Being Exposed and Doing an Exposure

The Difference Between Being Exposed and Doing an Exposure

If you've been throwing yourself at OCD's fears and wondering why nothing is working, the solution is simple but not very obvious. The problem isn't your bravery - many people with OCD are already incredibly brave. The real issue is that most of the time, you're running into triggers by accident.

Effective therapy requires something more intentional: practice and resisting OCD's rules.

You see, there's a huge difference between doing an exposure and being exposed. I find that many people have difficulty telling the difference.

The "Exposure" That Isn't Really an Exposure

I've heard many comments like this:

• "I visited this place and it was such an exposure to be there"
• "I went to my in-laws house - I did an exposure"
• "I went to a movie, ate at this place - this whole weekend was an exposure"

When I dive deeper, I realize the real question is: did you tolerate the moment, or did you actually do an exposure? Yes, it was hard, and we don't want to take away the value from that. But did you do anything to actually make it an exposure?

Just Facing a Fear Isn't Enough

Here's the catch: just facing a fear is not enough. Being in a place, touching a thing, or having a moment isn't an exposure unless you're making it into an exposure.

This happens naturally through life - we stumble into triggering situations where we can't leave or do much about it. So we tolerate the situation, and it feels like a really big thing.

Maybe you:

• Touched something you didn't mean to
• Had an inappropriate thought at the "wrong" time
• Found yourself in a triggering situation you couldn't escape

Your brain screams "Fix it! Fix it now!" And many people give in to the compulsion afterward. "This was so difficult for me to be there, but when I got home, I showered, checked the doors one more time, made sure everything was okay."

You were exposed, but you also did the compulsion. Your brain didn't actually learn anything therapeutic from the experience.

Making It Meaningful: Planning Ahead

I want your brain to learn something purposeful from these moments. We can't plan for everything, but when you know ahead of time what might happen, we want to make it meaningful.

You might know:

• "I'm going to this event and I'll have to sit on a specific couch"
• "I'm going to church and will possibly be triggered"
• "They're going to give me a knife to cut vegetables at this event"

Instead of just tolerating and getting through the moment, let's make it therapeutic.

Example: Planning for a Knife Exposure

Take out a piece of paper and write down what you think will happen:

"I'm going to get to that event. They're going to give me a knife. I'm going to be cutting vegetables for everyone."

Now plan your exposure response:

• Hold the knife really tight (don't try to be extra careful)
• Don't look around to make sure no one's near me
• Have phrases ready: "Maybe, maybe not," "We'll see," "That'd be cool if something happened"
• Put a big smile on my face
• Stand close to the person next to me while cutting
• Don't ask for reassurance
• Don't try to stay "safe"

When you get to the event, your plan comes into action.

When You Can't Plan: Your Go-To Strategy

What about times when you can't plan because you're unexpectedly triggered? That's not automatically an exposure, but you can still make it one.

Have your go-to commitment ready: "If I am triggered, I'm doing something about it. This is what I'm going to do."

For contamination triggers:

• Lean into it - touch it more
• Don't wash hands for 30 minutes, maybe 60, maybe never
• Use your uncertainty responses: "Maybe, maybe not. Sure. Cool. This is great."

For social situations:

• Sit on that couch your brain says to avoid
• Eat the nuts on the table
• Talk to the person you're worried about
• Use responses like "Love this feeling" while doing it

You can easily go to that house and avoid everything ("Nope, not sitting there. Not eating those. Not talking to that person"), but that's not an exposure - that's accommodation.

The Three Key Ingredients for Effective Exposures

I always make sure there are three components to make exposures as structured as possible:

1. Action

Something you're touching, thinking about, someone you're talking to, maybe doing jumping jacks - whatever your specific action happens to be. Are you reading scriptures? Touching a doorknob? Standing near someone?

2. Response

What statements are you using? Are you using uncertainty statements like "maybe, maybe not"? Are you agreeing with the scary thoughts? What's your planned response?

3. No Compulsions

What compulsions are you purposely not doing or delaying? This is often the hardest part.

It's going to feel uncomfortable, but you need to sit there long enough for your brain to learn. Anxiety will usually drop on its own, but even if it doesn't, that's okay - your brain is still learning that anxiety isn't an indication something's wrong unless you can see immediate danger right now.

Learning from Imperfect Attempts

We're not looking for perfection. If you had a moment where you thought "I did an exposure," think through what happened. See if there were any compulsions. Then learn from it.

Ask yourself: "If I could go back, what would I do differently?"

• "I wouldn't ask for reassurance"
• "I wouldn't hold that knife so carefully"
• "I wouldn't text asking 'Are there going to be kids there?'"

Learn from each experience.

Turning Daily Triggers into Planned Exposures

Start thinking throughout your day: "Am I being exposed, or am I doing an exposure?"

If you find day after day you're being exposed to something but not making it meaningful, what can you do tomorrow to plan for that?

Example: "I know I take that elevator every day at work and I'm just trying to get through it, not touching the buttons. Tomorrow I'm touching that button as fast as I can. I'm going to put a big smile on my face. I'm going to hope someone jumps in that elevator so it's just me and them alone, and let my thoughts run wild."

"Whatever happens, happens. I'm going to smile and say 'Yeah, maybe something bad will happen. Maybe not. I don't know. I hope it takes a long time. I want to be on here forever. That would be amazing.'"

Instead of "Get through it, get through it, get through it" - make it meaningful.

The Bottom Line

Don't aim for perfection. Use every situation as a learning opportunity, whether you did exposures or not, whether you did compulsions or not. Learn, learn, learn, and live life.

The difference between being exposed and doing an exposure is intentionality. When you're intentional about facing fears while resisting compulsions and using helpful responses, you're doing therapeutic work. When you're just enduring difficult moments and then doing compulsions afterward, you're missing the opportunity for real change.

Your brain learns from what you do consistently. Make sure you're teaching it the right lessons.