perfectionism and - Obsessive-Compulsive Foundation

IMAGINE THAT!: A SCRIPTING WORK-
SHOP
Jon Hershfield, MFT and Jonathan Grayson, Ph.D.
International OCD Foundation Conference July 19 th , 2013
Scripting (a.k.a. imaginal exposure) is a form of Exposure with
Response Prevention (ERP) that allows you to make contact with
your fear and confront your discomfort with uncertainty using the
written word. Thoughts present themselves in the mind as words
or strings of words, so our ability to read what the OCD is broadcasting
can be used to construct exposure assignments when direct
contact with feared consequences may be unrealistic or inaccessible.
Below you will find a few different approaches to scripting. No one
approach is automatically better than another. Which style or combination
of styles you use will be something you and your therapist
will collaborate on, but the general rule is TAKE THE FIGHT TO
THE OCD.
How you employ each imaginal script in your treatment can also
vary. You may write a script from scratch every day, read one script
many times throughout the day, or record your script in an audio
format to listen to on a loop. Which of these styles you use is also
something to collaborate with your therapist on as you balance
what you are likely to be consistent with against what level of discomfort
you are willing to tolerate.
Before beginning any ERP work, it is helpful to start by identifying
the “facts” of your OCD:
· What are your obsessions, e.g. what are you afraid of
· What are your compulsions, how do you try to “fix” things
or try to be sure you are safe
· What is likely to happen if you stop doing compulsions in
the short-term
· What about the long-term
***
Imagine That! A Scripting Exposure Workshop
The acceptance/motivation script – The objective here is to establish
a launching point for treating your OCD with ERP.
· What have you lost to OCD Be explicit, not just “I’ve lost
time,” but write about a painful occasion in which you lost
time, or a time you were humiliated by your OCD, or a job or
relationship you lost.
· How have you hurt your family Arguing, making them late,
forcing them to ritualize, nagging them for reassurance
Again write about specific times not generalizations.
· What values do you have that you permit OCD to interfere
with For example, being a good parent or role model
(making your children late or forcing them to ritualize is not
being a good parent or role model).
The uncertainty script – The objective here is to confront your
fear of living with uncertainty about your obsession so you can
stop doing compulsions.
· What obsession are you accepting could be true
· What thing are you going to stop avoiding, though it may
make your fear come true
· What unwanted consequences could this bring about (be
detailed)
· What kind of person would this make you if you allowed
this feared consequence to take place
· How will you probably deal with those consequences
· What would your life look like if you never took this risk
and just continued to obey the OCD
· How well do your rituals work – are there flaws in the rituals,
so that your fears could still happen
· Are your feared consequences more likely or less likely than
other disasters you wish to avoid, e.g. car accidents
o Why don’t you expend effort avoiding those
· Why is it worth it to you to risk the uncertainty
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