Carrie: Welcome back to the themes and treatment series of OCD. I think what’s so important for you all to know is that you have options when it comes to your treatment, and so that’s what I’m really big on talking about. Hello and welcome to Christian Faith and OCD with Carrie Bock.

I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing.

When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you with practical tools for developing greater peace. We’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith.

I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right into today’s episode. Today we’re talking about a particular option of treatment called intensive outpatient therapy. You may or may not be familiar with that. I am joined by special guest Madasen McGrath Wilson, who is an associate marriage and family therapist and associate professional clinical counselor in the state of California.

She received her master’s degree from Chapman University and has provided therapy to individuals of all ages facing a wide variety of mental health challenges. Madasen’s passion for helping others with OCD was born out of her own personal experience with the condition, and she is in a great place of recovery, which she’s going to talk about later, where OCD rarely affects her daily life.

Her mission is to support others in overcoming OCD and anxiety so that they too can experience that same life change that she experienced. Madasen, so you’re a therapist with a lived experience of OCD, and so I’m curious for you what that process was like of going from, hey, I know I need help, which is, I know, I think for you, like many people, there was a long road from symptom to diagnosis, which that’s like one hurdle.

A lot of people who struggle with OCD face, like, I have all these symptoms, I don’t know what it is, I just feel awful, I’m dealing with all these thoughts, and then once you got to have a diagnosis, what was that hurdle of like, oh, I know I need help, but maybe I’m not quite ready to do this, maybe I just want to avoid it all and not engage, how did you get through that hurdle?

Madasen: Yeah, I think everybody’s process looks different, but for me, just as you were saying, I probably lived with OCD for at least eight years undiagnosed, not knowing what it was. And as I was getting older throughout high school, college, it was progressively getting worse. A lot of intrusive thoughts, a lot of symptoms of OCD that kind of fly under the radar, because it doesn’t meet the stereotypical kind of understanding of what most people think of when they think of OCD.

Lived with it undiagnosed for a while and then once I did finally discover that it was OCD and that there was treatment for it, There was definitely a sense of relief that I experienced, but I would also say I was very resistant to the idea of getting treatment. I did a lot of research on what that would look like.

I read about exposure response prevention therapy. And to me, the idea of just opening up to anyone about the thoughts that I was having was Terrifying enough, let alone the idea of confronting my fears and learning how to tolerate the anxiety and respond differently to it. There was a good, probably two year process of me just kind of being on edge, knowing that I likely was struggling with OCD and hearing that treatment could be very effective, but being very hesitant about making that leap.

And like I said, I think everybody’s is different, but my own process kind of looks like. When I was graduating from college, I just finally had the realization, really at my college graduation, that things were not magically going to get better on their own. I think I had this idea in my mind that with enough time, OCD would Kind of cure itself.

It would fix itself. I thought it would go away on its own. It really hit me as I was finishing college, kind of not knowing what my next steps in life were going to look like feeling kind of at the end of my own rope, having had a really difficult time throughout high school and college because of OCD.

It just struck me that things were not going to magically resolve themselves. And if I wanted to get better, I needed to take the risk of being willing to be vulnerable and being willing to try something new. It kind of felt like my own personal rock bottom. I think everybody’s rock bottom looks different.

But for me, it was just coming to a place where I felt like I didn’t have anything to lose. I realized OCD was not going to go away on its own. I knew I needed help and I recognized I had to be willing to risk and do the hard work. I think for me, it was a process of kind of humility, kind of recognizing and accepting.

If I want things to change, I have to be willing to change. What I was doing was not working. I needed to take a new approach.

Carrie: It is hard for people to accept the OCD diagnosis because it does wax and wane sometimes with stress. And so people will have periods maybe that are a little bit better and they might think, Oh, okay, well, maybe it’s getting better.

Maybe it’s working itself out. I’m pretty sure you’re not alone on that as far as well. Just maybe we’ll just let this ride. Time heals all wounds, that type of situation. Of course. It’s hard enough to sit with the fear yourself, and then you think, oh, now I’ve got to go share this with somebody else. I really don’t want to do that.

But I appreciate you sharing that process because I have, I think, seen some of those same struggles in other individuals that I’ve worked with. I’m just getting to the place of, okay, it’s time. Here we are. It’s time to dig in, and it’s time to do the really hard thing. And you can do hard things when you have the right support.

That’s something I want people to know too. It’s a lot, it’s still going to be challenging, but it’s a better process when you have the right supports in place to be able to get you through those hard places. We’re talking today on the show about intensive outpatient therapy. So there’s different levels of care that people have.

You can go to outpatient therapy, which is typically like once a week, you see somebody in person or you see them online via telehealth. Some people may go every other week if they’re not too severe, or they may start going weekly and then go to every other week, obviously, and then intensive outpatient would be kind of this in between place between I can still kind of get some more intensive treatment while at the same time not having to go to an inpatient hospitalization where I stay there all day or I stay there for a week or something like that.

So it’s kind of this in between level of care. How do you define that? Or how do you look at it in terms of how do we know if we need this level of care or not?

Madasen: I would say intensive outpatient programs specific for OCD can be very helpful for people that are struggling with what we would label as severe symptoms of OCD.

Maybe they’re not homebound, they’re still going about their day to day life, they’re still functioning. But they’re struggling to get the help that they need through just weekly treatment. I know every intensive outpatient program looks different at every facility, but I think for the most part, intensive care is defined by the fact that, like you were saying, you’re not staying at a residential facility, you’re not being hospitalized.

But you are doing treatment on a much more regular basis than you would be if you were just doing weekly treatment. Typically, most programs are going to involve getting treatment for an extended period of time every day or at least most days of the week. And again, I think that can be very helpful for people that are maybe at the higher end of moderate symptoms and also those who are crossing over into more severe or extreme manifestations of OCD.

Carrie: Right. Tell us a little bit about the program at the OCD Treatment Center that you work with and how is that different maybe from other intensive outpatient programs that you’ve heard about or worked with?

Madason: Yeah, well I think first of all it’s very difficult to find an intensive outpatient program that’s specifically geared to OCD.

The program that we have here at the OCD Treatment Center where I work is unique in the sense that it is fully, it’s an OCD program, so that’s all we specialize in, that’s all we work with. I would say the other very unique feature of it is that it’s fully one on one. So the format of the program is, it involves working one on one with the same therapist for three hours a day, Monday through Friday, for three weeks.

And that one treatment, right, the component of being able to meet with the same therapist day in, day out, for three hours each day, I would say is, again, the most unique feature of the program. A lot of intensive outpatient programs tend to be group oriented. There’s a lot of group therapy involved. But with our intensive outpatient program, it is fully one on one because it gives us the ability to really tailor treatment to the individual, meet their specific needs, create a treatment plan that is specifically geared toward their symptoms.

Carrie: Yeah. And I found you specifically because you’re a therapist there that provides an integration between Christianity and these evidence based practices. So that was extremely unique to me, because I think, like you said, it’s very hard to find an OCD, intensive outpatient program, but then it’s definitely hard to find someone who’s willing to integrate Christianity into those pieces as well.

Like, that’s really huge. I think we have to kind of look at when we’re talking about should people do outpatient therapy or intensive outpatient therapy, you talked about the severity. Would you say that maybe you see individuals as well who have tried some ERP before, or they’ve tried specific therapies on an outpatient basis and maybe weren’t able to be successful with that for one reason or another, and this more intensive program has been beneficial to them?

Madasen: Yeah, absolutely. We get a lot of clients who have done OCD treatment before and have felt like treatment didn’t work for them. There can be a variety of reasons for that, but I would say the most common case is we get people who have tried weekly treatment for OCD and just felt like they were not getting the results they were looking for.

And I think it’s very easy for people to then become defeated and start to assume like, Oh, I am the small minority for which treatment doesn’t work. Maybe my case is exceptionally difficult. We get a lot of that coming in to our intensive outpatient programs. And what I find and what I always like to say is I think a lot of times it’s not the treatment that isn’t working.

I think people sometimes are just not getting enough of what they need. It’s a silly analogy to an extent, but I always like to say it would be like if you were sick and you needed to take an antibiotic and your doctor gave you like a tiny little dose. You might not get the results you’re looking for, you might not be feeling better.

It’s not necessarily that the antibiotic you’re taking isn’t working, it’s you’re not getting the dose you need. And so I see that a lot with therapy. When someone’s dealing with more severe symptoms, it’s not that weekly treatment can’t be effective, but you are sometimes putting a band aid on what feels like a bullet hole when you’re just meeting with a therapist for 50 minutes once a week.

I know a lot of people feel like they’re not able to build the momentum that they’re hoping to build and progress in the direction that they’d want to for people who feel kind of stuck in weekly treatment or people who feel like they need a greater sense of accountability, which I think an intensive outpatient program offers the intensive outpatient program format is really beneficial because Each day you’re building more momentum.

You are going to be held accountable, right? Your therapist is going to make sure that you’re implementing what’s being taught each day into your daily life. We’ve just had multiple stories here of people who have tried treatment elsewhere and came in kind of with a poor mindset, feeling like treatment wasn’t going to work for them, being very sick, skeptical of our intensive outpatient program, but on the other side, being very thankful that they gave it a chance because they realized they just needed to find the right fit in terms of a therapist and get that more intensive, highly individualized care.

Carrie: Yeah, I think that that’s a good point that obviously there’s challenges.

When you talk about doing weekly therapy, it’s not bad, but just to say that there’s benefits and challenges and the benefit, theoretically, of weekly therapy is you go, you leave, you practice the skills at home. Like you said, you integrate differently into your environment. If you’re doing exposure therapy, you’re doing some exposures outside of therapy and.

So forth and you come back and you report this went well, this didn’t go well, you adjust things like that, but it also can be challenging if your therapist is sick one week and then you have a sick child and aren’t able to come or you can, like you said, lose momentum in some of those situations or your schedule just gets really crazy with work and you’re having a hard time.

Sticking, being really devoted to that hour. And I know with me, like I’ve done some intensive work with clients and there’s something different that happens when your brain has more time and it knows that this is a dedicated space for treatment versus I have to leave here and then go home and make dinner for the family and put the kids to bed and do all of those things.

Can you talk a little bit maybe about like the compartmentalization and I mean that in a healthy way. We’ve compartmentalized these three weeks for treatment. How have you seen that be a helpful part of people’s process?

Madasen: Yeah, I think it allows people to prioritize treatment in a way that is difficult to do with weekly treatment.

And again, that doesn’t mean that weekly treatment is not a good fit for people. I’ve seen it work for a lot of people and nothing against it at all. But I think the benefit of the compartmentalization of the three weeks is you get to take three weeks and make OCD treatment your primary focus. And of course, everybody’s busy.

We all have other things going on alongside treatment, but for the most part, right, you’re at least designating three hours a day to focus on working with your therapist, implementing what you’re learning and integrating it into your life. I think that that’s a rare component of intensive outpatient therapy.

You’re kind of making the commitment to focus a designated period of time on your treatment and making that commitment to yourself, doing that for yourself, which I’ve seen work very well for people, especially people who have very busy lives. And if they were to do weekly treatment, as you’re saying, they’re kind of, it’s one of the plates that they’re balancing with.

Many other things, and it can be easy for treatment to get lost in that mix. Whereas I think with the intensive care, you’re kind of putting a spotlight on your treatment and that time that you’re devoting to yourself to get the care that you need.

Carrie: Yeah, I think that’s really huge. People also associate intensive outpatient therapy as being very expensive.

They’re like, oh. Wow. And you have people that travel to see you, so they’re paying travel expenses and situations like that. Do you believe that there are instances where this can actually save people money versus being in weekly therapy for a long time?

Madasen: I do. Again, if someone is dealing with more severe symptoms, it’s not that weekly treatment can’t work, but I think a lot of times people aren’t really considering the math of how much time and money weekly treatment is going to take potentially in their lives if they’re to continue with treatment for months or even years.

It does add up. It’s no surprise to anyone that OCD treatment is very expensive. And if you’re pursuing weekly treatment, those weekly session fees do quickly add up. And so the way that I see it is the intensive outpatient program is certainly an investment. It’s an investment financially. It’s an investment of your time.

But in all this, I’ve seen the return on that investment be huge because of the ways in which someone can create change in a condensed three week period. And our entire goal is to equip you with everything you need to essentially be the master of the tools and skills that you would be using. So that you feel like you can support yourself moving forward.

And that doesn’t mean that you might not need some follow up care after the three weeks. A lot of people will then do a few weekly sessions after the three week program, just to maintain their progress and feel like some support as they go back into their daily life and daily routine. But for the most part, the bulk of the work has been done in that three week period.

They have everything that we could possibly give them. We have trained them to be able to implement all of that stuff on their own, kind of build their confidence to be able to manage triggers on their own. As a result, I think it’s easier sometimes for people to, after doing that highly intensive care, Return back to work, and if they were returning back to work and they’re able to be more productive and engage with work in a more healthy way, there’s a return on that investment that they made in the program.

We have a lot of clients who aren’t working because they feel like OCD is interfering with their ability to work or focus at work. I’ve seen the three week program for certain people. Enable them to be able to find a job and get out of unemployment long term. I think the return on the big investment that someone is making with intensive outpatient program care can be huge and it is an investment upfront.

It’s a big investment up front for a lot of people, but I think it ultimately can save people time and money. And for me, I think about my personal experience. I didn’t realize that there was intensive outpatient care available for OCD, so I just thought weekly treatment was my only option. Weekly treatment was very successful for me, but it took me probably a good at least a year and a half to feel like I was in a place where I could discontinue care.

And when I think about intensive outpatient care, I think about How that probably would have suited me better in the sense that I probably would have made progress a lot more quickly and been able to taper down treatment and potentially save time and money that way. So it’s just something to think about and consider because it is a big investment for people.

But I think, like I said, potentially a huge return on that investment if you’re willing to find the care that is. It’s able to be tailored to you specifically and able to provide you with the support that you need.

Carrie: Yeah. I think that this is really great. I think you spoke to one of the reasons that we’re doing this themes and treatment series of OCD is so that people can know that they have options, that they don’t have to just pursue one type of treatment, that they can look at doing some therapeutic intensive, they can look at doing intensive outpatient treatment.

They can look at doing weekly therapy. And putting their whole heart into what am I doing inside a session? And then what am I doing outside a session? Because I think sometimes what you’re doing outside a session in those weekly sessions is just as important as what you’re doing in that 45 to 50 minutes that you’re in session.

That’s pretty huge. I definitely can see a difference in progress if clients are doing their homework versus not doing their homework. Like you said. When they’re there, when they’re right in front of you for a few hours, you have the accountability and you have a little bit more time maybe to get into some things a little bit deeper than you would have in just a 50 minute session.

So that’s a great benefit too, that people feel like, okay, I can really open up about maybe this big fear or this big issue. Sometimes it takes people a little while to get into it, if that makes sense. And then once they’re there and they’re like, oh, okay, well, I have this carved out space. I can get into it a little bit deeper and work through it.

And I think that that’s really beneficial to let people know they have options. And to not give up hope. That’s what we’re all about here on the show, as well as to let people know. Don’t give up hope. Don’t give up on treatment or yourself because the first thing didn’t work. Maybe you found a therapist and you guys just didn’t jive together at all.

You didn’t click. That doesn’t mean you just throw therapy out and say, I’m not going back. We wouldn’t do that with the doctor’s office. We’d find a different doctor and we’d say, okay, let me find somebody else that I feel like has a good bedside manner that I feel comfortable with, or I feel like is more knowledgeable about my condition.

Let me go try that again. I know that’s really hard. I just want to speak to that, that it’s hard if you feel like you’ve had a negative therapeutic experience. It’s tough to get back out there and to make the consultation calls and send the emails and the website forms to try to find the right fit. But I just encourage people to do that.

Take your little break, breathe if you need to, and then say, okay. This is about me. This is not about what happened with this person. I’m going to get back and I’m going to keep going and I’m going to continue to pursue having the abundant life in Christ, what we’re after. How have you seen, like, in this Christian integration that you do, like, the power of, you said, biblical based truth being combined with evidence based practice, and those were your words, that I stole, but I wholeheartedly agree with them because I feel like I try to do similar things.

So tell me about that power.

Madasen: Yeah, absolutely. This is something that I’m probably most passionate about. I really do feel that the evidence based treatment or anxiety and OCD treatment does align with biblical based truths. I love the integration of both. I think the biggest way that I see that alignment is whatever method of OCD treatment you end up pursuing, whether it’s exposure response prevention therapy or ICBT, At some point, that treatment is going to ask you to face your fears and to set aside your safety behaviors or compulsions to actually surrender control in the face of anxiety.

When I’m working with Christian clients, Right. The great thing is that I can remind them that we have someone to surrender that control to. We can learn to surrender our desire to have a sense of safety, a sense of security, give that to God. And for that reason, I see OCD treatment as an exercise of trust and faith.

We can put that faith in God. We can kind of loosen our grip on the steering wheel that we’re gripping so tightly, trying to make sure nothing bad happens or secure our safety in some way. But as Christians, we have somewhere to place that trust. And I find that to be very powerful because facing fears is not easy.

It’s a big ask to have someone confront their fears and set aside their compulsions because their compulsions are what is making them feel safe, even though it is perpetuating the entire problem. It’s a big ask for people, but I think when you have somewhere that you can place that faith and that trust, it makes a huge difference.

And so I really love that combination of evidence based treatment and the power of Christ. I think there’s nothing greater than that for people that are requesting a faith based approach to treatment. I think that not only does it help enable them to successfully overcome their OCD, but it can also be an opportunity for them to grow in their faith and their relationship with God.

And I just love being able to witness that.

Carrie: Yeah, I think that’s really incredible and recognizing that as you work through these. treatments, getting to a place where you can do things that you weren’t able to do before, whether that’s inside your faith, like going to church, Oh, I was getting too triggered and I wasn’t able to go to church or I had such a big struggle with reading my Bible because every time I would come across certain words or I couldn’t read certain stories, when they’re able to work through those things and get to the other side and say, okay, Now I’m actually able to serve in the church because I’m not afraid of children anymore.

I’m able to connect with the things that are really important to me. Like that’s completely life changing. So beautiful to watch people go through that process.

Madasen: A hundred percent it is. And I think it’s just such a powerful reminder just to point clients in the direction of relying upon God’s strength rather than their own strength, because I think part of the problem of OCD is oftentimes we are relying upon our own control.

We have a little bit of a control issue or wanting to be in control. When we can learn to, again, release some of that control unto God and rely more upon his strength and believe that he’s going to help fight this battle on our behalf. And we just have to trust and set aside our own safety behaviors and compulsions.

Yeah, it can be very transformational, and I love to just walk alongside people with that journey that they’re on.

Carrie: Awesome. Well, this has been great. I have one last question. Because you have lived experience, I had someone ask me recently, what does recovery look like? They said, does this mean it doesn’t show up anymore?

Does it mean that it pops up at different points? For you, how would you answer that? What does recovery look like?

Madasen: Yeah, such a great question. I don’t remember where I saw it, who wrote this quote. I cannot take credit for it. I saw some OCD therapists post online recently a quote that really resonated with me.

Something along the lines of recovery from OCD does not look like no longer experiencing the presence of OCD, but rather learning to not fear its presence. So I think what I take away from that is OCD is still there to some extent, granted it’s, if you’ve done the work, if you are no longer engaging compulsions, it’s usually much more in the background, it usually pops up for people a lot less frequently, that’s certainly my experience, I feel like it’s night and day from where I used to be and It’ll pop up here and there, but it’s nothing in comparison to how in my face and loud it was originally.

Its presence still is there to some extent. It lingers. It has the ability to kind of pop back in, pop up. But I think the biggest difference is that we don’t fear it to the same extent anymore. We’re not living in fear of it. We’re not feeling as though we’re walking on eggshells anticipating the next trigger.

There’s an acceptance of, yeah, it could rear its head. There’s some times where I’m gonna get triggered. But there’s a confidence in your ability to move through that and a confidence in the tools that you have to be able to manage it. As a result, there’s just less of an emotional reactivity that someone experiences when their OCD shows up.

And so I think it’s the fear component that’s the biggest difference. The fear begins to subside and ultimately OCD’s presence gets a whole lot smaller. Which is great, but I think it’s the fact that we’re no longer being terrorized by it and living in fear of it. That’s the biggest change. And there’s so much freedom and that to feel like the thing that was once your biggest fear, right?

The thing that was terrorizing you the most to watch it go from being all encompassing to being background noise and something that you no longer flinch at when it rears its head is really the change that I experienced myself and that I see for a lot of my clients. And that’s how I know someone is really in recovery and on the right path.

Carrie: Yeah, I think that’s a great answer. I love how you said in the background, too. That’s something that I, an analogy I usually use is it’s in the background, not in the foreground, but it’s also good for people to hear. Hey, it’s possible you’re living proof of that every day, and now you’re helping people get to that place of freedom as well.

So thank you for coming and sharing today.

Madasen: Oh, yeah, absolutely. Thank you for having me.

Carrie: As some of you already know, I’ve been providing intensive therapy for the last few years now where people come to see me. between one and three days. And it’s a great opportunity to really kickstart your recovery process, to get some foundational skills built in or to process through some trauma that you’ve had from your past that you know is really contributing to your obsessional story.

If you want more information on that, you can definitely check out my website at kerrybach. com. To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings, and receive information on exclusive sales, become an email insider today. All you have to do is go to carriebock.com and scroll towards the bottom of the page. You’ll find a spot to put in your email and receive a free download in your inbox from us. Until next time, may you be comforted by God’s great love for you. Christian Faith and OCD is a production of By The Well Counseling. Opinions given by our guests are their own and do not necessarily reflect the views of myself or By The Well Counseling.

This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.