10 IOP Activities That Painfully Healed Me


I was in a depression, anxiety and trauma intensive outpatient program (IOP). I still have a hard time saying it. I still can’t believe I am “one of those people” who needed the extra support. I loathed every minute, but it saved me. Here are 10 activities that made my IOP painfully healing. If your therapist is suggesting it, go for it. It might change your life.

10. Showing up. Showing up on my good days was hard and on my bad days even harder. It meant being honest about how depression and anxiety were affecting me. It meant if I hadn’t eaten normally or slept too much in the last 12 hours away from them they would ask why. I didn’t want to answer the whys so they held me accountable. Showing up was painful, physically and emotionally, but it taught me how to take care of myself outside of that room.

9. Processing time. Each afternoon started with a group processing. We all said how we were doing overall, then could choose if we wanted to process something. During this processing, the therapist would turn each situation into something the group could benefit from. Strategies on how to get out of bed to talking about boundaries. Processing time was healing because I didn’t feel alone, and painful because I had to be vulnerable. Processing time included days when I had to leave the room because I couldn’t handle it. It included many tears. It included laughter. It meant I had to learn how to trust and be vulnerable again.

8. Snack time. My least favorite time. We would sit around a table and eat a healthy snack. We learned to eat to feel good, learned that food affects us on every level. It was healing because I lost my preconceived ideas about dieting, and painful because my social anxiety and introverted-ness frequently got in the way of connection.

7. Pleasure building. My second least favorite time. (Also needs a new name…) We played games. Charades. Telepictionary. Spoons. We learned how to laugh at ourselves and each other.  We learned to make mistakes and be OK with it. We learned to take risks. It was painfully healing for my perfectionist side and also healing to notice how to create fun, positive relationships again with people who knew a whole lot about me.

6. Movement. Once a week we would do yoga or something movement-related with a specialist. Here I learned yoga could change my life. I learned the emotional freedom technique (EFT) and practiced it with her individually. I worked through a trauma by using EFT. I started doing yoga outside of the IOP. I found a yoga community and now some of my closest friends. I found connection with my body that I had been removed from for my 30 years here in this world. So many tears. So many panic attacks. I do believe trauma is stored in the body, and through movement we can heal. Check out “The Body Keeps the Score” by Bessel van der Kolk.

5. Sensorimotor therapy. A body-centered therapy. If during processing time I felt the fight-or-flight urge, I would tighten and relax my legs to move the energy through my body. If I felt like I wanted to hit something, I would push myself off a wall like a wall push-up. It taught me to follow my body’s urges when I’m feeling anxious and to not follow them when I’m feeling depressed. Sensorimotor therapy was exhausting and would lead to panic attacks, but it was also healing.

4. Spirituality. Connecting to something greater than myself. The Universe, God, Allah, whoever or whatever that is. We talked about creating a safe place, taking time to be still and what it looks like to trust myself and others. This group helped me learn how to feel calm. How to trust my gut. How to listen to that small voice that usually knows what is right and how to find hope.

3. Resources. I learned how to resource. I learned there are many things to do once I understood where I was in my “Window of Tolerance.” Through learning how to be mindful I could notice if I was hypo or hyper aroused. When I’m able to notice if I’m one or the other I know how to “resource” myself up or down. In the beginning I didn’t know what it all meant. I knew hypo was when I felt numb and hyper was when I felt like a panic attack was coming. It was painful to decide which resources I needed and when. I didn’t trust myself. I now know watching movies will keep me hypo aroused and a yoga sculpt class will make me more hyper aroused. The many resources I have learned and tried have significantly changed my life, but it was also and still is a painful process. I don’t want to have to think about these things. I don’t want to figure out what resource I need to use to stop feeling numb or how to calm myself down if I’m on edge. I don’t want to have to do this, and yet I know to be healthy I need to consistently think about these things.

2. Skill building. We had a skill building session once a week. Skills ranged from defeating cognitive distortions to practicing boundaries. At the time, I thought these were ridiculous. I already knew the logical aspects of it all. I’m a health teacher. I teach these things. Looking back, I didn’t know how to use these skills. When we were talking about boundaries we created forts for ourselves in the room. I remember answering that I was bored when she asked how I was feeling. Looking back I probably was, but I was also processing it on an unconscious level. Now, whenever I feel like a boundary might be crossed, I imagine myself in my fort, what adjustments I need to make and what I’m willing to take in and leave out.

1. I think the most important activity I did during this time was to trust the therapists. I learned to trust that they were on my side. I learned to trust that they needed to know where I was at emotionally but the group didn’t need to know the specifics. I learned how to feel safe in a space again. I learned how to keep myself safe. I learned that the learning is never over and depression and anxiety management will be a part of my life for the long-run. Because of this IOP, managing it all doesn’t seem hopeless every day. I see hope again. I experience joy again. I still have bad days. I still have panic attacks and nights I don’t want to remember, but because of the IOP I can keep facing each day knowing I have the therapist team behind me along with the others in the “real world” I have let in because of them.

This intensive outpatient program made me practice skills I needed to learn to find wellness and wholeness. I’m still on the search, and I’m still in therapy twice a week almost two years later, but the power I have found from this program is beyond words. Research different programs. If one doesn’t feel right it probably isn’t. Try another. There are many ways to do these programs, and this one way changed my life.

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Photo by Alex Jones, via Unsplash


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