Obsessive-compulsive disorder can be a distressing and disabling psychiatric problem. It’s characterized by unwanted repetitive, intrusive thoughts, impulses, or images that create great distress. OCD is also characterized by compulsions and behaviors aimed at reducing stress or doubt or preventing harm to self or others.

People with OCD may avoid triggers for their fears to avoid the distress of obsessions and compulsions. But it's often better to face fear head-on.

Here are some ideas for confronting OCD to reduce its power; they're called exposure and response prevention (ERP) exercises. These apply to all different kinds of OCD, so some may be irrelevant to you. Use these ideas to come up with exercises that can work for you.

Challenging an obsession with cleanliness and contamination

  • Touch the sole of your shoe and then touch your bed, your clean towels and everything in the kitchen.

  • Dilute urine to spread around the house.

  • Touch baby clothes and bottles in a shop to spread contaminant.

  • Place examples of all items that you feel are contaminated in a box or bag, rummage in it daily and spread those contaminants all over your home.

  • Walk around the house touching used underwear to everyday objects.

  • Sit on a public bench and then sit on your bed in the same clothes.

Challenging unwanted thoughts

  • Record yourself saying an intrusive thought out loud over and over again and play it to yourself repeatedly.

  • Watch ‘trigger’ scenes from film, TV and so on over and over until you feel your reaction reduce.

  • Write out your worst fear of yourself or a loved one becoming ill and reread it over and over.

  • Write out your own account of a feared catastrophe taking place, such as being arrested by the police and having your computer confiscated, and read it repeatedly.

  • Draw a picture, even just a sketch or a stick diagram, of your feared image and put it up on your wall or fridge.

  • Deliberately think an unwanted thought while eating chocolate (or another treat).

  • Write your unwanted thought on a piece of paper and throw it in a public bin.

Challenging an overactive sense of danger

  • Leave your electrical appliances plugged in while you are out at work.

  • Leave a tap running and go and run some errands.

  • Walk under a ladder and open an umbrella indoors.

  • Leave a pair of scissors on the table beside you while you have coffee with a friend.

  • Visit a gay bar and strike up conversation with someone of the same sex.

  • Deliberately make a mistake in your homework or assignment.

The key is to see the world as full of opportunities for facing your fears and resisting compulsions. ERP does not have to be perfect; there is always a way of moving toward your fears and helping yourself overcome your OCD.

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