I mentioned that I switched from community mental health to a private therapist in previous posts. I have been seeing the private therapist since December, and I'm really noticing a difference in myself. I'm noticing that my anxiety is holding at low to moderate levels now instead of the extreme highs that I was dealing with before. I also notice that I'm feeling more like my pre-diagnosis and pre-symptom self, and that was something I had been missing for the past 5 months since I'd been in treatment. (Yes, I've had OCD for over 6 years now, but things didn't get too terrible until this summer. I haven't really felt like myself since that time.)
I'm noticing these changes now for a couple of reasons. The first reason is that I'm having therapy once a week now for an entire hour each session instead of 45 minutes every three weeks. (Again, that isn't the fault of the community mental health system. They were doing the best they could with the resources they have.) Now, I have time to deal with one issue at a time, as that issue comes up, instead of trying to cram as much as possible into the sessions, like we were doing in the community mental health agency. (As a result of cramming so much work into each session, my previous therapist had flooded me, too, which wasn't good.)
The other major difference that is responsible for my drastic improvement is the change in the way my current therapist is treating my mental health condition. Both my previous and my current therapist are Cognitive Behavioral therapists (CBT), (which means they use an approach that identifies the unhelpful or messed up thinking patterns and beliefs and change behavior to be more in line with the new more positive and helpful thoughts and beliefs). However, the techniques they use are extremely different.
My previous therapist tried to treat my OCD with Exposure and Response Prevention therapy (ERP), which is a type of CBT that is the recommended treatment for OCD, even the nontraditional type of OCD that I have. However, my previous therapist didn't have a whole lot of experience with OCD, and she told me that before we started. (ERP raises anxiety levels, and then the anxiety is supposed to slowly decrease over time as you get used to the thoughts and challenge them with behavioral activities.) This wasn't happening with me, and more and more intrusive thoughts were coming, spanning all kinds of terrifying areas. The sort of approach my previous therapist used didn't work for me. I'm not sure why. They had also previously tried a medication, and it made my OCD worse even though it worked wonders for everyone else that I read about taking the medication for their Pure O.
My current therapist, also a Cognitive Behavioral therapist, uses a different approach to treat my OCD. So far, my current therapist seems to favor a more cognitive approach (which means she is focusing on changing my thought patterns and my faulty beliefs in regard to my OCD intrusive thoughts instead of stressing the ERP and behavioral changes). In other words, we're talking about my intrusive thoughts, my anxiety, and what I think and believe about all those things. I'm sure we'll get to some ERP activities, but we haven't so far in my treatment.
My current therapist has also pointed me in the direction of some extra resources: workbooks. On the second visit with my new therapist, she suggested that I order an OCD workbook to work through, and I ordered a workbook that actually takes the same cognitive-focused approach instead of an exposure-heavy approach. (The workbook is called Break Free from OCD: Overcoming OCD with CBT by Dr. Fiona Challacombe, Dr. Victoria Oldfield, and Professor Paul Salkovskis, and it comes from somewhere in the UK.) This workbook has helped me tremendously in the short time that I've been reading it and doing the suggested writing activities (making my own charts and things like it shows in the book). The workbook does have some exposure therapy activities that involve bringing on the distressing thoughts on purpose, but I haven't worked up the nerve to dive into those on my own yet. I'll get there, though.
I'm not saying that, objectively, one treatment is better than the other, and I'm not saying that a private therapist is better than a therapist at a community mental health agency. However, subjectively, I think the treatment I am receiving from a private therapist has been a better experience because I am responding better to the treatment used by a private therapist. Different things work for different people, and people respond differently to different treatments because everyone's brain works differently.
I'll end with this: Treatment for mental health conditions isn't a one size fits all sort of thing. People respond differently to different types of treatment because everyone's brain is different. Sometimes, you just have to try different therapeutic approaches and different therapists until you find one that works for you and your brain. The approach that works best may also include medication, and that's alright, too. Just, please, don't give up on treatment because the first few techniques or therapists you try aren't helpful.
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