Intensive Treatment Update

It's been an eventful few weeks.  I can hardly believe it, but I have been in my intensive treatment for almost a full month now and am about 2/3 of the way through the program.  Four hours a day, five days a week, I've been in treatment for OCD.  And I think I'm finally getting what I needed to propel me forward - a more aggressive, thorough, and persistent attack on my disorder, a sort of fight that I struggled to make with just one hour a week of therapy.

Perhaps I'll write more in depth on the actual experience of being in the program later, but right now I have another topic on my mind:  what will I do when I am out?  My number one fear:  slipping, losing not only the gains I've made but the forward momentum I've collected.  What I hope to take away with me is not necessarily the ability to face any one specific fear, but rather the willingness and readiness to do what it takes to get better.  It's so much easier to do what needs to be done when you are accountable each and every day of the week for the choices you make.  Can I maintain that and continue to progress when I am again on my own?  I hope so.

As I wrote in a previous post, what is often the hardest for me is breaking "the rules" without explicit permission from my therapist (i.e. I have often felt like I had to continue to perform a compulsion, whether or not it really seemed to serve much of a purpose anymore, until a therapist said the magic words, "This week I want you to work on not doing compulsions x, y, and z.").  I am continuing to get better at breaking "the rules" independently, and if I can hold onto the progress I've made in this area, I think I'll have an easier time applying my therapist's recommendations throughout the week, even with less time spent in therapy, once the program is over.  Though it still seems tenuous at times, I am so grateful to be working on and strengthening my ability to make therapeutically beneficial decisions without getting permission from a therapist for every last choice I make concerning exposure and response prevention.

What goes hand in hand with this is the realization that every compulsion, no matter how mandatory it feels, is ultimately a choice.  This idea has been discussed a lot over the last few weeks, and we also talked about how, at first, there really doesn't seem to be a choice.  OCD appears to have the all control.  But as you begin to make more and more non-compulsive choices, the power starts to feel as if its being transferred away from the OCD and back to you.

I was skeptical at first.  I knew deep down that compulsions were a choice:  I knew that if someone were to hold a gun to my head and threaten to shoot if I didn't stop washing, I could turn the faucet off.  But short of just that scenario, it seemed pretty impossible to choose to forgo so many compulsions.  And it was hard to imagine a space where I wouldn't constantly have to have a frustrated therapist breathing down my neck for me for me to be able to make non-compulsive choices.  But now, more than ever in my life and especially since my big relapse, I feel like the OCD and myself are on an equal playing field.  OCD no longer has me outnumbered a billion to one.  And what's even more interesting to consider is that, in reality, OCD actually has no power but the power I give it.  OCD may seem less threatening than it once did, but the only reason it still holds any clout at all is because I let it have that power when I choose to perform compulsions.

I don't know why it's taken so long for all this to sink in, but it has, and it's incredibly hopeful and freeing.