If anyone reading this is suffering through the nightmare that is OCD, and you are wondering what the trick is to ERP, I can tell you: consistency and ritual prevention.
For a few months, I did what I thought was ERP. I would force myself to do exposures, then I would either ritualize for hours afterward or I would take days off between ERP exercises to "recover". The only thing that recovered was OCD; I was getting worse for my efforts. The experience reminds me of a quote that really stuck with me, though I can't for the world recall where I found it. It basically stated that you cannot recover from OCD within the parameters of OCD. It is such an important thing to remember, because it is 100% true.
I have been feeling better lately, but not without hitting a new rock bottom first. One day, completely undone by my own anxiety, kneeling on the floor as bleach dissolved the skin on my hands and knees, I was howling in agony...and still could not stop the ritual. In fact, the pain was so severe (my chemical burns were so bad that I was bleeding) that I kept becoming distracted and having to start over. I was pleading for it to end, and I no longer cared how.
Over the days that followed, I knew I had two options; I either had to take control of my life back, or the self that had existed for more than 30 years would cease to be forever. I asked myself a very critical question; Is anything worth this? Anything? And I thought about that for a while. I examined the question, every terrible possibility, allowing myself to become immersed in the fears that had spawned this demon OCD. And the answer, unequivocally, was no. Even my very worst case scenario was almost laughable by comparison to the hell I had inflicted upon myself for two years.
Now, just having this realization is not a cure, and the feelings don't go away. However, it has served as a catalyst for me to begin doing the real, hard work of ERP. And, much to my astonishment, ERP does work. It really does. I know this because there are things I am doing now with a fair amount of ease which would have crippled me with fear to even think about a few months ago. Often, I find myself smiling because the work is becoming less like work and more automatic.
I faced a fear today that would have sent me into days of compulsion hell. I still did some precautionary measures, but it was not a full-on ritual disaster and I am not overcome with stress and anxiety. That alone is amazing. I don't think I'm out of the woods yet; I will never underestimate the power of OCD. But ERP, well, it's pretty powerful, too.