When exposure therapy isn't working...?

I have contamination OCD and I started exposure therapy a little over two months ago....and it just hasn't clicked. I don't know if it's me or the therapist or what, but I've made no progress. I'm wondering for the people who were successful with Exposure therapy, how did that success happen? Was the exposure always anxiety provoking (even though I know my anxiety goes down after an exposure, I still fear doing the exposures and hate sitting with the anxiety...it's so overwhelming), did a light just go off for you one day and you were able to change, was it REALLY hard and you just kept pushing, or what? How long did it taKe? Thank you for any info .... I feel so hopeless and the OCD is just ruining my life. I hate living in constant fear and I don't know what to do.

I have little knowledge of exposure therapy. There are articles and posts about it here on Psych Central that may be of interest.
Psych Central - Search results for Exposure therapy

Hang in there. OCD is one of the toughest mental illnesses out there, so don't expect magic. However, you should have been noticing some minor improvements. You're doing the homework assignments, the exposure and response prevention, etc, on time and in the manner discussed and decided? Obviously once you rank your anxiety and work through them and have desensitized yourself enough, then you move up the ladder. But if you don't do the steps properly, or rush it, won't work.

Any ideas you have as to why it's not working at all?

Well my hierarchy is rather interesting....most everything is on the higher end of the hierarchy....like we were looking for things around a 2 or 3 (outta 10) on the exposure list for homework to help build my confidence, but I don't have any exposures that are that low.....the stuff that scares me and that I avoid, are all high on the hierarchy list. Plus, even the exposures that I have done, haven't helped, because I always get anxious no matter what....I can think, well I washed my face last week with nothing bad happening, but what if something bad happens this time.....I get the anxiety, do the exposure, and it doesn't change anything for me....I'm still scared something bad will happen even though it never has. Maybe I have unrealistic expectations for what ERP therapy does....like how does it actually change OCD?

Well, I am no expert but exposure therapy is not for everyone. It can be a bit... brutal.

Have you been taught relaxation techniques and are you able to use them effectively? Are you also working on 'attacking' your cognitive thoughts (e.g. 'what if something bad happens if...' scenario)

Finally, have you tried, in T, to work on visualisation re those scary stimuli (i.e. those high on your list).

Just throwing some ideas out there, really.

exposure therapy isn't for everyone. have you tried CBT? SSRI antidepressants?

Ah man, OCD can be a real pain in the ***, lol. The uncertainty, the doubts, the constant "I know it didn't happen then but what if this time...." I've dealt with OCD. Sometimes it feels like any day I could die, from some unknown virus, some stupid accident, feel surrounded by danger, feel so helpless. I've read about people who died so suddenly, they become news, then forgotten. Life can be scary. And worst is nobody else seems to be aware or care. My therapist once told me, "it's quite unlikely...." As if saying that helps! It is the 1% that scares me to death, telling me probabilities is useless, it only takes one bad thing to hurt you. Certainty or nothing! Anyhow, more recently it's PTSD I been fighting. Intrusions of a different kind I guess. Then PTSD made the OCD bad again.

I don't think OCD ever goes, it's never "cured." You basically manage it. So it sort of disappears into the background, once in a while coming to the foreground when you're under great life pressure or something like that.

Depending on how severe your OCD is and how much of pain and suffering and disturbance in your life it causes, CBT might be all that you need at this point. Just make sure your therapist and you are on the same page, you're aware what he or she expects in terms of results, and discuss any issues with your T, such as the issue with the hierarchy.

For instance in my case, to expose myself to the trauma is complex. Like yourself, there doesn't seem to be anything on the lower rungs. I need my sister to be near suicidal again, in a mental hospital, and dad disappearing for some "business" trip and mom being abusive...and long story short, recreate the horror I felt. That traumatized me years ago. Going to a hospital does nothing. Or rather sometimes it does, something doesn't. There are no places that are guaranteed to give me a certain strong feelings.

So my case got kind of weird, so I tried to figure out other factors. If not place, then maybe having an argument with family would do that for me, would stress me out. Having an argument, when another family member is sick. You see what I'm doing? It's a little bit of puzzle solving thing. Maybe with help of your therapist, you can find out other factors that play a part in increasing your obsession. Then try to create them, experience the obsession, and prevent yourself from responding. Again I emphasize, go slow, it's counterproductive to do anything extreme. Can't rush this.

Anyhow, TMI, I digress. Last thing is that if you have other diagnoses, make sure they're also attended to. Be it depression or a psychotic illness. When they're present or when your OCD is particularly severe, it's quite likely a different approach will be taken. Meaning not only CBT stuff, but also medications, and perhaps other kinds of therapy to address other aspects of your mental health issues.

Good luck. You're not alone. Many people have OCD and other disorders with intrusive thoughts. When under extreme stress, just ground yourself, touch things, smell things, remind yourself of reality of outside world. Through meds or therapy, this will get better.

Thank you all for your thoughtful replies. My therapist doesn't do CBT with exposure therapy. So we don't confront my faulty thinking....just the exposure....I guess that exposing yourself and just feeling the anxiety is what is supposed to make the OCD better. I have tried CBT before and it doesn't work with me....I know my faulty thinking is faulty, I've confronted it, and it's still there. And, I did just start a different SSRI (prozac) so I am hoping that helps....I just wonder what else is out there besides Exposure therapy and CBT....maybe I'm a lost cause...hahaha!

Nothing has helped with my OCD. I "conquer" one obsession/compulsion and just go on the develop something new. It's pretty frustrating. Medication has helped some. I hope you can find something that will help.

Prozac helps my ocd. 5 mg (ie 30 mg vs 35 mg) makes a difference between me counting my walking steps or just effin walking.

Oh wow! What a big difference with only 5mg....I assume you need the higher dose (35mg) to effect the walking? I started at 20mg for 2 weeks, then 40 mg for two weeks, and now on 60 mg for the last week (so i have now been on prozac for 5 weeks). I have noticed a huge change in my depression, but it still hasn't really touched my OCD (contamination fears with hand washing).

I don't have OCD but did have exposure therapy with certain objects that I fear. It was extremely hard, painful and anxiety provoking. I sat next to these objects and I couldn't breathe so I asked my T to take them away. We have since moved on but I have a feeling the exposure therapy will come back at some point. And even that thought scares me.