Can Some Treatment For Mental Health Problems Make Issues Worse?

Peanuts are a great source of protein, anti oxidants, and have been shown to be beneficial to heart health. When I eat a peanut, my heart throws a little fiesta in celebration and uses every ounce of peanut to make itself extra awesome. When my imaginary friend Jimmy eats a peanut however, he explodes and turns into a bucket of water (Jimmy has a very severe imaginary peanut allergy. Don’t worry though, I gave him an imaginary unicorn to ride on as compensation for his unfortunate condition). 

Clearly then, sometimes, things that are supposed to be good for us and that are supposed to be beneficial to our health don’t work for some people, and the same can be said of mental health treatment. 

Now before I get carried away I would like to express that I am VERY grateful for all of the mental health treatment I have received over the years, even the things that haven’t worked out, because they have taught me what kind of things do and don’t work for me. I know I am very fortunate to have had so much and such a variety of support, as there are all too many people out there who don’t get any treatment at all and that is heartbreaking. Anyone suffering with a mental health condition should be able to access treatment, end of discussion, so I am not saying “screw all of you people who have never had any help, I have had some unhelpful help so pity me”. 

Instead, I think it is important to look at some aspects of mental health treatment that can maybe cause more problems than they solve so that we can improve that treatment and make it better in the future. It is all well and good to say “all treatment is good treatment and you should just take it no matter what” but if we did that we would never move further in the ways people with mental health problems are supported and increase the benefits that support can bring.

Hundreds of years ago, people with what we might potentially diagnose with mental health problems, were seen to have evil spirits lurking inside of them and were treated by having a drill shoved through their skull to let the spirits out. If nobody had ever stopped to think “hey, maybe this bashing people about the head isn’t very helpful after all”, we might still be doing that today (which would make my weekly trip to my psychologist even more terrifying), so although I don’t think anything around today is as detrimental as head drilling, I have personally found some treatments to be quite problematic. In this post I therefore I want to be seen as looking at the peanuts and trying to keep all the goodness in whilst getting rid of all that stuff that turns imaginary people like poor Jimmy into imaginary buckets, rather than as throwing all the peanuts into the bin and declaring them all to be useless. 

I am sure there are a lot of people out there who can attest to treatments that have been more detrimental than helpful in the sense that a lot of times, group treatments and inpatient settings can be rather triggering. I have known many people who have picked up behaviours from other people they have met in hospital, but I think this is less a problem of the style of treatment and more a problem with the competitive/comparative nature of certain illnesses themselves. It would be unrealistic to say that everyone who is ever hospitalised should be kept in a separate room away from other potentially triggering patients because that isn’t real life, there are always going to be people who trigger you no matter where you are, and the key is to learn to deal with and manage that. 

When it comes to problems with treatment however, an important example for me in terms of an actual treatment style that made things worse for me, was a certain inpatient unit I was in for my eating disorder, and their extreme “this is the most important thing ever” focus on weight. 

Before I went to that unit, I did not weigh myself, nor did I care about the number of kilos on the scale or what my BMI was. 

My eating disorder was all about how I saw myself in the mirror and how I felt inside. Some days I would struggle more because I “felt” and saw myself as extra disgusting, whereas other days I would do better because I maybe didn’t feel as terrible about myself. 

If I had been weighing myself during those times, there probably wouldn’t have been much difference between the numbers shown on the scales on the days that I “felt massive” compared to the days I “felt not as bad”, like I said, it was all subjective and all internally measured by my emotions as apposed to any little plastic square I could stand on that would then flash numbers at me. Ok, I counted calories obsessively, but when it came to weights, numbers were irrelevant to me, and if you had told me what I weighed it wouldn’t have had any meaning to me. 

During my first inpatient admission for my eating disorder however, all of that changed, and it is since that admission that my eating disorder has progressed to the point where my it is still concerned with how I feel but also obsessed with the number on the scales and the great significance “what that means” (spoiler alert: it means very little nothing at all in terms of a person’s self worth or value on this planet. That kind of thing is instead measured by how lovely you are to people and whether or not you are one of those cheeky people who puts an empty carton of milk back in the fridge just to destroy someone’s morning hopes of a bowl of Coco Pops. THE MILK CANNOT TURN CHOCOLATEY IF YOU DON’T LEAVE ME ANY MILK).

I understand that in eating disorder treatment it is important to be aware of weight to a certain degree for various reasons (not that the weight of someone with an eating disorder will tell you how ill they are or how physically at risk they are of serious complications), but in this unit, weight meant EVERYTHING and every number on the BMI scale had a significant consequence to it. It would have been one thing if there was a rough weight band stage thing to use as a guide, but instead of that each number specifically told you what you were allowed or not allowed to do. 

Some I could vaguely understand. There was a weight at which you were allowed to do yoga for example, a weight at which you could go bowling, and a weight at which you were given permission to walk around the grounds. It is the more arbitrary number obsessions that I think should have been focused more on the individual and their struggles/progress, rather than simply basing it on silly numbers. For example there was a weight under which you were not allowed to pick your own food at lunch and instead had to keep your fingers crossed that the nurse wouldn’t pick the one option that you genuinely hated for reasons outside of your eating disorder, a weight at which you were allowed to pour your own milk into your cereal, even a weight you had to reach to earn the right to spread butter and jam on your own toast. 

Again I get the importance of this, very early on in treatment people may be unable to spread an acceptable amount of toppings on their toast or decide what option to chose at lunch so that extra support may be warranted, but who is at what stage should not have been decided by weight alone. 

For example what if someone who was severely unwell came onto the unit above the weight of toast spreading privilege. Was it fair to leave them wrestling with the marmalade on day one just because their weight was a few digits out? And what about people who mentally progressed very quickly and although they came in at low weights were able to manage marmalade responsibility before their weight reached acceptable levels. I knew of several people whose bodies struggled to gain weight no matter what they ate and they got frustrated in feeling mentally held back by not being allowed to spread their own toast or pick from the options at lunch themselves, skills that would have been beneficial for them to practice to carry out responsibly. 

Obviously if they had started demanding dry toast and a celery stick for meals it might not have been the best idea, but neither is holding people back or pushing them forward simply because of a number that doesn’t measure the mental part of the mental illness. 

Like I said, before that admission, weight was not a concern, but ever since then, what I weigh has always been significant, and I still think of my personal weight as a measure of how well I am to some degree, regardless of the mental struggle. Even now I still see those weights as the “well enough to spread jam” weight which allows my head to use these opportunities when I am at these weights to convince me that I am “ok now” (clearly when one has the ability to spread jam on one’s own toast it means that a person is fully recovered and needs no other progress to enable a healthy life…YAY EATING DISORDER LOGIC.) It just seems a bit confusing to me how so many therapists and eating disorder services over the years will tell you to “ignore the number” and tell you that “it doesn’t matter”…yet then go on to measure your level of wellness by that number and dictate your rights accordingly, showing that it actually matters and means a lot…contradictory much? 

The second example of treatment that I personally think caused more problems than it solved was my first admission to hospital when I was about 11. Admittedly I needed to be there, my OCD behaviours were controlling my life, everything was completely out of hand and someone needed to step in, but remember I was a scared 11 year old suddenly waking up in this mental hospital and  living away from home for the first time. I needed treatment yes, but primarily, I needed mental support, and that wasn’t what I got.  

My shower and soap rituals were instead physically controlled by means such as locking me out of the bathroom and stealing my soap. Now, exposure therapy for things like OCD is a very valid method of treatment, you are scared of something, you expose yourself to it, people help you through that exposure with support and you keep practicing until it isn’t scary anymore. 

Problem was, I had nobody to help me work through that exposure, all treatment was physical and ironically there was no mental support whatsoever despite the fact it was a mental hospital. 

Therefore, instead of working through my problems, I was just traumatised for weeks and left to struggle alone in absolute terror, so naturally, when I went home, I was not a fan of psychologists and would refuse further treatment. Had they worked with rather than “on” me, I would have trusted them and would have seen them as people I could work with to get through my problems, but in my 11 year old brain that experience taught me that therapists were nasty people who take you away from your parents, lock your bathroom, leave you to suffer alone and then send you home with all the mental pain you had before plus a little bit of bonus anxiety. Consequently, there were several years where I refused to see therapists and would lock myself in our home bathroom when they came to visit, refuse to go to clinics, or “forget” to leave lessons when they came to visit at school for sessions (that’s right…I hated therapy so much I voluntarily stayed in Maths lessons that I was allowed to get out of…MATHS!)

It has taken a long time for me to get to the point where I can trust therapists again, actually talk to them, see them as humans rather than soap stealing villains, and still every mention of exposure therapy sends me bananas because my first bad experience of it has not left me excited to give it another go… 

So, can certain kinds of mental health treatments actually make a person worse? Well, yes, and though I think it is important to try new things and approaches, it is equally important not to label all treatment as helpful and to be able to critique the bits that maybe aren’t as helpful and could use a bit of a rethink so that we can improve them, keep the good and edit out the bad, or else we would still be in the time of drilling people in the head, and nobody wants that. By all means use a drill to put up a nice painting or build a table, but when it comes to my noggin, I would rather you kept all power tools at a safe distance. 

Take care everyone x 

Bucket

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13 thoughts on “Can Some Treatment For Mental Health Problems Make Issues Worse?

  1. I agree with you 100%! My hospitalization was the worst thing it could happen to me!
    I had to share my room with 10 OTHER PEOPLE (it was a big ass room), I could never pick my food, they took my phone away, I wasn’t allowed ANY visits during the week (not even my parents), I wasn’t allowed to go outside (basically I wasn’t allowed to have any type of contact with the outside world), I wasn’t allowed to stand (I had to sit ALL day) and if I was caught standing up they would restrain me to the bed, the nurses were very mean to us, the doctors didn’t believe our pain and treated us like society garbage and I received no mental help whatsoever.
    I could go on and on for days about how I was treated like an animal but I don’t want to remember that. I wanna forget.
    I’m sorry to hear that you went through a similar situation. No one deserves this.
    Hope you’re ok xx
    Kisses from Portugal ❤

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    • Oh my goodness that sounds awful! I had no idea you went through such a traumatic form of treatment I am so sorry! Really glad that you are out now though and back at home with your family. All the motivation to never go back eh? Hope you are having a good day today and know that I am always here for you. Kisses from England xxx

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  2. YES. 100%. Treatment for EDs is terrible, world-wide.
    I did a program for depression/anxiety (PHP then IOP) and it was so different. It was skills-based, so felt more like classes. Staff wasn’t trying to control. They respected us as adults. They didn’t treat you like you were always up to something, constantly observing you like you were in the zoo, forcing you to do this or that at certain times.

    I don’t claim to know the solution to treating EDs, but I do know that what’s being offered now is crap. And honestly, quite harmful for some. If I were to ever relapse, I’d NEVER go back to any sort of ED treatment, no matter what treatment level, because they just aren’t helpful for most people.

    Also, I hate the traumatic experiences you had. So messed up.

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    • That is such a shame to hear that if you were ever to relapse in terms of your ED you wouldn’t go into treatment for it…shows how messed up mental health services are these days! Something needs to change!

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  3. You know what made me give up my ED (well, as much as it’s gone now, which is not 100%)?

    I had to relocate and leave my secure treatment team and home. I feel like I was holding onto the ED to keep my treatment team #1. I mean, I know that’s terribly messed up, but I think that was keeping me stuck. When I was forced to move, my whole life had to change and I no longer had those supports and that identity and it was a really good kick in the butt. It basically forced me to change. No one was gonna coddle me further and care because I was struggling. 3 months after moving, despite being terribly depressed and unhappy in my new home, I freed myself from active restriction. Weird, I know, but it worked. Once you see that treatment is just a revolving door and people actively try to stay sick… well, I realized that’s not the life for me. Sorry, a bit of a tangent!

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    • No no I think that totally makes sense! I think that there are a lot of problems with bad mental health treatments but at the same time there are issues even with the good ones as people get addicted to them and become so reliant on certain people that they never move forward! An important thing to talk about I say!

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  4. Just to say that I’m really glad to see that a) you are still here b) some of your humour has returned (to your writing at least). I know we only get a snapshot of how you are doing each week, but I read last week’s and this week’s posts in quick succession and there is a noticeable shift (on paper at least. I know that you might not be feeling that)

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  5. I was put into an (NHS) group therapy unit for 6 months as an inpatient, and 12 months as a full-time day patient with around 10 – 15 other patients or ‘group members’ who also had mental health issues. Most were diagnosed with a personality disorder and had chaotic lives. Almost everyone had a history of abuse or neglect of some kind… except me. Some of the stories I heard in group therapy were really traumatising. Lucky for me, I had a good childhood, I’ve never suffered any horrific traumas or losses (not until much later), and even though I knew that awful stuff happened to people, it was so upsetting to have to try and support other patients who were reliving their horrific abuse, having flashbacks, re-experiencing the traumas over and over… I’m not a trained person! I’m just another patient with mental problems. I have huge compassion for the survivors of abuse, but I didn’t know how to soothe someone in intense psychological stress, or ‘ground’ someone during violent flashbacks etc. The shit some of those patients had gone through… I can never un-know those things. Being in that unit did me soooo much more harm than good. I made some amazing friends, but it was the worst treatment I’ve ever done.

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    • Oh god that sounds awful! I am so sorry you had to go through that! I think this comment highlights one of the big issues with inpatient units as I agree being around other people who struggle and hearing their stories can be really triggering (if that is the right word). I have also had experiences where I have made friends with people in hospital which is cool but then trying to support them through their traumas is hard. I really hope you never have to go through an experience like that again and I am sorry to hear that it happened. Thank you for sharing your story though, it is really great to hear from someone who feels the same way I do about negative treatment options! Thinking of you x

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    • I also experienced some of that at one treatment place. People talking about such horrific abuse in large groups, major dissociation that was often scary to witness… Definitely a difficult situation and I definitely got some kind of bystander trauma from it.

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