For the past couple of weeks, I have been discussing exposure therapy with my therapist. I decided this week was the week that I wanted to dive into that part of my treatment. Diving in might not be the best way to describe it because I had to do some prep work before I could try it out again, but, to me, it felt like diving into the deep end when I did the exposure exercise.
I mentioned before that therapy, especially something as potentially traumatic as exposure therapy, is taken at a baby steps pace. Before I could try out exposure exercises again, I had to make sure I remembered my relaxation techniques. I also had to make sure I had a place in my mind, like a safe area, that I could retreat to in distress. I actually had to construct a happy place in my mind. (I hadn't previously done that, so I had to do that the week before and practice going there.)
I went into my weekly session this week with my preferred relaxation technique and my happy place at the ready. Near the end of my session, I had to rate my anxiety so we could have a baseline. Then I had to set a number that I thought would be okay for my anxiety to jump to. (Think of it like judging pain on one of those ER pain scales.) A two point jump is all my therapist will allow, and I'm totally fine with that.
Then came the time for the exposure exercise. Since we are treating my religious obsession first, I had to do something that would deliberately trigger my blasphemous intrusive thoughts, and I couldn't do any compulsive prayer or anything to ward off any consequences of my bad thoughts. My time limit for the trigger was 5 minutes maximum, but I only made it a couple of seconds before my anxiety jumped from a 2 to a 4 and the guilt rushed in. I tried to listen to a Gospel song, and I backed out after at most 3 or 4 seconds of the song. Then I cried. Then I had to practice my relaxation technique and go to my happy place.
I'm surprised. First, I'm surprised at the fact that I couldn't do the exercise for more than a few seconds. I had expected to get closer to the five minute maximum time limit. Second, I'm surprised at the sheer amount of guilt that came rushing in and caused my anxiety to spike even higher. I hadn't felt guilt like that in over a year, since my diagnosis. In less than 5 seconds, I was right back to feeling like I was such a bad person that I didn't belong in my church with all the good people.
According to my therapist, you have to deal with leftover feelings doing ERP. I had to deal with guilt that was left over from all those years of sitting in church, with intrusive thoughts screaming in my mind, and then hiding the shame and guilt that came after those thoughts. I have a lot of guilt to deal with after nearly six years of hiding my mental health condition and thinking I was possessed.
I only needed a couple of minutes to calm back down so I could be logical, and that was also surprising. I had stopped shaking and crying by the time I left her office. My feelings of guilt had also dropped significantly by the time I left her office.
I had been terrified that doing exposure exercises would send me into a downward spiral that would put me back in a bad place in my recovery. That didn't happen. I was exhausted but fine even after I got home. I still carried around some guilt for the rest of the day, and I was a little bit more emotional after I got home. I did notice, though, that my intrusive thoughts weren't really more intense this time, as they had been the first time I tried out an exposure exercise some months ago.
How do I feel now? I feel relieved. I feel like I jumped over a hurdle, and I managed to land on my feet instead of flat on my face. I faced a fear and then felt like I could even do it again. Although, knowing that the exposures will become more intense the longer I keep doing them as part of the desensitization to my intrusive thoughts makes me feel a little nervous.
I'll end with this: Thinking about starting ERP is scary, but going through ERP is definitely a better course of action than avoiding ERP and being controlled by my OCD. ERP is not something to be taken lightly, and it does take some prep work before you can start exercises. I don't like doing the exposures, but I do them anyway because I know that is the way to get well again.
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