By Jen Kohlenberger
Prior to my treatment at Solstice Pacific I had never heard of an Intensive Outpatient or Partial Hospitalization Program. All I knew was that I needed this level of care and it sounded great and scary at the same time. Now after completing the PHP/IOP programs, I’d like to shed light on things I wish I had known going into it.
1. It’s Hard.
A lot of people think spending 20-40 hours a week away from work and life sounds an awful lot like a vacation. Daily meditation? Grilled cheese sandwiches? Cake on people’s birthdays? Sign me up!
The reality is, treatment is difficult. As a patient, you spend 4-8 hours a day in psychoeducation, learning about your diagnosis, making a treatment plan, learning coping skills, facing fears, processing trauma, and sitting through a lot of discomfort. On top of that, you might be trying different medications, getting to know a new environment and new people, and doing other modalities like MeRT or EMDR. While much of the day is spent in the clinic in a student setting and isn’t so much physically demanding, it is incredibly draining, mentally and emotionally. Each day is another opportunity to uncover truths about yourself– and sometimes it’s things we didn’t want to know. Wounds reopen, buried memories surface, and distractions are removed. But like Theodore Roosevelt said, “nothing in the world is worth having or worth doing unless it means effort, pain, difficulty…”
2. It’s Fun.
It may not be a walk in the park, but ironically, we do take a lot of walks in the park! While there are many moments of sadness and pain in treatment, there is a lot of joy too. A day in the life of a PHP patient may include an art project, listening to and interpreting music, a sound bath, a mindful walk, playing a game, and maybe even watching a movie. For as many tears that are shed there’s an equal amount of laughs shared.
Flight is one way we inject fun into treatment. Flight rallies are held every two weeks, during which patients are celebrated and rewarded for milestone achievements. Flight increases self-efficacy and the rallies are a fun way to create memories and enjoy each other’s company in a light-hearted way. It’s also really fun to see others grow and heal.
3. It’s Unlike Other Programs.
Some programs may have a similar structure to that offered at Solstice, but one major difference is the inclusion of family. In addition to having one-on-one sessions with a therapist, as a patient you also have family sessions with your therapist. A family session may include anyone who is a support in your life or someone who plays a role in creating a barrier to your treatment. At Solstice, your family will learn to show up for you and provide the support you need to succeed— because family is Solstice’s core value.
While I haven’t experienced other PHP or IOP programs, I know that there is a level of care at Solstice that exceeds expectations. Patient wellness is the priority, not only during their time in treatment, but beyond that as well. In order to complete the program I was required to provide information about my circumstances – living situation, employment, as well as dental and medical providers, safety plan for potential crisis, support numbers, etc. When I graduated from the program, I knew I was always welcome back, but I was secure and confident in knowing that I had plans and resources lined up to help prevent that from happening. Most importantly, I knew that no matter what happened, I wasn’t alone as my journey continued.
4. Group Therapy IS For Everyone.
When I first started the program, I was overwhelmed by the group setting. I wanted to have more one-on-one time with my therapist because I wanted to get well quickly and I thought that was the way to make that happen. I wasn’t interested in meeting new people or sharing life stories. However, I quickly realized group therapy was going to be extremely beneficial for me and an integral part of my healing journey.
The group format creates space to process with peers and share thoughts, feelings, and experiences, under the guidance of a facilitator. We explore ideas together and receive feedback in a supportive environment. Not only did I enjoy my time getting to know people in the program in this way, but I left with friendships that I will nurture for the rest of my life. There is truth to the saying, “friends are the family we choose for ourselves,” and while some people have a biological family to support them, for others, the Solstice family is their most stable support system. For me, group therapy was the support I never knew I needed.
5. Routine is Key in Healing.
Prior to starting PHP, every day in my life was different. Some days I would start work at 4:00am, some days 11:00am, and I would almost always only wake up barely early enough to grab toast on my way out the door and get to work on time. Many days I would skip lunch because there just wasn’t enough time between clients. Some nights I would work until 10:00pm, not eat dinner until midnight, and then binge watch How To Get Away With Murder until 3:00am.
My routine (or lack thereof) wasn’t a problem for me until it was. I couldn’t figure out why I was having such a hard time turning my brain off at night. When I was tired and unmotivated in the morning I would just drink more coffee and then be too anxious to function.
The rigid PHP schedule was an adjustment. However, I quickly learned that while a schedule can sometimes feel restrictive, it’s the best way for your brain to function optimally and to make room for setting attainable goals each day. The right routine provides for your physical, mental, spiritual, financial, emotional and social needs. It allows for structure, discipline, self-care, managing responsibilities, and celebrating achievements.
6. Vulnerability Leads to Faster Healing.
I’m generally a private person and while I don’t mind talking to people about deep topics, I typically don’t want to get into my stuff with others.
But let’s be honest, “I’m fine,” is the biggest lie ever told, and in the realm of treatment, it’s one of the biggest barriers. The sooner you can be honest about your thoughts and feelings, the sooner you will learn to manage them. The sooner you address your past or present trauma, the sooner you can process it and move forward. Most people struggle with this idea because there aren’t a lot of places or people in our lives that feel safe enough to be vulnerable in this way. But if there were ever a place to do so and people to do so with, it’s in PHP/IOP. Opening up and exposing ourselves can be incredibly painful, but it’s the only way healing can begin.
Idealistic patients have their own idea of how long they need to be in the program, but that time frame greatly depends on vulnerability of relinquishment of control.
7. The World Can Wait.
Prior to starting PHP, I was an incredibly busy person. I am a hairstylist, the Executive Director of a non-profit organization, I co-chair one golf tournament fundraiser and am the event manager for another, and am a graphic designer in my free time. When I was in my unhealthiest state I knew I needed help beyond once a week therapy, but I didn’t know 1) how I could afford it, and 2) how I could fit it into my schedule. What I did know was that I couldn’t continue to live the way I was living. The day I received a $2,200 medical bill from my last visit to the ER (with a panic attack) was the day I realized I didn’t have a choice. I committed to the PHP program indefinitely and essentially threw my hands up as if to say, “whatever happens, happens”.
I had to cancel on clients. I had to cancel social engagements. I was overwhelmed with the thought of how many people I was going to disappoint. But what I didn’t consider was that I was already canceling on clients and social engagements because I was anxiety-ridden. At least instead of canceling because I was succumbing to my disorder, now I was canceling in an attempt to regain my ability to overcome it.
One of the hardest lessons I had to learn on my mental health journey was how to say, “no”. When a client would ask me to schedule a haircut appointment on a Tuesday morning I had to say “no”. When someone would ask me to volunteer for an event, or to respond to an email faster, or make more time for them, I had to say “no”.
Society teaches us that we need to say yes to people and opportunities and make ourselves available to those who need us– whether for work or for personal reasons. In doing so, we sacrifice our own needs. At the end of the day, part of the reason I ended up in a mental health crisis is because I couldn’t say “no,” and I was trying to be too much to too many people. I was showing up for everyone else but I wasn’t showing up for myself. I didn’t know how I was going to commit 40 hours a week to treatment, but I did it, it worked, and it wasn’t the end of the world– the world waited.
8. I am Worth It. Because I’m self-employed, there aren’t a lot of options for me to step away from my job and dedicate 40 hours a week to a mental health program. I had styling commitments booked 8 months in advance that wouldn’t allow me to file for disability. I couldn’t possibly see how I could afford to step away from so many hours of work and still stay afloat. I didn’t know if gaining psychological stability was worth temporarily sacrificing my financial stability.
Sometimes our perception is off when we are in crisis. Catastrophic thinking kicked in and suddenly I believed, “if I go to treatment I’ll end up living in the streets!” In truth, I wasn’t seeing clearly at the time, but once I was able to assess my situation with the proper support, I realized I could make it work. I made decisions that allowed some room for less income for a few months. I cut back on spending and found ways to put certain expenses on hold until I could return to full-time work. I decided that my mental health was the priority and that without my mental stability, money did not matter. I made an investment that would provide me with future freedom to support myself comfortably. Ultimately, I made sacrifices and gave myself grace – and I asked for that from others as well – because I am worth it.
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