Full OCD Recovery: How To Identify What Level Of ERP Exposures Is Too Much For You?

Summary

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Episode Summary: "Full OCD Recovery: How To Identify What Level Of ERP Exposures Is Too Much For You?"

Podcast: OCD Recovery
Host: Ali Greymond
Date: December 31, 2025

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Overview

This episode dives into how to identify the appropriate level of Exposure and Response Prevention (ERP) in OCD recovery, specifically focusing on avoiding exposures that are “too much” for an individual’s current stage. Ali Greymond emphasizes the importance of manageable exposure, sustainable progress, and practical tools for listeners applying ERP to different OCD themes. The episode reflects Ali’s attentive, supportive coaching style and her commitment to safe, steady progress.

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Key Discussion Points & Insights

1. Recognizing Exposure Levels

• Ali explains that exposures are not all equal; their intensity (measured by anxiety level) matters greatly.

• Quote:

  "If your OCD is coming in at—let’s say, level 10 anxiety ... if it comes in automatically, you have to try to do response prevention, right?"
  (Ali, 00:02–00:09)

• The goal is to match exposure intensity to what a person can realistically handle, especially with planned (on-purpose) exposures.

2. The Role of Response Prevention in ERP

• The main purpose of exposure is "to do response prevention" rather than simply to provoke anxiety.

• If the exposure is too intense (level 8, 9, or 10), clients often struggle to resist compulsions and may ruminate afterward, undoing progress.

• Quote:

  “If you’re not sure if you’re going to be able to do the response prevention for exposure that’s that high ... we don’t really go above level 7 exposure when we do on purpose exposures.”
  (Ali, 00:26–00:44)

• High-anxiety exposures can backfire, making recovery harder as clients might regress due to unmanageable stress.

3. Guidelines for ERP Planning

• It’s more effective to use a “bite what you can realistically chew” approach rather than overwhelming yourself.
• Step-by-step, continuous progress beats attempting extreme exposures.
• Quote:

  “Don’t push yourself. In extreme exposures, it will actually backfire ... step by step, but do continuously.”
  (Ali, 00:55–01:32)

4. Difference Between Planned and Accidental Exposures

• A distinction is drawn between:

  • On-purpose exposures: Should stay at or below level 7 anxiety for best results.
  • Accidental exposures: Simply unavoidable; focus on doing the best response prevention possible when they arise.

• Quote:

  “Obviously accidental exposures, it is what it is. You can’t really do anything about it. But try your best to do response prevention.”
  (Ali, 01:34–01:39)

5. Small Wins Still Count

• Even if you don’t handle accidental exposures perfectly, any improvement (e.g., less rumination than last time) is positive and counts as progress.

• Quote:

  “Even if you fell down a little less than last time, that’s already a win also. So you can measure progress in this way with accidental exposures.”
  (Ali, 01:45–01:58)

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Notable Quotes & Memorable Moments

• On Therapy Mistakes:

  “I see this happening a lot with therapists who don’t know what they’re doing. They’ll scare the client half to death in the office ... and the client goes home and ruminates ... They actually regressed because they did a lot of damage for the rest of the day. Even though they took a brave step to do the exposure, they actually made themselves worse.”
  (Ali, 00:50–01:24)

• On Measuring Progress:

  “You can also measure progress in this way with accidental exposures.”
  (Ali, 01:58)

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Timestamps for Key Segments

• 00:02–00:09 — Defining high-anxiety exposures and response prevention
• 00:26–00:44 — Safe maximum anxiety level for on-purpose exposures
• 00:50–01:24 — Example of exposure backfiring and setting clients back
• 01:34–01:39 — How to handle accidental exposures
• 01:45–01:58 — Valuing incremental improvement in accidental exposures

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Tone and Language

Ali’s language throughout is calm, encouraging, and practical. She provides direct advice, drawing on experience, and addresses both the emotional and technical aspects of ERP for OCD recovery. The episode maintains a supportive tone, offering reassurance that steady, manageable steps are both safe and effective.

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Recap: Key Takeaways

• For on-purpose exposures, do not exceed a level 7 anxiety; higher can be counterproductive.
• Success is not just about facing the exposure, but about being able to resist compulsions afterwards.
• Progress includes small wins, especially in accidental exposures.
• Recovery should be sustainable, kind, and adapted to each person’s real readiness.

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Transcript

[A]

If your OCD is coming in at.

[B]

Let'S say, level 10 anxiety.

[A]

Yes, you can. I mean, if it comes in automatically.

[B]

You have to try to do response prevention, right?

[A]

But if you are doing on purpose exposure, I would not suggest doing exposures.

[B]

That bring you to that high of a level of anxiety.

[A]

Because the whole point of an exposure.

[B]

Is to do response prevention.

[A]

And if you're not sure if you're going to be able to do the.

[B]

Response prevention for exposure, that's that high.

[A]

Which I would say with clients, we.

[B]

Don'T really go above level 7 exposure when we do on purpose exposures because.

[A]

It'S just too high. And then it's very difficult for the.

[B]

Person afterwards to do response prevention.

[A]

I see this happening a lot with.

[B]

Therapists who don't know what they're doing.

[A]

Is that they'll scare the client half to death in the office and then they'll send them on their way because the hour is done and the client goes home and ruminates. Did they make themselves, did they, did they progress forward in that day in recovery? No, they actually regressed because they did a lot of damage for the rest of the day. Even though they took a brave step to do the exposure, they actually made themselves worse. So the moral of the story is bite what you realistically can chew. Don't push yourself. In extreme exposures, it will actually backfire step by step, but do continuously.

[B]

And that's on purpose exposures.

[A]

Obviously accidental exposures, it is what it is. You can't really do anything about it.

[B]

But try your best to do response prevention.

[A]

And even if, let's say with accidental.

[B]

Exposure, let's say it was level 10 and let's say you fell down, but.

[A]

Even if you fell down a little less than last time, that's already a win also. So you can also measure progress in.

[B]

This way with accidental exposures.

[A]

Emergency session is available. The link is in the description.