Guides
Facing the thing you cannot face for real.
Some fears cannot be practised. You cannot rehearse going to prison, or losing your soul, or the worst thing you can imagine doing to somebody you love. Imaginal exposure is the part of ERP built for exactly those, and it is the one people most often get wrong.
What it is.
A script: a written account of the feared thing, in your own words, that you then read or listen to on purpose IOCDF, Scripting for Success. Clinicians describe it as a scenario expressing the fearful thoughts and feelings that turn up in response to a trigger, and the point of writing it down is that it takes something vague and makes it concrete and specific IOCDF, Scripting for Success.
The dread you carry around is usually a smear: half a sentence, an image that arrives and leaves, a feeling with no edges. Written out in full, it becomes one specific thing that either happens or does not. Vague fear can be carried indefinitely. A definite one can be faced.
It sits alongside the other kind of exposure - the ordinary, in-the-world kind, where you touch the door handle and do not wash IOCDF, Scripting for Success. Most people doing ERP end up doing both.
Who it is for.
Three situations, and you may recognise yourself in more than one.
When facing it for real would be wrong
Nobody is going to practise harming a person to get over the fear of harming a person. Clinicians name this one plainly: there are fears where an in-the-world exposure is simply not ethical, and a script is what is used instead IOCDF, Scripting for Success.
When facing it for real is impossible
You cannot go to prison for an afternoon, or be damned on a trial basis, to find out whether you could bear it IOCDF, Scripting for Success. The fears that live furthest in the future, or outside the world entirely, have no door handle to touch.
When the compulsion is all in your head
If there is nothing outward to stop doing - no washing, no checking, just hours of reviewing and arguing - there is no obvious thing to practise not doing. A script gives you something to face: the possibility, left open, that the feared thing could be true IOCDF, Scripting for Success.
Why it is not rumination, though it looks like it.
You have spent years going over the worst case in your head. How is deliberately going over the worst case any different?
The difference is what you are doing while it happens. Rumination is an attempt to settle something: you turn the thought over looking for the angle that makes it safe, and the relief when you find one is what keeps you coming back NOCD. A script does the opposite. It is fixed, it goes the same way every time, and it deliberately does not resolve. Nothing in it is trying to get you off the hook.
So the same content, faced two ways: one seeking an answer, one refusing to look for one. While you listen you do nothing at all to reduce the distress it causes, physical or mental IOCDF, Scripting for Success. Rumination is nothing but that reducing.
One more thing worth saying, because the fear stops people starting: deliberately turning towards a fear does not make it bigger IOCDF, Scripting for Success.
Why it must not comfort you.
When clinicians look at why a script has stopped working, the first thing they check for is quiet self-reassurance: talking yourself down while it plays, or arguing rationally with the thought as you listen IOCDF, Scripting for Success. It feels like coping. It is the thing stopping the practice working, because the lesson your brain takes from it is that the feeling had to be managed rather than simply had.
Which is why a soothing script is a contradiction. Anything in it that reassures you, softens the ending, or tells you it will be all right is doing the compulsion for you. The script states the feared thing and leaves it standing. That is uncomfortable, and being uncomfortable is not a sign it is going wrong.
The same goes for how you judge it afterwards. Checking whether the fear has gone down yet is its own kind of checking, and it turns the practice into one more thing to monitor. You are not listening in order to feel better by the end. You are practising having the feeling and doing nothing about it.
How it goes wrong.
- The script argues with itself. A line that explains why the fear is unlikely is reassurance with better grammar. Take it out.
- You listen once, at maximum intensity, and never again. A script is meant to be repeated and to start somewhere you can actually bear.
- You keep editing it. Rewording until it feels right is the same move as re-asking a question until the answer feels right.
- You check whether it worked. Measuring the fear afterwards is monitoring, and monitoring is a compulsion wearing a lab coat.
- You use it instead of the real thing. Where an ordinary exposure is possible, do that too; a script is for what cannot be practised, not a way round what can.
If you can get to a therapist who treats this, do. Writing a script for the fears in the first section is work worth doing with somebody trained, and this page is not a substitute for that. It is here because plenty of people meet the phrase in a forum thread at 2am with nobody to ask.
Where this sits in the practice.
Imaginal exposure is one technique inside ERP, which is the practice published clinical guidance recommends first for obsessive-compulsive disorder NICE CG31. If the ideas here are new, the ERP guide is the place to start, and the one on reassurance covers the habit this technique is built to interrupt.
Writing one of these for yourself is the hard part, which is why most people who read about the technique never try it. Maybe writes one for you: it takes the rung you are working on and the words you have used for it, and reads the script aloud on your own device. It stays on the uncertainty rather than settling it, and it does not talk the feeling down while it plays, for the reason the section above gives.
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