The OCD Whisperer Podcast with Kristina Orlova

Episode 150: OCD Expert: This Is Why ERP Feels Like Torture (But Works)
Guest: Natalia
Date: September 16, 2025

Episode Overview

In this episode of the OCD Whisperer Podcast, Kristina Orlova hosts Natalia, an OCD therapist and advocate, for the second installment in a special four-part series on Exposure and Response Prevention (ERP). This episode focuses on "imaginal exposures" — a technique often used in ERP to confront intrusive thoughts and obsessive fears. Through personal stories and clinical insight, the two explore why ERP can feel excruciating yet remains powerfully effective in treating OCD.

Key Discussion Points & Insights

1. What Are Imaginal Exposures?

(00:49 – 02:15)

• Natalia introduces imaginal exposures as "writing a diary entry from the point of view of your OCD."
• The idea is to fully articulate the feared story in detail, rather than repress or avoid it.
• Kristina highlights that the thoughts people fear most are often the most avoided, leading to more distress.

Quote:
"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."
— Natalia (02:15)

2. Facing Intrusive Thoughts

(02:15 – 05:04)

• Trying to suppress thoughts (“pushing the beach ball down”) gives them power; allowing them to surface helps them lose intensity.
• Imaginal exposure is about openly engaging with the fear story—not avoiding it.

3. Personal Example of an Imaginal Script

(03:24 – 05:04)

• Natalia shares her own intense imaginal script about a fear of harming her children, demonstrating the level of detail and vulnerability involved.
• She underscores this is not who she truly is—it's giving voice to OCD’s darkest fears.

Quote:
"I wake up one morning and my mind doesn’t seem my own... 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 look around and realize that I have done that thing I fear. I am such a bad person. There is no life left for me."
— Natalia (04:00)

4. Breaking Down the Purpose and Structure

(05:04 – 11:56)

• Core premise: You are not your OCD—there's your “feared self” (the OCD’s story) and your “true self.”
• Natalia used to use safety precautions due to these fears (e.g., duct-taping windows shut).
• Through imaginal scripts, she became desensitized to her personal OCD fear story, rendering it almost "boring" over time.
• The exposure helps reveal core fears and shows how much power compulsions and avoidance can have.
• Emphasis on letting the story flow during drafting, but removing any attempts to neutralize the fear (such as "but I would never do this" or "I’d call for help").

Quote:
"When you do an imaginal, you listen to it so many times that you are just totally desensitized. In fact, it starts to sound totally ridiculous."
— Natalia (08:36)

5. Crafting Effective Imaginal Scripts

(11:56 – 16:35)

• The script should be in the first person, present tense, and directly face the worst-case scenario.
• Avoid using the script as a way to seek reassurance or slip into compulsions.
• Therapists may differ in how much they encourage clients to free-write vs. stick to a script.
• Over time, repeated exposure to the narrative helps reduce its emotional charge.

Quote:
"It's a horror story, right? It's like a campfire, like, give-you-chills type of story, but it's written by your OCD."
— Natalia (10:19)

6. Creative Flexibility and Compassion in ERP

(14:32 – 16:35)

• Natalia believes in harnessing storytelling, allowing clients to write creatively before editing out compulsive elements.
• She stresses the importance of compassion and adjusting the process to individual needs.
• Kristina affirms that while methods may vary, the goal is always to support clients effectively, balancing evidence-based practice with personalization.

7. Key Tips for Imaginal Exposure Scripts

(16:35 – 18:15)

• Scripts must be:
  • First-person
  • Present tense
  • Facing the worst outcome directly (not using “what if” language)
  • Recorded and listened to repeatedly until the fear subsides

8. Handling Taboo or Extremely Distressing Content

(18:15 – 22:35)

• Distinctions between being desensitized to a fear story versus the real-world concept.
• Begin with manageable steps (e.g., even a single letter) and gradually build up exposure if needed.
• The key is not to lose sensitivity to what is truly wrong, but reduce OCD’s grip on the intrusive narrative.

Quote:
"We get desensitized to the story. And the key is to make some version of the story that is accessible for you and that you can get desensitized to."
— Natalia (20:46)

9. Separating Self from OCD & Real-World Triggers

(21:18 – 24:37)

• Recognizing the difference between one's values and intrusive thoughts can help create distance from OCD.
• We’re often exposed to real-life triggers (like news stories), but ERP training allows us to react with less distress and fewer compulsions.

10. Breaking Superstitions & Shame

(24:37 – 27:03)

• Writing and sharing the imaginal story helps break the taboo and secrecy around intrusive thoughts.
• Naming fears openly in therapy is a form of reclaiming power and challenging the belief that “thinking means doing.”

Quote:
"Thoughts are not facts. Thoughts do not manifest in the real world. Our OCD wants us to think they do, and they do not."
— Natalia (26:35)

Memorable Moments & Quotes

• The Beach Ball Metaphor:
  "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."
  — Natalia (02:15)

• On Compassion in ERP:
  "They [clients] were saying some of those things that the Reddit users 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 kindness forward."
  — Natalia (14:54)

• On Tackling Superstitions:
  "Even though there was a very big part of me that understood and knew fundamentally that I was like a non-violent person, making it imaginal is also about like breaking that taboo with your therapist and really letting the therapist into that messy inner life."
  — Natalia (25:13)

Timestamps for Key Segments

• [00:49] What is imaginal exposure? Basic definition
• [03:24] Natalia’s personal imaginal example
• [05:04] Why write out your worst fears? Explaining the purpose
• [08:36] Becoming desensitized by repetition
• [10:19] Story structure versus free-flow journal
• [14:32] Therapist flexibility and empathy
• [16:35] Key “rules” for writing scripts
• [18:15] Facing disturbing themes gently, stepwise
• [20:46] Gradual exposure—starting with just a letter
• [24:37] Breaking superstitions and secrecy
• [26:35] The core message: thoughts are not facts

Conclusion & Takeaways

• ERP, and particularly imaginal exposure, can feel like torture because it requires directly facing one's worst fears, but this is exactly why it is so effective.
• Separating self from OCD, breaking through taboo thoughts, and repetitive exposure mean the fear gradually loses its power.
• The structure of imaginal scripts is important—first person, present tense, confronting the fear head-on—but compassionate, individualized approaches can make the process manageable.
• Above all, exposure work is about reclaiming power from OCD and destigmatizing intrusive thoughts through honesty, repetition, and support.

Guest Info:

• Natalia, therapist at Kairis Wellness
• Instagram: @letstalkocd

For listeners who want to know more about imaginal exposure or ERP, this episode provides a rich, honest, and compassionate roadmap—with the powerful reminder that thoughts are not facts and you are not alone in your struggle with OCD.