I think most people would be surprised to learn that exposure therapy can actually be a lot of fun. Hear me out: I know exposure therapy tends to get a bad rap. We’re asking people to face their fears, and on the surface, that certainly doesn’t sound like a lot of fun. Even some therapists have a negative reaction to the idea of exposure therapy. But in my experience, people who have negative feelings about exposure therapy are generally people who don’t know much about what it's really like. A large number of my friends and colleagues practice exposure thearpy, and I think they’d agree with my assessment that it can actually be fun.
Now, to be very clear, I don’t think there’s anything fun or funny about having OCD. I have a lot of compassion for people who struggle with OCD. From my perspective, most people enter into OCD treatment with a lot of heaviness surrounding their symptoms — meaning when they think about their intrusive thoughts and their compulsions, they feel all kinds of negative emotions like anxiety, disgust, fear, shame, and sadness. There’s certainly nothing light or uplifting about the way people describe their OCD symptoms. But if that’s how OCD feels, shouldn’t OCD treatment feel very differently? I think it should, so here are some of the ways it can be helpful to add some laughter and silliness to exposure therapy.
Treatment is hard, and sometimes people dread coming to session. I’ve had people tell me, “No offense, but I didn’t want to come to session today.” What they mean is that they know we’re going to do exposures in our sessions, and a part of them doesn’t want to. That’s normal! If you’re doing exposures right, it’s going to be emotionally challenging. Hopefully, you end your sessions feeling like you’ve accomplished something, but that doesn’t necessarily mean you’re going to look forward to each session. So having some laughter infused into treatment can help keep things from being so terribly heavy and might give you something to look forward to.
Another reason to use laughter in exposure therapy is that it helps you detach from your obsessions. A key component of OCD treatment is learning to objectify your thoughts — meaning you learn to view them as separate from yourself. This generally helps people get some distance from their thoughts, which makes it easier not to automatically respond to them. It can also reduce the shame around certain obsessions.
There are many ways to encourage detachment from obsessions, but laughter is the most fun. Try it! Choose one of your obsessions — this works especially well for harm, sexual, or religious obsessions — and say it aloud. Now say it aloud using a Mickey Mouse voice or a British accent (unless you’re British — then pick something else). You can use this to “mess up” mental/verbal rituals too. If one of your compulsions is to think/say a prayer or repeat a mantra, try doing it with your best Darth Vader impression. OCD has no sense of humor, and it absolutely thrives on rigidity and predictability. Anything you can do to challenge that is good for you and bad for OCD.
How else can laughter be helpful in exposure therapy? Well, maybe it can help you feel less alone. There’s something about sharing a laugh with another person that brings people closer together and reminds us how connected we are. Some of my favorite (and I think most therapeutic) moments have happened in the midst of laughter.
I remember many years ago doing a contamination exposure with one of my clients. We were sitting in a bathroom eating crackers directly off the tile floor. At first, my client was visibly anxious because he was concerned about getting sick, but we sat there for a while just eating cracker after cracker until he began to feel calmer. And then we looked at each other… and looked at the crackers… and then looked back at each other, and then we both just started laughing hysterically. There was something about the overall ridiculousness of the situation that hit both of us at the same time, and we thought it was hilarious. I really think something healing happened in that moment, as odd as that might sound. We just became two people sharing a silly moment, and aren’t those always the best moments?
I talk a lot about shame because I know it’s something most of my clients struggle with. For me, being able to laugh with someone about their OCD symptoms seems to help decrease that shame, so I’m all for it.
I do want to caution against using laughter as a distraction technique or as a way to avoid feeling uncomfortable feelings. That’s not what I’m talking about here. During exposures, we need to focus on the discomfort and not try to make it go away by cracking jokes or making light of things. But it’s also not all or nothing. Even alongside high-quality exposure therapy, I think there’s room for some irreverent humor to help us get through the hard stuff, see our thoughts for what they are and not what OCD says they are, and to remind us we don’t have to do this alone.