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 

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