna go for dbs. Cause i felt very little effect from rtms.
Hi, good information. please give some tips to teeneger having ocd...how can they increase their IQlevels. Are there any gadgets that are helpful to ocd teenegers to focus quickly on thier studies...12th class...please let me know.
There are several studies. Here is one: Review dx.doi.org/10.9758/cpn.2015.13.1.12 pISSN 1738-1088 / eISSN 2093-4327 Clinical Psychopharmacology and Neuroscience 2015;13(1):12-24 Copyrightc 2015, Korean College of Neuropsychopharmacology N-Acetyl Cysteine in the Treatment of Obsessive Compulsive and Related Disorders: A Systematic Review Georgina Oliver1, Olivia Dean1,2,3, David Camfield4,5,6, Scott Blair-West1, Chee Ng1, Michael Berk1,2,3,4, Jerome Sarris1,4 1Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, 2Innovation in Mental and Physical Health and Clinical Treatment: Strategic Research Centre, School of Medicine, Deakin University, Geelong, 3The Florey Institute of Neuroscience and Mental Health, 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, 5Illawarra Health & Medical Research Institute (IHMRI), 6School of Psychology, University of Wollongong, Wollongong, Australia Objective: Obsessive compulsive and related disorders are a collection of debilitating psychiatric disorders in which the role of glutamate dysfunction in the underpinning neurobiology is becoming well established. N-acetyl cysteine (NAC) is a glutamate modulator with promising therapeutic effect. This paper presents a systematic review of clinical trials and case reports exploring the use of NAC for these disorders. A further objective was to detail the methodology of current clinical trials being conducted in the area. Methods: PubMed, Web of Science and Cochrane Library Database were searched for human clinical trials or case reports investigating NAC in the treatment of obsessive compulsive disorder (OCD) or obsessive compulsive related disorders. Researchers with known involvement in NAC studies were contacted for any unpublished data. Results: Four clinical trials and five case reports/series were identified. Study durations were commonly 12-weeks, using 2,400-3,000 mg/day of NAC. Overall, NAC demonstrates activity in reducing the severity of symptoms, with a good tolerability profile and minimal adverse effects. Currently there are three ongoing randomized controlled trials using NAC for OCD (two adults and one pediatric), and one for excoriation. Conclusion: Encouraging results have been demonstrated from the few pilot studies that have been conducted. These results are detailed, in addition to a discussion of future potential research
Hi Miha. The International OCD Foundation recommends SSRI antidepressants for OCD. Some of my clients choose to take them, some do not. Benzodiazepines can actually make OCD worse.
Recommendations by the International OCD Foundation include Luvox, Prozac, Zoloft, Paxil, Celexa, Anafranil, Lexipro, and Effexor. These are the brand names.
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. 🙏
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. th-cam.com/video/i-wY-nGD0zo/w-d-xo.html
Hi Colin. I am hoping to do a separate video on sensorimotor ocd this year. I get the issue with hyper awareness of breathing myself at times. There are 2 methods of ERP I recommend. One is just allowing the awareness as long as it wants to be there with an attitude of complete acceptance. The second is to go deeper into the fear and tell yourself that this breathing awareness may be there forever and may result in complete insanity. This is a strategy to move into your deepest fear. You could even record a script where you describe yourself forever focused on your breath and going insane...and then immerse yourself listening to that script several times a day. It sounds absolutely horrible, but, it works.
@@PaigePradkoTherapy thank you so much Paige been having this since last August had it about 10 years ago aswell and sort of got over it dont k ow how though. Sleeping is a mjor major issue at the minute trying to get to sleep. If i could manage some sleep i think the anxiety would drop.dramatically sorry for the long reply
That’s exactly when mine acts up too...when I am having problems sleeping. Try your best to just allow what ever comes up and do not try to fight it in any way. Here is a playlist for insomnia if you haven’t seen it. th-cam.com/play/PL1lUhuKpYUYoq2g2GlxmYyjz2yg1L6gJ9.html
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.
Dear Dr. Paige Pradko, My name is Hung, I have watched your videos on TH-cam 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
Thái Hưng Hoàng, 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.
Nice job presenting this topic. I am an ocd contamination person and I don’t think I can do erp. I’m trying to use the motivation of not having to go through it and medication to try and relax my standards of cleanliness. I’m not sure how well it’s working but I’m trying. I’ve 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 “doable” for some. I want you to know that you are not alone and I wish you well.
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).
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.
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.
Hi Jas. Here is a playlist for OCD th-cam.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html. There is training available from the IOCDF.org. I will have more training for OCD in the coming months. There are also several great books. Check out Freedom from OCD by J.Grayson.
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...
That is a great question. You have the choice in how you set up or combine your triggers or obsession themes. When working with clients, we typically pick an exposure that we know they can get through to begin with, then we make it a little more challenging. Then we change it up and maybe add scripts and behavior exposures together and combine exposures in creative ways. We try to be as creative as possible and vary exposures slightly every time instead of doing the same exposure over and over again. You do not have to complete one trigger before moving on. You want to vary or change up exposures as much as possible to keep your brain a little surprised. I hope that helps to answer your question. This video may help you as well. th-cam.com/video/439l0c-P3lg/w-d-xo.html
@@PaigePradkoTherapy hi Paige, thankyou for replying so quickly. I think your videos are fab and I look forward to watching a lot more now I have found them. I do have another question though. In the video I have just watched it said not to combine ERP with cognitive therapy, but another I watched of yours(the complete guide) ,it said you should so I am a little confused. I work with children aged 7-11 and I would be really grateful if you could tell me or signpost me to the right videos about techniques to help with their anxiety since lockdown it has understandably affected a lot of children. Best wishes to you Jan
Hi Jan. I admire you for searching out treatment for your young clients. This year has been so tough for them. You are correct, I have changed my treatment of clients with OCD. I used to use Cognitive Therapy and challenge their beliefs as part of a treatment combined with ERP Exposure and Response Prevention. However, I have shifted from Emotional Processing Theory to Inhibitory Learning Theory in the last year and a half or so. Michelle Craske’s research has demonstrated that Cognitive work (the C of CBT) makes the Exposures less effective because they lesson the violation of the expectancy in exposures. According to her research and others, the brain has to be surprised in exposures. For example, a person with contamination OCD expects that they cannot stand to contaminate their hands and touch everything in their room. Then, they do just that in their exposure and surprise themselves that they did it. When I work with kids, I do have them externalize OCD and draw pictures and talk back to it in a humorous way. I also am always working on tolerating anxiety instead of getting rid of it and highly praise and support every time they tolerate it whether in an exposure or not. In treating children with anxiety, I have used almost all of my techniques in my CALM Series. But, I have to say that the Cognitive or Logic techniques are my least favorite. As I said, I believe it is so much more helpful to teach tolerance of anxiety and helping them do what they want to do in life despite their level of anxiety (a combination of Inhibitory Learning Theory and ACT). With OCD clients, I take the same approach but work very collaboratively with them and getting as creative as we can with designing exposures and changing it up every time. Here is a video on how to incorporate some of the research from Inhibitory Learning Theory th-cam.com/video/439l0c-P3lg/w-d-xo.html. I often use this I. A.M. technique with kids and adults with Anxiety and OCD. It is a form of incidental exposure and mindfulness: th-cam.com/video/c-HKZNh88dQ/w-d-xo.html. And here is my complete CALM series for Anxiety th-cam.com/play/PL1lUhuKpYUYrz66IflJ5_GfQsysdScD-C.html. Here is a playlist for OCD: th-cam.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html
@@PaigePradkoTherapy oh thankyou so much, I really do appreciate the time you have taken and I look forward to watching your recommendations, that you have sent me. Take good care of yourself. You are no doubt helping so many people to live a more fulfilling life with your videos and knowledge. Thanks again 😊😊😊😊😊😊😊😊😊😊
Hi Kevin. I made a video about benzodiazepines that you can watch here: th-cam.com/video/xyIxRnuRSQc/w-d-xo.html. Basically, the reason that ERP / Exposure Therapy is used for OCD, phobias and some anxiety disorders is because new neuropathways are created when the amygdala (fear center of the brain) is activated (the person is anxious when exposed to their fearful thought or situation) and then new safety learning takes place. These new neuropathways override the old fearful network. No new neuropathways are formed over that fearful network if the person is not anxious. The researcher, Catherine Pittman who wrote Rewire my Anxious Brain, and Rewire my OCD Brain has researched and written about how benzodiazepines suppress the nervous system, and prevents the amygdala from being fully activated and therefore this new network is not created. In addition, new safety learning is not consolidated to long term memory as efficiently when a person is on benzodiazepines. There are certain circumstances especially for a person with severe agoraphobia, when they may use a benzodiazepine at first, to allow them to do an exposure and then the medication is withdrawn and the exposures are continued.
Thank you. I am just one of many therapists that treat ocd. I am creating online therapy classes to offer help to more people that will be available later this year. Unfortunately, my practice is full and I refer people to IOCDF.org for a list of trained therapists by state.
Hi Paige, thankyou so much for these videos, they make so much sense and are really helpful. I am struggling though with trying not to have the bad thoughts deliberately instead of them just popping into my mind. I feel very afraid of having the bad thoughts deliberately. Any advice please? Thankyou very much. X
Hi Julia. I have 3 new videos on OCD coming out next week (4/5, 4/6 and 4/7) that may be very helpful. There are different methods of ERP. In planned exposures, you expose yourself to your fear triggers, obsessions and core fear on purpose. And then, you resist any mental or physical compulsions. If you are having intrusive thoughts, one method of ERP is to expose yourself to your intrusive thought on purpose. You can do so with a recorded script. Here is a pdf that you may find helpful: www.paigepradko.com/erp You can also use a technique that is an unplanned, incidental (in the moment) ERP technique. Here is a video to help you with that: th-cam.com/video/9nEC8yIgFKg/w-d-xo.html
@@PaigePradkoTherapy thankyou so much Paige, it's so kind of you to reply to me, I appreciate it so much. I have been really suffering with this and haven't known what to do. I will take a look at the things you have recommended to me and work with those. Thankyou so much, love Julia xx 🥰
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 say…okay anxiety, you win. You are allowed to stay as long as you wish. Even if I don’t sleep, I suppose my body will find a way to catch up on sleep eventually. This kind of attitude will help. 😊
If ones OCD revolves around more thoughts (intrusive thoughts) about other people, would we do ERP in the form of ‘thinking’ 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. You’ve got it!
Those themes do require different exposures. More recent research has shown that hierarchies are not as important (working your way up to more challenging exposures), as doing the exposures and tolerating the discomfort. You may vary the difficulty and vary the exposures. But, harm ocd may require chopping food with knives, and contamination exposure may involve not washing hands, and religious scrupulosity may involve writing and listening to scripts of your worst feared scenarios. These are all different exposures. It may be possible to combine exposure themes and create exposures that trigger more than one core fear. For example, you could write and listen to scripts about your fears in all of those themes while chopping vegetables and not washing your hands. The more you mix things up while still triggering your fear, the better.
@@PaigePradkoTherapy ma'am ! I have an example that confuses me . Suppose i have a doubt while praying to GOD that did i wash my hands properly after coming from washroom ? It has contamination + religious / moral + harm (god will punish me ), which theme category should it be put in ? Kindly guide.
@@OCDawareness563 , yes, this is a great example how ocd can combine themes. In your case, you can trigger your fear in all of these themes by not washing your hands properly on purpose and sitting with those fears. You can combine fear triggers and themes and get creative in triggering them as the example you gave. I share more details in how to combine exposures in my ocd course: www.paigepradko.com/ocd
Do u think u can overcome intrusive thoughts alone ? When I say alone I mean like educating myself through yours and other videos but doing this process by myself ? Thank u
Hi Danny. I wish I could say, “yes”, but the answer to that question seems to vary from person to person. If you ever need more help, I have a course where I walk you through step-by-step what to do for treatment and to sustain recovery and get unstuck from your intrusive thoughts. It is designed to help people with Pure O and OCD. Should you be interested, go to www.paigepradko.com/ocd. The on-demand course is being offered beginning 4/4/22. You may join a waitlist on that site to be sent a reminder. 😊
I've got sensorimotor ocd, breathing, eyes blinking, etc, so it's quite hard to find the triggers. It's just comes at random times all day long. Thus i can't make any list. So i simply practice erp every time it comes, by accepting it, smiling to it, blinking, breathing, feeling myself, ACCEPTING myself, my thoughts. Did i choose a right strategy, or should I change something? It is super intuitive with the example of hands washing (I've got that, and that was easy to deal), but with sensorimotor, it's contrintuitive to properly define obsession compulsion triggers. I've figured that my obsession was thinking that i will always be like that thinking constantly about breathing and stuff, and can't have normal life. My compulsion was avoiding these thoughts, trying to run away from them as hard as i could. Maybe i should sit down, and simply breathe, and nothing else, like rapidly, slow etc, and that would be exposure. Same with blinking the eyes. Will be happy with any advice. Hugs from Ukraine 😘 Oh, and huge thanks for this video. Absolutely brilliant. Much appreciated.
Hi Tomash. We have been so concerned about our friends in Ukraine and I hope that you and your family are safe. I have sensory awareness OCD as well and mine is with breathing. And, my fear is that I won’t get to sleep or stop attending to my breathing and the consequences of that. I also allow it to be there. I welcome it to hang around as long as it wishes. But, I do my best to not check on it. My brain wants to check on it and attend to it, but I do my best to shift my focus to something else, even while I know it is still in the background in my mind. I do not get frustrated but stay with a welcoming and accepting approach. If the brain gets annoyed, frustrated or anxious, it will keep occurring. The brain has to learn that you are completely unconcerned and nonreactive. Here is a video where I discuss the I. A.M. method that may help you. th-cam.com/video/c-HKZNh88dQ/w-d-xo.html
@@PaigePradkoTherapy appreciate your response. Thanks for the warm words. But isn't that avoiding mechanism, to try focusing on something else? I mean, maybe it's better to just let it be, and it will go. Lil bit confusing, i understand that constantly checking if i am checking is not the best approach definitely 🤣😂. But is there a chance that shifting a focus approach could become an avoiding mechanism of any kind? Once again, things that you are doing here are very important, it's super hard to find therapist here in my hometown, even when it's not a war, especially CBT one, OCD specialist. Thank you 😊 💓
Shifting focus is different from avoidance. You are allowing the thought or urge or sensation to be there in the background. It is like shining a flashlight on one item in a dark room and then shining a flashlight on a different item. You still know the first item is there, but you do not attend to it. But, if you are concerned about that approach, you can just stay in the mode of allowing. It is just difficult to not check on it if your brain does not have something to shift to while the awareness is there. 😊
@@PaigePradkoTherapy thank you once again😍😍😍. I have watched your video about I AM approach. Liked it. Im going to dig in to your other videos. I just love how you reference to studies and show what actually happening in a brain while we have all of those things. Good stuff 👏 Btw you've got very Ukrainian last name. 🥰 Have the most beautiful day. Hugs 🫂 🤗
What about existential ocd, where there isn’t 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 I’m in a new city I’ll 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… I’ve 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 couldn’t stop ruminating about it. It’s sounds all crazy but whenever I’m uncertain about something I’ll ruminate about it even tho I don’t want to. When it comes to existential topics obviously there no definite answer but when they’re questions about reality or philosophical things it makes me feel very disconnected and that reality isn’t how I think it is
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.
Hmmm would this apply to the bathroom? I have IBS which causes anxiety about leaving the house and doing things because a lot of the time it results in unpleasant bathroom experiences. Now I obsess over using the bathroom a ton of times before actually leaving the house. Would that be considered a form of OCD? Cbt therapy is not helping me at all.
Hi Danielle. Believe it or not, what you are experiencing is very common. (Of course, I cannot diagnose based on a comment on TH-cam, but, I am giving my general opinion based on what you have shared. It is not exactly OCD, but, it is treated in a very similar way. It sounds like you may have a form of agoraphobia (without panic disorder) where you are anxious about whether or not you will have an ibs episode and whether or not you will have access to a restroom. I treat people with this condition often. Exposure therapy ERP is central in the treatment as you build up confidence that you can tolerate the anxiety without avoiding situations and environments. I am working on an online therapy course right now (literally) for treating agoraphobia with and without panic disorder. It will not be out for about 90 days. If you email me at info@paigepradko.com, I will email you more information when the course is available. Here is a playlist for more information on how to do exposures. I address your symptoms and treatment specifically in my course, but not in these videos. But, they will give you ideas on how to begin exposures. th-cam.com/play/PL1lUhuKpYUYoJdExc0g8zVZuekW2zhGG7.html
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.
That’s 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. 🙏❤️
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 doubt…if you are doubting and asking yourself…”what if I do this or that” 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.
Hi Paige thank you for your wonderful video. I'm 55 years old and struggling with thoughts about my past, over 25 years ago. Things that have really happened, and because they did it makes me a terrible person. How do you write a script for past mistakes that I have been ruminating over for years now, I need to move on. Again thanks so much
Hi Mike. I hope you are able to process that you have learned from your mistakes and have made changes to not repeat them. If you believe this is OCD in your case, you certainly can write a script. What is your deepest fear about making those mistakes? Go into that fear in the script itself. Did you see my video on writing scripts? th-cam.com/video/HrjM091rcXc/w-d-xo.html
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 “feel” contaminated. Of course you will not do something that is literally life threatening…..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.
Dear Madam, As regarding me the obsessions are mainly mentally and very rarely physically, especially when I want to do a particular thing I like most, there comes a thought connected with a fear that a close relative will be harmed if I embark on that project I am going to do. And I have to do mental compulsions that can cancel that harm and start on my project. Now that thing has got into many of my "to do" things and I am taking medications. Will ERP work for this
Yes, ERP can work for intrusive thoughts and mental compulsions. Do your best to stop doing the mental compulsion. I often recommend my I. A.M. method to help people with this situation. th-cam.com/video/9nEC8yIgFKg/w-d-xo.html
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.
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
I've had OCD for years now. I know what actions I do repeatedly but I frankly don't know what triggers it. Can u please help how to finds out my triggers. Is it coz i overthink alot.
Hi Stephanie. Almost anything can trigger ocd. Yes, even a thought or stress in your life. It is important to identify what your core fear is. That is the what you fear may happen if you don’t do a compulsion like rumination. That is the fear you will need to trigger on purpose in your exposures.
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, “It 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.”
I have seen psychiatrists prescribe them both together. This is not medical advice, as I am not a physician. But, NAC is over the counter and in studies the doses given are quite high.
Thank you for explaining all this I have breathing ocd. If the thought is constant 24/7 and the compulsions are 24/7 do you do erp 24/7 or just certain times of the day. Also people say stop after your anxiety goes down. So once it goes down than what?. Cause the thought is just gonna come right back and your gonna want to do compulsions. Also what if you have a panic attack and pass out than what do you do after. Please help thank you
I understand. I also have obsessive focus on my breathing. I spent so much of my life not understanding what it was or what to do about it. But, I now understand it is a form of ocd and what works for me when it pops up. It is on my list of videos to cover in the coming months. There are several ways of doing ERP with breathing. I prefer incidental (in the moment) ERP, which is to fully allow the attention to be on the breath when it occurs naturally (as opposed to planning ERP sessions). I welcome the focused attention to my breath and do not get annoyed or try to distract myself. I think, “stay as long as you like”. I do not do any compulsive behaviors like trying to breath in certain ways or distractions. This method has really helped me. I used to get so annoyed and irritated....I actually made it worse. When I make the video, I will cover several methods of ERP for breathing and other Sensory Focused OCD.
@@PaigePradkoTherapy Thank you so much for the reply. When I think about my breathing with no compulsions I get like I will have a panic attack or pass out. Is this normal during erp what am I supposed to do after the exposure?. Once again thank you so much
With all ERP, Response Prevention means that we do not ritualize or do compulsive behaviors during exposure sessions or between exposure sessions. Sometimes this is difficult to not go back to old habits. I teach a technique called I. A.M. for clients to use when an obsessive thought comes up between exposures. I explain it here th-cam.com/video/c-HKZNh88dQ/w-d-xo.html.
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 brain’s 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.
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
DO YOU NEED MORE HELP WITH OCD & ERP?
👉🏼 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.
👉🏼 Here is a link to a FREE SELF ASSESSMENT for OCD:
www.paigepradko.com/ocdquiz
👉🏼 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
Wow….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. 🙏😊
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
For me the first step would be hell because I suck at decision making and will overthink the shit out of it
@@mihanich there's a trigger then :) "going with something despite not being sure it's the right choice"
@@instant_mint spot on
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 I’ve built much of my social circle, job, and daily life around enabling my OCD. I’m 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.
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:
th-cam.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
Love the video, it really helps put things in perspective. I’m a compulsive checker and let me tell ya doing the exposure is torture, but if you can power through it, it’s very worth it.
Thank you, Justin. Keep up the good work!
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? I’m 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!
A relative has OCD so I decided to learn about ERP. The background music is super annoying but the information was very helpful.
I’m 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:
th-cam.com/play/PL1lUhuKpYUYqRtx-_xbr5gofDxBYIBdq0.html
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.th-cam.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html
@@PaigePradkoTherapy I’ll be watching and practicing other methods, as well.Thank you, again.
How are u feeling now? What type of OCD did u have? @@selinderin_karaoke
The way you explained everything so smoothly thankyousomuch 💗💗💗
My pleasure 😊
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. I’ve been telling myself when they pop up, out loud “NOPE, not engaging with you” 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 “am I going to be okay?” So I’ve 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.
Thank you very much! It is true not many specialist know very well about OCD. I didn’t think about secondary gain, I will be aware of it.
Thanks Paige, this is the best explanation of ERP I have come across, it has been very helpful, thanks again.
Glad it was helpful! ❤️
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 ❤️❤️
@@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.....
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. It’s 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. You’re the angel. Believe me :) sending a huge hug and regards from Slovakia.
@@robes2883 your comment gave me hope, thank you ❤️
@@robes2883 do you still take SSRI? do you feel like the SSRI is needed during ERP therapy?
@@naomio.7503 thank you ❤️ 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.
I’m Finding therapists who can help me expose myself to my triggers to reclaim my life & try NAC to support my process.👍
That’s 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
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.
Thanks for the guidance! I'm a therapist and am working with OCD clients with contamination-bodily excretions focus. This is never an example in trainings, and I would greatly appreciate some examples of how to do exposures with them.
@@lilag2290 yes, this is a much, much needed topic. I cover it in detail in my course, but on youtube…it would likely be censored. Feel free to drop me a line at paigepradko.com and I will try to give you some pointers. 😊
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 😢😢 I am going for medicine give me ur contact I can tell u about my progress
Thank you so much for this wonderful video. With research and self-observation, I think I have HOCD - it’s 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 “go crazy” 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 I’m 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.
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 Denny😘🙏
Thank you, Denny. I really appreciate it and am happy to hear that you find them helpful. Keep up the good work. 🙏❤️
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.
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 ... .
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.
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 :)
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. 🤗
How are you doing now?
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
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 SSRI’s 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 don’t. 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! :)
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 effort❤.
this is excellent! God Bless You!
Thank you. And you as well 🙏❤️
This content is amazing thank you for sharing this!!!
You’re welcome and glad you found it helpful.
Very good your therapy. I am a ocd patient. I will practised this.
Your clients are very lucky. Thank you. X
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
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 “Dose” 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 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 “do it yourself”, especially if your son is willing. The more he understands about OCD, the better. I wish you and your son the best.
It helps alot. i was searching for something like this. Thanks
Hi Zubair. I am glad you found it helpful 🙏❤️
Looking forward towards more.
Very helpful, thank you.
You’re welcome 🙏❤️
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 😊
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 it’s own.
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
THANKYOU FOR YOUR WORK❤❤❤
You’re welcome. Thank you for your appreciation 🙏❤️
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.
I’m 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 didn’t 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. 😊
@@PaigePradkoTherapy Thank you so much for this reply! I am definitely going to follow you and check it out!
Great summation of ERP strategies.👍🏽
Thank you. I have made a few updates to ERP treatment that are summarized here th-cam.com/video/0xpDmuIe53E/w-d-xo.html.
Thanks for the link to your update👍🏽
Good information and very nice.
I keep doing exposure and it really pays off in the long run. I now get excited about challenging myself because I’ve experienced the results.
Would really like a video on CBM haven’t been able to find much but sounds like a great subject.
Keep up the good work 👍
That’s 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.
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 well explained. Thank you!
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.
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: th-cam.com/play/PL1lUhuKpYUYqKvEwlGXoRPDu_8blhbaq-.html
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.
How much time usually does it take to feel high improvement? (I mean for a really severe ocd) cause i use medications for about 10 years and did anterior capsulotomy & limbic leucotomy but they were totally useless & i wanna go for dbs.
Cause i felt very little effect from rtms.
awesome facts explained.
Thank you. I’m glad you liked it. 😊
Hi, good information.
please give some tips to teeneger having ocd...how can they increase their IQlevels.
Are there any gadgets that are helpful to ocd teenegers to focus quickly on thier studies...12th class...please let me know.
Wonderful information. Can you please point me to more information on NAC
There are several studies. Here is one:
Review
dx.doi.org/10.9758/cpn.2015.13.1.12 pISSN 1738-1088 / eISSN 2093-4327 Clinical Psychopharmacology and Neuroscience 2015;13(1):12-24 Copyrightc 2015, Korean College of Neuropsychopharmacology
N-Acetyl Cysteine in the Treatment of Obsessive Compulsive and Related Disorders: A Systematic Review
Georgina Oliver1, Olivia Dean1,2,3, David Camfield4,5,6, Scott Blair-West1, Chee Ng1, Michael Berk1,2,3,4, Jerome Sarris1,4
1Department of Psychiatry, The Melbourne Clinic, The University of Melbourne, Melbourne, 2Innovation in Mental and Physical Health and Clinical Treatment: Strategic Research Centre, School of Medicine, Deakin University, Geelong, 3The Florey Institute of Neuroscience and Mental Health, 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, 5Illawarra Health & Medical Research Institute (IHMRI), 6School of Psychology, University of Wollongong, Wollongong, Australia
Objective: Obsessive compulsive and related disorders are a collection of debilitating psychiatric disorders in which the role of glutamate dysfunction in the underpinning neurobiology is becoming well established. N-acetyl cysteine (NAC) is a glutamate modulator with promising therapeutic effect. This paper presents a systematic review of clinical trials and case reports exploring the use of NAC for these disorders. A further objective was to detail the methodology of current clinical trials being conducted in the area.
Methods: PubMed, Web of Science and Cochrane Library Database were searched for human clinical trials or case reports investigating NAC in the treatment of obsessive compulsive disorder (OCD) or obsessive compulsive related disorders. Researchers with known involvement in NAC studies were contacted for any unpublished data.
Results: Four clinical trials and five case reports/series were identified. Study durations were commonly 12-weeks, using 2,400-3,000 mg/day of NAC. Overall, NAC demonstrates activity in reducing the severity of symptoms, with a good tolerability profile and minimal adverse effects. Currently there are three ongoing randomized controlled trials using NAC for OCD (two adults and one pediatric), and one for excoriation.
Conclusion: Encouraging results have been demonstrated from the few pilot studies that have been conducted. These results are detailed, in addition to a discussion of future potential research
Which medication would you recomend for OCD “pure O” for obsesive intrusive toughts?
Hi Miha. The International OCD Foundation recommends SSRI antidepressants for OCD. Some of my clients choose to take them, some do not. Benzodiazepines can actually make OCD worse.
No matter which SSRI? Is any of them more likely to help?
Recommendations by the International OCD Foundation include Luvox, Prozac, Zoloft, Paxil, Celexa, Anafranil, Lexipro, and Effexor. These are the brand names.
Thanks again!!
You’re welcome, Larry.😊
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. 🙏
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.
th-cam.com/video/i-wY-nGD0zo/w-d-xo.html
What would good erp be for breathing sensorimotor. Fear of having it forever/fear of stopping breathing
Hi Colin.
I am hoping to do a separate video on sensorimotor ocd this year. I get the issue with hyper awareness of breathing myself at times. There are 2 methods of ERP I recommend. One is just allowing the awareness as long as it wants to be there with an attitude of complete acceptance. The second is to go deeper into the fear and tell yourself that this breathing awareness may be there forever and may result in complete insanity. This is a strategy to move into your deepest fear. You could even record a script where you describe yourself forever focused on your breath and going insane...and then immerse yourself listening to that script several times a day. It sounds absolutely horrible, but, it works.
@@PaigePradkoTherapy thank you so much Paige been having this since last August had it about 10 years ago aswell and sort of got over it dont k ow how though. Sleeping is a mjor major issue at the minute trying to get to sleep. If i could manage some sleep i think the anxiety would drop.dramatically sorry for the long reply
That’s exactly when mine acts up too...when I am having problems sleeping. Try your best to just allow what ever comes up and do not try to fight it in any way. Here is a playlist for insomnia if you haven’t seen it. th-cam.com/play/PL1lUhuKpYUYoq2g2GlxmYyjz2yg1L6gJ9.html
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.
Dear Dr. Paige Pradko,
My name is Hung, I have watched your videos on TH-cam 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
Thái Hưng Hoàng, 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.
Nice job presenting this topic. I am an ocd contamination person and I don’t think I can do erp. I’m trying to use the motivation of not having to go through it and medication to try and relax my standards of cleanliness. I’m not sure how well it’s working but I’m trying. I’ve 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 “doable” for some. I want you to know that you are not alone and I wish you well.
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).
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.
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.
Hi Paige, thank you so much. this is very useful as I am a therapist and going to see a client for OCD. Is there any training available on this?
Hi Jas. Here is a playlist for OCD th-cam.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html.
There is training available from the IOCDF.org. I will have more training for OCD in the coming months. There are also several great books. Check out Freedom from OCD by J.Grayson.
@@PaigePradkoTherapy Great, thank you so much.
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...
Hi great video, do you only conquer one trigger at a time before moving on to another.
That is a great question. You have the choice in how you set up or combine your triggers or obsession themes. When working with clients, we typically pick an exposure that we know they can get through to begin with, then we make it a little more challenging. Then we change it up and maybe add scripts and behavior exposures together and combine exposures in creative ways. We try to be as creative as possible and vary exposures slightly every time instead of doing the same exposure over and over again. You do not have to complete one trigger before moving on. You want to vary or change up exposures as much as possible to keep your brain a little surprised. I hope that helps to answer your question. This video may help you as well. th-cam.com/video/439l0c-P3lg/w-d-xo.html
@@PaigePradkoTherapy hi Paige, thankyou for replying so quickly. I think your videos are fab and I look forward to watching a lot more now I have found them. I do have another question though. In the video I have just watched it said not to combine ERP with cognitive therapy, but another I watched of yours(the complete guide) ,it said you should so I am a little confused.
I work with children aged 7-11 and I would be really grateful if you could tell me or signpost me to the right videos about techniques to help with their anxiety since lockdown it has understandably affected a lot of children.
Best wishes to you
Jan
Hi Jan.
I admire you for searching out treatment for your young clients. This year has been so tough for them. You are correct, I have changed my treatment of clients with OCD. I used to use Cognitive Therapy and challenge their beliefs as part of a treatment combined with ERP Exposure and Response Prevention. However, I have shifted from Emotional Processing Theory to Inhibitory Learning Theory in the last year and a half or so. Michelle Craske’s research has demonstrated that Cognitive work (the C of CBT) makes the Exposures less effective because they lesson the violation of the expectancy in exposures. According to her research and others, the brain has to be surprised in exposures. For example, a person with contamination OCD expects that they cannot stand to contaminate their hands and touch everything in their room. Then, they do just that in their exposure and surprise themselves that they did it. When I work with kids, I do have them externalize OCD and draw pictures and talk back to it in a humorous way. I also am always working on tolerating anxiety instead of getting rid of it and highly praise and support every time they tolerate it whether in an exposure or not. In treating children with anxiety, I have used almost all of my techniques in my CALM Series. But, I have to say that the Cognitive or Logic techniques are my least favorite. As I said, I believe it is so much more helpful to teach tolerance of anxiety and helping them do what they want to do in life despite their level of anxiety (a combination of Inhibitory Learning Theory and ACT). With OCD clients, I take the same approach but work very collaboratively with them and getting as creative as we can with designing exposures and changing it up every time. Here is a video on how to incorporate some of the research from Inhibitory Learning Theory th-cam.com/video/439l0c-P3lg/w-d-xo.html.
I often use this I. A.M. technique with kids and adults with Anxiety and OCD. It is a form of incidental exposure and mindfulness: th-cam.com/video/c-HKZNh88dQ/w-d-xo.html.
And here is my complete CALM series for Anxiety th-cam.com/play/PL1lUhuKpYUYrz66IflJ5_GfQsysdScD-C.html.
Here is a playlist for OCD: th-cam.com/play/PL1lUhuKpYUYqeYEMpq99fWkjLMxFR4ySU.html
@@PaigePradkoTherapy oh thankyou so much, I really do appreciate the time you have taken and I look forward to watching your recommendations, that you have sent me. Take good care of yourself. You are no doubt helping so many people to live a more fulfilling life with your videos and knowledge. Thanks again 😊😊😊😊😊😊😊😊😊😊
Have you explained in a video why/how benzos make ERP ineffective? Thanks!
Hi Kevin. I made a video about benzodiazepines that you can watch here: th-cam.com/video/xyIxRnuRSQc/w-d-xo.html.
Basically, the reason that ERP / Exposure Therapy is used for OCD, phobias and some anxiety disorders is because new neuropathways are created when the amygdala (fear center of the brain) is activated (the person is anxious when exposed to their fearful thought or situation) and then new safety learning takes place. These new neuropathways override the old fearful network. No new neuropathways are formed over that fearful network if the person is not anxious.
The researcher, Catherine Pittman who wrote Rewire my Anxious Brain, and Rewire my OCD Brain has researched and written about how benzodiazepines suppress the nervous system, and prevents the amygdala from being fully activated and therefore this new network is not created. In addition, new safety learning is not consolidated to long term memory as efficiently when a person is on benzodiazepines.
There are certain circumstances especially for a person with severe agoraphobia, when they may use a benzodiazepine at first, to allow them to do an exposure and then the medication is withdrawn and the exposures are continued.
Mam I think u can only help me how to connect to u???? please
Thank you. I am just one of many therapists that treat ocd. I am creating online therapy classes to offer help to more people that will be available later this year. Unfortunately, my practice is full and I refer people to IOCDF.org for a list of trained therapists by state.
Hi Paige, thankyou so much for these videos, they make so much sense and are really helpful. I am struggling though with trying not to have the bad thoughts deliberately instead of them just popping into my mind. I feel very afraid of having the bad thoughts deliberately. Any advice please? Thankyou very much. X
Hi Julia. I have 3 new videos on OCD coming out next week (4/5, 4/6 and 4/7) that may be very helpful. There are different methods of ERP. In planned exposures, you expose yourself to your fear triggers, obsessions and core fear on purpose. And then, you resist any mental or physical compulsions. If you are having intrusive thoughts, one method of ERP is to expose yourself to your intrusive thought on purpose. You can do so with a recorded script. Here is a pdf that you may find helpful: www.paigepradko.com/erp
You can also use a technique that is an unplanned, incidental (in the moment) ERP technique. Here is a video to help you with that: th-cam.com/video/9nEC8yIgFKg/w-d-xo.html
@@PaigePradkoTherapy thankyou so much Paige, it's so kind of you to reply to me, I appreciate it so much. I have been really suffering with this and haven't known what to do. I will take a look at the things you have recommended to me and work with those. Thankyou so much, love Julia xx 🥰
Omg this video help me so much thank you
Glad it was helpful 😊
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 say…okay anxiety, you win. You are allowed to stay as long as you wish. Even if I don’t sleep, I suppose my body will find a way to catch up on sleep eventually. This kind of attitude will help. 😊
@@PaigePradkoTherapy that was so kind of you, thank you!!
If ones OCD revolves around more thoughts (intrusive thoughts) about other people, would we do ERP in the form of ‘thinking’ 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. You’ve 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.
Hi ma'am !
Do we have to make different heirarchy list for different themes ?
Like one for contamination , one for harm ocd and one for religious ?
Those themes do require different exposures. More recent research has shown that hierarchies are not as important (working your way up to more challenging exposures), as doing the exposures and tolerating the discomfort. You may vary the difficulty and vary the exposures. But, harm ocd may require chopping food with knives, and contamination exposure may involve not washing hands, and religious scrupulosity may involve writing and listening to scripts of your worst feared scenarios. These are all different exposures. It may be possible to combine exposure themes and create exposures that trigger more than one core fear. For example, you could write and listen to scripts about your fears in all of those themes while chopping vegetables and not washing your hands. The more you mix things up while still triggering your fear, the better.
@@PaigePradkoTherapy ma'am ! I have an example that confuses me . Suppose i have a doubt while praying to GOD that did i wash my hands properly after coming from washroom ? It has contamination + religious / moral + harm (god will punish me ), which theme category should it be put in ? Kindly guide.
@@OCDawareness563 , yes, this is a great example how ocd can combine themes. In your case, you can trigger your fear in all of these themes by not washing your hands properly on purpose and sitting with those fears. You can combine fear triggers and themes and get creative in triggering them as the example you gave. I share more details in how to combine exposures in my ocd course: www.paigepradko.com/ocd
@@PaigePradkoTherapy thanks ma'am 😇
Why do benzos make erp ineffective? Curious to learn more
Do u think u can overcome intrusive thoughts alone ? When I say alone I mean like educating myself through yours and other videos but doing this process by myself ? Thank u
Hi Danny. I wish I could say, “yes”, but the answer to that question seems to vary from person to person. If you ever need more help, I have a course where I walk you through step-by-step what to do for treatment and to sustain recovery and get unstuck from your intrusive thoughts. It is designed to help people with Pure O and OCD. Should you be interested, go to www.paigepradko.com/ocd. The on-demand course is being offered beginning 4/4/22. You may join a waitlist on that site to be sent a reminder. 😊
I've got sensorimotor ocd, breathing, eyes blinking, etc, so it's quite hard to find the triggers. It's just comes at random times all day long. Thus i can't make any list. So i simply practice erp every time it comes, by accepting it, smiling to it, blinking, breathing, feeling myself, ACCEPTING myself, my thoughts. Did i choose a right strategy, or should I change something?
It is super intuitive with the example of hands washing (I've got that, and that was easy to deal), but with sensorimotor, it's contrintuitive to properly define obsession compulsion triggers. I've figured that my obsession was thinking that i will always be like that thinking constantly about breathing and stuff, and can't have normal life. My compulsion was avoiding these thoughts, trying to run away from them as hard as i could.
Maybe i should sit down, and simply breathe, and nothing else, like rapidly, slow etc, and that would be exposure. Same with blinking the eyes.
Will be happy with any advice. Hugs from Ukraine 😘
Oh, and huge thanks for this video. Absolutely brilliant. Much appreciated.
Hi Tomash. We have been so concerned about our friends in Ukraine and I hope that you and your family are safe. I have sensory awareness OCD as well and mine is with breathing. And, my fear is that I won’t get to sleep or stop attending to my breathing and the consequences of that. I also allow it to be there. I welcome it to hang around as long as it wishes. But, I do my best to not check on it. My brain wants to check on it and attend to it, but I do my best to shift my focus to something else, even while I know it is still in the background in my mind. I do not get frustrated but stay with a welcoming and accepting approach. If the brain gets annoyed, frustrated or anxious, it will keep occurring. The brain has to learn that you are completely unconcerned and nonreactive. Here is a video where I discuss the I. A.M. method that may help you. th-cam.com/video/c-HKZNh88dQ/w-d-xo.html
@@PaigePradkoTherapy appreciate your response. Thanks for the warm words.
But isn't that avoiding mechanism, to try focusing on something else? I mean, maybe it's better to just let it be, and it will go. Lil bit confusing, i understand that constantly checking if i am checking is not the best approach definitely 🤣😂. But is there a chance that shifting a focus approach could become an avoiding mechanism of any kind?
Once again, things that you are doing here are very important, it's super hard to find therapist here in my hometown, even when it's not a war, especially CBT one, OCD specialist. Thank you 😊 💓
Shifting focus is different from avoidance. You are allowing the thought or urge or sensation to be there in the background. It is like shining a flashlight on one item in a dark room and then shining a flashlight on a different item. You still know the first item is there, but you do not attend to it. But, if you are concerned about that approach, you can just stay in the mode of allowing. It is just difficult to not check on it if your brain does not have something to shift to while the awareness is there. 😊
@@PaigePradkoTherapy thank you once again😍😍😍. I have watched your video about I AM approach. Liked it. Im going to dig in to your other videos. I just love how you reference to studies and show what actually happening in a brain while we have all of those things. Good stuff 👏
Btw you've got very Ukrainian last name. 🥰 Have the most beautiful day. Hugs 🫂 🤗
@@tomashgrey2211, Thank you and yes, my husband’s family is from Ukraine. ❤️
What about existential ocd, where there isn’t 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 I’m in a new city I’ll 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… I’ve 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 couldn’t stop ruminating about it. It’s sounds all crazy but whenever I’m uncertain about something I’ll ruminate about it even tho I don’t want to. When it comes to existential topics obviously there no definite answer but when they’re questions about reality or philosophical things it makes me feel very disconnected and that reality isn’t how I think it is
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.
Very informative video
Glad you think so!
Hmmm would this apply to the bathroom? I have IBS which causes anxiety about leaving the house and doing things because a lot of the time it results in unpleasant bathroom experiences. Now I obsess over using the bathroom a ton of times before actually leaving the house. Would that be considered a form of OCD? Cbt therapy is not helping me at all.
Hi Danielle. Believe it or not, what you are experiencing is very common. (Of course, I cannot diagnose based on a comment on TH-cam, but, I am giving my general opinion based on what you have shared. It is not exactly OCD, but, it is treated in a very similar way. It sounds like you may have a form of agoraphobia (without panic disorder) where you are anxious about whether or not you will have an ibs episode and whether or not you will have access to a restroom. I treat people with this condition often. Exposure therapy ERP is central in the treatment as you build up confidence that you can tolerate the anxiety without avoiding situations and environments. I am working on an online therapy course right now (literally) for treating agoraphobia with and without panic disorder. It will not be out for about 90 days. If you email me at info@paigepradko.com, I will email you more information when the course is available. Here is a playlist for more information on how to do exposures. I address your symptoms and treatment specifically in my course, but not in these videos. But, they will give you ideas on how to begin exposures. th-cam.com/play/PL1lUhuKpYUYoJdExc0g8zVZuekW2zhGG7.html
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
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?
That’s 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. 🙏❤️
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 doubt…if you are doubting and asking yourself…”what if I do this or that” 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
Hi Paige thank you for your wonderful video. I'm 55 years old and struggling with thoughts about my past, over 25 years ago.
Things that have really happened, and because they did it makes me a terrible person. How do you write a script for past mistakes that I have been ruminating over for years now, I need to move on. Again thanks so much
Hi Mike. I hope you are able to process that you have learned from your mistakes and have made changes to not repeat them. If you believe this is OCD in your case, you certainly can write a script. What is your deepest fear about making those mistakes? Go into that fear in the script itself. Did you see my video on writing scripts? th-cam.com/video/HrjM091rcXc/w-d-xo.html
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 “feel” contaminated. Of course you will not do something that is literally life threatening…..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.
Wow thank you mam it literally helps a lot ....hoping this kind of therapist in india......
Dear Madam, As regarding me the obsessions are mainly mentally and very rarely physically, especially when I want to do a particular thing I like most, there comes a thought connected with a fear that a close relative will be harmed if I embark on that project I am going to do. And I have to do mental compulsions that can cancel that harm and start on my project. Now that thing has got into many of my "to do" things and I am taking medications. Will ERP work for this
Yes, ERP can work for intrusive thoughts and mental compulsions. Do your best to stop doing the mental compulsion. I often recommend my I. A.M. method to help people with this situation. th-cam.com/video/9nEC8yIgFKg/w-d-xo.html
Thank you for the reply, I will do my best to stop doing mental compulsions, and also practice the method given by you
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.
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. 🥺
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
One word solution for this: "Don't take life serious!!!!"
Note: This line said by experienced people at the end of the life.
Mam i have very mild ocd ...Can i go for a therapist ..???
Yes, a therapist experienced in OCD can help you.
@@PaigePradkoTherapy how much they charge for this ..???
I've had OCD for years now. I know what actions I do repeatedly but I frankly don't know what triggers it. Can u please help how to finds out my triggers. Is it coz i overthink alot.
Hi Stephanie. Almost anything can trigger ocd. Yes, even a thought or stress in your life. It is important to identify what your core fear is. That is the what you fear may happen if you don’t do a compulsion like rumination. That is the fear you will need to trigger on purpose in your exposures.
@@PaigePradkoTherapy I'm not able to know what fear when I think of it. So how do I find out.
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, “It 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.”
Hi I have magical thinking ocd and on fluoxetine, would taking nac help calm the anxiety or dont they work together?thanks
I have seen psychiatrists prescribe them both together. This is not medical advice, as I am not a physician. But, NAC is over the counter and in studies the doses given are quite high.
Thank you for explaining all this I have breathing ocd. If the thought is constant 24/7 and the compulsions are 24/7 do you do erp 24/7 or just certain times of the day. Also people say stop after your anxiety goes down. So once it goes down than what?. Cause the thought is just gonna come right back and your gonna want to do compulsions. Also what if you have a panic attack and pass out than what do you do after. Please help thank you
I understand. I also have obsessive focus on my breathing. I spent so much of my life not understanding what it was or what to do about it. But, I now understand it is a form of ocd and what works for me when it pops up. It is on my list of videos to cover in the coming months. There are several ways of doing ERP with breathing. I prefer incidental (in the moment) ERP, which is to fully allow the attention to be on the breath when it occurs naturally (as opposed to planning ERP sessions). I welcome the focused attention to my breath and do not get annoyed or try to distract myself. I think, “stay as long as you like”. I do not do any compulsive behaviors like trying to breath in certain ways or distractions. This method has really helped me. I used to get so annoyed and irritated....I actually made it worse. When I make the video, I will cover several methods of ERP for breathing and other Sensory Focused OCD.
@@PaigePradkoTherapy Thank you so much for the reply. When I think about my breathing with no compulsions I get like I will have a panic attack or pass out. Is this normal during erp what am I supposed to do after the exposure?. Once again thank you so much
People say stop when your anxiety breaks in half but than what do you do after?
With all ERP, Response Prevention means that we do not ritualize or do compulsive behaviors during exposure sessions or between exposure sessions. Sometimes this is difficult to not go back to old habits. I teach a technique called I. A.M. for clients to use when an obsessive thought comes up between exposures. I explain it here th-cam.com/video/c-HKZNh88dQ/w-d-xo.html.
@@PaigePradkoTherapy I will watch the video thank you. If I try to do erp an hour out of the day. And not all at once will I still get better?
Wonderful video
🙏❤️
Paige I'm so grateful to you for loving my comment. You are Amazing
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 brain’s 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.
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