Key takeaways
- OCD compulsions and avoidance can feel motivating because they reduce anxiety in the short term.
- One way to increase motivation for ERP is to outweigh short-term compulsive relief with immediate, meaningful rewards for doing exposures.
- Motivation can also be strengthened by making the long-term cost of compulsions more immediate, such as pairing avoidance with a small, unpleasant consequence.
- ERP motivation strategies are meant to highlight choice and cost, not to punish, and to help people pause long enough to act in ways that weaken OCD.
Estimated reading time: 5 minutes
Sometimes all of us with OCD need a little help motivating ourselves to do those between-therapy-session exposure and response prevention or ERP exercises. Before I talk about some creative ways to motivate yourself, let’s talk about how OCD gets you to avoid your fears and/or to do compulsions.
The “benefits” of doing compulsions or avoiding triggers
OCD cons us into doing compulsions or avoiding triggering situations simply because those actions often reduce our anxiety. Not all the time, not completely, and sometimes not even for all that long, but a reduction in anxiety is motivating nevertheless. And this is especially true because the anxiety reduction often occurs immediately after we avoid something scary and/or do a compulsion.
But there’s a cost to this short-term anxiety reduction, which is the long-term increase in OCD symptoms that avoiding and/or doing compulsions creates. But that long-term negative doesn’t seem as bad when faced with the short-term possibility of feeling a little bit less anxious…even if it’s for a moment.
ERP is the opposite of avoiding and doing compulsions
ERP is learning how to do the things that matter to us in life, even if they’re scary, without participating in compulsions. To motivate ourselves to do ERP, we need to figure out how to do two things:
- Outweigh the short-term benefits of the anxiety reduction that occurs when we do compulsions/avoid, and
- Mimic their long-term negative consequences.
One of the best ways to achieve #1 is to change our relationship with anxiety so that we want to be anxious on purpose in order to reclaim our lives. I’ve written extensively about this concept including in:
- The 5 Secrets OCD Doesn’t Want You to Know about Anxiety
- #FaceYourFear: Transform your triggers to win
- The Best TED Talks for People with OCD: Part 3; How you think about anxiety matters
- Is Fred in the Refrigerator? Taming OCD and Reclaiming My Life, including Dr. Reid Wilson’s Afterword, where he covers these concepts in detail.
But it’s helpful to have multiple ways to motivate yourself to do ERP, so let’s talk about additional ways to achieve #1 and 2.
ERP motivation
Creatively outweighing those anxiety reduction “benefits”
Giving credit where credit is due, I first got the idea of using rewards and consequences as part of OCD treatment from Dr. Reid Wilson (…it’s one of the many things I learned from Reid, which is why I asked him to write Fred‘s Afterword!) He talked about putting $10 in your pocket (let’s say your left pocket), and then every time you do a compulsion, you move $1 to the right pocket, and at the end of the day, you must give the money in the right pocket to an organization you don’t like. Love this idea!
You can also do the other way around, and every time you do an exposure, you move $1 from the left to the right pocket. At the end of the day you can treat yourself to something nice with all the money in the right pocket that you’ve earned from facing your fears.
Mimicking the long-term consequences of compulsions: a vomit-flavored jelly bean, anyone?
Often what I will propose to clients who are having trouble doing their exposures is to use a variation of Reid’s idea, which might include one or both of the following options:
- If you choose to do your exposure, excellent! Then you can do [insert fun thing here]. I’ve written about this technique in a previous blog called “This Before That.”
- If you choose not to do your exposure exercise for the day, that’s fine, but you’re also choosing to [insert somewhat disagreeable/annoying/distasteful small action here].
For #2, this disagreeable/annoying/distasteful small action could be something like:
- Eat something you find gross: popular choices are olives, mushrooms, pickles, a spoonful of cottage cheese or mayo, licorice candy, the less appetizing flavors in Bertie Bott’s Every Flavor Beans (a vomit-flavored jelly bean, anyone?).
- Do a chore that’s not very much fun: clean a toilet or hand wash some dishes or one of those smelly sweat socks at the bottom of the laundry bin.
- Put money in a jar labeled with a person or organization you don’t like, and every week or two, you must send whatever is in there to them: another version of Reid’s idea, this one works particularly well in election season! There’s even an app you can use to help you track how much money you owe based on how you’re doing with your particular goal: stickK!
The rationale behind a small, annoying consequence for not doing ERP
- We’re empowering ourselves by recognizing we have a choice about whether to do our exposure exercises or not.
- If we don’t do our exposure exercises, we get a short-term benefit of anxiety reduction because we’re avoiding triggering things or situations. If we’re about to make that choice, then knowing there will be an immediate negative consequence like the ones described above does two things
- It makes us think just a little bit longer about the consequences we will face if we avoid ERP (yummy vomit jelly beans!), giving us a chance to change our minds and do the ERP.
- Something like a vomit-flavored jelly bean mimics in the short-term the true long-term negative consequences of not doing ERP. The mental torment of OCD is far worse than the disgustingness of eating gross candy, of course. But the disgusting jelly bean serves as a proxy to remind us of what we’re really choosing when we avoid ERP: we’re choosing more OCD, which we really, really do not want.
This is not self-punishment
My last blog post was about self-punishment as a ritual, so I will close this post by emphasizing that we are not using negative consequences to punish you for not doing ERP. If you do self-punishment as a ritual, you might want to stick with only rewarding yourself for doing your exposure exercises, so that a negative consequence isn’t turned by OCD into more self-punishment.
The strategies above are simply about moving up the timeline for when the negative consequence for not doing ERP occurs: from it being a far away, “avoiding my ERP might make my OCD worse but I don’t care because I don’t like anxiety and doing ERP,” to “If I don’t do my ERP, I’ve committed to eating these nasty jelly beans, which I don’t want to do, so I think I’ll go ahead and do my ERP.”
Learn more about taming OCD
To learn more about how I motivated myself to do ERP to reclaim my life from OCD, see Is Fred in the Refrigerator? Taming OCD and Reclaiming My Life. Click here to purchase your copy.
