Thoughts about an Intensive Outpatient Program

Well, tomorrow could decide the direction of the rest of my life. After my worst OCD episode yet, I'm at a crossroads: Should I attend an intensive outpatient program for OCD?

I'm blessed to live in a city that hosts one of the 10 programs of its kind. Called an IOP, it would likely be 10 weeks of 3-hour individual therapy, group therapy, and exposure and response prevention, and I would be encouraged to leave my job to focus on the task. Attending the IOP would be a radical step in my learning to deal with OCD, and not even 2 weeks ago I was dead set on going after months of desperation. Now, the night before my intake appointment, I'm trying to gather the thoughts and questions that have run through my head since I scheduled the meeting a month ago.

What will I get out of it?
Will it be helpful at this stage, since I seem to be doing better at this moment?
How will the IOP help me to be prepared when unforeseen episodes strike?
Is there a better medication for me in light of my goals for my life?
What kind of ERP exposures will I do given that most of my OCD is pure obsession?
Should I go?

The decision I make tomorrow could mean I'm putting my life on pause for 10 weeks. My husband, of course, is supportive, as he encouraged me to at least go to the intake appointment. I will, with my notepad of questions in-hand.

Overcompensating for OCD

So much about living with OCD is about not doing what our minds tell us we have to do. If I listened to mine all the time, I'd have to check that I haven't offended a friend. I'd have to apologize again.

I'd have to get the medical test done to make sure I'm healthy. I'd have to explain myself repeatedly to make sure I'm understood.

If not, anxiety and panic ensue. But when I get in a rhythm of saying no to my mind, it can actually be satisfying to deprive myself of this pressure.

It's part of why Exposure and Response Prevention works for some people: We expose ourselves to what makes us anxious in order that the response, the panic, subsides with repetition. And for me it does, when I work with my therapist and support group.

But suppose you have hoarding issues (patterns that are closely related to OCD). Maybe you collect everything you can find--plastic bags, Tupperware containers, pens and pencils, old keys, anything--for no real reason other the paralyzing fear that these items will go to waste.

Maybe you're afraid that letting go of these things, if it really does mean you're being wasteful, will make you a bad person. This obsession with pragmatism has your house brimming with stuff you'll never use, and you can't find the articles you actually need.

So you're this person, and say a friend offers to help you by having a yard sale. (This is really tempting for you because you've been trying to work on the hoarding for your own sake, and the clean-up for practicality's sake.)

But here's the question: You know that if you have a yard sale, you're bound to find shoppers who will buy what you have. If someone buys the pens he's probably restocking a home office. If someone buys the keys she needs them for a craft project. The items are being used, not wasted.

But are you really confronting your OCD if you're ultimately satisfying the same goal that has you hung up--absolute practicality at any cost? Aren't you just feeding the fear?

My answer to this question is: "Stop thinking!" You're taking it too far. Maybe it's a little perfectionism setting in. In any case, it's keeping you from being productive and actually making progress at cleaning your house.

The question persists: If you were REALLY trying to practice ERP, wouldn't you throw everything away, in the trash, where it's certain nobody would ever find a use for your discards? Maybe. But that's just doing the opposite for opposite's sake. If you struggled with contamination, the tenets of ERP wouldn't require you to drink urine, would they?

We don't need to overcompensate for OCD. We just need to find our comfort zones...the place where healthy minds of the world function every day.

Support Groups: A Helpful OCD Treatment for You?

Like my profile says, I've had OCD since I was 13. Since then, therapists have recommended finding a support group. Only during my last severe regression in April of 2008 did I seriously consider it. I love my support group, and I've been going ever since. But it took a fit of desperation one day at work for me to find mine on the internet. Looks like you're in just the right place to find yours, too.

If you're considering a support group as a form of OCD treatment, perhaps these points to ponder will help you make the decision quicker than I did.

Support groups provide community.
I know OCD can make us feel lonely, stupid, and codependent. It closes the world in around us, isolating us. But at group I've met people who can sometimes think the same irrational way I think. I understand them, too. Bottom line: Join a group and if you were alone in your OCD before, you aren't anymore.

Support groups give you objectivity.
Join a group and you'll encounter all types of OCD--the hoarders, the scrupulous, the contaminated, the guilt-ridden, and those who can't be labeled. You'll hear all types of OCD stories. You'll see what it can be at its best, and you'll see what it can be at its worst, and hopefully identify tendencies in yourself so you can learn to keep the OCD in check. It's like looking in a mirror. If you see that a hair is out of place, you fix it.

Support groups let you see what works.
Before attending group, I had never heard of ERP, or Exposure/Response Prevention (more about that in a later post). My therapists through the years had always used Cognitive Behavioral Therapy, or CBT, the other part of the OCD treatment dichotomy. I never even knew that this other kind of therapy existed, or that it could benefit me. Join a group and you can discuss treatment styles, therapists, and mental exercises and analyze what works for you.

Support groups give you accountability.
Every week at group we get together in small clusters and set goals, and check in on last session's goals. If needed or wanted, group members exchange numbers to serve as checkposts with whom to check in and record progress. Conversely, if we want to sit a week out and not give ourselves a goal, we allow that. We understand that each of us is choosing to be here, and choosing to get better. There's a lot of power in that, and a sense of control over what feels out of control.

If you are not a member of a support group as a means of OCD treatment, click here to visit the OC Foundation's "find a support group" page. Until then, if you're reading this blog, feel free to call what we have going here our little support group. : )