health and weelbeing

Not that long ago, I was going through a super rough period in my life dealing with a terrible depressive episode and causing myself harm because I couldn’t deal with it all alone. Because of how worried my family and friends were, I ended up deciding it was time that I needed more help and support than I was receiving. My therapist told me about a Intensive Outpatient Program (IOP), where, for at least a month, I would have to go to more intense therapy sessions online that consisted not only of talk therapy.
Right when I started IOP, the world was entering into a period of utter chaos. People were stocking up on toilet paper like nobody’s business and glued to the news talking about the latest surge of COVID cases in the U.S. I couldn’t have chosen a better time to start intensive therapy. But due to quarantine restrictions, the program I decided to do made everything virtual. Like many other places, it was the first time the IOP program had ever been held virtually, so they were worried about how it would go and if it would be as effective. There were definitely pros and cons of it being held virtually. Read on to learn more about Intensive Outpatient Care and the lessons that I learned from my own experience.

What is the Intensive Outpatient Program (IOP)?
Before my therapist recommended IOP, I had absolutely no idea what it entailed. There are different types of IOP depending on individual needs. While it can look different to everyone or in different programs, it’s typically a short-term treatment, meaning more intensive focus than therapy sessions once or twice a week. IOP care is meant for anyone suffering from eating disorders, bipolar disorder, depression, self-harm, or chemical dependency. Doctors and therapists will recommend IOP to patients when they have been identified as needing a higher level of care in an outpatient setting. While most people spend 3-12 weeks in IOP treatment, it can be much more or less, depending on individual needs (my IOP program lasted for two months). 

My experience doing IOP
During my IOP program, I did both group therapy and individual therapy, working on a combination of trauma therapy, Dialectical Behavioral Therapy (DBT), and relationship skills. For three days a week, I started with about an hour of individual therapy sessions (just me and my therapist), followed by three hours of group therapy. The first hour was dedicated to trauma therapy, which was about processing past difficult experiences (this one was the most difficult for me because it was so personal). The following hour focused on relationship skills, including discussing our attachment styles and how we show up in relationships. Lastly, the third session focused on DBT. DBT is meant to provide coping skills when someone is in emotional distress. DBT also hones in on the practice of mindfulness. I’m now able to turn to some of these skills whenever I feel emotionally triggered or upset.
While it sounds like a lot, I still had time to keep up with normal day-to-day activities, and doing it all online made it a little easier to fit into my days. Since it was online, I was still able to show up to classes, complete work, and keep up with outside clubs and activities at school. However, everyone is different and all patients should establish individual schedules that would work best with their lifestyle, needs, and program of choice.

How does it work when it’s all virtual?
Online IOP obviously worked a bit differently from how it would function in person. Everything was held via Zoom, with a moderator for extra safety. They wanted to make sure that no one besides group members and the therapist would go into the meeting. In the program I was in, people in person could usually choose their own therapy schedule that involved different groups of people. However, since it was online, we had to stick to the same schedule and have the same group members. Many programs had to cut a lot of the different types of therapy since not all therapists were comfortable switching to a completely virtual IOP.
One benefit of doing IOP online was having the freedom to still be at home with my family while I was going through intensive therapy. It was extremely helpful to have them around me during a difficult time. Another great thing was that I was in an environment where I felt comfortable. I don’t know about you, but my room is my safe haven. No matter what’s going on in my life, when I enter my own personal space, I feel calmer and less anxious. Intensive therapy can sometimes be draining and bring up a lot of difficult emotions, so it was nice to be in a familiar, comfortable place. It can also be difficult for me to express my feelings in a group setting, and the virtual option made group therapy a little bit easier for me to communicate without feeling intimidated.
But there were also challenges to the virtual setting. I get distracted easily, so sitting in front of a computer screen for four hours of total concentration was definitely difficult. It’s so tempting to scroll through Instagram or check my text messages instead of paying attention. But overall, I still feel as if I got as much as I could out of my experience with IOP despite it being done online.

What I learned from my experience
It’s powerful to be vulnerable
I am definitely someone who finds it difficult to share my emotions with other people. When I feel vulnerable, I tend to shut down and isolate myself. Although I was in talk therapy before, I still found it quite difficult to be completely open and honest with my therapist. I started IOP in a very vulnerable state; I had just gone through an intense breakup and was deeply depressed. The thought of having to talk to other people about what I was going through seemed terrifying. I just wanted other people to think that I was doing OK and pushing through it when really, I was suffering tremendously. During my time in IOP, we focused on how being vulnerable isn’t necessarily a bad thing.
Like Brené Brown says, vulnerability is an act of courage, not a weakness. It is so difficult to show and share with others what we’re really going through, but when we do it, it actually allows us to connect with others on a deeper level. When I opened up to my IOP group about my depression and past traumatic experiences, I learned that other people related to me and felt the same way. It made me feel heard and like I wasn’t alone in what I was going through. I’ve applied this practice in my own life too. I’ve started becoming more open and honest with my family and friends when I am struggling with something, and every single time it always has a positive outcome.

It’s OK to need help
I have always been a very independent person. I used to feel like a burden to other people if I ever asked for help. Although independence is good, we need support from others—it’s impossible to do everything alone. I was barely passing my classes, dealing with a breakup, and couldn’t get out of bed; yet I still thought I could do it all by myself. I thought I had to fix myself because I would look weak if I reached out for help. It was a huge decision for me to enter IOP.
A lot of it did have to do with my personal therapist saying that I needed it, but I also acknowledged that I wanted to get better but had no clue where to start. The first step to really getting better is finally accepting that you need help. Like me, you may have a lot of judgment around asking for help, but I promise you it’s worth it. People want to see you succeed and get better; you don’t have to deal with everything yourself. Although I still struggle with asking for help from others, I’ve realized that the benefits outweigh the challenges.

Accept the past and let it go
IOP brings up a lot of things from your past that you may not really want to relive. Sometimes during therapy, I would remember really painful memories that I had repressed for so long. There were times when it was really emotionally challenging to think of things that made me so upset, but talking through these past memories helps us acknowledge the hard times that we have endured in our past and be able to move on. Bad things may have happened in your past, but that doesn’t mean they should define your future.
One of the skills of DBT is radical acceptance, which means accepting things for how they are, even if it makes us feel uncomfortable. It’s a pretty hard skill to learn, especially since it sometimes feels impossible to accept some things we have been through. But there is so much power in letting go. We are getting rid of all the things that have been holding us back for so long. After talking through some of my most difficult memories, I was able to finally let go and get rid of so many negative emotions that I felt toward those particular experiences.

How to know if IOP is right for you
Before I started IOP, nothing was really working for me. I was in talk therapy, but it didn’t seem to be enough to process and heal from what I was going through. I knew that I needed more support than I was receiving. If you are experiencing severe depression, an eating disorder, addiction, or bipolar disorder and feel like you’re not getting the support you need, talk to your doctor or therapist about IOP options near you. You are not alone and people are here to help you.

National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255)Crisis Textline: text CONNECT to 741741 More

I’m the first to cheer on a friend when she’s training for a marathon or congratulate her for launching her own business. But when it comes to celebrating myself, it doesn’t come easily or naturally (it’s almost nonexistent, TBH). I often play that “I’ll be happy when…” game (you know the one when you think you don’t deserve to pat yourself on the back until you land that dream job, reach your goal weight, save enough for a down payment, or find “the one?”). Sound familiar?
So how do we change our mindset and learn to celebrate ourselves just as we are today? Enter: Mel Robbins. With an impressive resume—motivational speaker, best-selling author, former TV host and criminal defense lawyer, mother and wife—Robbins knows a thing or two about dishing out wisdom. According to Robbins, all it takes is a simple habit and an easy morning routine to shift your mood and perspective, which she calls the “High 5 Habit.” So I decided to read the best-selling book and give it a go. Spoiler alert: It changed my life.

The habit:
The daily habit randomly came to Robbins when she was staring at her reflection in the bathroom mirror years ago, feeling overwhelmed and defeated after drowning in debt and being in a rocky marriage. In an effort to cheer herself up, she gave her reflection a high-five in the mirror and decided to do it again the next day—and the day after that. By the third day, Robbins started to look forward to seeing her reflection, accept herself as she was in that moment, and feel ready to take on the day with a sense of enthusiasm. 
You might be thinking that sounds silly (I definitely did), but let’s unpack the science behind it. In Robbins’ book, she refers to a body of research called Neurobics, conducted by Dr. Lawrence Katz, a neurobiologist and researcher at Duke University. “In a neurobic exercise, you combine a routine activity, like looking at yourself in the mirror every morning, and you pair it with two things: something unexpected that involves your senses and an emotion that you’d like to feel, like celebration or being seen,” she explained. In other words, when you high-five yourself in the mirror (an act you don’t normally do), the mind connects it with positive associations like “Great job,” “You’ve got this,” and “I’m proud of you” because of interactions you’ve had with the action and other people since you were a child.
Robbins claims that adding the “High 5 Habit” to your morning routine will not only transform your relationship with yourself but also cultivate self-confidence, motivation, and happiness (are you sold yet?). Read on for what Robbins calls a “High 5 Morning,” which is six steps that can set you up for the day by putting yourself first, and my experience incorporating them into my daily routine. 

The 6 steps of the “High 5 Morning”

1. Get up when the alarm rings
That’s right: No snoozing allowed. Robbins said that when you hit the snooze button, it’s doing more damage than just delaying the inevitable. “If you always hit the snooze button, your actions are saying you don’t do what you say you’re going to do,” she explained. “And that impacts how your reticular activating system (RAS) filters what information gets kept in and filtered out of the brain. You make a promise when you set the alarm clock at night, and getting up at the time you set is you keeping that promise.” Confidence is just self-efficacy, which means believing that you’ll keep promises to yourself and follow through when you say you’re going to do something (like wake up at 6:30 a.m. instead of 6:35 a.m. or 6:40 a.m.). 
As hard as it was to avoid the “just five more minutes” rhetoric in my head and get right out of bed instead of scroll through my phone, I felt much more at ease and productive after just day one. It was as if I was given more time in the day to do things I otherwise wouldn’t have been able to fit in, like drinking my hot lemon water on my deck in the sun and dusting off my foam roller for some much-needed stretching. A five-minute snooze or 10-minute Instagram scroll in bed may not seem like a lot, but it adds up. Plus, I did feel much more capable when I actually got out of bed when I intended to. 

2. Try a self-love affirmation
To decrease everyday stress and to increase overall self-love, Robbins suggested placing your hands over your heart and repeating “I’m OK, I’m safe, I’m loved.” She explained that by reciting that affirmation, you center yourself, relax the body, and increase confidence. The physical action of putting your hands over your heart may sound cheesy, but a Polish study discovered that the hand-over-heart gesture can help promote better judgments and behavior. 
Whenever I feel anxiety start to creep up, I stop what I’m doing, place my hands on my heart, and repeat the affirmation over and over until the anxiety starts to dissipate. After doing this for just a few days, the perception of each current situation shifted, and I saw things more clearly. It reminded me that my fears are not based in reality, I am safe, and I am deserving of love. Needless to say, this habit is definitely going into my arsenal of confidence-building tools. 
 
3. Make your bed
Yes, the chore you dreaded as a kid had more benefits than just avoiding a fight with your mom. “Making your bed every morning is another way to strengthen the muscle of discipline and commitment to yourself,” Robbins said. What may seem like a trivial task actually has a lot of benefits: Some research shows that it improves your mood and increases productivity. When I walk into my bedroom to disheveled sheets and pillows, my mood totally shifts. Call me a neat freak, but a made bed makes a difference (science says so!). This was one habit I already had in my wheelhouse (high-five, Katherine!), but after trying the High 5 Habits, I’m going to make my bed when I’m traveling as well. “The key to putting yourself first is practicing what you said you would do, no matter where you are, how you feel, or what excuses you might have,” Robbins said.

4. High-five your reflection
Every day, it’s important to “greet your biggest ally and best friend—you,” Robbins advised. High-fiving your reflection is obviously the most crucial routine to Robbins, but this habit was the hardest for me to adopt. I was so used to looking at myself in the mirror and seeing only flaws (and it felt so…uncomfortable?). But as soon as I started getting used to high-fiving my reflection, I couldn’t help but smile and think to myself, “I got this. It’s going to be a great day.” Putting the habit into practice was like giving myself a pep talk every morning, and when I looked back at my reflection in the gym mirror or checked my makeup in the car later in the day, the harsh critic in me was way quieter. If you’re struggling to adopt the habit, place a Post-it Note on your mirror to remind yourself to follow through with your high-fives (it saved me a couple of mornings!). 

5. Put your workout clothes on
We all know that getting a sweat in is physically and mentally beneficial, but it’s hard to follow through. Robbins lays out her workout clothes the night before, which forces her to put them on the next morning before she leaves her bedroom (she calls it “productive guilt”). This promise isn’t anything new or revolutionary, but it helped me celebrate every win, even the small act of getting dressed in workout gear (whether or not I actually worked out that day).
I have recently been struggling with motivation to go to the gym, so I was especially excited to try this routine. Every night, I picked out my workout OOTD and laid it out on my dresser before going to bed. It was a bit of a struggle to remember the first day, but there wasn’t anything a cute matching set couldn’t fix (nothing is more motivating than fashion!). By the fifth day, it became second nature to get some movement in, be it a 20-minute walk, Pilates class, or lifting sesh, because I already had the outfit on. Try putting on your workout clothes first thing when you get ready in the morning or pack a gym bag with your clothes ready to go if you need to put on work attire. 

6. Journal
Robbins encourages “dreaming in the morning” to shift your dreams from subconscious to conscious and put them at the front of your mind where they can “act like a searchlight” to help you manifest your happiest life but to also gain awareness of what you need. Grab your journal and write down exactly what you’re feeling, which will allow you to be present and process emotions (both good and bad). Then, jot down five things you want (it can be anything, from finding love to exploring Europe). By writing your dreams down, you’re validating them. “A critical part of living a High 5 Life is giving yourself permission—permission to dream big and to want what seems impossible,” she explained.
For as long as I can remember, I’ve loved lists and found putting pen to paper cathartic, so “dreaming in the morning” was the easiest for me to adapt. When I added this last step to my morning routine, I noticed I was more grounded and had more clarity. Making note of my thoughts and feelings meant they weren’t nagging at and controlling me all day. Instead of being bogged down by negative thoughts, I created space for more positive beliefs, and seeing my desires written out made them more real and feel more attainable. I see you, Katherine. 

Final thoughts
At the end of my week trying the High 5 Morning, I’d give Robbins’ methods a 10/10 for boosting confidence and feeling more connected to myself. The multiple steps didn’t seem daunting, tedious, or silly once I realized I was investing in myself and my confidence. It all comes down to the relationship I have with myself and being my own biggest cheerleader. PSA: We shouldn’t wait to receive a promotion, fit in our favorite pair of jeans from high school, or finally get reciprocation from a longtime crush to feel more confident. We deserve to be happy now. The icing on the cake? The “High 5 Habit” tools are free and easy, which means anyone, anywhere, at any age can benefit from them (you bet I taught my 2-year-old nephew to high-five himself in the mirror). So go ahead and give your strong, confident, happy self a high-five to achieve the confidence you deserve.

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