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Dr. Tim DiGiacomo Interviews MVTC Residents Living with OCD, Anxiety and OC-related Challenges

Posted on by Carl Lovejoy

In the words of rock and roll titan Alice Cooper, “School’s out for summer!”  Well, sorry, Alice, but it’s that time of year again, summer is in the rear view mirror and most adolescents are back in school.  Actually, most adolescents have been back in school for a couple of months now, and many have, once again, hit the proverbial “wall,” and are refusing to go to school.   

As children, when my siblings and I felt nervous or upset before school, our mom would just tell us “eat a banana and get on the bus.”  She was a nurse, so we trusted that this was a legitimate cure and eating this magical fruit would miraculously make everything right in the world.  And, while this is not an evidence-based first line treatment, it apparently worked for us and got us to school and her to work.

So, what happens when you need more than just bananas (or prunes, for that matter – another magical fruit so familiar to Mountain Valley alums) to respond differently to your OCD or anxiety, live your life more fully and unburdened, and get yourself to school?

Well, I’ve recently read some interesting and informative blogs and articles related to the start of school and OCD and anxiety. There is a great deal of good information out there from professionals related to evidence-based treatments, but I also thought it would be useful to include some thoughts from those living with OCD, anxiety, and OC-related challenges.  So, I sat down with several gracious Mountain Valley residents to get their thoughts…

Awareness and Insight

 I was curious about awareness and insight into OCD and school-related challenges, so when I asked how Tommy* became more aware that challenges started to increase for him, he noted, “when little things became big problems…I had always loved school but then I started to hate school and then I started to think ‘what’s the point?’”

This was the evolution of OCD and BDD-related challenges leading to depression-related challenges. This is what led to an increase in isolation and avoidance.  Tommy stated, “Just the thought of school was so distressing that I didn’t want to move.”  Having to avoid certain places and situations at school, due to the OCD-related stress, took a toll and despite his efforts, it was exhausting.  He was unable to consistently get to school and he fell farther and farther behind in school.

Similarly, Gina* noted that it’s important to remember that school is not just about academics, and that academics are not the only sign of difficulties.  She could keep up her grades fine for a time; however, prior to challenges with her grades, she noticed an increase in isolation and time trying to distract herself from distressing thoughts and situations, stating, “I didn’t want to spend time with my thoughts.”  She and her family began to notice a need for more help as she became more withdrawn and started avoiding school.  For Gina, as she returns to school, she plans to keep in mind that “it’s not just about academics,” but also overall health and living life in a meaningful and fulfilling way.

Reaching Out for Support

 Another important theme came out of these conversations; the importance of reaching out for support.  Both Tommy and Gina noted the importance of trusting others enough to share their challenges, but also noted that it was hard for them to understand their challenges enough to articulate them to others.  As such, it can be challenging for others to respond in a way that is helpful.  Sometimes, family, friends, and teachers will not understand what’s happening for someone living with OCD or anxiety and it’s challenging to talk about this.

Tommy noted that he didn’t feel shame in talking about his challenges, but also just did not know that he could talk with others about this, despite having loving and caring relationships.  Gina noted, “I didn’t want others to see how vulnerable I was, but I didn’t have the energy to cover it up either…so I just didn’t go to school.”  Both also noted that in the absence of sharing with others that it’s too easy to rationalize their challenges, minimize them, make excuses, or be overwhelmed with their obsessions and compulsions.  By bringing in others to the challenges, you’re able to get feedback and support.

 Get Creative with School and Treatment

 Tommy and Gina suggested using academic advisors, school counselors, family and friends for support and to tailor your OCD and anxiety treatment to school.  That is, to incorporate exposure therapy into your school day to address your OCD while still working on your academics and engaging in other school activities.  They suggested getting creative with school schedules, if possible, so that you’re able to attend school and achieve, while also still giving yourself time to recover and engage in treatment.  Gina noted that if you are really suffering and stuck, “It’s okay to sacrifice a semester or to take time out of school to get treatment.”  This, in reference to a more intensive level of treatment, more so than typical outpatient therapy.

You are More than your OCD

 A final overarching theme was to find ways to continuously challenge yourself to overcome your stuck points with OCD and also to continuously care for yourself.  It’s crucial to remember that you are more than your OCD and more than your OCD is allowing you to be during challenging times.  Living with OCD, anxiety and OC-related challenges is not easy and change can be difficult; however, you’ve got people like Tommy, Gina, and the staff at Mountain Valley to keep cheering you on.

  • Intrusive thoughts à distraction
  • Engaging in compulsions à distraction – can open you up to bullying and ridicule
  • Address the lack of understanding of OCD by educating school staff
  • Help your child find ways of explaining their OCD to their friends
  • Identify self-care to help your child continue attending school
  • Identify support people at school
  • Help your child understand their reasons for continuing to attend school and engage fully
  • Know that there will be ups and downs – some days are harder than others
  • It may be harder during the transition times and also when the work increases/becomes more challenging

*Names have been changed to protect confidentiality. Prior to MVTC, Tommy attended school and worked a part-time job on the docks.

*Names have been changed to protect confidentiality. Prior to MVTC, Gina attended school and worked a part-time job at a diner.

Dr. Timothy DiGiacomo, Mountain Valley’s Clinical Director, is a licensed clinical psychologist with comprehensive experience treating children, adolescents and adults with individual, group and family therapy, including utilizing CBT-based modalities for anxiety, depression and trauma. Tim has treated individuals with anxiety, depressed mood, motivational difficulties, stress-related problems, learning difficulties, and trauma.  Tim has completed the International OCD Foundation’s Advanced Behavior Therapy Training Institute (BTTI) and is trained in Trauma Focused Cognitive Behavioral Therapy, Child Parent Psychotherapy, and other evidence-based treatments.  He has a particular interest in family therapy.  Tim enjoys meeting clients where they are at and helping them to learn the tools that they need to resolve their difficulties.  Tim takes a strengths-based and supportive approach to empower families to make positive changes that work for their family’s needs.
Dr. DiGiacomo oversees, leads and guides the clinical program and strategic development of our clinical services.  This includes, but is not limited to, ensuring the incorporation of the latest in Evidence Based Practices (EBP) for the treatment of OCD and Anxiety Disorders, overseeing Performance Measures systems including Outcomes Monitoring, research, and screening approval for prospective clients.  He also serves as the “Clinical Face” of Mountain Valley externally.  This includes, but is not limited to, developing and delivering local, regional and national conference presentations, supporting clinical outreach activities, liaison with external organizations and entities to the benefit of Mountain Valley and in the overall treatment of OCD and Anxiety Disorders.
Dr. DiGiacomo provides on-site clinical supervision of staff and systems including directly supervising the Senior Clinician and at least one therapist for both administrative/performance and clinical supervision and providing clinical supervision for the Associate Clinical Director.  He actively engages in and supports the marketing communications initiatives and branding to include, but not be limited to, identifying national accreditation for the Residential Exposure Specialist training, supporting the digital marketing program, and publication of the work we do.
During his time at West Central Behavioral Health in Lebanon, NH, Dr. DiGiacomo worked as a clinician, psychological assessment coordinator, Team Leader, and Acting Director of the Child Team.  He served as a Clinical/Adjunct Assistant Professor of Psychiatry for the Geisel School of Medicine at Dartmouth College, providing therapy and assessment supervision, and teaching seminars for psychology interns and post-doctoral fellows.  He has taught courses on co-parenting and alternative dispute resolution for the State of New Hampshire for families going through divorce.  He has also served as adjunct faculty for New England College and Franklin Pierce University, teaching at both the undergraduate and graduate levels.  He served as a psychologist and consultant for the Plainfield, NH and Lebanon, NH school districts.  Tim has worked in research at Yale University, in clinical roles at VA Medical Centers, and in various mental health facilities.
Dr. DiGiacomo graduated from the Virginia Consortium Program in Clinical Psychology and completed his internship and post-doctoral fellowship at Dartmouth Medical School.  He earned his Master of Arts in Community and Clinical Psychology at Norfolk State University.  He completed his B.A. in psychology at Fairfield University.

 

 

 

 

 

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Don Vardell Writes about The Importance of Traditions at MVTC

Posted on by Carl Lovejoy

Having and maintaining traditions are important both for families and organizations.  They are a vehicle for supporting positive aspects of an organization’s culture, spotlighting what makes the group unique, and make for great stories. Some of my favorite traditions from my family and my previous work experience include:  the ugly Christmas sweater passed down to other family members, monthly ice cream socials, making holiday cookies with Grandma, dressing up like your therapist at Halloween.

The best traditions are those that are organic – those that come from the bottom up.  At Mountain Valley we are filled with fun, unique and resident-developed traditions.  Here are just a few with their reason/purpose:

  1. The “Elder Stick” – a walking stick adorned with holiday lights and sayings from past residents.  The most senior resident (by number of days at Mountain Valley) is handed down the stick the evening after a graduation.
  2. The “Auction” – the evening before a graduation, the resident graduating auctions off specific items collected while at Mountain Valley.  Things like specific clothing, books, or crafts made in the art module are examples of the most common items.  Other residents make their “case” for why they want the item and the soon-to-be graduate awards items based on the case made.
  3. Graduation Day Meal – the resident graduating picks the lunch meal that will be served to the whole community, family members and staff.  Classic meals include sweat potato gnocchi,  pasta bar, and make your own ramen bowl.  All flawlessly prepared by our Chef, Pete Bayless.  During the graduation ceremony, ice cream from the local dairy, McNamara Dairy, is served.  Who is hungry?

Again, all of these have been resident-driven.  These, in addition to so many other things about Mountain Valley’s model are what make our treatment program special.  While being clinically intensive, we also strive to make a resident and families’ experience memorable and effective.  What are the traditions within your family or workplace?  I’ll bet they don’t include an ‘Elder Stick.”

 

Don Vardell, Mountain Valley’s Executive Director, is seasoned healthcare administrator and operational leader with experience at the helms of private residential treatment centers, therapeutic boarding schools and non-profit service organizations.

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Erika Faust Returns as First MVTC Graduate to Join Staff

Posted on by Carl Lovejoy

Since Mountain Valley opened in 2011, we have looked forward to the day when we would invite a graduate to work on the staff. That day occurred last month, when Erika Faust was hired as our Program Outcomes Associate. Her thoughts on returning to MVTC are below.

I entered Mountain Valley in July of 2016 at 20 years old after realizing I needed a greater level of care in order to learn how to manage the anxiety I had struggled with my whole life. I wanted a fix for my anxiety, but learned that in order to get better, I had to radically accept my anxiety and learn to live with it in a healthy way. I learned that I would still experience anxiety and could use the skills I learned at Mountain Valley to return to college and live in accordance with my values and goals. Over the course of my final year at Villanova, I realized that I wanted to put my mathematical degree to use in the mental health field – and I fantasized about one day working for the place that made such a positive difference in my life.

Upon my graduation, Don Vardell provided me the incredible opportunity of becoming Mountain Valley’s first Program Outcomes Associate. In this role, I use my mathematics background to coordinate data collection and analysis. In addition, I also get to assess activity therapy modules to ensure they are meeting programmatic goals. With 19 years of equestrian experience, I especially enjoy joining the equine group, where I lead the activity occurring in conjunction with horseback riding and make suggestions for the equine program’s continual improvement.

As MVTC’s first alumnus to be hired to work on the staff, I hope to serve as a positive role model for current residents. Though I am working in Plainfield instead of Pike – the campus on which I spent my time at MVTC – the beautiful Mountain Valley culture remains the same. I thoroughly enjoy being back at Mountain Valley in this capacity and hope to play a role in keeping it the incredible place it is.

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MVTC’s Clinical Director, Dr. Tim DiGiacomo, asks, “How’s Your Moooooood?”

Posted on by Carl Lovejoy

An article in a recent edition of The New York Times would like readers to believe that animal-based therapy using cows is something new. Mountain Valley residents, however, would be quick to tell you that they have been exposed to these amazing creatures for years. Cow cuddling, as the practice is called, invites interaction with the farm animals via brushing, petting or heartfelt chats. Our current favorite cow, Zeke, isn’t actually a cow, he’s a steer, and he possesses the same traits that make for an excellent therapist – he’s calm, accommodating of a range of personalities, and has the patience to listen to endless problems without so much as a judgmental moo.

MVTC’s Clinical Director, Tim DiGiacomo, a long-time advocate of cow cuddling, shares his light-hearted thoughts on animal-based therapy here in Plainfield.

How’s Your Moooood? *

*Disclaimer: This blog post comes to you complete with incredibly well-thought-out animal puns and jokes.

I’ve felt a bit sheepish (I warned you) about writing this blog but I wanted to get the message out.  Mountain Valley is not your typical residential treatment center for anxiety and OCD.  Sure, we use empirically supported treatments for anxiety and OCD including CBT, ERP, DBT, and ACT.  We also provide therapeutic activities fostering exposure to, appreciation of, and interaction with the outdoors and of course…our fantastic animals.  Our residents say that it is these therapeutic activities and the animals specifically that help to rejuvenate and provide moments of joy, humor, and connection, especially during challenging times.  For many residents, it is the animals that help them get unstuck, re-energized, and back to working so hard towards their goals.

MV is a place where chickens, sheep, horses and a steer roam…no buffalo yet.  It’s a place where you can feel herd, understood, and supported while engaging in the challenging work to address your anxiety and OCD and to learn to reduce symptoms, live your life in the present moment and to move towards your values and goals.  For many at MV, the animals on campus help to reduce stress, provide a reason to get outside, and provide a sense of commitment, responsibility, and a desire to care for the animals.  There’s not a day that goes by that residents aren’t talking to or cuddling with the sheep and hens.  It can really make someone’s day when Gandalf, and the other ladies run up to them in between activities or on their way to a therapy session.  And then there’s Zeke…a behemoth of affection.  I’m not sure if he realizes that he’s a steer or knows his size, especially when he trots over to you for a pet.  In a recent survey, Zeke was voted the most favorite MV animal and beat out the udders by a whole 2 percent! (Wow, that was a stretch!)   And, thanks to the excellent equine work being done at Willow Brook Farm, Froggy, Leo, Cesar, and Shenanigans are always ready for a pat down or a trot too.  Nothing like a 2000-pound horse to provide a few lessons on anxiety as well as confidence for you.

In all seriousness though, the presence of and work with the animals at MV has a very significant effect on the well-being of those who live here.  For those struggling with contamination-related challenges, they can offer an opportunity for exposure.  For those wanting to learn to be more present and mindful, the animals offer a source of comfort and a refocusing of attention.  For those trying to use the animals to avoid feelings or exposures…the animals tell them to get back to work, don’t avoid but rather engage, and that they’ll be around to hang out later.

So, while the backbone of MV is evidence-based practice, I’d have to say that the heart is the animals, the residents, and those who work here.  Please feel free to reach out to us to learn more about Mountain Valley, or check out The New York Times Magazine article featuring the work of the residents at Mountain Valley.

Written with assistance from MV’s Canine Crew – Luna, Betty, and Hopa

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How to Walk the Line Between Support and Tough Love as your Child Enters His or Her First Year of College

Posted on by Carl Lovejoy

This month’s guest blogger is Talia Rosen, a student at Barnard College and a good friend of Mountain Valley. As she prepares for her second year of college, Talia offers an interesting perspective on how parents can support their children as they begin their college experience.

It is not surprising that going to college for the first time is an incredibly stressful experience for many teens. As someone who recently completed their freshman year, I can attest to this. So many vital aspects of a teen’s life are changing or shifting during this time: where they live, with whom they “hang,” what they do with free time, and how they manage their responsibilities.

School guidance counselors and college admissions officers encourage students to get help if they are feeling anxious about the transition and provide helpful tips and tricks to manage the fear and uncertainty of this major change in one’s life. Unfortunately, not many people seem to consider the feelings of these teens’ parents.

I know that this process wasn’t much easier for my parents than it was for me. I’m here to tell you that it’s okay to be unsure or confused. I’m here to help you find the balance between support and tough love as your child enters his or her first year of college.

The first thing you should know as your child’s first year of college approaches is that it is okay for you to be scared. Perhaps more importantly, it is okay to let people know that you are scared. Change is unsettling, and transition can be scary. Watching your child leave home for the first time is difficult. These are completely natural emotions and, as you express how you are feeling, your child will begin to feel more comfortable speaking up about their own fears and feelings about going to college.

While trying to hide negative emotions from your child, you may be sending the message that it is not okay or normal to be feeling afraid of this next step. Open and honest communication allows both you and your child to know that these feelings are valid and that neither of you are in this alone.

My next piece of advice is to truly listen to your child. This is essential in remaining supportive, even while handing out some healthy doses of tough love. I will be the first to admit that teenagers are often complicated and difficult to understand. Sometimes, on the other hand, we say exactly what we mean.

If your child tells you that he or she must have their dorm room microwave completely set-up before you depart for home, it is important to take a minute to understand what your child is asking for and support their journey as best you can. Something as small as fixing a microwave can help your child feel more in control of this new situation and ease the transition immensely. This will be a year of challenges, growth, and lessons in independence for your child. As such, easing the transition into this new phase of life is not “enabling” or “coddling.” You are simply helping your child acquire all the tools they might need in order to face the twisting road ahead.

Now, in all honesty, I cannot claim to fully understand how it feels to watch your child go off to their first year of college. I am a 19-year-old student whose only experience with parenting is getting paid $15 to take care of my little sister when my parents couldn’t find a babysitter. On the other hand, I watched my own mother go through this process just a year ago, and we’ve each learned a lot from journeying over this rocky terrain together.  The most important advice I can give to both you and your child is to work as a team. When things are going wrong or become overwhelming, remember that you two are in this together, and you can make it through this together.

I will leave you with one final message: it is okay if things don’t go according to plan. Going to college for the first time is not an easy or simple task, and sometimes things change or shift in the turbulence of this process. Hang on to each other and remember that you are both doing the best that you can. Keep in mind, sometimes the winding path is so much more fun than the straight one!

 

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ERP or ACT/ERP: When to do what?

Posted on by Carl Lovejoy

Timothy DiGiacomo, Psy.D., Clinical Director, Mountain Valley Treatment Center

Recent research (Twohig, M., and Abramowitz, J., 2017), has demonstrated that both Exposure Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT) plus ERP with adults is effective for symptom reduction and maintenance of gains at one and three-month follow-ups post treatment. 

Traditional ERP consists of habituation-based and inhibitory learning-based ERP models while ACT/ERP is based on relational-frame theory incorporating mindfulness, flexibility, values, acceptance and behavioral change.  Despite the data from the aforementioned research, clinicians are still faced with the challenge of determining which clients may benefit from traditional ERP versus an ACT-based exposure approach.

I recently had the opportunity to present on this topic, along with Drs. Patricia “Dr. Z” Zurita-Ona, and Dustin Siegel, at the 2019 Conference for the Anxiety and Depression Association of America in Chicago.  We described our methods for choosing which approach to take with clients and how our programs utilized both ERP and ACT/ERP.  Despite the differing theoretical underpinnings and explanations for change, we all agreed that our focus remains on helping clients to achieve changes in their relationship with feared situations and overall improvements in functioning.

We discussed one client whose movement through therapeutic approaches involved beginning with traditional ERP, which initially led to good results and improved functioning, but then was complicated by ongoing intrusive obsessional thinking, significant difficulties accepting uncertainty, existential concerns, and symptoms of depression.  Despite good adherence to facilitation of the traditional ERP model and working with a very competent therapist, traditional ERP was no longer appearing to be beneficial and the client was not making the changes that they desired. 

At this point in treatment, the client began working with Mountain Valley Treatment Center.  Not only was Mountain Valley a higher level of care, it was able to offer a different approach by incorporating elements of ACT into the exposure therapy.  At Mountain Valley, we teach our residents about both traditional ERP as well as ACT with ERP. 

As such, and with the assistance of staff, clients are able to move towards and utilize the approach that they find most appealing.  This client found the inclusion of ACT to be both challenging and beneficial.  Learning to engage in mindfulness; working towards identifying rigidity and fusion to thoughts; engaging in a process of learning to become more flexible and to practice defusion; to know that they were not their thoughts but to rather have distance between their thoughts; and being able to identify their values and then to take action that moved them towards a more values-based life was an eye-opening experience for this client. 

This was also very different than being driven solely by OCD, anxiety, and overwhelming negative thinking.  Inclusion of ACT for this client also led to more meaning and understanding for engagement in exposures and helped this client to be more ready and willing to engage in the difficult exposure work.

Mountain Valley found it useful to understand this client’s treatment history, and response to treatment, in deciding to incorporate ACT into the exposure work or to continue with a more traditional ERP model.  Drs. Z and Siegel also echoed this sentiment as important in understanding which approach to utilize.  In addition to accounting for past responses to treatment, we also discussed taking into account readiness to engage in ERP; the types of presenting problems; current willingness/readiness to potentially experience discomfort by engaging in exposures; the presence of comorbid disorders/problems; inconsistencies between exposures and a client’s values; client engagement in exposures as part of the compulsion; and client engagement in mental rituals. 

It was exciting to be a part of this discussion and I found it encouraging to share and hear from other clinicians.  If you’d like to keep the conversation going, or to learn more about Mountain Valley’s approach to treatment, please reach out and check out Mountain Valley.

To learn more about the excellent work being done by Drs. Z and Siegel:

Dr. Patricia Zurita-Ona: https://eastbaybehaviortherapycenter.com/

Dr. Dustin Siegel: https://anxietytreatmentcenter.com/

To learn more about ACT and ERP, check out the following sites:

ACT: https://contextualscience.org/

Exposure Therapy:  https://adaa.org/finding-help/treatment/therapy

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Phoebe Manchester on turning mistakes into wins.

Posted on by Carl Lovejoy

Phoebe Manchester, M.S., one of Mountain Valley’s talented therapists, has an extensive background in athletics – as a player, coach and administrator. A member of Dartmouth College’s Women’s Hockey Team in the mid-1990s, she went on to be the head coach of two NCAA hockey programs before becoming the Director of Facilities Operations for the Pittsburgh Penguins’ training facility. Since then, she has, among other things, coached at various USA Hockey levels and officiates youth, high school and prep school games.

In the wake of the many articles posted recently about how high-profile college and professional athletes deal with anxiety and perfectionism, we asked Phoebe to reflect on her experiences working with anxious athletes.

Many of the Mountain Valley residents with whom I work are perfectionists, and have a lot in common with many of the athletes with whom I worked both in college and in the National Hockey League. One of the comparisons that I made as a coach that is also appropriate for many of my residents is this:

The best players in the game have worked their entire lives, and continue to practice day in and day out, and get paid millions of dollars to be the best at what they do…and they still make mistakes. Why? Because hockey, like life, is a game of mistakes. The true value of a player is not judged by how many mistakes they make, but by how they respond to those mistakes. A player could make a silly mistake and give the puck away, but if they work hard to win it back – it is no longer a mistake – it just becomes part of the game.  In response, the player gets to demonstrate their work ethic and tenacity and, perhaps, make something even better out of what could have been considered a mistake. If that player had given up after losing the puck, then it would have only been a mistake. The same is true for life: if we quit when we make a mistake, there is no chance to show our grit and determination, just a chance to make a mistake.

A player with whom I once worked was an NCAA Division 1 caliber player in practice, but as soon as a game started, she seemingly disappeared, unable to compete due to her overwhelming anxiety. I wish MVTC existed at that time – she would have been perfect for our program! Anxiety can render even the most skilled players essentially powerless. The more anxious they become, the less they are able to access their skills. Anxiety is a second “opponent” that talented, albeit anxious players have to overcome.

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Guest Blogger, Dr. Lisa Rosen, Mountain Valley’s Newly Appointed Parent Support Advisor

Posted on by Carl Lovejoy

We asked Dr. Lisa Rosen, MVTC’s recently appointed Parent Support Advisor, to share some thoughts on her own family’s Mountain Valley experience. As both a parent of a former Mountain Valley resident and a clinical professional who has worked with adolescents for more than 20 years, Dr. Rosen is uniquely qualified to serve in her new role. Her responsibility is to offer support and guidance to parents at three very critical stages of their Mountain Valley journey – prior to enrollment, while their child is at MVTC and after graduation. By working closely with the clinical team, Dr. Rosen offers an additional layer of support to parents throughout their child’s MVTC experience – listening to their concerns, helping them overcome their fears, and assuaging any doubts they might have.

We thank Dr. Rosen for sharing her thoughts!

My youngest daughter has battled anxiety, OCD, panic disorder, school avoidance and depression since she was 13 years old.  She has been in and out of public school, private school, homeschooling and one on one schooling off and on until the beginning of 10th grade when she felt she had no more fight left in her.  She had been in every form of therapy available and known to be successful with these mental health issues.  She was on nine different classes of psychotropic medications.  She was so tired of fighting her own brain, and our family felt her pain and suffering so acutely, it was hard for any of us to function well.

We had heard of Mountain Valley Treatment Program from a friend whose son had graduated months earlier.  Over an emotional Labor Day weekend, we made our first contact with the incredible team at Mountain Valley.  On a Sunday afternoon, Jennifer Fullerton spent hours listening to our story,  comforting us and guiding us with knowledge and kindness.  For years we had felt our story was met with questions and concern.  On that Sunday, our story was familiar, one MV had heard over and over, one that the team at Mountain Valley heard and responded to with knowledge, guidance, expertise and empathy.  The confidence I heard in the voices of the team there – that they could help our daughter and our family and that we were making the bravest and wisest decision – left me speechless.  We were finally hopeful.

The next 76 days for our daughter were filled with tears and tremendous challenges and also triumphs and incredible pride in the hurdles she was able to overcome using the skills and strategies she was taught at MV.  She also graduated having made connections to an incredible team of support and friendships that she values and accesses daily.  For our family, we feel we have literally pressed a reset button and have begun to travel a new path filled with hope and confidence that while our daughter will always have an anxious brain, she and we all now have the tools, the team and the confidence that we need to ’sit with it’ – to survive and thrive.

Since her stay at MV, our daughter has successfully transitioned back to school.  She is planning to travel on a summer program to Australia – a trip that we would never have had the confidence she could manage before.  Our family will be forever grateful to MV.

My experiences with the MV team before my daughter arrived, while she was there, and after she has left, have motivated me to want to be a voice of support for new families beginning this very emotionally challenging process. I, of course, know firsthand what can go on in a parent’s mind while their child is away.  I know the struggles and the fears, and feel very strongly that I can help parents navigate these emotional hurdles and ease the fears given both my clinical background and my personal journey.  I am so thrilled to be joining this amazing team, and look forward to working alongside the MV staff for many years to come.

 

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Blogger of the Week – Liz Edwards – Improv for Anxiety

Posted on by Carl Lovejoy

This week’s blogger is Liz Edwards, MVTC’s Director of Clinical and Community Outreach for greater New York City.  Liz, a Licensed Creative Arts Therapist and Registered Drama Therapist, provides connection and maintains relationships between MVTC and Manhattan and its surrounding communities, and includes the families, educators and mental health professionals who help support our mission.

 

When I was living in Los Angeles as an actor, I signed myself up for an improv class at Upright Citizens Brigade. As a Musical Theater major in college, I had exposure to improv in the form of warm-up games, but less exposure to longer form improvisation. Naturally, I was terrified. The day of the first class came around, and instead of showing up enthusiastically, I spent a good 10 minutes sitting in my car convincing myself I should go. I was so nervous that I wouldn’t be funny enough, or smart enough, or that I would be judged harshly by others. I’m so happy to report that the experience was the direct opposite of what I feared.

After speaking with Becca Barish, LCSW, the Head of the Wellness Program at Second City in Chicago, I realized that I’m not the only one to feel the anticipatory anxiety, and then a release after participating in improvisation. Becca runs the Improvisation for Anxiety classes at Second City, which falls under the Wellness Program, which also incorporates yoga into their programming. This unique class offers improvisation sessions for adolescents ages 13 to 18 over the course of eight weeks, with one week including their parents at the culmination of the course. A two-hour class includes improvisation with a Second City instructor for the first hour, and then a clinician coming in to take over, offering a CBT-oriented session for the second. Barish shared that she often sees a significant shift in participants over the time they spend in the class. She stated participants often “surprise themselves” with what they can do spontaneously in their last few class sessions.

So why would anyone subject themselves to this kind of an exercise? After all, it is incredibly anxiety-producing, even for professionally trained actors and actresses to get on stage and improvise without a script. Barish shared that there are so many aspects of improvisation that help abate symptoms of Anxiety Disorders, even though it might seem counterintuitive at first. Barish shared that the best part of the class is to see participants relating to each other and breaking down barriers that their disorder may have put up for themselves to avoid their symptoms. When given a playful and most importantly, fun outlet, participants are able to feel that they can relate their experiences to others, particularly those that they may not have known shared their symptoms otherwise. As Barish says, it can be “humanizing to connect with others who make you feel like you aren’t alone,” and may create more ability for interpersonal connection within a disorder that can often be isolating.

In addition to breaking down barriers, improvisation can make treatment for anxiety disorders more fun. The leading forms of treatment for anxiety are Cognitive Behavioral Therapy and Exposure and Response Prevention Therapy, both primary forms of treatment practiced at Mountain Valley. At times, it can be difficult, particularly for teens, to feel motivated to take part in activities that incite anxiety, despite that being the best method to treat it. Through playful games, exercises and improvised role play, participants are not only able to feel more inspired and motivated, but are able to access a more childlike part of themselves. As Barish says, “Exposures are a drag, it’s better for teens to feel like they are playing.” One of the core rules for improvisation is to say “yes, and” to the partners with which one is sharing the stage. This creates an environment where one can never be rejected, and is given unconditional positive regard, which allows the freedom to play. When participants feel safe and trusting of the environment, it sets the stage for more authenticity: something you may be hard-pressed to find in a high school hallway or cafeteria.

Another core principle within improvisation is that the participant does their best not to think too much about what they are doing or saying, but rather to follow their first instincts. Barish noted that this aspect is also helpful to those who suffer from anxiety disorders, as they don’t have as much time to ruminate or obsess over whatever they are going to do or say, but rather they are present in the current moment. Doing versus thinking is a great way to be prepared for real-life situations, where you may have to act spontaneously and make decisions without much time to consider options. These are situations that could produce anxiety for those who suffer from the disorder, but through improvisation, Barish has seen participants grow more confident in being grounded. They are better able to take risks, to tell a joke on the spot, or to lead the group in a warm up—something they previously would not have believed they were able to do.

Ultimately, Barish doesn’t pretend that improvisation is a “cure” for anxiety. She shared that many participants in her class might say things like “I just want it [my anxiety] to go away…” We know from our work at Mountain Valley that there isn’t a magic pill to make anxiety cease to exist for a person, but the more one is able to manage their symptoms and believe that they are more capable than they realize, they have more power over the disorder. And why not receive applause for your work in the meantime?

To learn more about the courses offered for kids and teens at Second City in Chicago, visit their site: https://www.secondcity.com/chicago/find-a-class/lets-get-started/

 

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Former Resident Writes Grateful Email to MVTC Community

Posted on by Carl Lovejoy

Mountain Valley frequently receives cards and emails from former residents and their parents.  Yesterday’s email from a graduate was truly special, and with his permission, is copied below for all to enjoy.

Dear Carl (and all of MVTC),

In just a few weeks, I will be coming up on my anniversary of being admitted to Mountain Valley. This got me thinking and it made me want to write you all a letter just expressing how grateful I am for all of you who helped me take my life back.

Going to Mountain Valley and the work that I did at Mountain Valley was some of the most challenging work that I have ever done. At times it was painful. If it weren’t for Bryan, the therapists, and especially the residential staff I have no idea how I would have made it. But you all helped me through some of the toughest moments of my life. I am extremely grateful for that. Thank you.

After graduating Mountain Valley in July, I joined a gym in my town, which was a surprise to my whole family as I would have never gone to the gym in fear that I might see someone I knew. I got my drivers license! I also returned to Marvelwood, and all of my teachers kept on saying “The old (before panic attack) Lee was back.” I returned to being a tour guide, a RA in the dorm, and was voted Junior Class President! I also have made the high honor roll for my Fall and Winter term. I have even become apart of a management team for a program at the American Red Cross, which I couldn’t have done last year because of my panic. It was thanks to all of you and the work that Mountain Valley enabled me to do that made all of this possible.

Right now I am looking at colleges and what I want to do with the rest of my life. I have been looking in to Psychology programs at different schools up in Boston and NYC. I want to try to give help to people like me who suffer from anxiety and depression.

I hope I get to come see Mountain Valley (and the new campus) soon!

Again, thank you so much for all you have done for my family and me.

Lee

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