Not only have I read a lot about eating disorder treatment, I have also experienced its cruelty first-hand. I vividly remember the day I entered the Rogers Memorial Hospital’s Child and Adolescent ED Unit. As the admittance staff member used her key card to open the units locked double doors, I can recall feeling like a prisoner being taken to their cell. Once the heavy door opened, I could feel the unit’s sanitary, hospital-like odor flood my nostrils. In front of me, I could see young adolescents sitting on plump, dark coaches. Some of their eyes were glued to the TV screen while a few other’s fingers moved rapidly as they constructed intricate macrame bracelets.
The admittance staff member didn’t stop moving. She led me past the nurse’s station and down a rather wide hallway to a small, white room, complete with a computer. There a nurse took over my care. She interrogated me and my family, trying to pry every once of information from us. Eventually she lead me out of the room and ordered me to urinate and put on a hideous hospital gown. I didn’t know what was going on, but I didn’t question her. I knew it would lead me into more trouble and it would be a losing battle.
As I entered the bathroom, she closed the door, but I knew I had no privacy. She was right outside with her ear pressed against the door trying to hear if I was pulling any “funny business”. After I peed, she barged in and informed me flushing was prohibited. She look at the toilet where urine had contaminated the clean water and flushed it. As she exited, I then proceeded to put on my ugly hospital gown. When I finished I was taken down the hall. I could see another staff member in another room fingering through the contents of my suitcase and tossing several items on the floor. With each passing second I began to feel more like a felon than an ill patient.
Once the lengthy intake process was completed, I watched my parents be escorted out of the unit. I felt my heart sink because now I knew I had no one to protect me, no one to comfort me, no one to kiss me good night. I (only 13 years old at the time) was on my own and I had a terrible feeling that I would be for quite so time.
And I was right. I was trapped in treatment for a total of 3 months and though I know many people have stayed much longer, for me that was a horrendously long period of time to be separated from my parents. After my discharge, I was disappointed in my treatment I received. I wasn’t the only one though who felt this way. My parents were extraordinarily discontented with the care as well. They were hoping their would be more family bonding time and family therapy sessions. Well, were they wrong or what! Many times (especially in the residential center at Rogers), I was forbidden to see my parents because I blew up in a rage or refused to eat everything on my plate. The folks at Rogers though didn’t recognize that the reason I was just filled with anger was because I wasn’t receiving a basic need – love. At inpatient or at residential, no staff member went out of their way to comfort me in times of distress or give me a hug. My parents though would have done that and by denying them of visiting, it was only further contributing to my anger.
Due to the ghastly treatment my parents and I received at Rogers, I ended up imagining my own treatment center for young children and adolescents trapped in the clutches of their eating disorder.
Instead of dubbing the treatment center as a hospital or clinic, I gave it the name Cineraria Place. It’s enchanted appellation comes from the stunning winter perennial, the Cineraria. I chose this name because this plant is hardy and can thrive in even the coldest of times. To me, this relates incredibly to ED patients because even though times may be rough for them when the come to my treatment center, they all have the ability to thrive.
Unlike most eating disorder treatment centers I have seen, Cineraria Place will not have one single building on it’s campus. Instead it will possess multiple cottages. Each charming cottage is meant for one patient and one or both of the patient’s parents or guardians. Why have parent’s live with their child while they are in treatment? Because children and adolescents are still so very young and require the love and compassion of the people who have cared for them throughout their lives. Plus it is important to remember that eating disorders affect the whole family, thus the whole family MUST be treated in order for the patient to enter recovery.
The cottages will each have 2 small bedrooms (one of the patient and one of the guardian) each with an open shelf to store their items. The utilization of an open shelf instead of a dresser or closet prevents the patient from hiding any counter band that may inhibit the patient’s chances at recovery. The cottage will also contain a small kitchen for meal preparation and a bathroom with a toilet that cannot be flushed without a key (the prevents the patient from participating in purging). All in all, the cottage will resemble a normal home-like environment. The only main difference about Cineraria Place’s cottages is that there will be NO interior doors. Though this may sound like an invasion of privacy, ED patients are notorious for exercising in secret. By having no interior doors, we are not giving the eating disorder a chance to harm the patient’s recovery.
So now that you have an idea of what Cineraria Place’s cottages look like, let’s dig into the details of the program. Most treatment centers utilize the “tough love” approach and use punitive techniques when a patient engages in eating disorder behaviors (like refusing to complete a meal or supplement). I believe that punishing a sick individual for being sick is completely cruel and inhumane. The patients DID NOT choose bulimia, anorexia, or EDNOS and therefore they should not be treated so heartlessly! At Cineraria Place, the patient will be loved and supported through each challenge in their recovery. If they refuse to finish a meal, we will help them work through it no matter how long it takes.
Upon admittance, each patient and their guardian will be assigned one nurse who has been thoroughly trained in managing eating disorder through the utilization of love-based techniques. The nurse will be with the patient and guardian 24/7 to help settle problems that may arise and to support the patient through trying times.
Another unique characteristic of Cineraria Place is that, with the help of a dietitian who specializes in eating disorders, the parent will actually learn to properly prepare meals and snacks for their sick child. The meals will eaten in the privacy of their own home. This way, ED patients will not be triggered or influenced by other patients. We all know that ED patients are extremely competitive about their illness and feed off each other’s unhealthy behaviors. By completely cutting out their contact with other ED patients, we helping to prevent triggering the eating disorder.
During the day, parents will spend time attending classes with other parents of eating disorder victims. At these classes, they will learnmore about what an eating disorder is and how to best manage it. They will also be instructed in the preparation of healthful food and learn about the basics of adequate nutrition.
Patients, on the other hand, will not spend their day in classes that have a community setting like the parents will. Instead they will spend time each day attending different forms of therapy targeted to help relieve anxiety and to free them from their eating disorder. This includes yoga, meditation, massage, DBT, nutrition education, and tradition talk therapy. They will also meet with their psychiatrist and medical doctor at least twice a week to ensure their physical and emotional health is improving.
There are obviously a few more details, but that’s really the just of what I think a treatment center should be like. It should be a place of love, caring, and most importantly . . . hope.