The Journey to IOP: Exploring Acceptance and Change

Primary Therapist Amanda Countryman Strunin, PhD shares insight into the need for acceptance and change throughout life and recovery; particularly in the context of stepping down from a residential level of care to intensive outpatient programming. 

Amanda Strunin

I have worked at Oliver-Pyatt Centers for almost three years and have been blessed to work with a fantastic group of women and clients. One of the most challenging experiences I have witnessed for our clients is the transition from the residential level of care to intensive outpatient programming. Most often, women feel “discombobulated” as they navigate the step down and infamously, it has been compared to feeling like “a wedgie you just can’t pick.”

For all of us, change has many connotations, some pleasant and some quite unpleasant. As our women go through what looks like a relatively minor change on the surface, and what is in fact a vast change in their life and the context of treatment, my job is to help them find a balance of accepting their reality and changing what they can to improve their circumstance – essentially to pick the metaphorical wedgie. The concept of acceptance and change is one of the core dialectics in Marsha Linehan’s heralded and widely used dialectical behavior therapy. It is often explained as “The Purple Problem” – Imagine you hate the color purple and you buy a house that is purple. You must accept the color of the house, however despicable, before you can paint to suit your palate. Though I myself like the color purple, what we can infer from this valuable euphemism (for our clients and ourselves) is that life requires patience, willingness, and constantly being able to revise and change our status quo. Our patients encounter “the purple problem” in struggling with the delicate balance of accepting the changes that occur within their bodies, minds, and spirits during the process of recovery. It is our job to hold the hope that this acceptance can be achieved, that change is inevitable, and though frightening and painful at times, necessary for growth in life and recovery.

Perhaps watching my patients hold both truths – acceptance and change – as they reconnect with the world in intensive outpatient programming is one of the most rewarding aspects of my job. It also proves to me what we know from research and experience in our own lives, and that is we are resilient creatures.

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