Residential Programs for OCD: How Long Should You Stay?
Toward the end of his freshman year of college, my son Dan's Obsessive Compulsive Disorder was so severe that he could not even eat. He would get "stuck" in the same chair for hours, barely able to move. Despite his condition, Dan was determined to successfully complete the semester. After all, he had worked hard for years to get into his dream college, and he wasn't going to let OCD take that away from him. With the support of a close friend who is a clinical psychologist, my son was somehow able to get through the semester.
More than anything Dan wanted to return to school in the fall, and so he was thrilled to be accepted into a world-renowned, intensive residential program for the summer. The staff there assured him that he would have plenty of time to get back on track and return to school. Dan was so excited; he couldn't wait to go. You'd have thought we were sending him to summer camp.
At the residential program, Dan was the model "client." He committed himself totally to his Exposure Response Prevention Therapy and though it provoked panic attacks, he forged ahead. He did everything that was asked of him and never complained. He took his meds. He bonded with his therapist and other staff members. Everyone loved him. He was one of the easiest clients (in terms of temperament) with severe OCD to ever walk through the clinic's doors. In short, he was a pleasure to have around.
In fact, he was such a pleasure to have around, nobody wanted him to leave. Though Dan was making serious progress, we began to hear concerns from his psychiatrist and therapist at the clinic about him not being ready to return to school. If he stayed in the program longer, he could make that much more progress. At this point even Dan, heavily influenced by the staff that he had grown so close to, wanted to stay. He was comfortable there, surrounded by people who understood him.Never mind that he would not go back to college. Never mind that Dan's school did not grant leaves of absence in his major. Never mind that by not going back, he would be giving up his almost life-long dream. Better he should stay at the clinic and conquer that OCD.
What happened? How could it be that my son, who had insisted on completing his freshman year of college in the midst of severe OCD, was now saying he wasn't well enough to return to school? He had chosen this program specifically so that he could return to college, and now he was telling us that school wasn't that important to him. In terms of his OCD he was in much better shape at this point than when he arrived at the clinic, but his frame of mind was worse. It's as if he didn't realize how sick he was until he entered the treatment program.
So how long should you stay in a residential program? Until your OCD is totally under control, and there is not an obsession or compulsion to be found? Or should you get back into the world and live your life, all the while continuing to fight your OCD? One of Dan's arguments for wanting to stay in the program was, "If I go back to school I won't have time to concentrate on my OCD." Hmm. Isn't that a good thing?
As with most things related to OCD, there are no easy answers. But there are some things to keep in mind. In my opinion, the longer you stay, the harder it is to leave. Dan was at his residential program for nine weeks, and toward the end of his stay he was saying things such as, "I'm so comfortable here, I could stay forever." And he meant it. Also, while there is no question that the staff at this clinic knew everything there is to know about OCD and its treatment, there is also no question that they did not know my son. Their interactions with him took place during the worst time of his life. They knew nothing about Dan's passions, hopes, or dreams. They did a great job treating his OCD and I credit the ERP Therapy for literally saving his life. But they did not treat Dan, the whole person. They failed to look at the big picture.
In my heart, I knew the right thing was for Dan to leave the program and go back to school. It was time for him to get back to his life, which included so much more than OCD. But when you have a psychiatrist, therapist and social worker telling you otherwise, it can be intimidating. Thankfully the same friend who helped Dan get through those last weeks of his freshman year came to our rescue again. If he hadn't said, "Get him out of there," my husband and I may very well have let him stay.
Dan returned to school and a tumultuous year followed. I second guessed our decision many times.But if I ever doubt that we did the right thing, I just look at Dan now. His OCD is practically nonexistent and his passion for life has returned. And he is a senior in college, following his dreams.