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Kate
At the age of sixteen I was admitted
for the first time into a well-known, respected psychiatric hospital
in Dublin. This was the first of eight admissions to this hospital
over a five-year period. Of those eight admissions, two of them were
spent in the specialist Eating Disorder programme. The other six
were in various other wards in that psychiatric hospital without any
specialist treatment.
I was told that the average length of stay on the programme was
approximately 12 weeks. On both admissions, I spent a total of six
months in-patient. In fact, the only reason I was discharged the
first time I did the programme was because my VHI ran out (our health
plan only covers six months in-patient care per year). This was not
to be the last time this would happen.
The Eating Disorders team comprised one specialist nurse; the
consultant psychiatrist; the registrar and family therapist/social
worker. There were maybe two or three other people but I never spoke
to them and I don’t know who they were.
Your time on the ED programme was divided into three stages – your
transition from one stage to another based solely on weight gain /
weight loss.
During the first stage, I was weighed three times weekly. I wasn’t
allowed any phone calls and only allowed see my family at weekends.
I wasn’t allowed eat my meals in the dining room with the other
patients. Instead meals were severed at my bed with a nurse watching
over me. I had to finish everything on my plate.
I wasn’t allowed off the ward except to attend groups but I had to
be accompanied by a nurse or another patient who was in a higher
stage to me. On both admissions I spent six weeks on this stage.
In the second stage, I was weighed twice weekly and ate my meals in
the dining room. Again, I had to finish absolutely everything on my
plate. I had greater freedom of the hospital and I was allowed home
for one night at the weekend.
The third stage was similar to the second except I got an extra
night out at the weekend and I decided what I ate and how much I
ate. It was at this stage that the option of family therapy was
offered to me. We
attended two or three sessions but didn’t find it particularly
helpful. It often felt like the social worker was trying to find
somebody to blame for my eating disorder. It would have been more
helpful if the aim were to alleviate my family’s guilt instead of
increasing it. It was also very intimidating because the sessions
were always video taped and there was a one-way mirror with other
social workers (I think) observing behind it.
Throughout your stay, you had to keep your weight above a certain
level. If it dropped below this, you were put on bed-rest until your
gained enough weight. You couldn’t use the shower or toilet. No
visitors or phone calls. You were not allowed speak to any of the
other patients and you were only permitted to attend groups that
took place on the ward and you were brought to and from them in a
wheelchair.
There were groups during the week such as art therapy, cooking and
an education class. These all took place once weekly. We also had a
body image group. This involved walking up and down in front of a
huge mirror whilst wearing a swimming suit. Also, on admission, and
then again at discharge, you were videoed wearing a bikini, standing
in different positions and this was shown in a group. Afterwards you
discussed what you saw and the rest of the group gave feedback. I
always found both these exercises extremely humiliating and to this
day I still believe they were detrimental, not beneficial, to my
body image.
We saw the consultant psychiatrist twice a week, for approximately
five minutes each time. We also saw the registrar once a week, again
for about five minutes. That was all the psychotherapy I received
each week.
I have heard the director of this programme say publicly that he has
never used medication in the treatment of eating disorders but both
times I was on the programme I was prescribed antidepressants,
tranquillisers and sleeping tablets, as were some of the other
patients on the programme.
After discharge, you attended a weekly group meeting, where you were
also weighed. I never attended many of these groups as each time I
was discharged from hospital I immediately began to relapse again.
I cannot say my experience on this programme was a positive one.
Firstly, I feel that there was too much emphasis on weight. How can
a sufferer be expected to lose their dangerous obsession with weight
and numbers whilst being weighed up to three times weekly? A lot of
us ‘ate’ our way out of hospital, only to resume our old habits
again as soon as we left. There certainly wasn’t enough one-to-one
therapy. Three five-minute sessions a week with a psychiatrist is
inadequate. I also don’t remember the word recovery being used very
much. I honestly don’t know if the psychiatrists and other members
of the team believed in it themselves.
I completed the Eating Disorder in-patient programme twice. I was
told that is the maximum number of times you can do it. After that,
any time I needed to be re-admitted into the hospital, I was
admitted into the ‘regular’ wards. There, without the sufficient
time or resources available to deal with me correctly, my main
treatment was with medication and, during one admission, seven
sessions of electroconvulsive therapy – otherwise known as ECT or
electric shock treatment. It was when they realised that this
drastic course of treatment had done nothing to help my condition
that my parents sat down with the consultant, pleading with him for
help. All this expert could do was shake his head and shrug his
shoulders in bewilderment. I started attending another consultant in
the hospital, but unfortunately two years later, he would respond in
exactly the same way when he had also run out of ideas. Over the
space of five years, I found myself in hospital more than I was out
of it. I was placed in the locked, secure ward five times, on so
much medication that sometimes I found it difficult to stay awake or
even walk. At one stage I was swallowing 23 tablets every day.
During one admission, I spent three months in that ward, all the
time in my pyjamas, not allowed out of the unit. The last time I was
admitted there, I think the staff had given up on me, as this was
evident by their attitude towards me. All this could have been
avoided if there had been somebody with the time and the training to
just listen.
You may be forgiven if you have conjured up an image of a crazy
person after reading this. The truth is, there was absolutely no
reason for me to go through what I went through in that hospital. I
wasn’t insane, I just had a slightly insane way of coping with
things. In my last job, after hiring and firing three people in my
position because of their behaviour, my boss commented one day,
after a few months of me being there, how nice it was to be finally
working with “normal people”.
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