What to do when ERP isn’t working?
I’ve been in weekly ERP (at one point twice weekly) for almost two years now and I’m at a point where I think I need to reassess my options. My therapist does a mix of ERP, I-cbt & ACT. He’s supposed to be one of the best ocd therapists in my state and yet I’m still majorly struggling. Idk if my expectations are realistic or not but I still go through periods where I struggle so bad, the only choice i feel I have is to shut down/close off from all my thoughts and try to get by until my next session. So, we compiled a list of my rituals and been working through them, but there are still my main fears that’ve landed me in therapy in the first place that we haven’t even touched. My anxiety gets all consuming. I’m not progressing in the way that I apparently should. Like, you work on the ritual reductions and they go down with time. For me, they could go down and out of nowhere something triggers me and they go straight back up to a 10 and my OCD rule is that it’s not safe to do anything anymore. The frustrating part is that I’ll get triggers that are not even on my list to begin with that come out of nowhere, when I otherwise feel like I’m progressing and then it’s game over again. It happens so quickly, I suddenly have all these new rules I must live by and if I try to expose myself to them, anxiety level is 10/10. It’s like my brain has an automatic rule that it’s linked to the highest anxiety thing on my list. A rule that keeps seeming to come up is that when I feel overwhelmed by something, as a safety behaviour, I have to avoid a bunch of other things on my list that previously was a 0-2. When I speak to my shrink about it, he tells me not to engage with the thoughts and not let the theme expand and I try but I feel like it’s a Chinese finger trap. I don’t even know how I got there in the first place. Then before I know it I’m stuck in this web that’s so confusing to get out of. Then I don’t even remember what is dangerous and what isn’t so everything just feels dangerous. Even doing the therapy work feels dangerous. I feel like recovery has become so all consuming and I’m spending so much on it, I barely get to go on vacations or do things I like. I’m on 40mg of fluoxetine and take a bunch of calming supplements but my therapist doesn’t want me to increase my dose because I went through a period of nasty side effects whenever I increased dose. I don’t know if I’m just not getting it or if I’m not a candidate for this type of treatment or what. But I do not what this to be my life. It’s so debilitating