Can someone help me see the purpose of this exposure?

[canigetawitness]

I'm trying to understand why a therapist would recommend dropping my wallet and debit card/cash if my intrusive thought was "What if I've lost my wallet?" A therapist actually did say they'd have people do this. I thought you exposed yourself to the thought itself, not the content. I'm very anxious, confused & scared, because ERP really confuses me. I know it's the primary treatment for OCD. But I thought it was about embracing your intrusive thoughts & not doing the compulsions, not willing throwing your wallet away? I'm so distressed by this. I mean by this logic we'd be leaving on stoves, unlocking front doors, throwing away valuables, etc. anytime we got the thought. And my understanding of therapy is that we are sitting with the thoughts and letting them be there without compulsions.

[Carbon21]

Hi, I’m only about to start ERP for the first time with my DD. so I can’t answer to this. Is losing your wallet a fear of yours? I’d talk your concern through with the therapist, sorry I can’t really help. Hopefully someone experienced with this will respond soon. Sometimes it takes awhile, but hopefully someone on here has this experience. Wishing you all the best.

[canigetawitness in reply to Carbon21]

Thank you, wish the best to you as well!

[Albertina_G]

So your thought is "What if you lost my wallet?" your therapist is saying to drop your wallet, cards, and cash so that you can expose yourself to those thoughts. Doing this will tell your mind that nothing happens if you lost your wallet and you will stop thinking about it. For example, if you suffer from Harm OCD and get thought of hurting someone of yourself then the therapist might say you hold a knife or other things that trigger your thoughts. After holding such things you are not going to kill yourself and your mind will come to know that it is a thought and nothing will happen. I am not sure if I am right or not but according to me this is how ERP works.

You can read these articles on ERP to know how it works or else ask your therapist that how dropping my wallet can help with your thoughts.

treatmyocd.com/blog/what-ex...

iocdf.org/about-ocd/ocd-tre...

mentalhelp.net/blogs/erp-th...

[canigetawitness in reply to Albertina_G]

OCD aside, throwing away from valuables would be distressing anyway, so I don't really understand ERP. I thought it was about exposing yourself to the intrusive thought "Have I dropped my valuables?" And thinking maybe, maybe not. Not actually doing what the thought says. And it's confusing to me because I thought all OCD was treated the same no matter what. For example of if had the intrusive thought "What if I've left the stove on?" The ERP would be sitting with that thought and not doing checking compulsions. Surely therapy wouldn't want you to leave the stove on all the time. I don't know, maybe I'm confused. Thanks for your response and support though

[MothFir in reply to canigetawitness]

I think you should ask the therapist exactly what they had in mind. I know sometimes patients are asked to go beyond normal behavior in order to build up tolerance to their feared scenarios. Someone with contamination issues might be asked to eat a cookie that's touched a toilet seat, or handle a trash can lid without washing afterwards. I have one self-help book that recommends turning a stove burner on (with nothing on it, of course) and then taking a walk around the block.

Obviously therapists don't really want their clients getting sick, burning their houses down, or constantly having to cancel and reapply for debit cards. So I think "extreme ERP" is a balance between creating enough anxiety and uncertainty so the client is distressed, but not creating a significant danger. Like you, I can't believe that a therapist would really want you to drop your wallet on a public sidewalk and then go home to wait and see who steals your savings and identity. Maybe they meant for you to drop/lose a little cash, or leave your wallet unattended for a few seconds?

Again, it's probably best to ask the therapist for clarity on this one.

[dutchgirl71 in reply to MothFir]

Very good answer MothFir. I believe the therapist's intent was as you stated. ERP can be tricky.