Should The Government Be Teaching Children To Count Calories?

When it comes to the government, they are always coming up with handy suggestions as to how people should live their lives. You know the stuff, “eat at least five portions of fruit and vegetables a day”, “don’t drink more than 14 units of alcohol a week” and “drive on the left hand side of the road” (actually that one might be a rule rather than a suggestion…I wouldn’t know. I failed my driving test and every time I asked my instructor for more driving tips after that, he ran away screaming which really did not help with answering any of my questions…)
Always ready to tell the population what to do then, for 2018, the government in the UK have come up with a new suggestion, complete with its very own catchy advert, where play-dough people morph around the screen and a happy jingle plays advising parents to teach their children to restrict themselves to “100 calorie snacks, two a day max”. Now I am not one to turn down advice from our dear Theresa May who is doing such a wonderful job of running the United Kingdom without any trouble whatsoever (pause for laughter), and even I can admit that it is a catchy slogan with a tune that isn’t bad either, but in my opinion this “handy lifestyle suggestion” is a terrible thing that should cease being taught to children immediately.

Obviously for someone (aka me) who is in hospital trying to recover from anorexia and is following a meal plan where snacks exceed 100 calories and are more frequent than twice a day, this kind of thing is unhelpful and triggering. On one hand I have dieticians and psychiatrists coming out of my ears (I really don’t know how they got in there in the first place), telling me that I need to eat this far higher meal plan than the one Theresa May suggests and on the other hand I have play dough people telling me to restrict my intake, which as I have said is obviously confusing and not particularly useful, but it is not just to people with eating disorders that I think this advert is detrimental, rather it is bad for the entire population (far worse for your health in fact than, dare I say, more than two snacks a day comprised of over 100 calories each).

The problem I think with any lifestyle suggestion or diet tip from any source, is that people hear it and immediately take it as gospel. In the real world however, nutrition isn’t governed by blanket black and white, one size fits all rules like that, and there is no such thing as a “diet expert”, only people who have done a lot of research about food and have opinions about it, a point highlighted to me during my brief stint working in a bookshop.
Unsurprisingly, this job involved various tasks including book shelving, and one day I was in the self help department (insert joke about how I need to spend a lot more of my time in such a section here), which was helpfully next to all the diet books. Therefore whilst shelving, I couldn’t help but get a good look at all the titles and diets being advocated.
Now generally, when it comes to reading about a topic, one would assume the more books you read, the more educated you become. For instance say you read 30 books about penguins, it is then likely that you will be more intelligent on that topic than someone who has only read one and that you would do better on any quiz regarding penguins. Alas, when it comes to nutrition, things are not like that, for as I shelved those diet books (working very hard I might add just incase my former boss is reading this…), I realised something ridiculous. Turned out if I were to read all of the diet books, take all of the information, all the “no carb”, “no protein”, “no fat” nonsense and I were to mush it together to make one overall diet plan (which you would think would be the best and most informed having been the culmination of so many books’ worth of information), I wouldn’t be able to eat anything. All the health advice added up together in the world and the conclusion from it? No food is safe, which I think is fairly unhealthy considering such a thing would lead to death, and, were we all to follow that advice, the extinction of all human life on earth. Marvellous. Therefore when it comes to rules like this “twice daily 100 calorie snacks” thing dolled out by nutritionists, taking them as gospel is never a good idea as they are merely opinions rather than facts.

“But for some people limiting snacks to twice daily amounts of 100 calories might be a good, healthier idea than their current lifestyle choices” I hear you cry and I am not going to disagree with you on that, but another thing I want to point out when it comes to guidelines is that they are not universal and are actually only helpful or beneficial to SOME people, which is why it is not helpful to have them rolled out as rules for the general population. As I have already said, this advert is obviously not applicable to people who are in recovery from eating disorders, but neither is it applicable to a large number of the population who all vary in height, weight, activity levels and nutritional needs. What about athletes for example. Is this rule supposed to apply to them too because I am pretty sure that that Mo Farah and Usain Bolt wouldn’t get very far nor would they get any more gold medals were they to restrict themselves to two 100 calorie snacks a day…
Okay I get it, there does need to be some kind of suggestion out there as to how to live a healthy lifestyle and it is important to teach children about food and nutrition but whatever happened to “general education” and suggestions like “eat your vegetables”, “everything in moderation” and try to have a “balanced diet” as opposed to these rigid rules and guidelines ridden with fixed numbers. Where pray did these numbers come from because last time I checked people don’t eat numbers, they eat food (and for good reason too. I once tried to eat a number nine and it was terrible. Tasted purely of pepper.)

It is just somewhat ironic that the whole focus of this campaign is to encourage health but encouraging children to see food in terms of calories and numbers really is a disordered habit struggled with by many people with eating disorders. If healthy snacking is the priority then advising healthy snack foods and providing possible examples would be a far better way to go about it because this focus on calories isn’t healthy at all. When numbers are brought up things start to get obsessive and this is where I think the problem lies. By specifying 100 calorie snacks they are labelling a strict limit to adhere to, but how ridiculously close are people supposed to stick to it? Is a 101 calorie snack ok? What if it is a really healthy snack that is slightly over? Should an “unhealthier” food be chosen instead simply because it fits the amount? Should we weigh already healthy fruit to check that they are “safe” in this new government scheme? Should children be taught how to count calories from the moment they exit the womb? Is that a normal healthy attitude to food? Seriously, think about it, does all of this sound healthy and worth advocating or more akin to rigid disordered behaviour seen in people with eating disorders aka a mental health condition needing treatment?

Overall then, if I had any say or control in any of this government malarky, I would say the whole “100 calorie snacks” with “two a day max” idea needs to be binned and for calculating numbers to be kept in children’s maths lessons in schools rather than in their lunch boxes or at the dining table at home. If you want to educate and give healthy food guidelines from the government then fine, go ahead, but when this advice is given it should be just that, GUIDELINES like the old “eat more fruit and veg” rather than strict, prescribed, rigid calorie counted rules that must be followed exactly and are carved in stone and sung over the breakfast table like some terrible national anthem.

If you have or even if you don’t have an eating disorder but are finding these adverts unhelpful, as hard as it is, my advice would be to do your very best to ignore them. Remember, just because it is prescribed by the government it doesn’t mean it is automatically healthy and it doesn’t mean that its obsession with numbers is not disordered. Nobody is the authority on rules regarding food and diet, it is all opinion, and strict rules, hell even general guidelines, are not applicable to everyone.

Take care everyone x

GovernmentFood

50 Ways To Celebrate Christmas When You Are In A Psychiatric Unit

Christmas is like Global warming. Whether you believe in it or not, it exists as a concept/event that people talk about. Maybe you have already written your letter to Santa (or to use the Global warming analogy, separated out your recycling for the week), or maybe you hate Christmas trees and are a real life embodiment of Scrooge (I guess in the global warming analogy, equivalent to this would be burying hundreds of plastic carrier bags in the back garden under a fire of perfectly recyclable paper, that you then dance around whilst spraying aerosol cans and cackling manically), either way, no matter what you do, whether you celebrate it or live by it or not, it is a thing and it is not going away.

Christmas is also something that is happening in the very near future, and is a festive period that a portion of the world’s population will be celebrating/experiencing in psychiatric hospitals. Maybe the idea of missing out on properly taking part in the holiday season doesn’t bother you because you are our embodiment of Scrooge (in which case hello, here is a friendly reminder that December does not last forever…also I have a sweetie for you…it is a humbug), but what if you are our Santa Claus worshipping/Christmas loving wannabe elf? What do you do then? How can you get through the Christmas period and celebrate what you consider to be the most wonderful time of the year when all the mince pies and fairy lights are in the outside world, whilst you are stuck on a corridor of mental health nurses, health care assistants and locked doors at every turn? Well my friends, if that is you then what you do is come to this blog (as you have done already, so thanks for that…I would give you a sweetie but I don’t think I have any that you will like…I do have some tinsel though…go wild!), because today I am here to solve that problem and provide you with 50 ways to celebrate this festive season if you are, like I am, spending all or part of it stuck in hospital…

  1. Get a reed diffuser with a Christmas scent like “Winter Spice” or “Gingerbread” to give your room a more Christmassy ambience/make it smell less like industrial strength cleaner, and the pile of tear soaked tissues in the corner.
  2. Buy a pair of antlers and put them on the pet therapy dog.
  3. Impersonate crackers by wandering the corridors shouting “BANG” at random intervals, then proceeding to tell a joke and throw a paper hat and tiny pack of cards at anyone nearby (real crackers are unfortunately NOT allowed in most units because apparently they count as “explosives”…)
  4. Have a Christmas movie night with the other patients (if choosing a film is difficult maybe write down a list of suggestions and pull one from a hat…a Santa hat…obviously.)
  5. Spray fake snow on the windows which are likely to be misted over so that people can’t see in anyway and therefore will not interfere with the ability to see daylight/the clouds if you live in the UK.
  6. Do Christmas shopping online or send everyone a message saying that you can’t buy them a present this year because you are in hospital where shopping opportunities are severely limited.
  7. If allowed foliage, get a Christmas tree for the ward or at least a plastic one.
  8. Again, if allowed, decorate your room excessively to the point that Doctors and nurses comment on it in your notes.
  9. March the corridors with a CD player booming out all of the Christmas songs that the people around you will surely not be sick of hearing quite yet.
  10. Tie string around one of the staff members and then shout “On Donner on Blitzen! Now Prancer and Vixen!”
  11. Run around/walk glacially if on an Eating Disorder ward, asking “Has he been yet?” with frantic excitement.
  12. Set up a fancy dress competition and judge the therapeutic abilities of every staff member by how much effort they put in.
  13. Jingle bells outside everyone’s room each morning to add a festive wake up call to their morning routine.
  14. If you are allowed to cook or have a supported cooking group with an Occupational Therapist, bake mince pies and gingerbread men.
  15. Gather cotton wool balls for blood tests from the clinic and make your very own Santa beard.
  16. Knock on the staff room door and when they open it start carol singing.
  17. Insist that all wheelchairs be referred to as “sleighs”
  18. Insist your bedroom be referred to as “The Grotto”
  19. When visitors message you and ask if you need them to bring anything in for you, phone them back and sing out “BRING US SOME FIGGY PUDDING OH BRING US SOME FIGGY PUDDING”. Put a bit of gusto into it.
  20. Leave mistletoe above all of the doors that only staff are allowed to use in order to create awkward situations between the pharmacist and ward manager.
  21. Write a letter to Santa asking for leave over Christmas or maybe a discharge date if you have been VERY well behaved this year.
  22. Whenever a decision is made or treatment option that you do not agree with is suggested shout “Humbug”.
  23. Play Charades (a really good Christmas game for the days you are too depressed to talk but are physically capable of using mime to portray the literary classic “Little Women”.)
  24. Put glitter on your therapy homework
  25. Make a “gingerbread house” out of care plans.
  26. When you feel a panic attack coming on, get that CD player out and start playing “The Carol Of the Bells” aka the most intense and dramatically stressful song of all time (they use it in Home Alone when things are getting really dangerous and the burglars are on the way).
  27. Yell at the night staff for staying awake through the night and making noise, because at Christmas it is supposed to be that “not a creature was stirring, not even a mouse” let alone a mental health nurse doing checks.
  28. Write to the catering department and request sprouts.
  29. Create a tombola to raise money for the ward and leave posters around so that visitors can enter.
  30. Name one member of staff “Rudolph” and then do not let that member of staff play any of your reindeer games.
  31. Gather the patients together and perform your very own nativity
  32. If the ward is full (and let’s face it, with the shortage of inpatient beds across the country it is going to be), make a sign and hang it on the door to let people know there is “no room at the inn”
  33. Make Christmas cards for everyone on the ward.
  34. When you see the cleaner, steal their broom (sounds weird but apparently in Norway it is traditional to hide the brooms to keep all the bad spirits out at Christmas time…seriously google it…and steal those brooms!)
  35. Make your own Christmas drink stall with decorated mugs so that patients don’t miss out on the vital Christmas activity of taking a photo of their gingerbread latte in a Christmas cup to post on Facebook and Instagram.
  36. If a nurse asks to do a heart tracing/ECG refuse because last Christmas you gave someone your heart and “the very next day they gave it away” meaning that this year to save you from tears you have given it “to someone special”.
  37. Set up a secret Santa situation so that everyone gets a little present in December.
  38. Bring three wise men to your ward round. Or some shepherds (sheep optional).
  39. If you need the toilet in the night, pull the emergency alarm and ask staff to escort you through the dark to the bathroom with their star (aka the torch they keep shining through your window).
  40. Tie carrots to every door handle incase one of Santa’s reindeer comes past and gets peckish. EVERY door. Reindeers are unpredictable in terms of location especially at this time of year.
  41. Tamper with the emergency response alarms so that every time staff pull them they play Good King Wenceslas instead of that infuriating beeping noise
  42. Make balls of coal out of papermache and give them to all the staff who have been annoying you recently. Also tell them that they are on the naughty list.
  43. Flood the wet room, freeze it and go ice skating.
  44. If you are on 1:1, take a little drum to the toilet with you and bang it furiously in impersonation of “the little drummer boy” so that staff cannot hear you urinating.
  45. Wrap all objects available in wrapping paper and put bows on everything. It will be incredibly inconvenient and will likely destroy the rainforest but damn will things look lovely.
  46. When you knock on the clinic door for medication every morning have the staff announce the date as they open the door prior to the giving of the meds in order to be a real life mental health version of an advent calendar.
  47. Knock a hole in the wall, wear orange, sit in the hole and flail around a bit next to a sign inviting passers by to roast chestnuts over the “open fire”. Technically you should get planning permission for this one but my advice is to not bother because it will probably be denied and you do not want this opportunity for festive activity ruined…
  48. Ask to be treated for “Low Elf Esteem”
  49. In art therapy make some puppets and re-enact The Muppet’s Christmas Carol.
  50. Rewrite the lyrics to the 12 days of Christmas (Examples of ideas include “four HCAs three bank staff two stress balls and Lorazepam in a pear treeeeeeeeee”.)

So there you have it! 50 ways to celebrate Christmas when you are stuck in a psychiatric unit and are feeling all too far away from the fairy lights, Christmas markets and winter wonderland set ups across the country. As I said last year, when it comes to Christmas there is nothing I or any of us can do to make sure it is definitely a “Merry” occasion, but I do hope at least, that however you feel about Christmas and wherever you are spending it, you get through the festive season in the best possible way with the best possible and safest outcomes for all. If you have a merry time then that is fabulous, but remember, if you are struggling with it, that is ok too. Christmas is a hard time for a lot of us but I will be thinking of you all.

Take care everyone x

HospitalChristmas

Is It Ok To Give Food Related Christmas Presents To People With Eating Disorders?

As soon as winter rolls around, there are certain questions that suddenly pop up every time you interact with another human. These questions vary but include things like:
“Are you doing anything nice for Christmas?”
“What do you want for Christmas?”
“Do you really need to buy more penguin themed decorations this year?” (Yes. Yes I do)…
And of course the ever sigh inducing “Have you started your Christmas shopping yet?”

Due to the birth of commercialisation and consumerism (two things that, although very much involved in Christmas, were not actually born in Bethlehem and laid in a manger), Christmas shopping is a big stress over the festive season both for money reasons and of course wondering what the hell to buy for everyone. Mental health wise however, there are further complications because sometimes there is a question not just to what you should buy a friend or relative, but whether there is anything that you should definitely not be buying…

As you may know, I have a lot of friends with eating disorders and several of these friends have come to me in the past exasperated and fed up, poised with a story to tell me about a distant relative who sent them food as a birthday or Christmas present. I know a lot of people with eating disorders might get frustrated, find the gift insensitive, rude, or even cruel, like taunting an alcoholic with a bottle of gin, and the majority of people I know have stated that “people should not give food related presents to people with eating disorders”.

I think that one of the difficulties in this issue, is trying to decide whose responsibility it is for someone to manage the whole gift giving/receiving situation. Is it the responsibility of the person who is choosing the gift to give (maybe an unfair burden considering not everyone will know every personal detail of whoever they are buying for this December and surely if it is “the thought that counts” any present is incredibly kind and generous), or is it the responsibility of the person receiving the gift, to manage what it is appropriately for them?
If you give a Dolly Parton hater (for-shame! Come on now, you have to at least like Jolene? 9-5? IT IS A SONG ABOUT THE MONOTONY OF WORK LIFE! DOLLY GETS US!), a copy of Dolly Parton’s Greatest hits, whose responsibility is it to deal with the CD? The gift giver for not knowing about a person’s hatred of the world’s greatest country singer and for not being too careful, or is it the responsibility of the gift receiver to simply donate the generous present to a charity shop where it can be enjoyed by someone else who is able to appreciate a bit of “I will always love you” blasting from the speakers? However, what if a gift is medically inappropriate? Whose responsibility is it to manage then?

For example what about Horris who is deathly allergic to peanuts? Maybe Horris didn’t write a Christmas list this year (always a risky move), and maybe his third cousin twice removed’s husband’s goldfish wants to send Horris a gift (for he is a very generous goldfish), but is unaware of Horris’ unfortunate peanut condition.
If this lovely Christmas loving goldfish sends Horris three tonnes of peanut butter, a t-shirt made from knitted peanuts and a trip to the “World of Peanut” theme park with the “Ultimate Peanut Experience Peanut roller coaster” (you ride around the track within the shell of a giant genetically modified peanut and then at the end enter a flume tube filled with peanut butter that will leave you utterly soaked upon plunging into it). If Horris uses this ticket to the theme park, surely it is partly his fault for not taking proper care of his health requirements (aka the requirement to not plunge into a pool of peanut butter at 100mph in the shell of a giant peanut). Then again, what if Horris is so allergic that the mere sight of the ticket and the tonne of peanut butter sends him off in an allergic reaction without him having any warning of the deadly gift? Who do we blame? Goldfish or Horris? Surely this is a very different kettle of ethics than the previous Dolly Parton debate? So what about people with eating disorders?

On one hand, as a person with an Eating disorder myself, I can see the point of those who say that giving food as a present to someone with an eating disorder is inappropriate or something they don’t like happening. It can indeed be frustrating to be given food presents that you fear every year and are possibly unable to enjoy due to your illness. I have heard people with anorexia say that it makes them feel more isolated from the rest of the Christmas festivities because being given, say a Christmas present that is a box of merry smiling gingerbread men with chocolate buttons, a freshly cut yule log or a batch of homemade mince pies is like being shown something “normal” about Christmas that others can enjoy and that they may want to take part in like other people, but due to their illness, feel they can’t. Some could say that getting food presents makes them feel misunderstood or like their problems/disorders have not been taken seriously, belittled and assumed to be “a mild difficulty with food” that can easily be solved if you put a nice bow on a box of chocolate penguins, rather than a fully fledged eating disorder ruining their lives no matter how many bows you stick on top of that box of rich 70% cocoa waddlers.
As well as food presents for disordered eaters being problematic in the sense the present receiver may be too scared to enjoy them, there is also the risk that food presents could trigger someone in other ways, for example someone who feels the compulsion to binge and maybe purge afterwards. Some sufferers keep certain foods that they are likely to binge on out of the house to make them feel more in control, so when that food is suddenly handed to them wrapped in glittery ribbon tied paper, they struggle to deal with it in the way they might like to when fighting their disorder.

That said, though what I am about to say is something most Eating Disorder sufferers would disagree with, I don’t think that people should put a full-on ban on food presents for people with eating disorders and I think that getting a food present once in a while is more likely to help rather than hinder your recovery.
What if one Christmas as the countdown to the 25th was underway, you went into some form of new treatment that you started to find more beneficial than any you had tried before. What if an image of what life could be like without your eating disorder started to give you hope in a positive future and what if, like a Christmas miracle, your eating disorder backed off a bit and you felt strong and determined enough to kick some ass. What if in this Christmas miracle you became so inspired to fight your demons that you made a promise to join in on all the scary Christmas food things this year, finally buy that advent calendar, make that gingerbread house with the candy cane decorations, try one of Aunt Enid’s famous mince pies and join in on all the party canapé platters at the work Christmas buffet (I hear the brie and cranberry filo tarts and chocolate penguin profiteroles are a delight). What if all of these goals arise, all this determination to fight and join in with everyone else…and then nobody gives you the opportunity to do any of it because they are all too scared to offer you that filo tart or wrap up that tub of Celebrations. To me, that would be incredibly triggering, if I were to be there ready to fight, ready to eat and join in and everyone just left me out anyway because they assumed I wouldn’t do it. This year, considering i am in hospital and not particularly well right now, that assumption might be right but in my head, never being given food presents at Christmas or any other time of year like Easter or a birthday, is simply a way of other people confirming the idea you already have in your head that you don’t deserve or need food and therefore shouldn’t eat it. People treat you like an eating disorder and you will find it hard to see another identity for yourself. Furthermore, when would the food ban stop and would it ever? How would that be decided and wouldn’t that be more triggering in itself to have food presents suddenly reintroduced? If you have an eating disorder at one point, are families to avoid food gifts even if you are recovered “just incase” which again isolates you from certain celebrations. Yes food can be triggering as a gift but wouldn’t it be more triggering to be very unwell for years and then one year to be maybe doing a little better mentally and physically, so much so that people notice, give you food and then you freak out thinking that they are insinuating that you “aren’t ill anymore” or that they think you have put on weight so are clearly fine with eating again.
Personally to avoid all of these issues, when it comes to food presents, I would rather be treated as normal, like everyone else, receiving the odd box of Quality Street and being offered the iced mince pies. Even if I can’t accept the mince pies or have to give the Quality Street to my mum, I would rather they were there to make other people treat me “normally” until I am in a place to play that role of “normal person who eats food presents at Christmas and gets two candy canes stuck in their gums by getting a bit too enthusiastic when impersonating a walrus”.

Overall though, I guess that with this topic, it is impossible to make any conclusion because whether or not you give food to someone with an eating disorder is going to be a tricky thing to gauge and will vary from person to person. As I said, even I and my group of friends who share the diagnosis feel very differently about the topic so to be on the safe side, if you are wondering whether or not to give someone with an eating disorder a food related gift, you might want to check with the individual or maybe a relative of that individual first to see how they might react to it. There are many types of eating disorder and even people with the same one will experience them differently at different times, such as when they are going through periods of relapse or recovery, so as much as I would like to have given you a black and white simple answer (and we all know how much I love things that are black and white ahem penguins ahem), I am afraid I will have to conclude in a rather hazy grey as the answer will vary from person to person.
All I would say is, if you are the gift giver, try not to get too anxious or caught up in overthinking it because ultimately you have a 50/50 shot of getting it right and if you get it wrong, it isn’t your fault, nor does it make you a bad person. Similarly, if you are the receiver I am sorry if food present wise, things don’t go your way this year, but equally remember that other people may not be thinking as deeply into the meaning or significance of a box of chocolates as you might be and maybe it is just their way of trying to show they think you are pretty awesome. A Christmas present is a Christmas present, it isn’t a holy significant statement laden with meaning as to how someone views you or your body, it is a sign of appreciation, a sign someone cares, and at the end of the day, it is always the thought that counts.

Take care everyone x

Pudding blog

The Difficulty Of Knowing What Counts As “A Behaviour” When You Have An Eating Disorder

How do you tell the difference between an elephant and a letterbox? You check to see which one has a trunk and which one is filled with neatly addressed handwritten letters that will soon be lost in the abyss that is “the postal service”.
How can you tell the difference between a brand new slipper and a boomerang? You throw it to see which one comes back and smacks you in the face.
So far so good (apart from the fact you may have just been smacked in the face with a boomerang or lost a perfectly good slipper), but now for the third question:
How do you tell the difference between the genuine preferences of someone with an eating disorder and the disordered behaviours of someone with an eating disorder? The answer? With extreme difficulty…if at all.

When you are on an eating disorder unit, the food aspect of things/what you can and cannot do with food, is a lot more regimented and controlled by sets of rules than it is in normal life.
Rules will vary depending on what hospital ward or inpatient unit you have been admitted to, but as a general list of examples these rules will be things like “no eating cereal with tea spoons”, “no breaking food up into tiny pieces”, “no sleeves at the dinner table”, “you must scrape the plate that you are eating from clean to complete the meal”, “only X number of minutes to eat your meal” and “no inserting parsnips into the nostrils of the person sitting next to you” (pretty sure that last one is also relevant in real life actually but I am not quite sure…my mother was never very clear when it came to table manners.)
These rules are often frustrating and can seem a bit harsh but they exist because often an eating disorder controls how a person eats and behaves around food, as well as how much or little of it they eat, so part of treatment during recovery involves tackling those food behaviours as well as things like the amount of food someone might be eating. Like I said it can be annoying, but it makes sense. Take the “you must scrape your plate to complete a meal” thing. It may seem over the top (and is a rule that will destroy the lovely willow pattern adorning all of your best crockery), but were it not for rules like that in hospital, there is the risk of people arguing that they have finished their meal when really all they have done is smear it across the good china.

With behaviours like that, I think it is easy to tell the difference between them and genuine food preferences as I don’t think I know any people without eating disorders who “prefer” trying to mash a lasagne into oblivion rather than consuming it.
There are however, a lot of actions people do where it is far harder to tell if the person is making a genuine choice or following a behaviour, and in these situations it is less like trying to distinguish an elephant from a letter box, and more like trying to tell the difference between an elephant, a tea pot and a vacuum cleaner (if you line all three up together you have to admit they do look rather similar…trunks, nozzles and spouts are easily confused…I learnt that the hard way…and broke a teapot).

For example at the hospital I am in at the moment, there are certain rules regarding condiments such as “only two pepper/ketchup/vinegar/mayonnaise/brown sauce etc sachets per meal”. The logic behind this is that some people with eating disorders tend to totally cover their food with a certain condiment in order to make it all taste the same/spoil the food and make it taste horrible as a punishment etc.
Then again, as well as people who use pepper to burn the roof of their mouths off by using it excessively, there are people who use what looks like an excessive amount of pepper simply because they like it. Every time my Dad eats a meal he uses so much pepper that even people scuba diving at the bottom of the Atlantic start sneezing because he likes the spice, and I have a friend who uses what may look like a lot of salt because she has been brought up using that amount and things taste wrong without it. Neither of these people have eating disorders, but they would still struggle living by the rules that are in place to help someone in recovery from a disorder. I guess you could say that the way you tell the difference is to see which came first, the food preference or the disorder, but that isn’t as easy as it sounds. Eating disorders are sneaky, they slip into your life gradually without you really noticing, so it is rare for someone to be able to pin point the day they officially became unwell.

What if my Dad, who currently does not have an eating disorder, developed one in years to come and had to go into hospital? Or my friend who likes a lot of salt? They might, quite rightly, argue that their preferences existed years before their illnesses began and they may be right but the thing is, in hospital, that doesn’t really matter and this is where it gets frustrating. Once you are tarnished with the Eating Disorder brush, suddenly people assume that EVERYTHING you do around food is because of that disorder and they rarely give in or believe you even when you are expressing a genuine dislike. It can be really annoying when you know that your love of toast that is not particularly well cooked is because you like soft as opposed to crisp bread, yet when you are consistently told that everything you do is disordered, sometimes you can start to doubt and be unable to tell the difference between your own choices yourself (aka the is it an elephant, teapot or a vacuum cleaner situation).

How about timings and things like time limits on eating disorder wards? Admittedly they are necessary to avoid still working on Monday’s bowl of cereal at Sunday dinner time (rather soggy cereal I would imagine), but in addition to timings perhaps being affected by disordered thoughts or behaviours, people naturally have varying eating speeds. I certainly know that in my household my Dad will always finish his dinner a good 10-15 minutes before my mum for the simple reason that he has a bigger mouth and more violent set of gnashers (not abnormally large I might add…like he is still a handsome chap and isn’t frequently being mistaken for a shark who needs to be sent back to the aquarium…just clarifying…love you Dad.)

The main rule/“behaviour” that got me thinking about this topic however, the rule I have seen come up in every single one of my admissions to an eating disorder unit and the rule that is carved in a stone tablet and worshipped on a mountain guarded by holy cherubim:

“Thou shalt not dunk biscuits”.

Some of you reading this, who have never heard of such a rule, may be a little shocked, stunned and perhaps distressed to hear that there are people all over the country being forced to eat rich teas that have never actually taken a dip in a real mug of the beverage after which they are named (I know, it is upsetting but we can get through it).
Again, as with all hospital rules there is a reason behind it, that being that people sometimes submerge and drown their biscuits rather than dabbling in a quick dunk and then smear the soggy remains around the inside of their mugs or leave them in sorrowful abandoned mush mountains at the very bottom.

The issue though, comes when you are someone who wants to safely and appropriately dunk their biscuit, yet are prevented by the rule that may not be relevant to you. Of course rules have to apply to everyone on the ward to make them fair, but that is what is annoying, i.e. having an eating disorder and then having EVERYTHING you do with food put down to your disorder when maybe you have just grown up liking a lot of ketchup on your curly fries, or genuinely prefer the texture of a cookie that has had a quick swim in a mug of hot chocolate. Dunking biscuits CAN be a disordered behaviour, but it isn’t always.

Just imagine if the world had to live by eating disorder ward rules with the act of dunking a biscuit being classed as a disordered/unhealthy behaviour and thus banned for all. How would any of us ever eat an Oreo? The dunking aspect to those delights is even in the damn advert! They literally explain how to eat them on the packet! First you twist it, then you lick it, then YOU DUNK IT. If that bit was deleted from the process the country would grind to a halt and living rooms across the world would be filled with poor distressed people holding opened licked Oreos and crying out in agony “WHERE DO I GO FROM HERE?” Think of the number of teeth that would be broken on undunked ginger nuts!

You could maybe be a generous dictator and say that only people who appropriately dunk their biscuits are permitted to do so (something I have asked for on multiple previous admissions), but how can you tell if someone is dunking appropriately? What if someone is genuinely dunking for the resulting soggy biscuit end goal but is such a poor judge of the strength of their chosen biscuit that they get the timings wrong and remove their Custard cream or Bourbon from their brew not to find a perfectly melted vanilla or chocolate cream centre but instead a blank space, an empty half in which biscuit perfection had existed seconds before it was too late and the perfection turned into a sinking disappointment of heartbreak, sorrow and missed opportunities.
Should biscuit dunking be classed as an eating disorder behaviour just because it can sometimes be used as one or can it just be a preference?

Overall then it is clearly very difficult to tell the difference between an eating disorder behaviour and a genuine food preference, especially when you yourself have the eating disorder. I guess when it comes to people who have no issues with food the answer is obvious…until that person is unfortunate enough to develop the disorder and we are caught in the whole confusing “which came first the soggy biscuit or the mental health problem?” dilemma which has plagued scientists for years (scientists who I feel are doing valuable work but are also perhaps taking advantage of their right to order in free biscuits from the big companies under the guise of “research purposes”….)
Of course there will always be ways to figure out the disordered act from the genuine preference but it isn’t always as clear cut as the elephant and the letter box example and sometimes even knowing your own reasons for doing things can get you into a confused muddle of soggy biscuit yourself.

Take care everyone x

ElephantHoover

The Importance Of Triangles In Times Of A Mental Health Crisis

When you are going through what is known as a “mental health crisis”, everything feels like such a mess that you cannot even begin to start tidying it all up. Tiny jobs become momentous tasks, trying to survive an hour feels like trying to survive a millennium and it all feels completely unmanageable. Unhelpfully, being in the 21st century, the general busy non stop, non sleep, 24/7 side to modern life does not help matters (on the other hand there is the positive that, helpfully, we are not in the 16th century where, although it was less busy, you had a higher chance of being murdered by your husband if his name was Henry and he happened to wear a crown).
In simpler times your daily activities may have simply comprised of getting some water from your well, milking a few cows, doing a bit of hoeing out in the fields and then perhaps settling down by the fire with a nice bowl of homemade stew, (it is my understanding that in the olden days people ate nothing but stew). Nowadays however, the list of tasks one must perform to get through the days are endless.

Instead of walking out to a field there are specific buses you have to run to catch for work, computer programs that randomly malfunction and delete all the work you have done for the past week (something that never happened when “work” mainly focused on hoeing), specific coffee orders you have to remember for your boss to avoid being fired over a missed shot of espresso in their large cappuccino, bills to pay, TV shows to catch up on, appointments to make, social events to come up with excuses for, washing machines to fix, ironing to do and earphone wires to untangle (SERIOUSLY WHO IS TANGLING ALL OF THE EARPHONE WIRES WHEN I AM NOT LOOKING AND PLEASE CAN YOU STOP IT). It is exhausting and when in crisis, you need to delete it all and focus on one thing.

Triangles.

I am not talking your equilateral triangles, your scalene, or even your isosceles. I sneer at your Bermuda triangles, love triangles, even your 3D Egyptian pyramid triangles, for no triangle is better in a crisis than the great “Maslow’s Triangle” (toast triangles are a close second for being helpful in time of a crisis though, because you can have peanut butter or marmalade on them).

“What is this mysterious Maslow’s Triangle?” I hear you ask? Well I’ll tell you!

Basically there was once this psychologist named Abraham Maslow (I hear he was quite the dude), and he came up with this list of things needed to fulfil humans and reach “self fulfilment” or “self actualisation”, aka “Maslow’s Hierarchy of Needs” (that is the official term in all the text books but I am calling it Maslow’s triangle because it looks like a triangle, that is a catchier name and it meant that I could sound smart in that first paragraph by talking about other kinds of triangle which are now irrelevant to this post…calling it this also gave me the opportunity to mention toast triangles which are tasty, so I went with it and now here we are).
These needs are pretty much all Maslow thinks you need to become a whole and happy person and who knows, he may be right, but right now it doesn’t matter if he was right or not because to be honest, survival is what we want and aiming for his idea for self actualisation is a bit of a stretch at this moment in time/any moment in time during a mental health crisis. As I always say, we need to learn to waddle before we can fly.

“What does this mysterious Maslow’s Triangle look like?” I hear you cry! Well I’ll tell you that too (and may I say you are asking a lot of questions today…)
So here it is:

YayMaslow

As you can see, all of these “needs” are prioritised in order of importance with the most important on the bottom and the least important/ones that will make you happy but are not essential for purely physical survival, on the top. It is like a pointy version of Jenga, you have to have enough of the blocks to make up the bottom or else it doesn’t matter what is going on at the top, that pyramid is going to fall and there will be sand EVERYWHERE.

In times of crisis, I think people (by which I mean I), try to keep going with all the busy things of modern life that make up the entire triangle and in doing so get overwhelmed, miss out some of the more important things, and consequently make myself/my health worse. For example my magnifying glass and entire life focus is pretty much entirely zoomed in on the second from the top level, “esteem needs”, and because I hate myself oh so very much and thus have very low supplies of the “esteems”, I forage for these like a bear who is late in preparing for hibernation, without caring about anything else because in my eyes it is not as important. In my head, I need to feel worthy of and deserving of life before I can do all the things people need to do to actually survive…and yeah…it doesn’t work like that, hence why my pyramid has fallen, leaving me in hospital, in crisis, and trying to pick sand out of all the crevices (like I said, it gets EVERYWHERE).

In every situation I will sacrifice the bottom sections as I claw for that esteem level. When I am worrying about something like my blog/don’t feel productive/like I have accomplished or achieved “enough”, I ignore all other levels of needs until that achievement feeling has been somewhat reached (I say somewhat because, as I am sure many people can relate, no matter what I do in anything, it is never enough). Need to write a blog post but don’t have any time? Better cross “sleep” off the to-do list. Haven’t drawn that pesky diagram of the triangle you need to insert into this blog yet? No food or drink until that triangle is drawn! Not posted on Instagram and need an “outdoorsy” photo but it is freezing outside? Get out there and Valencia the hell out of some greenery even if you freeze to death in the process!
That is exactly what I do, what I think a lot of people do, and that is why mental health crises often get worse and spiral, because we are focusing on the wrong things when trying to survive and get through the day. Self actualisation is great and all that and we can work on getting to that eventually but if you are in a crisis, the most important thing to do is get your Maslow’s triangle out (and toast triangles if you are feeling peckish), and focus all your energy on the bottom levels. No “I should be doing this” or “I need to be doing that”, no, you are in crisis, it is time to prioritise, remove the stress and simply focus on basic survival. Only when you have got that covered can you start building all the other things on top and if you don’t, even if you work really hard at the achievement stuff, eventually it is going to crumble and remember what happens when pyramids crumble…SAND EVERYWHERE.

When you are in a mental health crisis you need to cut yourself a nice bit of slack. If it is necessary, take a mental health day off work to go to an appointment or get some rest, because without the rest you won’t be able to stay at work very long anyway. It is necessary to focus on keeping yourself hydrated (BUT NOT TOO HYDRATED REMEMBER THE SODIUM) and get yourself a cup of tea before sorting out all the ironing (which in the long run is not necessary at all…I don’t see ironing on the triangle…), and it is necessary, nay fundamental, to nourish yourself and give yourself a good supply of food at meal times before worrying about all the other things on your to-do list (I REALLY need to work on this one). In times of mental health crises it is OK to strip things back and take a step back from the things at the top of the triangle so that you can look after yourself and build your way back up to that self actualisation tip. Focus my friends, on the bare necessities, the simple bare necessities, forget about your worries and your strife, I mean the BARE necessities aka the bottom layers of Maslow’s triangle (I think a bear even sang a song about that whilst dancing around in a jungle with a half naked child in orange pants but that might have been one of those weird hallucinations I have been having lately…they are wherever I wander…wherever I roam!)

So, why is it important to focus on triangles in times of mental health crisis? Because my dear friends, in times of crisis, you need to allow yourself to simply focus on looking after yourself, keeping yourself physically well and safe so that you are strong enough to survive that crisis and work your way back up to the top of your Maslow’s triangle with the fun, self actualisation stuff going on. Forget the other shapes, hold onto your triangles, and if those triangles happen to be made of toast, eat them with some jam and a nice mug of warm tea.

As always, take care everyone. x

CoolTriangles

The Difficulties Of Communal Life In An Inpatient Setting

If you put one fish in a fish bowl, that fish will probably be very happy, especially if you give that fish one of those little plastic castles that sit at the bottom of fish tanks in cartoons. Fish love castles. Nothing makes them feel more content than a nice turret.

If you then add another fish to this bowl, there is a chance that both fish will be happy and will be able to enjoy their plastic castle together, ruling over their water sphere of a home like aquamarine royalty. Add another fish to the bowl however, and the chance of problems will naturally arise as while all fish love castles, every individual fin flapper has their own specific tastes and preferences. Some fish may like a drawbridge on their castle, some may enjoy a moat, maybe there are even a rare few who, dare I say, like their castles without those lofty turrets.
The more fish you add into the fishbowl then, aka the more individuals you have trapped in a confined space, the harder it will be for those individuals to breathe/swim about without accidentally smacking a passer by with a wayward fin and in this sense, psychiatric units are very much like fish bowls (except with really mentally ill fish and no castles…God I wish I had a turret…some fish don’t realise how good they have it).
Like fish bowls, psychiatric units are small confined spaces where you can often find yourself trapped living amongst a group of people you have never met before and it is unlikely that you will get along with all of them, not because any of them are bad people, but because all people, like fish, are different. I think it is easy to think of going into hospital as a very private, individual experience between the patient and their inner struggles and in essence I suppose it is, but that doesn’t take away the community side to inpatient treatment and how difficult it can be living in close proximity to people who are, like you, working through their own personal hell.

No matter how much you go into hospital focusing on yourself, I think a lot of people forget or don’t know about the community side that is bound to be a part of any inpatient admission. Every inpatient setting and inpatient group will have a certain feel, an ambiance if you will that creates some kind of atmosphere, be that positive or negative, on the ward. Sometimes that atmosphere can be constructive and helpful in advancing recovery but as with the fish in the bowl, eventually there are going to be disagreements about whether you install a drawbridge or start knocking down all the turrets, and that can be really difficult and affect your personal treatment more than you would like to admit.

It is a side of treatment that is really difficult to manage and not often discussed, but over the years I think I have realised that there is only one way to manage the difficulties of life in a fish bowl with your fellow mental mackerel, that way being:

  1. Be friends with everyone
  2. Ignore everyone

On the surface, trying to do both of those things are the same time sounds like kind of conflicting advice to give, but then again a lot of great things in life involve components which at first appear to be conflicting.
Just think of the person who invented sweet and sour sauce or the hero that discovered salted caramel. People said they were crazy, that their ideas involved too much conflict between opposing opposites, and where are those legends now? Living the high life in their very own castles (with turrets). And as for the naysayers? Why, they are all cowering shamefully in their hollow lives devoid of delightfully sticky sauce accompaniments with their egg fried rice and of sweet milk chocolate coated toffees set off by the salty tang of the sea.

Personally, I really struggle with the communal living side to hospital admissions and every time I go into an inpatient unit I privately vow to speak to no-one, close my eyes and hope that because I can’t see anyone else, they can’t see me either…But like I said, this is unrealistic and at the end of the day, it doesn’t matter how social or unsocial you intend to be, you do have to live with these people and if you want to survive a shared space of communal compromise, you are going to have to get along to some degree.

I guess it is very much like any communal office or work place where a group of people are forced to spend long periods of time together, regardless of whether or not you have anything in common. Though I have never worked in an office like you see in the movies with all the rows of desks and dividers, I highly doubt that people who do work in those kinds of places would be willing to give all of their colleagues their last Rolo, but you couldn’t get through the day if you held grudges and took things too personally, and I am pretty sure people would be fired if they weren’t at least civil to each other and forced themselves to be a little extra on the polite side.

Maybe you have an office neighbour called Janet who keeps stealing your stapler, puts empty cartons of milk back in the fridge after making a cup of tea and is well known for dropping those little white paper circles that fall out of hole punches all over your paperwork (if this is you then damn it Janet, pull yourself together and keep your little white paper circles to yourself for the love of God.)
If we all had a Janet and behaved as we wanted to (aka smacked her over the head with that stapler she clearly loves so much and changed all the passwords to “Empty milk cartons go in the bin Janet”), it is unlikely we would keep our jobs for very long and nobody would get anything done in life. To keep the country moving and employment rates up then, people tend to bite their tongue at work around their own personal Janets, to keep the peace. That is sort of what it is like in an inpatient setting. You will be in a close proximity to a variety of people for large portions of the day and basically if you want to survive, you have to treat others with all the kindness and respect that you can muster and get on, as good a group of friends as you can.

Sometimes it isn’t even hard to be friends with everyone in an inpatient setting and it is a thing that comes naturally with no extra effort required. After all you are all stuck in a very similar situation going through similar experiences that not everyone in the outside world can relate to. Whilst in hospital it is easy to feel disconnected and isolated from any friends or family members who come into visits talking about holidays abroad and new umbrella decorated cocktails they have tried, whilst the only trips you have been on have been to a walled garden and the only cocktails a brand new combination of anti-psychotics (little umbrella not included).
Fellow patients will be able to relate to that kind of thing and can certainly make you feel less alone. They can also be a great support system who you share a lot in common with and often the most helpful things you can find in treatment are people you can relate to, who maybe give tips as to what has helped them in the past. I have even had admissions where the whole group of patients have got on so well that it has actually been like one giant sleepover in a boarding school with friends and you build such strong relationships that you won’t know how you would have survived the inpatient experience without them. Dare I say it, on special occasions when the brain devils are not out to play, you may even have a few laughs and leave inpatient with a fondly remembered evening of choreographing dance routines to “Spice up your life” by the Spice girls, after a rebellious water fight to cool off in the summer in the wet room (not that I have any experiences of such things personally you understand).

That said, when inpatient it is also important to stick to the second “way” of surviving the experience, aka part two “Ignore everyone”. This is not to say that when a fellow patient greets you with “good morning”, you keep your eyes on the floor and pretend that they don’t exist (a nice smile and “morning” is a far nicer option for both parties involved), but you do need to keep yourself to yourself to a certain degree. As helpful as it is having people you can relate to, it can also be triggering in ways detrimental to your mental health and wellbeing.
When you are in the fish bowl, everything is intensified and feels more dramatic than it might do in the outside world. In the outside world for example, like in the workplace, there is one Janet out of a global population of several million billion thousand other humans (that is a rough estimate…I lost count). Thus your Janet/difficult person in life makes up a tiny 0.000004% of the population or something and so it is easy in a way to avoid that person, avoid conflict and take yourself out of a situation. Say however that when inpatient there is one person you don’t get on with and it is a 10 bed ward, that is ten percent of the population, so the actions of that person can feel a lot more dramatic.
It is therefore important not to get too caught up in other people’s business and let them affect you , rather it is safe to keep yourself to yourself with your blinkers on and focus on your recovery and goals for admission.
I know I really struggle with getting caught up in the inpatient bubble, very distracted and involved in the lives and worries of people in the other bedrooms along the corridor and it is only when you start to get things like leave that you realise there was a whole other world still outside of those walls and half of the things that were incredibly dramatic whilst on the ward are totally irrelevant back home. When you are in hospital, those people you see everyday are constantly on your mind because they are constantly in view, but when you are home with family and friends living your life and benefitting from all the hard work you did on the unit, you are unlikely to think of them at all (unless you keep photos of them on your bedside or something…don’t do that…that would be weird.)

As much as an inpatient stay is an individual experience then, there is a lesser discussed fish bowl style communal element and that is going to be difficult. There are however ways to deal with it, and for me, this blog post is how I get through and is the advice I would give to anyone else who is currently stuck in a mental hospital fish bowl or anyone looking to an admission in the near future. Never forget that any unit is really just a small glass orb on a coffee table and there is a flipping massive ocean to swim in when you get back out.

Now if you don’t mind, I am off to the nurses’ office to demand we get an immediate emergency supply of turrets on this ward. Fish get whole castles and damn it. I WANT A TURRET.

Take care everyone x

Fishbowl