Eleven years ago this week, I was admitted to an eating disorder hospital for my third inpatient admission. I had become what you would call a revolving door patient. So why would this eating disorder inpatient admission be any different? It very nearly wasn’t. Rather than helping me to progress towards eating disorder recovery, the unit I was admitted to pushed me to the brink of suicide.
With it being the anniversary of my eating disorder inpatient admission to this unit, I wanted to reflect on this experience. From the treatment (or lack of), the regime, the staff mentality – it beggars belief that the approach of this unit was deemed appropriate. So here are my thoughts. And I hope that in sharing these, it will help raise awareness and improve understanding of eating disorders so that no one experiences an admission like I did.
The Eating Disorder Inpatient Regime
Where do I start? In summary, within a day of being admitted, I was sectioned, put on nil by mouth, total bed rest, and a one to one. Regarding the nil by mouth, basically I had a NG tube inserted and everything went through the tube. I wasn’t given any choice in this. Once they had decided that I was on nil by mouth, I wasn’t given the opportunity to eat any food or drink any liquid. I wasn’t even allowed to drink water. Literally everything went through the tube, even my medication. And they wouldn’t tell me what medication they were giving me either.
The nil by mouth regime continued for a period of three weeks. After the three weeks, I was then allowed to have three cups of water a day and take my own medication orally. My ‘food’ still went through the tube and I was not offered the opportunity to attempt to eat anything. The ‘food’ I was given through the tube was a liquid supplement that was in a bag and attached to stand. I had this stand next to my bed and the liquid would just trickle down the tube, up my nose and into my stomach. It was continuous so for 24 hours a day, I could sit and watch this supplement enter my body. Not particularly helpful for someone with an eating disorder who is terrified of food and calories. Just sitting and watching this going into me. This regime continued for a period of three months.
1. Bed rest
I could understand the need for rest as I was very unwell and my physical state was not good. However, the way the unit enforced the bed rest felt extreme and excessive. For the first three weeks, I was not allowed to move from my bed. If I needed the toilet, my one to one would bring a commode to my bed and I would get off the bed and instantly be made to sit down on the commode. After the first three weeks, I was allowed to use a normal toilet but I was made to be taken to the toilet in a wheelchair. My one to one would wheel me to the toilet, stand in the bathroom while I did my business, and then wheel me back to my bed. It was degrading.
I developed bed sores because of the pressure on my bottom from sitting down all of the time. My mum asked if they could provide me with a cushion to sit on to relieve some of the pressure but this was not provided. I would try sometimes to roll from side to side to help ease the pressure but I was told by my one to one that this sort of movement was not allowed. I wasn’t even allowed to sit on my bed with legs down over the side of the bed, like you would be sat if you were sitting on a chair. If I did this, the staff would push my legs up back onto my bed and put the barriers up on the side of the bed. I felt like I was being locked into this bed like a caged animal.
The staff had to inject me every day with blood thinning medication. This was to prevent blood clots developing as result of my immobility. I fail to see how this kind of regime is necessary, or meant to facilitate recovery from an eating disorder.
2. Showers and washing
One of the most inhumane elements of my eating disorder inpatient admission to this unit was that I was not allowed to have a shower. There were seats in the showers, so I could have potentially had a seated shower if they were concerned that I would not be sitting down whilst in the shower. But having a shower was denied. I was desperate to have shower and I just wanted water to wash over my body. I didn’t just feel dirty on the outside, but I also felt dirty on the inside. On a daily basis I would beg the staff to be allowed to have a shower. But I was always told I was not allowed.
I didn’t even wash at all for two weeks. I just sat on that bed basically rotting, both physically and mentally. It wasn’t until my mum complained about the lack of hygiene I was being provided with, that the staff started to bring a bucket of soap and water to my bed on a daily basis so that I could give myself some sort of wash. Likewise, I was not provided with clean bedding for two weeks. It took my mum to complain about this before they decided I could sit on clean bedding.
I was allowed my first seated shower after two months. Two months of not having a proper wash. Two months without washing my hair. It had been awful. I can remember that first shower, with the water running over my body and rubbing the shampoo into my grease filled hair. It made such a difference to just be clean. I was then allowed a seated shower twice a week. I really do not understand how denying someone the right to have a shower is meant to help them recover from an eating disorder. It just does not make sense to me.
Staff Mentality During My Eating Disorder Inpatient Admission
During this eating disorder inpatient admission, staff treated me as if I had chosen to develop an eating disorder. Their approach was one of punishment and that people with eating disorders are bad and are deliberately choosing to behave as they do.
My parents queried the regime (described above) as they could not see how it would help me, or anyone else. My parent’s could see that my mental state was deteriorating and that I was becoming helpless and suicidal. The response to my parent’s was “people with anorexia are deviant and manipulative and need to be treated in this way in order to fix them.” For anybody to have this belief about people with anorexia demonstrates such a lack of understanding, but for the health care professionals who are meant to be helping these sufferers to have this approach? Well, it is down-right disgusting.
People who suffer from anorexia, or any other type of eating disorder, have an illness. Illness is not choice. In the same way that people don’t chose to have diabetes, or cancer, or heart disease. And to define people with anorexia as deviant and manipulative is dreadful.
Secondly, the philosophy of ‘treating’ people on an eating disorder inpatient admission on a reward and punishment basis is barbaric. When I would beg the staff to be allowed a shower, do you know what their response was?
“Showers are a reward and a privilege that has to be earnt through good behaviour and compliance.”
Sorry – what?!!! To me, being allowed to clean yourself and have a shower is basic human right. It is not a prize for good behaviour. I wasn’t even ‘misbehaving’ anyway, I was lying in bed all day being fed and watered through a tube! If they were treating someone with a physical illness, I am sure that they would not have this same approach.
Another example of the terrible attitude of the staff is when I slept with my TV on. Being an inpatient in an eating disorder unit can be a very lonely experience. I felt incredibly lonely and scared al of the time and I liked to sleep with my TV on. It helped to ease my anxiety and was a source of comfort. However, there were occasions in the middle of the night when the staff would switch my TV off. I would tell them that I couldn’t sleep without my TV on and they would say to me that:
“when you are an adult going out to work, you can’t just lie in bed all day watching TV.”
Again, this suggests that they thought it was my choice to be unwell. That I was simply choosing to lie there all day just watching the TV. I was clearly just being lazy and needed to get a full time job (I’m sure you see my sarcasm here). They seemed to have forgotten that I was sectioned and on enforced bed rest with nothing but a TV for company.
To be exposed to such attitudes and beliefs on a daily, hourly, minute by minute basis is incredibly upsetting, distressing and soul destroying. But in their eyes, this was the right way for them to treat someone like me. This was how they would ‘fix me’. Unbelievable.
The treatment I received during this eating disorder inpatient admission was no better than the regime or attitude of the staff. Basically, I didn’t receive any treatment, other than being fed and medicated. The ‘treatment’ was to make me gain weight. There was no therapy, no psychological input, no opportunity to talk to staff about my fears, anxieties and thoughts. Maybe they thought that weight gain alone would ‘fix me’. They could not be further from the truth. By focusing soley on weight gain, it highlights again how they did not recognise anorexia as a mental illness. Eating disorders are an illness of the mind that has the physical symptom of weight loss. Unless you address the underlying issues, simply making people gain weight is like putting a plaster over a gaping wound.
For the three months that I was there, I was also kept in isolation in my bedroom. I wasn’t allowed to see or speak to other patients. I could not leave my room and they could not come in. My only company was my one to one (who wasn’t really any company at all), my parents when they visited, and my TV.
There was the odd occasion when the unit was short staffed and unable to provide a sufficient number of one to one’s for all the patient’s needing one. On those occasions, myself and all the other patients on a one to one were made to sit in the communal lounge so that one member of staff could watch over all of us. Sat in there like animals in a zoo. Obviously it was convenient for the unit for me not to be isolated on those occasions. But the rest of the time I couldn’t possible be allowed out of my room or in contact with other people.
The three months that I spent in that eating disorder unit were some of the worst of my life. Thankfully, after three months, my parents were able to get me transferred to a different eating disorder unit where the treatment was much more beneficial. I am not sure I would ever have survived if I had to stay in that unit. It was not going to help me recover and God knows what would have happened to me once discharged. I was very fortunate to be transferred.
I hope that in sharing this, it will help raise awareness of some of the unhelpful treatment approaches experienced by eating disorder inpatients. In doing so, hopefully it will help change discriminatory attitudes and prevent other sufferers experiencing what I did. My experience still haunts me to this day. And it is haunting to think that regimes like the above could still be in practice. This is why I deliver talks to nursing, medical and healthcare students about eating disorders and my inpatient experiences. Improving education and understanding of eating disorders in the future healthcare professionals is essential. And I won’t stop until this happens.
I’d love to hear your thoughts on my experiences or any experiences you have had so please do leave a comment. And please do sign up to follow my blog.
(This admission was my third inpatient admission – you can read a bit about my first in my blog that I wrote in 2017 https://www.bexquinlan.com/2017/05/9-years-ago.html(opens in a new tab)