What to Do Between Therapy Sessions for OCD
One of the things I tell every client when we start ERP is this: therapy is one hour a week. OCD does not take the other 167 hours off.
That is not meant to be overwhelming. It is meant to be honest. Because ERP works through repetition. Through practice. Through learning over and over again that you can tolerate the discomfort of an intrusive thought without doing anything to make it go away.
That kind of learning cannot only happen in a therapy office. It has to happen in real life.
So here is what to actually do between sessions.
Do Your Exposures
This is the most important one. Your therapist should be sending you home with specific exposures to practice. Not optional. Not when you feel like it. Regularly, consistently, on purpose.
If you are not doing between-session exposures, ERP will not work as well. The treatment mechanism is repeated practice. One session a week without practice is like going to the gym once every seven days and wondering why you are not getting stronger.
If your therapist is not giving you homework, ask for it.
Track Your SUDS
SUDS stands for subjective units of distress. It is a 0 to 100 scale of how anxious you feel during an exposure.
Tracking your SUDS before, during, and after exposures gives you real data. You start to see that the anxiety peaks and then comes down, even without doing the compulsion. That evidence is incredibly powerful for your brain to see over time.
Write it down. Keep a log. Your brain will try to convince you that the anxiety never decreases. The data will tell a different story.
Notice Compulsions You Did Not Know You Had
A lot of people come into ERP thinking they do not have compulsions because they cannot see them. But mental compulsions are just as real as behavioral ones.
Mental reviewing. Seeking reassurance from yourself. Replaying a memory to check if it actually happened. Googling symptoms. Asking someone else if you are a good person.
Between sessions, start noticing these. You do not have to stop them all at once. Just notice. Awareness is the first step in the work.
Resist the Urge to Seek Reassurance
Reassurance feels like relief. It is not. For OCD, reassurance is a compulsion. It feeds the cycle.
When you feel the urge to ask someone if everything is okay, or Google something to make yourself feel better, or replay something in your head until it feels right, that is OCD doing its thing.
The between-session work is practicing not doing that. Even for a few minutes longer than last time.
Use a Structured Workbook
Between sessions, having something concrete to work through makes a real difference. Not a journal where you write about your feelings. A workbook that walks you through how ERP actually works and gives you the structure to practice it.
I created This Isn't a Journal specifically for this. It is built around the ERP framework I use with my own clients. It is not a replacement for therapy. It is the between-session tool that makes therapy actually stick.
Be Honest With Your Therapist
If you did not do your exposures this week, say that. If something felt too hard, say that too. The work cannot progress if your therapist does not know what is actually happening.
ERP requires honesty about avoidance. Avoidance is part of OCD. Your therapist knows that. They are not going to judge you for it. But they need the real picture to help you.
Ready to book a session? Head to https://www.mentalhealthissexy.org/anxiety-and-ocd-therapy
Want to grab the workbook? Download it instantly https://www.mentalhealthissexy.org/store/p/erp-workbook
