The first time I walked into the doors at my local psychiatric hospital to start their Intensive Outpatient Program (IOP), I was absolutely terrified…so terrified in fact that my best friend went with me to make sure I didn’t back out. Although I’d done individual therapy as a teen and was starting it again as an adult, I had no clue what to expect from this sort of therapy. I wondered how helpful such a thing could be, especially for people like me who had a history of trauma, struggled with trust, feared conflict, and found it easy to get overwhelmed by emotions. What I came to find over the next three months, though, was so much more than I could ever have imagined.
Each evening, there would be a small group of us and two therapists sitting at our long conference table. The sessions were always split into two parts: check-ins and activities. During check-ins, we’d share some of what’s been going on in our lives in the last few days, progress on goals we’re working towards, and a feeling word for the day. We would get feedback and support from the therapists and the group when we shared. I became the “go-to person” for anyone struggling with self-harm, the sweet divorced lady was always able to find a positive to everyone’s struggles, and the resident old man always had advice for everyone that was thoughtful and excellent. Everyone in the group had something to contribute, and often times we’d remind each other what we were all working towards: recovery.
We’d take a break after check-ins, then dive into an activity for the remaining half of the session. Every night, I was able to find meaning and ways to apply the focus activity into my life…it always seemed like the therapists knew just what we all needed and planned the activities perfectly. The activities varied between reading, writing, watching videos, meditation, art or music therapy.
One time we even got to go out to the parking lot and smash pots: it was an exercise on expectations. We discussed expectations, the sources of them, and how they make us feel. Then we thought of unrealistic or negative expectations that we felt had been placed on us, wrote them on the pot we were given, and smashed them. My pot was filled with so many words, so many perceived expectations, so many things that I tried to be daily for as long as I could remember. Out in the parking lot, everyone began to smash their pots with excitement and enthusiasm…except for me. I was scared to break my pot, scared this was the start of breaking myself. After I threw the pot, I began to cry and frantically tried to pick back up the pieces. “I want to glue them back together! I’m not ready to let go!” The therapists comforted me but told me that I would not be allowed to glue the pot back together. That night was deeply emotional for me and I’ll never forget it.
Through each night of IOP, through the weeks and the months, I found so many truths about myself. I discovered how little I really knew about myself. I learned how much I worry about things that are completely out of my control and how much I try to live in the past or the future instead of embracing the present. I was reacquainted with my love of writing and discovered a new love of coloring.
I also learned that my illness may be more complex than just “clinical depression.” What the professionals who managed my care and I found together is that I have borderline personality disorder. Discovering this made so many of my struggles I’ve had for my entire life suddenly start to make sense and I could see that these struggles were not random coincidence, but rather complex patterns of behaviors that had developed over the span of my life. My fears of being alone or abandoned, my difficulty in maintaining friendships for long periods of time, the overwhelming feelings I would often have but not understand or be able to rein them in…all of these things were my life and they were all key symptoms of BPD.
I’ll admit, though, the process of IOP was far from easy at times and I’m far from being “fixed.” There were nights where I had to go to another room and talk to one of the therapists one on one, there were nights I had to stay after and do grounding techniques with the therapists to make sure I would be safe to drive home, and there were lots of tears and even some rage…but I always felt safe and able to express myself, even when my emotions became overwhelming. I got so much out of the process of going into IOP.
I think that for many of us who struggle with mental illness, we tend to feel isolated, conflicted, and that nobody can ever understand. What I found through IOP, though, was that no matter how dark I get, I’m never alone. I found support, encouragement, and empathy from people who I would have never have met if I didn’t go through the program. I was also surprised by something else that I never thought would happen: I began to finally feel like I knew myself. I’ve spent my entire life searching for purpose and seeking approval from others because I felt lost and confused about who I really was. As the three months I was in IOP flew by, I starting picking out the pieces one by one and finding how they fit together. I was starting to see all the bad and unhealthy, but I was also starting to see something new…I began to see good things about myself, too. I began to see that I am a passionate, giving person. I began to hear and accept praise from others for my courage and talent for expressing myself through writing. I began to understand that I could be more than my darkness, I could be a light.
I graduated from the IOP program over a month ago and have since started Dialectical Behavior Therapy with yet another amazing professional I feel honored to meet through my journey. I know I wouldn’t be alive right now if I hadn’t been lightly pushed to go to the hospital and learn about what “Intensive Outpatient Program” really means. I’m thankful to be alive and that I was able to find a place to start to mend myself to evolve into this newest, truest version of me. I have all that I learned neatly organized in a binder and can look back on what IOP did for me anytime I need it. And although I’ve “left the nest,” I know that if I need a little guidance or a good ear, my IOP therapists are only a phone call away.