One hurdle that was difficult for me was understanding Behaviors (which are an abstraction used in both Erlang and Elixir). On the one hand, a Behavior is much like an class/object: it has public methods, internal state, polymorphism (via message passing) and to some extent a notion of inheritance. According to Alan Kay, it's more Object-Oriented than Smalltalk!
However, a Behavior runs in it's own process. Like a typical class, public and private functions are defined in the same file This makes reading the code where a Behavior is defined more difficult because the public methods are executing in the client process, but the callbacks (i.e. private functions) are executing in the Behavior's own process.
One insight I gained from working with Erlang was that the "academic" notion of OOP modeling (i.e. model the entities of your domain as discrete objects) works much better with Erlang's proceses/Behaviors than it ever did with classes/objects in languages like Java.
Objects in languages like Java, C#, Ruby, JS, etc. are much at modeling the architectural components of a system, than at actually modeling domain entities directly. That's actually partly why I really the Pony language: it combines both objects as processes (called Actors) and objects as components/capabilities (called Objects).