My Treatment Journey

By: Abigail Anerella ❤️

My time in the IOP (Intensive Outpatient Program)

Although my therapy journey really began in January of 2021, my OCD treatment journey started in March of 2023.

I always knew in the back of my mind that I needed a more advanced level of treatment for my OCD than just regular talk therapy. I used to spend hours online searching up the best treatment options for OCD, and what kind of programs would be the most helpful.

When I was officially given a diagnosis in February of 2023, my hometown therapist and I started our search for an OCD outpatient facility. To our surprise, it was a lot harder than we anticipated.

We had a lot of outpatient facilities on our list (whose names I will not mention) that listed OCD as apart of their treatment plan. Although this was listed as a course of action, none of them were trained in ERP and I knew that's what I needed. One even said, and I quote, "once you fix your anxiety, your OCD should be fixed too."

Phone call after phone call each place seemed to be a swing and a miss. Some places that I left voicemails at never called me back, and other places didn't even know what OCD was in its entirety.

Everyday that went by was more of a day that proved how the phrase, "The Silent Disease", came to be.

Throughout the entire state of New Jersey, there was only 1 place that specialized in OCD and ERP therapy. One. If it weren't for this institution, I don't know where I would be today.

And so I landed at an amazing outpatient program. The Anxiety Institute in Madison, New Jersey. I hadn't even gone there yet, and my life already seemed to be getting back on track.

I scheduled an intake with my parents and the head director, in which they did more testing to see if I was right for the IOP. When they told me I was a perfect fit, I was set to start the program that following Wednesday.

The woman showed us around the building and brought my parents and I to a hallway with a bunch of artwork on it. The left side of the hallway read, "What Anxiety Looks Like...", and it was filled with patient artwork that displayed how anxiety feels in ways that words never could. The right side of the hallway read, "What I've Learned...", and it was filled with patient artwork that was created at the end of their treatment. My eyes got really heavy looking at the wall. Not because I felt a connection to the drawings, but because I knew my parents did. And all my time spent trying to describe my feelings to them, was now described perfectly by a bunch of people I had never even met.

The program schedule was laid out like this...

• Monday-Friday: therapy 9am-1pm

• 9am-10am: Exposure therapy with exposure coach

• 10am-11am: Talk therapy with lead clinician

• 11am-12pm: Wellness

• 12pm-1pm: Group therapy

The wellness program varied over the course of the week. Mondays and Fridays were reserved for fitness, Tuesdays and Thursdays were reserved for art therapy, and Wednesdays were for yoga.

I was nervous about being in such an intensive program. 20 hours of therapy a week for 8 weeks is not anyone's idea of fun. On top of that, the institute was an hour away from my house, I had to be up at 7 am every morning in order to leave on time for therapy.

Although I was nervous, I knew I needed this treatment. My mind already felt a little bit more at peace walking through the front door. The air smelt a little cleaner too.

The thing I was the most afraid of was ERP. What if it made everything worse instead of better?

I think the biggest misconception about ERP is that they will throw you into a bunch of uncomfortable situations and just expect you to handle them. Every therapist meets you where you're at, and puts you in the drivers seat when it comes to your exposures. If one seems too challenging, they find one that isn't as distressing. It was really really comforting having this experience. All of my therapists were so educated about OCD, that for once in my life, I felt safe living with this disorder.

My lead clinician (who is probably the smartest woman I've ever met) guided me through managing to sit with my anxiety rather than push it away, exposures, distress tolerance, and overall OCD management.

As the weeks go on, the exposures they have you do become increasingly more difficult. This is because your distress tolerance has now increased, and you are able to tackle bigger things.

Before I went to AI (Anxiety Institute), I was never a huge fan of group therapy. I thought it to be weird to sit in a room with a bunch of people you don't know and talk about your toughest battles. But the truth is, over time you learn to know these people. You start to learn a lot of heavier information about them. And although you may not know the basics, like what their favorite color is, or even their last name, you know you're in a space free of judgment and full of support.

The added wellness into the IOP was really good for me. It was a really healthy way to relax and get your mind off of things with a bunch of people who only wanted the same thing.

I started to make friends in the program that I'm still really grateful for. I was the second oldest in the group for a while, and I liked being able to be somebody that other group members looked up to. We were all different ages, but with similar struggles.

Weeks turned into months, and before I knew it, it was time for me to graduate the program. I knew I had come a long way from where I started. My biggest fear was that I was going to graduate from the program and relapse back to where I started. The thing is, you can never go back to not knowing. All of the knowledge you learned throughout your treatment will never leave you. You have the luxury of getting to carry that knowledge with you everyday. Even on your hardest days, it's impossible to go back to where you started.

It's also important to remember that progress isn't linear. You can have a bunch of really good days followed by a bunch of bad days. This doesn't mean you're going back to where you started, it means you're growing how you're supposed to be growing. Even those who don't have mental health problems have good days and bad days. It doesn't mean all their future days will be bad.

I love this picture because it's a perfect representation of how you can grow and struggle at the same time.

I graduated the program with a lot of tools in my pocket, with a lot of space left to add more. My time in the IOP was over, but my journey was just beginning. I was now taking the first step to branch away.

I stayed with my lead clinician from the IOP slowly decreasing the time I saw her over the course of a couple months.

Recently I made an even bigger step to my treatment. I decided it would be a good idea to see my hometown therapist one week, and my OCD therapist the following week in order to have the opportunity to tackle my mental health in its entirety.

And so... that's where I'm at now as I'm writing this. If I'm being honest, I'm still scared. I still do exposures that are really hard for me, and I still have days where I don't feel like getting out of bed. I've gained peace in knowing I'm still growing through all of that.

If there's one piece of advice I can give anyone who's reading this it's this: some things will never get less scary, you will just be more comfortable being scared.

P.S. this was my, "What Anxiety Looks Like..." drawing...

And this was my, "What I've Learned..." drawing.

How to Deal With Depersonalization

In full transparency, I still struggle to manage depersonalization episodes. They're terrifying, they suck, and they put a gray cloud over your head. All of that isn't going to change, that's what depersonalization does. But like I said before, some things will never get less scary, you will just be more comfortable being scared.

My depersonalization episodes scare me just as much as they did the first time I experienced them. The only difference now is that my time at the IOP has taught me to sit with my anxiety. When you feel yourself entering an episode, the only way it's going to end is if you sit and ride it's wave. Of course there are things that you can do to help ride the wave a little quicker, but sitting with your emotions around your experience is something I've found to be incredibly helpful.

Acknowledge the reasons you may be feeling this way. The most important thing you can do are grounding techniques. This is where your 5 senses will start to become your best friends.

The 5-4-3-2-1 coping mechanism for anxiety is a really good way to ground yourself. The method has you list 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. I've also come to find that holding something really cold in your hands, like ice, is a very good way to redirect your mind to the present moment.

Management for depersonalization is the same as it is for OCD. Target what's at the heart of your fears, acknowledge your anxiety without pushing it away, engaging in your present moment, and shifting your attention to something more values based.

This is probably the worst symptom of OCD that I've experienced. With the right help, it doesn't always have to control you.

You are always in control, no matter what.