In preparing to write this article, I had to do the one thing I’ve wanted to do for ages but never tried: reviewing some of my old journals and two red folders from my time three years ago in the OCD Institute of McLean Hospital. McLean offers one of the three major OCD facilities treating the disorder across the United States (and it’s a world-renowned program). The OCD-I is not a locked unit, so I could actually leave the campus for dinner at Friendly’s with family but was expected to be back, by I’d guess 10 p.m., to sleep there overnight. Besides medication, the most-used tool for treating OCD is called Exposure and Response Prevention or ERP, of which the goal is to expose the client to their distress related to OCD and refrain from using compulsions.
Because this took place three years ago, I can only describe what my experiences were like given my particular circumstance. I was first told about the OCD-I by the Counseling Center on campus as a potential treatment option for myself (at the time experiencing mostly OCD behaviors). Over the Spring 2015 semester, I transitioned to an OCD-specialist therapist who I saw twice a week for a year. I remember that before I landed in my third hospitalization of 2015, I learned that the OCD-I had a three-month waiting list. The helplessness and hopelessness I felt at that moment was unbearable and led me to accruing more suicidal thoughts that I wanted to act on at the time. However, during my hospitalization, I did begin to fill out the application and eventually sent it over to the OCD-I.
In Fall 2015, I took a leave of absence from school as I got accepted into the OCD-I around October and stayed there for five weeks. Because it wasn’t a locked unit, we could have laptops and iPods and things to that effect (strings!). People who were dealing with OCD around cleaning or cooking were often the ones serving food and experiencing their ERPs firsthand. We had about four hours of ERPs each day and two hours of them on the weekends. We would often go out on the weekends into the Boston area to practice the skills we were learning at program to apply in the real world. The average stay for an individual was up to three months, but insurance often bottomed out before then. We would follow a set schedule—a goal-oriented group in the morning while sitting in a circle, two hours of ERP and track A– or track B– specific groups, which for me, meant a mindfulness group on some days, intrusive thoughts group, expressive therapy, emotion regulation, and a motivation group.
I find it quite funny that I’ve found some DBT-related worksheets from within these red folders that I didn’t realize would play such an important role in my treatment and recovery three years later.
My ERPs had involved exposing myself to methods that I had used in the past to harm myself, saying that I was going to use it to harm myself (which would produce distress) that I then had to shift gears completely from and “live my life. While living my life, I would have to practice mindfulness skills of defusion and practice staying in the moment. Living my life could include just about anything except sleeping and talking about suicide.”
If it sounds slightly warped and unethical, I did have to return the methods after the ERPs were over as they were keeping it behind the nurse’s station.
A few of my notable memories from this time period were some of the friendships that I made and rolling down a big hill out on the campus, “Fight Song” by Rachel Platten and “Stitches” by Shawn Mendes being songs that I danced to, practicing grounding techniques with one of the other clients, a client getting kicked out for stealing and a suicidal crisis that emerged from this consequence, my getting the chance to be my authentic self and make positive messages for the other clients, and attending the OCD support group and a few notable lectures.
One of those lectures involved a client focusing on the whiteboard of their values while other clients played their intrusive thoughts. It was a harrowing and emotional experience and even though they cried, they kept their attention forwards and didn’t interact with the ‘thoughts’. Another involved what you would say if you had to give a last speech before you died and another was the memorable speech Alan Rabinowitz gave featured on The Moth titled: “Man and Beast” and the book “The Happiness Trap” which is about ACT.
And finally, there was a set of questions from the OCD-I’s surveys that always stuck with me:
“When I want to feel *more* positive emotions, I change the way I’m thinking” and “when I want to feel *less* negative emotions, I change the way I’m thinking.”
At the time, these two questions were the resounding hum of my treatment after I got released. And from there, well, the rest is history.