Treatment 101: OCD-Institute & ERP | Article F18

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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 10PM, 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 from 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 whom I saw twice a week for a year. I remember before I landed in my third hospitalization of 2015 I learned that the OCD-I had a three month wait 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 into 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 goals 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, 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.


Article written: Nov. 21.2018

Present day A/N: I’m trying out the newer layout option and while it’s fancy and nice, I feel it’s also a little more complicated than complicated needs to be. Regardless, here I am.

I hope you guys enjoyed this post! Again, it’s from a while ago but soon I’ll be able to write my final 2 articles to share with you guys here (that I’ll be writing this month, just to clarify). Okay, I hope you’re all well!

I’m thinking I might return to the OCD support group that continues to meet every first Tues of the month as I haven’t gone in a year and I would like to reappear plus I now have a really, really good GPS to bust out. I might send them all an email, too, actually. 🙂 Interesting! ❤ ❤ ❤

I’m typing up my poem next to be uploaded tomorrow on here! 🙂

Stay safe!!! xxx

EDIT: I have no idea what happened but the new layout forced this post into the past and before my MoP one which makes no sense to me so that’s why there’s a discrepancy between the images used and the way the descriptions/A/N’s were written. Sorry about that!! Fucking WordPress.

Treatment 101: Stigma | Article F18

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Trigger Warning: Discussion of suicide

 

If you’ve been reading my articles since the dawn of time, you’ll know that I’ve touched on stigma and its effects on those of us living with mental health conditions, such as myself, quite a few times. In fact, my first article in The Mass Media was because of stigmatizing comments I had encountered in my day to day trekking home and to UMass Boston. (Back when we didn’t have dorms!)

 

Stigma is something that many brave souls have combatted in the past, in the present, and unfortunately, will likely continue to combat in the future. Stigma eliminates person first language (as you read about in the Diagnosis segment of the series) by identifying those struggling with mental health conditions *as* their illness and not who they are as a whole. Stigma is often said by those who are uneducated about the field of mental health and who are either ignorant to the weight of their comments or do not care to understand at all (to put it bluntly in black and white terms). Stigma harms those who are struggling both silently and with their voices loudly echoing the room. Stigma has the power to drain every ounce of energy from you and collide into you with the hopelessness of why we, as a community, should fight back against it at all.

 

Stigma, most importantly, while largely being external can also become internalized, posing even higher stakes and problems for the individual’s minds.

 

When I was first diagnosed in 2014 with Obsessive Compulsive Disorder on self-harm and suicide obsessions (not genuine thoughts of suicide), I faced my mind’s enemy with phrases that I was “just attention-seeking” and “I didn’t really have OCD”, or that I “should check whether or not I have hidden intentions to harm myself”–which would perpetuate a cycle of anxiety and doubt that I would engage in mental rituals to arrive on the conclusion that I was in fact safe which only then prompted additional intrusive thoughts that began the cycle all over again.

 

I know I also struggled with coming to terms with the idea that I didn’t know I was living with a diagnosable mental health condition. I felt that if I couldn’t tell something was “wrong” with me than what else was I missing?

 

Over the years, I’ve faced stigma in a few different places–on the train, in passing conversation, in people mentioning “craziness” off-handedly, in text-based mediums and within my own mind. I still have some internalized stigma mostly regarding those individuals living with psychosis and personality disorders as those are areas of psychoeducation that I, myself, am not well educated in.

 

Along those lines, personality disorders like borderline (BPD), psychosis, eating disorders, substance use disorders, self-harm and suicidal ideation tend to be *heavily* stigmatized in multiple cultures and countries around the world.

 

In fact, there’s a public health crisis ongoing at the moment regarding the alarming rates of suicide worldwide along with the presence of an opioid epidemic in America.

 

Again, I don’t have lived experience with the latter so I can’t talk too much about that but for the former, suicide is still a hushed topic with a lot of stigma stemming from the idea that its act is one of “selfish-ness” or seen as a sin in a religious perspective. Then there’s also the idea that self-harm is equivalent to suicidal ideation–when it’s not–and that suicide attempts are marked as “cries for help”, “attention-seeking”, and “if they were really serious they would have completed suicide.”

 

Stigma has the knack for perpetuating lies and misconceptions about mental health conditions as though those of us living with them are meant to be feared and shunned, or worse, sterilized and institutionalized. There have been many cruel acts done to us in the past, and we’re repeatedly demonized by the media still today.

 

Choosing to not talk about suicide envelopes and pushes those of us who struggle with its ideation further into the darkness. Normalization and approaching individuals with compassion and light is what’s required to bring down the statistics that say every forty seconds another person loses their life to suicide (WHO, 2018).

 

It’s not easy to talk about, it’s not fair, and it’s still important.

 

There will always be the people who don’t believe mental health conditions are a reality for one out of five American adults (NAMI, 2015). There will always be those who claim it’s for one reason or another, but there will also be people who are willing to understand and want to for the sake of their loved ones.

 

Our mission is to find those individuals and educate them, leaving behind the rest; because saving even just one life can make a world of difference.

 

If you are struggling with suicidal thoughts: you can call the National Suicide Prevention Lifeline at 1800 273 8255; contact the Counseling Center any time; text HOME to 741-741; or find additional resources via Google.


Hey everyone!! I haven’t completely decided if I’m uploading this article this Saturday or tomorrow (Sunday) as a scheduled post. But I thought I could keep you guys up in the loop by sending it out soon.

Wellness deadlines for the paper this semester are Thursday’s at 5p, which means I send in my articles for the week by Wednesday evening, the day before. I’ve already written about 7 articles and from what I was overhearing the other day, the paper may change from bi-weekly to weekly, which would be awesome.

For now, I have about 3 ongoing series going on, and this article itself took a turn down suicide prevention lane that I had not anticipated at the get-go. But, that’s okay.

Hope you guys enjoy this post! I have a really cool one coming up after this from my week two’s submission. 🙂

 

I’ll try not to be a stranger! Hope you’re all well. ❤ ❤ ❤

PS I forgot to say: This piece was written September 9.2018 🙂

Treatment 101: Diagnosis | Article F18

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It’s only fair to start off this new series, one I’ve wanted to do for a year, with the broad category of diagnosis. What is a mental health condition diagnosis and why does it matter? Some of these ins and outs about mental health diagnoses, how they are described, and the system used in which to understand them will be discussed below. But first, a disclaimer is in order.

 

My disclaimer for this article, and one that you will often see in each new article of the series, is that I am not a mental health professional and my opinions on these matters stems only from my own experiences, of which I am an expert in, and should not be taken as medical advice. I only wish to shed light on treatments that have been beneficial for me and inspire ideas in others that they can bring to their own treatment teams and potentially incorporate into their own recoveries where applicable. What works for me may not work for you, as we are all unique individuals, so take what I say with a grain of salt.

 

With that out of the way, we can begin addressing the issue of diagnosis–although, word choice is an important topic to briefly mention first.

 

I personally prefer the term “mental health condition” over “mental illness.” In 2016 I used the term “mental health issues” as a bridge between condition and illness and I suppose I reject the term “mental illness” as it feels too stigmatizing and I revoke the notion that I am “ill.” Even though at the same time I back the mission of Canadian Michael Landsberg’s “Sick not Weak” which is a nonprofit organization and popular hashtag on Twitter.

 

I think my logic in that is I’d prefer being thought of as “sick” or “ill” over “weak” as mental health conditions are not a sign of a character defect or purposeful fault of the one struggling with them.

 

I don’t mind thinking of the diagnoses I live with as chronic illnesses but there’s something about “mental illness” that just makes my skin crawl. Adopting person first language is also critical as a person is not inherently “anorexic” or “schizophrenic” they are instead a person “living with” or “struggling with” a condition.

 

But back to diagnoses, in the Diagnostic and Statistical Manual (DSM) 5 there are around two hundred and fifty disorders with a specific, varying amount of symptoms occurring over a detailed duration of time that can explain the behaviors, thoughts, emotions and physical symptoms a person with a mental health condition may experience. According to Grohol (2011) approximately 50% of people living in the US will meet the criteria for a diagnosable mental health condition at some point in their lifetime, as measured back in 2004 by the CDC.

It’s been discussed before whether the DSM should be approached as a medical model (as it has in the past), a categorical approach (as it is presently) or in a new direction altogether.

 

Having mental health conditions listed in a categorical approach has its limits (in fact, most approaches will). If I only fit the criteria for four out of nine symptoms of borderline personality disorder (BPD) I’ll meet the criteria for borderline tendencies (or ‘traits’ as it were) however if I have five or more symptoms I would fit the criteria for BPD as a whole.

 

The problem is people don’t fit so neatly into these classified boxes. And the truth is is that diagnoses have the ability to change over time. A person can be initially diagnosed with depression only for years later to come to the conclusion that the true disorder behind the curtains is bipolar (either type one or type two). That’s why although it can be instinctual to define one’s self in a diagnosis, becoming too attached and too dependent upon the labeling can create a host of chaos on its own.

 

When I was in one of my hospitalizations in spring 2017 one of the mental health specialists (MHS), where I was first introduced to the BPD tendencies diagnosis, described diagnosis as a fluid spectrum. At one point I was to the left of the spectrum and at that present moment I was elsewhere. And, ultimately, that’s okay because diagnoses are mainly important for insurance billing purposes and ways to direct treatment approaches.

 

The time when a set of symptoms begins to cause distress and impairs functioning is the biggest indicator of an underlying mental health condition. People who experience some symptoms of mental health conditions but aren’t impaired, distressed, a danger to themselves or others, or deviate from their society’s norms are not categorized as fulfilling the necessary quota to be diagnosed.

 

Lastly, treatment itself is an interwoven spider-web; there will be many overlaps and connections within each treatment to be discussed in this series.


I still don’t know if I should quote that statistic in here although I heard it first from program but later found an article that goes with it and yeah. My brain is a little muddled at the moment (I’ve totes supposed to have been doing homework but I’ve been writing instead :/)

Any who, I’ve covered ‘Diagnosis’ here (as you can see) and some of stigma (next article) and will begin to venture into other articles within the series in the next few months.

I hope that you enjoyed this piece. Things will definitely overlap and possibly split into multiple parts because I always just have too much to say.

Hope that you’re doing well!!

See you next time.

❤ ❤ ❤

PS A portion of this piece was handwritten 9/7/2018 with more of it edited and added 9/9/2018. 🙂

Bringing Light to the Shadows | Article F18

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Photographer & Contributing Writer: Raquel Lyons


Trigger Warning: Depression, suicidal themes

 

“I’ve got no excuses for all of these goodbyes; call me when it’s over, ’cause I’m dying inside. Call me when it’s over and myself has reappeared. I don’t know, I don’t know, I don’t know why, I do it every time. It’s only when I’m lonely. Sometimes I just want to cave and I don’t want to fight; I try and I try and I try and I try… Momma, I’m so sorry I’m not sober anymore. To the ones who never left me, we’ve been down this road before. I’m so sorry; I’m not sober anymore…I want to be a role model, but I’m only human…I’m sorry that I’m here again, I promise I’ll get help. It wasn’t my intention, I’m sorry to myself.” – Lyrics from Demi Lovato’s song “Sober.”

 

In the aftermath of “Stable, Until Triggered” I listened to this song from my iPod as I stared up at my ceiling, not completely seeing the masked face that I pieced together out of the white shapes and swirls, but instead saw the overpowering thoughts and felt the immense sadness that clung to my shoulders like shadows slowly eating away at my flesh.

 

It was safe to say that I accidentally triggered myself with epiphanies about my place in recovery.

 

Stabilization had given me a sense of pride and absolute happiness which makes the darkness that much more painful. In the hours after, I felt knocked off my pedestal that rose ten feet above the ground, which I have been in so solidly for over six months, and had landed squarely and roughly on my bum to ground zero. In the process of this article’s first draft, I cried profusely, something I hadn’t done in months.

 

I felt a mixture of having been lied to and being lied to continuously from an entity, so to speak, within my skull. There’s the feeling of how easily my happiness and restored identity can be taken away so unexpectedly. It almost feels like the depression is showing me the biggest middle finger and taunting me with its lies. I suppose it’s improvement for me to recognize that what it’s saying isn’t factual, it’s not true. It just feels so very, very convincing.

 

I could tell in the moment that I was judging my judgments. I know that this feeling will go away, albeit a lot slower if I did nothing, so instead I chose to do different actions, or what is known as opposite action, to the harm and death flickering and weaving through my brain. The best way I can describe intrusive images is getting as close to hallucinating without actually hallucinating. At its worst, it’s like being aware that the physical world is around me while being distracted by intense, intrusive images overlaying true reality.

I feel like it’s as if I’ve been kidnapped and am being held hostage, tied to a chair with my eyes opened wide, forced to watch a screen that shows me all these horrible, terrible, painful actions I’m doing to myself, except all of this is happening in my mind and in reality I’m just staring blankly into space. There’s something uniquely disturbing about being forced to mentally watch myself die and be maimed over and over again when in reality, none of it has actually happened. It’s so utterly mind-boggling and it *feels* emotionally like it’s happened, even though it hasn’t at all. (An instance in which checking the facts and mindfulness practices would help.)

 

At the same time, while those images are playing I can also notice my brain trying to convince me that life isn’t worth living if I have to experience these moments which triggers hopelessness of having to experience these crises in the future; the progress I’ve made deceptively being unraveled; the powerlessness I have over being forced to watch the tape and hear the BS; the notion that my suicide is inevitable and that every success I’ve made is meant to be undone by invisible forces.

 

To sum up: mental health conditions are impolite, ruthless, cruel, soul-crushing, seemingly all-consuming forces that have poop stains inherent to their hazy figures because of all their BS. Basically, they suck…a lot.

 

The real sustenance in the face of these matters is how we choose to overcome them–which are an article series I plan to uncover this semester. Maybe it’s not about being knocked from ten feet high to zero; maybe the fact that I got out of bed and wrote this article means something after all. Maybe within the darkness we can find the light again–not to eliminate the shadows but to co-exist within them.

 

And, maybe that’s enough.

 

Stay as safe as you can out there, ride the waves of pain and seek extra support when you need it. You’re doing the best you can.


Written August 29.2018

Originally titled “Surviving Trips in Hell”. I had to edit this one quite a bit, taking out certain things, changing tenses and the like. It was (and still is, in ways) more like a journal entry than a pure article, but I like that I set the pavement down to where I want to explore treatment options in a new and upcoming series. So, in the end, it works out all right. 🙂

Hope you enjoy this read! Let me know what you’ve thought of it in the comments down below. I’ll try to be more active soon–school’s began and I’ve run into technical problems with my coursework (which is so aggravating). Just stressed out, strung out and exhausted in more ways than one. Let’s hope the weekend fixes this up!

Much love,

❤ ❤ ❤ ❤