Exposure planning
How to Build an OCD Exposure Hierarchy
An exposure hierarchy, sometimes called a ladder, is simply an ordered list of feared situations. It exists so that practice can start somewhere possible rather than somewhere overwhelming.
Step one: list the triggers
Write down the situations, objects, places, people, thoughts, and activities that set off an obsession or that you have been avoiding.
Be specific. "Touching the door handle in the shared hallway" is easier to practise than "germs".
Step two: rate each one
Give every item a rating, for example from 1 to 10, based on how much distress you expect it to bring. The rating is your own estimate and does not need to be precise.
Ratings often shift once practice begins, and revising them is part of the process rather than a sign of doing it wrong.
Step three: order and start low
Sort the list from least to most distressing. Starting near the lower end makes it more likely that the first exposures get completed, which matters more than starting somewhere impressive.
- Pick an item you believe you could actually do this week.
- Decide in advance what compulsion you will delay, reduce, or resist.
- Repeat the same step until it feels more familiar before moving up.
- Move up gradually rather than jumping to the top of the list.
Keeping the hierarchy alive
A hierarchy is a working document. New triggers appear, old ones lose their charge, and the order changes.
OCDly's Challenge Ladder holds this list in the app, with a rating from 1 to 10 per challenge and suggested tools for each step, while Situational Exposure covers the places, objects, and activities you have been avoiding.
This article is general educational information about OCD and is not individual medical advice. OCDly is designed to complement professional care and is not a substitute for diagnosis or treatment by a qualified mental health professional.