Update on PHP for Anxiety and OCD
I've been in PHP for a little over 2 weeks now and I guess I'm unsure how common that is for social anxiety type problems so I thought I'd give my experience so far. Especially considering how much I complained about it prior.
PHP is Partial Hospitalization Program. Mine is focused on anxiety and mood disorders but a lot of the ones I have been to in the past were mostly mood focused, so thank god for the anxiety part! Its M-F 9am-4pm. There's 5 groups per day and you're generally in the program 4-6 weeks (which means I'm about halfway!)
First day was so hard! I pushed it off a few times. It was like going back to school. I hadn't been leaving the house nearly at all because the anxiety was so bad. When I realized I couldn't make the anxiety stop for anything (I'd genuinely sit in my room thinking stop stop stop stop stop...) I knew I had to make some change.
The biggest part of that first week was that I learned the root cause of my anxiety. It's not solely "social" though it does connect to how I'm perceived. I'm afraid of people knowing me.... To a deep extent. Therefore I cope by acting like not-me so that there's no way in hell you could ever know and judge ME because you've only met not-me. Since then I've been making steady progress in noticing my detrimental coping behaviors and finding and practicing replacements.
The most detrimental coping skill I had for the social anxiety was acting/feeling like I wasn't there. Though part of that is a strong dissociation when the anxiety is too high, I'd also been slouching in my seat, or sitting behind things or other people, or giving auto responses when asked questions. I was an "I don't know" guy! I do know! Acting more confident has already put me on the path to being more confident... That's majorly oversimplifying it, however fixing posture and walking/moving slower has made a major difference in itself. The feeling of not knowing myself has also lessened because I am not pretending as often and I've had time to explore what brings me joy and what values I have and want to have. The dissociation has lessened too!
I've also found it easier to move forward. It's hard to come to terms with losing your teenage years to this (and I lost a part of my gender transition) and I am still grieving but I am simultaneously moving forward. I am missing the past and believing that I can have a different future.
The routine of the program is also majorly helpful. I get up in the morning, eat, wash my face, and go to program. Lunch is at a set time. I come home and have dinner at a set time and shower at a set time. There's not a lot of time to sit home and ruminate. There is a lot of time to practice new behaviors with support and reminders. There is a lot of time for introspection. Being there all day makes it easy to be home for a couple hours because it's as if I have been practicing for the afternoon ALL DAY. Now's my time to shine!
To conclude my long large speech, I would highly recommend trying a PHP/IOP program if the social anxiety is majorly screwing up your life and you think you can't come back. I realize it's out of reach for some (the cost is absolutely insane some places) but it is SO different than individual therapy. They will also hook you up with medication pretty quick if you're interested!
I'm open to questions if you've read this far. I've done the adolescent programs as well and IOP and inpatient, so I can give some insight if anyone's considering.