Inpatient Nightmares: Lessons Learned & Shared
NOTE: “Rejuvenate” is not the actual name of the facility described in this article. If a treatment center exists with that name, or anything similiar, it is purely coincidental.
Recently, I was admitted to a widely-known inpatient eating disorders treatment center. I am 30 years old and have been suffering with anorexia nervosa for 20 years. When my outpatient treatment team and I began to see the all-too-familiar signs that I was relapsing, we immediately began investigating more intensive treatment options. Ultimately, I chose a place I’ll call “Rejuvenate.” My experience at Rejuvenate was horrifically negative, and my wish is to share my story in hopes of helping others avoid finding themselves in a similar situation.
Before I arrived at Rejuvenate, I had had a series of telephone conversations, all of which had been conducted, I later learned, by a senior member of Rejuvenate’smarketing team. I had also poured over the facility’s excellent looking website, clicking on the many pages that touted their philosophy. I was promised that I would be treated for a maximum of 45 days (the length my insurance allowed) and that my outpatient treatment team would be included in the formation of my inpatient treatment plan. It sounded great!
Upon My Arrival
When my fiancé and I arrived at the “hospital,” we were unearthed immediately. We arrived while the patients were having dinner, so the nurse who greeted us said she would get us both a sandwich and we could sit down and take a breather after our long journey. The mounds of admissions paperwork could wait.
We were ushered into the dining room and brought sandwiches, condiment trays and diet sodas. I did a double take, thinking, certainly, the kitchen staff must have mistaken the request for a new patient tray for a staff tray. When a staff person came around, I asked if I could exchange the diet soda, please, for a regular one. “No, dear, we don’t have anything except diet. That’s all we serve here.” Why did I not bolt right then and there?
Taking It All In
Diet soda was the least of it. After a 24-hour waiting period for labs to come back, all the patients were required to go on two and a half mile power walks every morning, five days per week. I was one of several emaciated patients who had no business being anywhere near a diet soda much less going on a long power walk. I have a significant cardiac history, was malnourished upon entering the program, was extremely underweight, and have an exercise addiction. And these were just my presenting medical problems! The message the forced exercise sent to my anorectic thinking was powerful and destructive. Rejuvenate definitely had a one-size-fits-all approach to treating eating disorders, and this showed in the exercise program, the non-regular sodas they served, the sugar-substitutes which could be ordered at every meal (and which were regularly abused by patients), etc.
Patients were allowed to choose their own meals, based on a consultation with the nutritionist, but the meal options were the same for all patients, without regard to weight, health status, or eating disorder. (Rejuvenate, I later learned, was founded to treat compulsive overeating.) I recall one frightening meal planning session where “Lean Cuisine” was actually one of the main course options for that day’s dinner. Where was I? Was this truly an eating disorders treatment center?
The entire time I was at Rejuvenate, I had only one session with an individual psychotherapist. When I expressed my frustration at the lack of individual care, I was informed that peer support, in the spirit of Overeaters Anonymous (“OA”), was the foundation of the program. I did, however, meet with the head psychiatrist several times. Unfortunately, Dr. X. and I disagreed that I should be treated with high doses of Topamax, a drug that causes appetite suppression. His theory held that I was actually not anorectic at all but a closet binge eater, and that if I truly let go of my anorectic control I would find this to be true.
I was, quite literally, starved at this facility. I suffered severe dehydration, orthostasis, and lectures from the medical director about how I needed to surrender and “work the steps” (of OA, meetings of which were regularly scheduled for all the patients).
Having Been There
What would I recommend to other sufferers who are considering inpatient treatment?
- Ask every single question you can possibly think of. Keep calling back until all of your concerns are satisfied. If you don’t have the physical or emotional energy to do this, enlist support.
- Find out what a typical day of treatment is like at the facility.
- Be sure that you’ll have access to qualified nursing around the clock if you have medical issues.
- If you are going to be prescribed medications, will you be able to use thePhysician’s Desk Reference or other resources?
- Inquire about their policy on refeeding, and what forms of meal replacements will be made available to you. Also ask if nasogastric tube feeding is used on the unit.
- Ask how often you will be seen by an individual therapist.
- Don’t settle for a phone call with a marketing associate, and try to speak with the program director for solid answers about personal issues such as sexual trauma, major mood disorders and psychoses, or spiritual practices.
- Get assurances about personal safety, privacy, and dignity.
I’ve been home from Rejuvenate for two months now and am doing really well. I’ve had to do a lot of backtracking nutritionally, given that I lost weight while there. But my weight is up, and I’m engaged with fortitude in my outpatient treatment, including psychoanalysis, which has afforded me personal insights that were sorely missing while I was at Rejuvenate. Fortunately, my experience there has made me angry enough that I’ve been able to mobilize this anger and fight back, rather than shrink away. And for anyone who has struggled along with me throughout this mad battle, you know this is no minor accomplishment.
by Robyn H.
Reprinted with permission from Eating Disorders Recovery Today
Summer 2004 Volume 2, Number 4
©2004 Gürze Books
Dr. Gnap website editor eatingdisordersrecoverytoday.com. Dr. Gnap is a family practice physician and behavioral medicine specialist in suburban Chicago. Dr. Gnap developed the Inner Control™ Program in 1970 and has worked with thousands of people to improve and correct medical, emotional, behavioral and learning problems including performance.