Tara (Way back when): “I am purging everything I eat but I still feel fat.”
Psychiatrist (For only two weeks): “Well, you must be eating something because you’re not losing weight.”
Conversations like this should not happen - in general - but especially not with mental health professionals. Not only did I feel offended by this Psychiatrist’s ignorant comment, I felt alone. Feeling alone is a vulnerable and scary place in my mind – in all of our minds, I think. I no longer trusted this person with the thoughts and emotions that I had been hiding for so long. He had just validated (in my mind) that I was worthless and obviously fat.
As Erikson et. al (2014) stated in a recent journal article, “Openness meant being free to speak without fearing the consequences…” Not being able to have an open conversation has a snowball effect and can lead to more problems; where something seemingly small leads to something bigger again and again, causing the outcome to be somewhat disastrous.
Between the ages of 18 and 26, I was hospitalized ten different times while in my hometown of Halifax, Nova Scotia. During those hospital stays, I was seen as being depressed, anxious, hypo-manic, and even stoic. No one ever thought I was angry or confrontational, because I knew better.
It’s not that I wasn’t angry; I was furious. I was furious about the lack of recommended therapy compared to the abundance of prescribed medications. I was furious about the loss of my dignity and autonomy. I was enraged about the reductionist approach that stripped away my personhood, transforming what once was a bright young woman into a collection of pathologies.
However, far more than I was angry, I was afraid. I was afraid of what would be done with me or what would be taken away from me if I gave that anger a voice. I did not want my passes taken away, my visitors restricted, or to incite hostility from the staff, because they were the ones with the power. More than anything I feared being placed in “therapeutic quiet” (TQ), also known as seclusion.
We embrace the Recovery Philosophy at Ontario Shores Centre for Mental Health Sciences (Ontario Shores). Recovery applies to a person’s whole being; their mental, physical, social and spiritual aspects. It works best in an environment that mirrors the community beyond the hospital walls where it is possible and reasonable. To that end, Ontario Shores has established a suite called Our Place, where patients can engage in intimate activities – including sex, in a private and dignified way.
Talking about intimacy and sex can make us feel uncomfortable. From a very young age, we’re warned about the bad consequences of sex and our society has taken great effort to develop measures that mitigate the physical risks. Despite the unease, it’s important to have conversations with patients about these risks. It’s equally important, if not more so, to help patients navigate the emotional twists and turns that come with intimate relationships.