3 Types of Exposure
This lesson covers the 3 major types of exposure, how and why they work.
Exposure is rooted in the idea of breaking the avoidance cycle. Anxiety is our brain's way of trying to protect us, and when we participate in avoidance behavior (not eating certain food, washing hands multiple times) our brain thinks that the anxiety saved us. So the brain reinforces the connection, and will come back with even more discomfort next time thinking it is saving us again.
Exposure incrementally breaks down this connection, and reduces the anxiety we feel. Exposure is not about building tolerance. The goal is not to control anxiety. The goal is to accept it in small steps. When we accept anxiety, it no longer drives avoidance, and the cycle is broken.
Remember MyOCD is about practicing and conquering contamination OCD in incremental steps. As you learn about exposure, know that you are in control of the pace and order of your journey.
In Vivo Exposure
In Vivo ("in life") exposure is when we take steps in real life to face triggers and do not resort to avoidance or rituals. Starting small and working up, in vivo exposure teaches the brain that previous beliefs were wrong.
Examples
Some examples of in vivo exposure include:
- Trying new food or eating at a new place
- Going for a car ride, or riding the bus.
- Intentionally stopping rituals, like throwing away all mints or antacids.
- Visiting a hospital
As you practice exposure here on MyOCD, look for opportunities to take that practice into real life by facing things you might typically avoid, or not engaging in rituals.
Imaginal Exposure
Imaginal exposure is when we vividly imagine a feared situation or activity. This might involve recalling previous memories or imagining new scenarios. We can complete imaginal exposure by talking out loud, journaling, or drawing. With contamination OCD, we often push away unwanted thoughts. Just like avoidance, pushing thoughts away gives them power. Imaginal exposure takes power away from thoughts by facing them head on.
Examples
Some examples of imaginal exposure include:
- Describing out loud what it would be like experience a feared situation
- Facing your thoughts directly. Asking 'What about this is making me uncomfortable?'
- Drawing, writing, or journaling about a scenario
- Recalling a specific event from your past
Interoceptive Exposure
Interoceptive exposure focuses on the physical ('somatic') sensations felt during anxiety. This exposure is particularly challenging, and essential, for contamination OCD. Because anxiety and nausea are often related, sitting in the physical discomfort can be very challenging. Taken in small steps, interoceptive exposure unlearns faulty connections we have made between physical sensations and mental beliefs.
Examples
Some examples of interoceptive exposure include:
- Spinning in a circle to make yourself feel dizzy
- Breathing heavily to intentionally trigger the feeling of anxiety
- Drinking a glass of water quickly to simulate feeling of fullness
Conclusion
The three major types of exposure each focus on breaking the avoidance cycle, practicing discomfort, and unlearning faulty connections. Your journey with MyOCD will include practicing all three types at a pace you control.
Every day is a new day to practice exposure, sit in discomfort, and not engage in rituals.
Additional Reading:
You may find the following resources helpful additional reading.