Hi, I have been seeing a young religious man in his early twenties ( with an apparent OCPD diagnosis) whose main goal in seeking therapy was to deal with a desire to look at woman which he considers to be a sinful act (due to his failing to resist his desires). This takes a few forms, 1. he dreads going to populated areas in the summer (fearing he will see 'scantily clad women') where he would then find himself obsessing, 'don't look, don't look...', if he looks he may than obsess, 'these thoughts will never leave my head unless I masturbate, I must stop thinking of them...' or 2. he fears/attempts to avoid being at locales where he can privately watch TV, for then he is unable to stop a cycle of zipping through channels until finding one suitably provocative, masturbating and then continuing the search - all of which can go on for hours, at the expense of day to day responsibilities (such as academic requirements).
I have been wondering if EX/RP is indicated for such a case (would we have a gambler stand outside a casino if the SUDS was manageable?) if so, would the exposure be to be in public while resisting to watch women (or a more moderate form of this) or to the contrary, to encourage him to partake in the act of gazing yet remain with the thought that these images would not go away on their own.
any thoughts would be appreciated.