← The OCD Whisperer Podcast with Kristina Orlova
The OCD Whisperer Podcast with Kristina Orlova
150. OCD Expert: This Is Why ERP Feels Like Torture (But Works)
00:27:46
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- [00:01]
A
Hi, I'm Kristina Orlova, host of the OCD Whisperer podcast. As someone who lives with ocd, I understand the struggles firsthand. If you're here, you're not alone. Before we start, grab your free OCD survival kit at www.corresults.com to help you take control. That's K O R results dot com. Now let's dive into today's episode. Welcome to OCD Whisperer podcast. So today with me, I have Natalia, and this is episode two of our four series episode, all about ERP and today we're going to be talking about imaginal exposures. So welcome back, Natalia, and let's dive right on in.
- [00:46]
B
Oh, thank you for having me again.
- [00:49]
A
So let's talk about imaginal. So imaginal scripts, imaginal exposures. Let's just start with basics. What exactly is that?
- [00:58]
B
Hmm. I like to explain it as writing a diary entry from the point of view of your ocd. So rather than speak in terms of our authentic self, we're trying to give voice to the ocd. Letting the OCD tell that fear story and putting it on the paper.
- [01:19]
A
I love that. Okay, so if somebody is having really, like, really dark, bad, uncomfortable thoughts, right? A lot of those doubt questions. What if I'm, you know, filling the blank? What if I'm this horrible, you know, violent person that's going to harm somebody? What if I cause sexual harm? What if I already did that? What if this is not the right relationship and I'll be alone? I mean, sources, all sorts of things, right? We have so many different kind of noises in our head, especially with OCD brains. What would you say to that person? Why and how would they even consider trying to have that thought? Right? Because most people, when they have that, I'm sure you hear this too, right? That's what I hear is, oh, my gosh. No. Right? Make that stop. I want it to go away. I do not want to think about it. I'm doing everything in my power to not think about it and not have it.
- [02:15]
B
Yeah. So I like to think of it as a beach ball. I think that's the simplest way when we're trying not to have an intrusive thought. It's like we're trying to push a beach ball under the water and it comes and smacks us right up in the face. So when we have these intrusive thoughts, what we want instead is to allow them to be in the surface. We in imaginal is saying, you know, hello, beach ball. What you up to. And that allows those intrusive thoughts to kind of be and then float away. In OCD world, we talk a lot about what we resist, persists. And the more we try to push things under the surface, the more they pop back up and sometimes with a vengeance. And so the idea with imaginals is, okay, well, I'm going to be having these thoughts anyways. If I weren't having them, I wouldn't be here. And so I'm going to flip the power dynamic and actually welcome the OCD to write out its full fear story rather than and resisting it.
- [03:22]
A
So what would that look like?
- [03:24]
B
I can give an example. I have my imaginal memorize from when I was earlier in treatment. Would love to hear it. So, yeah, okay. Had to listen to it a lot of times. So just for context, one of my intrusive fears was, was kill my children. And so I had to write a story about me actually snapping and becoming one of those mommy killers. So alert to people who might find this triggering. But this is my real imaginal. So I wake up one morning and my mind doesn't seem my own. I am derealized. I don't quite feel like myself. I go into my baby's room, I grab them out of the crib, and I immediately know I am going to do them harm. I open up my window and I drop my baby out. I then go on to each one of my children. I am happy to be doing this. I am satisfied to be doing this. I feel ready to be free of my children. And then suddenly the derealization goes away. And I look around and realize that I have done that thing that I fear. I am such a bad person. There is no life left for me. I can only face my consequences and hopefully lose my life. That's my.
- [05:04]
A
So that's pretty intense, right? I mean, thank you for being vulnerable and honest. I super appreciate that. I think real examples like this are pretty powerful. But I think that there's a couple of things, you know, we've got to kind of process through for people listening. Because, you know, I'm gonna assume that some people know this stuff, some people might be brand new and go, what the heck was that? Like, that sounds crazy, right? So let, let's, let's, let's break it down for folks to understand, like, so what exactly? Like, why would you do that? Right? Why would you take the time to write something out in that way? You know, let's talk about the style of how you wrote it. Let's talk about what? What's the purpose and the goal of this? What is it supposed to generate? What does it help you achieve? Because again. Right. I'm thinking of kind of the folks who maybe are still more kind of in that beginning, or maybe they don't even know yet phase, right. When they might even read about something like this or hear this and think, well, that's. That's. That's crazy. Like, you've lost your mind. Why would you ever do that? Right. So let's address that, because I know that even though I'd love to say that, you know, people don't make those comments, but we do. People do make those comments. So, you know, let's. Yeah, let's call it for what it is. So if you can help us break down exactly what just happened there.
- [06:24]
B
Absolutely. So my. And it's worth mentioning that my babies are all now teenagers, and they are just fine. And they know that I had to do therapy because of this. This fear. So the basic premise of OCD work is that we are not our feared self. Like, I am not a baby murderer. I, in fact, have never even, you know, pinched them or like, done anything of any sort. So there's my feared self, which my OCD makes me think I am, and then there's my true self, which is a pretty, you know, gentle, normal human. However, OCD has power overall us. By convincing us that we have this other gear, that there is some, like, darker piece of ourselves, and if we're not very, very careful and we don't do a bunch of compulsions, that fear itself could actually come true. So to use the example of, like, my particular situation, and this was only one part of my ocd, but I had all of my windows duct taped shut. And part of that was because my OCD had never quite convinced me that it was real. I didn't actually think I could do this, but my OCD brought up these intrusive thoughts enough that I couldn't take that chance. And I developed other safety compulsions that were really unnecessary and unhelpful. And so this is working under the premise that you are not your ocd. I am not my ocd. I am not a person that harms others. And so in order to really feel that and know that and do that, I have to tell the story from the point of view of the ocd. So, you know, that story might have felt very powerful to you hearing it for the first time, but for me, it's positively boring, because when you do an imaginal, you listen to it so many times that you are just totally deceptive. And in fact, it starts to sound totally ridiculous. So me listening to this story now, I'd be like, whatever. It doesn't even. It doesn't even shock me. It does nothing for me because I have desensitized myself to those fears.
- [08:55]
A
So, you know, again, to help break this down, part of what you're talking about is then if somebody has kind of bad thoughts, fears, kind of loops, is to essentially be able to say, okay, the way we want to expose to those is to basically let OCD speak. But it sounds like it's not like we're just kind of free flow and writing, you know, like actual true journal entry style. Because, you know, I think we both know that would actually could be a way that a person starts to sneakily compute pulse because they can start writing out. Like, I'm processing this thought and then, oh, my God, why am I having this thought? I'm a bad person. And now they're mentally evaluating it, right? What you're talking about, it's. It's a whole different way of how you construct this and that when you do this, it's like, okay, if I. If I. It's already happening, right? So if I take it and put it forward and. And allow it, like, allow my brain to finish that bad thought, and I listen to it over and over and over, read it over and over and over, it starts to lose its grip. It's no longer powerful. So can we talk a little bit about that structure then? Like, how. What's. What. How do you want to set this up? How would you start? Because when you were saying it, it wasn't just like I said, a free flow journal entry. It was different. So would you mind talking about that?
- [10:20]
B
Yeah. It was a story. It was a horror story, right? It's like a campfire, like, give you chills type of story, but it's written by your ocd. So before I did an imaginal, I had never actually let the story play out because I was doing mental compulsions. After, like, once my. My brain was like, I'm gonna hurt my baby or I'm gonna open the window. Like, I didn't even know where the story ended. I didn't realize. Um, and sometimes the story only was. Was stopped at the derealization. And then I became obsessed with whether or not I was actually derealized or not. So, you know, when we actually allow the OCD to speak, that's when we kind of understand the. The deeper. The deeper Fears that are happening. And, and you know, obviously the deepest fear in my story is murder.
- [11:19]
A
But.
- [11:19]
B
But in addition to that, like you heard at the end that it's this idea that my brain is not my own and at some point I might click into this other version of myself and then click out and realize that I just did these horrible things. So that, you know, writing it all down and allowing myself to actually free flow, I do let my clients free flow with it. We do have to edit out some parts. But. But letting myself free flow, that's how I was able to see what the real fears were.
- [11:57]
A
I see. So you. Okay, because one of the things I know with erp, right, and imaginals, for example, like one of my trainings was there's a certain way to write this. Like you want to write in first person, like it's happening right now. You know, make sure you address the worst feared outcome in the story. And kind of that's a structure and that we're not looking to like, do this creative writing class where we're, you know, in this exaggerated way going on and on and on to keep explaining kind of the scenario. We want to kind of go right into it as if, as if it's here now. You know, Another way I've learned is using some more acceptance, commitment, therapy style where we're designing this imaginal exposure more like, I'm facing this, this thing is happening, but it's in service of my value. And you know, I'm, I'm. Because of that, I'm willing to essentially, you know, not, not maybe forever know the exact answer or something like that. So there's a couple of different ways, but you're describing a different way where you kind of let people free flow and let them get whatever, the whole thing out and then you go in and then you edit. So what would you edit then?
- [13:04]
B
Oh, well, I would edit any compulsions that happen in there. I don't quite remember, but I think my first version had like. But I wouldn't do that, but, but I would call for help. You know, it had all of these sort of like arguments in it or, you know, sort of trying to neutralize that, the horribleness of it. So that would be something I would edit out. I personally, honestly, it's like you learn the rule book and then you throw it out. I was a literature major in college and I really believe in the power of the story. And so I allow my clients to really heart harness the story and let it flow anywhere that it needs to Go a lot of my clients there. When we really, really let the fears play out, it ends with them dying or needing to commit suicide. Something like very, very dark that has absolutely nothing to do with where it started, like, you know, fear of vomiting. But if we allow, we really let the ball roll. Sometimes we get a lot of insight from it. So I my exposure response prevention. Imaginals are a creative writing exercise, but, you know, we're not going to let it loop around and repeat the same things.
- [14:32]
A
Got it? Yeah. I love that, like you said, right, Every therapist has a slightly different way that they will do the work. And also, you know, you've been doing this for a while. How many years, by the way.
- [14:42]
B
Doing OCD work? It's only been four years, but I've been a therapist far longer than that. But I actually became an OCD specialist because as a ADHD specialist in my town, I had to send a lot of my clients to the local OCD specialists. And they were saying some of those things that the Reddit users, you know, claim that it's like torture, that it was done without compassion. And so I felt determined to do this work, but in my own way with, you know, kindness forward.
- [15:20]
A
I love that. That's great. Yeah, I mean, to your point. Exactly. I think we all kind of have to find our way and, you know, use the evidence based practice, but then also, you know, notice where and how we can again keep meeting the client where they're at, you know, and yeah, a lot of times you need compassion and sometimes, dare I say, we do need to push a little bit, you know, because everybody's different. Okay, so back to the imaginal point. So I love that you actually let folks really have the creative process. I love that you actually let them go forward and just kind of write it out, however long it takes. But then you go in and you really start to edit this. Again, not a format I was trained in like that. My training was a little different. Right. So here you go, people, as you're listening, right? Like I would do imaginals a little differently and even when I did them for myself, I don't know, I kind of liked it. But who knows, you know, there isn't again, there isn't like, I wouldn't say a hard, fast rule about, you know, right and wrong. It's more noticing what is it that seems to work for you? Because yeah, I think some clients do well and actually benefit for it being really more focused. And some folks actually do well when you give them a Little more of that creative space and. And kind of let them get enveloped, if you will.
- [16:36]
B
Absolutely. There are some, like, rules that you can't. You. It's not great to break one. It should be in the first person. So you're speaking from the eye. The present tense is preferred because you want the person to be feeling like this is actually happening right now. And then you want to record the script, you know, on. On a device. And we want to re. Listen to it as many times as is needed in order to find it boring. That's why I have mine memorized because it's. It got to the point where it was just such a boring rote thing to listen to it.
- [17:18]
A
Yeah. And that. I love that you actually pointed those out. Right. So for people listening, like, yeah, those are. Those are some things you definitely want to make sure you have in if you're doing imaginal exposure scripts. And I do agree with you. I think the whole goal here is to remember that it's like we're not trying to torture ourselves, but if we're thinking about, like, look, the fear is already there. Right? You're already having it. It's not like you're having to do something totally new. It's just from what you even said. Right. Helping your brain finish having the whole. The whole sequence, if you will. Because we often step in and start to. Oh, my God. But what if this? What if that? No, I don't want this. I don't like that. And so we interrupt it instead. Hey, let's finish that loop and then be with that. It'll generate the feelings. But as you stay with it to your point, you notice it starts to lose its grip because you start to get bored. So what is. So would you say that that's where the brain habituates what's going on there?
- [18:16]
B
Absolutely. So, you know, it just gets. It just gets less activating because really, it's a story. OCD is controlling us with a fear story. And so we have to claim that story story and see how we can desensitize ourselves to that story. This does not mean I was desensitized to the concept of child murder. Absolutely not. But it's my particular fear story that I was getting desensitized to. Another important point is that this. We don't want to be speaking in what ifs in our imaginal. So if your client, or if you are saying, what if I murder my children? We change it into a decline declarative sentence. It's like, I am going to Or I do. And in that way, we sort of take away that uncertainty piece and we lean into like the horrible thing is happening and here it is and we're facing it.
- [19:19]
A
Yeah. So again, as you're saying that, right, like, I know you and I know this work and I understand, but I know people listening, especially with things like, you know, pedophilia, ocd, or it could be some, some other sexual themed ocd. A lot of those things, you know, again, murder. Right. Stuff like that. It really is difficult to kind of wrap the mind around writing some of that out. Like actually writing, I am right now, this. What would you say to help people maybe reframe this or think about this differently and help them be able to use the strategy that, you know, can really help them. Again, like you said, get used to this and even get bored with this thought so they can really move on.
- [20:08]
B
Yeah. So. So again, we can make gentler versions of this. So I, with one of my clients, I literally just started with the letter M on a piece of paper. That's it, M for. And, you know, that was all we could do was the letter M. Cool. We did it. You go, girl. And then we built out from that letter M. So, you know, again, we do what we can. Sometimes, you know, pedophilia, OCD is an excellent example of. It's just so incredibly gross that we, we really, really struggle to, you know, write it on a piece of paper, say it, even, like, think it, even imagine it is horrifying. And so, you know, and that's not going to get desensitized. We're never going to be as, like, healthy humans desensitized, the idea of some of these horrible things. But we get desensitized to the story. And the key is to make some version of the story that is accepted, accessible for you and that you can get desensitized to.
- [21:19]
A
Yeah. And I think as you were talking, I was also thinking about, you know, just understanding that, you know, there we are living in real life and we are going to be seeing these different topics and different things. And, you know, I think there's a point to be made in terms of, like, you know, that you're like, ugh, like, this is. This is not for me. I don't like this. This is super uncomfortable. I mean, that right there already gives you insight as well that this is clearly not something you're aligned with or are behind, but you're kind of tormented, right? Because your brain keeps going into these, you know, really intense, incessant doubts and, you know, I dare say even there's probably a lot of compulsive rumination going on. They're trying to figure this out, trying to, you know, go back and remember or trying to reassure yourself. So, you know, a big piece of this is recognizing that, you know, you're not the thing that you're experiencing internally, because that's such an internal experience, but that we can start to create a little bit of that separation. Right. A little bit of that detachment to see it as, okay, it's a thought, not a thought I like, but can I have it? Can I tolerate it? I love what you said. Can we start with maybe just a letter? M for Murder. That almost sounds like a show. I.
- [22:36]
B
If you and I do a TLC special on erp, it can be M for Murder. That'll be the title. But I mean, I think one of the fallacies that we have when we have this type of OCD is that we're actually avoiding our triggers. And that's. That's. I mean, it's not like we. We are constantly inundated with our triggers. We. I was continuously getting messages from, you know, at the time, it was in social media, but from, like, news feeds. I was like. And I was searching for examples of other moms that had lost their minds and committed infanticide. Like my ocd. Yes, it was avoiding it on some level, but it was also seeking that input. So, you know, we. We need to talk about these taboo topics because we can't hide from them. There's no. And we don't actually want to, because that makes the OCD stronger.
- [23:40]
A
Absolutely. And I, again, I love the clarification. It's just the understanding. And again, I think, like you said, it's important to point out we are having news. We have. I mean, life happens. There's. There's things happening all the time. So it's not like you're going to be void of things that are triggering for you. But as you said, if you're using this strategy, imaginal exposures and, you know, create a response prevention plan, of course you get better in terms of, you know, those. Those aspects of your mind that want to latch on and have you do something about that thought that you deem as, you know, intolerable or can't have it and, and recognize that that's what it is. It's a thought, and I don't have to latch onto it in this way. So then when I'm in front of, or suddenly get that news that maybe comes organically or whatnot. Like, okay, I see it, yes, it's, it's like part of my topic or vulnerability, but I don't have to do anything about that.
- [24:37]
B
Yeah, absolutely. And I, I also, I like, I like to think of it as taking our power back and like breaking some of the superstitions too. Like there was a period of time where I, I would not have been able to like name, name that so openly because there was a part of me that would, was so superstitious that like the moment that I said I'm afraid that I'll do this, that like, you know, the police would come like bursting into my apartment, I had all of these like fears of sort of outing myself as having these fears. And so even though there was a very big part of me that understood and knew fundamentally that I was like a non violent person, I, you know, making it imaginal is also about like breaking that taboo with your therapist and like really letting the therapist into that like messy inner life. Those like unspoken fears.
- [25:40]
A
Yeah, I love that. You know, I just want to say thank you so much again for putting this out there and diving right in with sharing your imaginal because you know.
- [25:49]
B
We'Ll put a trigger warning on this.
- [25:51]
A
Yeah, well, we'll do our best and everything is always going to be, you know, we'll do our best in our show notes. But I mean I, again, I think it's powerful for folks to, you know, when we can share it so that we can lead by example, if you will. Right. And demonstrate to other folks, like look, it is, it is absolutely scary and uncomfortable and it's something that we can loosen that grip so it doesn't have all that power over us. So thank you for sharing that.
- [26:21]
B
Absolutely. And think about the fact that I am putting this out on the Internet and my children have access to the Internet and they will hear my imaginal and that's how like silly and like imaginative it is that there is no part of me that feels like shame or embarrassment or even any sort of, you know, fear of repercussions. Because again, thoughts are not facts. Thoughts do not manifest in the real world. Our OCD wants us to think they do and they do not. And at the end of the day we are the people that are most judging ourselves for our thoughts. Apart from that, there is no harsher critic.
- [27:04]
A
Yeah, that's absolutely true. I definitely second that. Well, thank you so much for coming on today and absolutely we know that folks can find you at Kairis Wellness and we will include all of that in the show notes. And would you remind us of your Instagram tag?
- [27:19]
B
It's letstalk ocd.
- [27:22]
A
And there you have it, folks. Thanks for coming.
- [27:25]
B
Thank you, Christina. Sam.