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Tap the SUDS level you're feeling right now. Each tap adds a timestamped reading.
Rank your OCD triggers from least to most distressing. Start ERP with items at the bottom and work your way up.
Not sure what your triggers are? This checklist can help identify problematic obsessions and compulsions. Check off any that trouble you at least once a week or more.
Checked items can be added to your Exposure Hierarchy.
Please rate each of the following questions about your obsessions and compulsions over the past week:
Feeling the urge to perform a compulsion? Try delaying it. Set a timer and sit with the discomfort. Often the urge will pass before the timer ends.
See how your anxiety response changes over repeated exposures to the same trigger. The curve should flatten and peak lower over time.
Understanding which compulsions your brain uses in response to specific obsessions is key to designing effective exposures. Map your pairs below.
Celebrating progress matters. Each badge marks a real step forward in your OCD treatment.
Feeling an OCD spike right now? This guided exercise walks you through riding the wave without giving in to the compulsion.
Struggling to design exposures? These suggestions are organized by OCD subtype and difficulty. Tap any to add it to your hierarchy.
Track your daily medication and supplement adherence. Tap AM/PM to mark as taken.
OCD is fueled by two cognitive roots: the need for certainty and the need for control. When something feels uncertain, our brains work overtime to resolve it. When something feels out of our control, it's perceived as a threat.
The OCD loop works like this: a trigger thought or image causes anxiety, something feels "not right," and we perform a compulsion (behavioral or mental) to get temporary relief. But the relief doesn't last, and another trigger starts the cycle again.
Exposure and Response Prevention (ERP) breaks this cycle. By purposely exposing yourself to feared stimuli and preventing the corresponding compulsion, you teach your brain that anxiety will decrease on its own — no compulsion needed. This is called habituation.
ERP is hard work. You know you're doing it correctly if it's difficult. Not many patients are asked to confront their worst fears on a regular basis; it takes incredible strength.
In the traditional OCD loop, anxiety rises with a trigger and drops briefly when you perform a compulsion — but it comes right back, often worse than before.
With ERP, because you prevent the compulsion, distress rises much higher initially (this is the hard part). Eventually, however, anxiety begins to decrease on its own. This may take minutes or hours, but it will come down. Anxiety cannot stay elevated forever.
As anxiety drops without a compulsion, your brain forms a new association: "I didn't need to do anything to make this go away." With repeated exposures, your peak anxiety decreases and recovery time shortens.
When is an exposure complete? Generally, when distress falls below 3/10 (30/100). The goal: "I could do this compulsion, but I don't have to."
Contamination/Cleaning — Fear of dirt, germs, toxins. May include washing or cleaning compulsions.
Scrupulosity — OCD focused on morality, faith, and rules. Compulsions may include confessing, praying, or analyzing theology.
Symmetry/Ordering — Involves alignment, symmetry, or order of objects. Compulsions may include reorganization or mental rituals.
Checking/Counting — Making sure electronics are off, doors locked, counting objects or behaviors.
Relational (rOCD) — Worries about relationships: is my partner right for me? Do I love them enough?
Sexual Orientation (SO-OCD) — Intrusive thoughts about sexual orientation different from one's own.
Harm — Intrusive thoughts that harm may come to self or others, intentionally or unintentionally.
Forbidden/Taboo Thoughts — Intrusive thoughts and images considered repulsive, offensive, illegal, or blasphemous.
Stay present with the anxiety. Unlike other approaches, ERP asks you to keep the distressing thought in consciousness rather than distract yourself.
Focus on uncertainty. Notice the elements of "not knowing" in your intrusive thought. Sit with that uncertainty.
Remember the curve. Anxiety will rise dramatically — well above where it would have been if you'd performed the compulsion. But it will come down.
Trust the process. The freedom produced on the other side of ERP is well worth the work.
Don't seek reassurance. Asking others "Is this really OCD?" or "Am I going to be okay?" is itself a compulsion that feeds the loop.
Progress over perfection. If you partially resist, that still counts. Every moment of resistance weakens the OCD loop.
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) measures the severity of OCD symptoms. It evaluates both obsessions and compulsions separately across 10 questions.
Scoring: 0–7 Subclinical | 8–15 Mild | 16–23 Moderate | 24–31 Severe | 32–40 Extreme
Track your Y-BOCS every 2–4 weeks during ERP to measure progress. Watching the score decrease is a rewarding part of the process.
OCD often attacks the things we care about most — and for believers, that includes faith. Scrupulosity is especially distressing because faith exists at the core of who we are.
Freedom from scrupulosity comes not as we indulge the compulsions our brains insist are necessary for peace, but in resisting those same compulsions and seeing that the feared spiritual consequence has not occurred. For the believer, this is a great act of faith — one that glorifies God.
It is a great act of faith to fall completely into God's sovereignty, realizing we can do nothing to save ourselves; it is entirely, from start to finish, a work of the Holy Spirit.
"O LORD, my heart is not lifted up; my eyes are not raised too high; I do not occupy myself with things too great and too marvelous for me. But I have calmed and quieted my soul, like a weaned child with its mother; like a weaned child is my soul within me." — Psalm 131:1–2 (ESV)
Martin Luther struggled intensely with doubts about salvation and recurrent violent, lustful, and blasphemous intrusive images. His confessors grew restless as he presented for confession for up to six hours at a time.
Luther's freedom came when he realized his ultimate powerlessness to effect his own salvation through any work of his own. The spark that lit the Reformation was formed in the kindling of his deep struggle with intrusive and obsessional thoughts.
Over a century later, John Bunyan — author of The Pilgrim's Progress — would walk a similar road, writing of "whole floods of blasphemies" poured upon his spirit. His freedom also came when he realized his righteousness was not caused by him, held by him, or changeable by him.
You are not alone in this struggle. Throughout history, people of profound faith have faced the same battle — and found freedom.
Family members and friends can find themselves as part of an OCD loop through reassurance-seeking. Though it's difficult to see someone you care for in pain, the right thing to do is not to participate in the compulsion.
A gentle response: "I care for you, but I'm not going to participate in an OCD loop." If that phrase itself becomes a compulsive trigger, simply "No, I'm sorry" may be appropriate.
Your care for your loved one — even reading this — is a true gift. It's a quiet presence that says you are not alone.
Toward the end of treatment, many patients encounter this intrusive thought: "What if it wasn't OCD all along?"
Despite all the evidence, despite all the success in resisting intrusive thoughts and compulsions, OCD attempts to convince you it was never OCD. The corresponding compulsion is reassurance-seeking — from clinicians, textbooks, or online resources.
Recognize this for what it is: OCD's last stand. It remains an attempt to resolve uncertainty. The same principles of ERP apply here: sit with the uncertainty, resist the compulsion to seek reassurance, and the distress will pass.
988 Suicide & Crisis Lifeline: Call or text 988
Crisis Text Line: Text HOME to 741741
International OCD Foundation: iocdf.org
NOCD: treatmyocd.com
faithandmedicine.foundation
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AOA ERP Tracker — A companion app for OCD treatment using Exposure and Response Prevention. Developed by Adam O'Neill & Associates, Fairfax, VA.
This app is not medical advice and does not act as a substitute for proper care. OCD is best treated in coordination with counselors/psychologists and medical providers.