Sometimes (ok, maybe most of the time!) ERPs can be quite painful. It is for that reason that we should try to get the most out of them so we don't waste our efforts. My psychologist was really great about educating me in the proper way to do ERPs. She introduced me to the concept of "looping" them. Essentially, it is not enough to do an ERP just once and then wait days or weeks to attempt it once more. In fact, if we do it just once, it can be so painful that we may be afraid to ever do it again in the future.
To loop an ERP, simply means to re-do the ERP. For example, perhaps I am anxious about touching a public toilet. What I need to do is touch the toilet and then rate where I am on the SUDS scale (it can be 1-10, or 1-100). I like to use a 1-100 scale. Maybe after touching the toilet, my level is 80, which means I am experiencing a LOT of anxiety. At this level of anxiety, I am usually crying and shaking, and hating those three little letters: OCD. At some point, though, my anxiety will drop. When my anxiety reaches a 40, (half of my initial peak of anxiety), I need to go back and touch the toilet again. Once more, my anxiety will peak. I might only peak at a 70 this time. Once the anxiety drops to 35 (again - half of my peak), I need to loop back and touch the toilet. I will experience another peak and another drop. I think you get the idea from here.
To get more effectiveness from looping, it's helpful to loop it every day, as often as you can. Before you know it, touching that toilet will get easier and easier! I did not loop my exposure when I sat down in my finished basement the first time after it was cleaned. In fact, when my anxiety got really high, I left the room. Big mistake. Of course, this made it harder to go back down again days later. It took me a lot longer to get used to the basement room than it probably would have if I had looped it.
Looping seems easy to apply with contamination type items, but I'm sure it can work for other types of OCD too. Obviously, there are some obsessions that can't be physically looped because of safety reasons, or perhaps they are impossible to duplicate. That might be a great time to script out a worst case scenario of what you fear, read the script and sit with the anxiety, and then go back and re-read that worse case scenario once the anxiety comes down by half. Jonathan Grayson's book (see his book listed under Helpful Books to the right) gives directions on how to do scripting.
I thought my psychologist's idea of looping was great, so I wanted to share it with you. I wish I could say I did lots of looping. (Sunny writes this with her head hung low.) I wonder how much more quickly I would have gotten better if I had. It certainly does take time, effort, and planning. If you decide to try looping, I would love to hear if and how it worked for you. I'm always thankful to receive helpful tips and strategies from my fellow OCD sufferers to add to my own recovery "toolbox." Good luck!