No Empathy

The first staffing that I mentioned before also included another, separate mess that I tried to clear up in the second staffing, but only got worse.

In the eating disorders program, partial hospital patients are supposed to follow their whole meal plan when they are at home. Patients are not supposed to weigh themselves. I did not follow my whole meal plan for the first week and I did weigh myself. There were daily "check in" sheets to fill out with what we ate for dinner and whether we had used any eating disorder "behaviors"*. I lied to the staff on these sheets and I lied to the staff when they asked me about these things. I did not trust the staff or the hospital program and I acted on that distrust by restricting what I ate and by weighing myself. Eventually, when I trusted a little bit more, I started eating my full meal plan. Because I was weighing myself, I saw that my weight wasn't increasing and I was able to trust a little bit more. At that point, I started being honest with the staff and on my "check in" sheets about weighing myself and not eating everything I was supposed to.

I was upfront with the staff about my distrust of the hospital program and the staff. I wrote my psychiatrist a letter that described several areas of distrust. She had read that letter before I went to the hospital. Hospital-therapist read the letter when she did my psycho-social assessment. Hospital-dietitian read the letter when we had a meeting to establish that I am a real vegetarian (as opposed to an eating-disorder vegetarian) and that I was not willing to compromise about my vegetarianism. I mentioned several times in conversation that I did not trust the program or the staff. I'm pretty sure I made my distrust clear.

By the time of the first of the two disastrous staffings, I had been honest with the staff and on the "check in" sheets for a few days about what I was eating and about weighing myself. The dietitian expressed surprise at the fact that I was weighing myself when it came up in the staffing. Though that may not have been a reprimand, it felt like one (I don't care if that is unreasonable because I can't change how I felt about it into something more rational). I had written on the "check in" sheet for the past few days that I had been weighing myself, so, as far as I was concerned, I had done my part in communicating this "behavior" to the staff. It was not my fault that the dietitian didn't know I was weighing myself. My psychiatrist asked why I was restricting and weighing myself. I said that I did not trust the staff or the program. I said that weighing myself actually gave me a tiny amount of trust in my meal plan and that it was a large factor in my beginning to follow my meal plan, though no one seemed interested in that genuine positive. The staff were pointing out ways in which my behavior was sub-optimal in the context of the hospital program. They may not have been angry, scolding, or disappointed in me, but that is how it felt. It felt like an attempt to shame me into reform.

Later, I asked the dietitian if the "check in" sheets were meant to be a device of communication between the patients and the staff and she said that they were, but that the therapists usually took them. Hospital-therapist never spoke up and said, "Oh, maybe I should have showed you Jessa's 'check in' sheets because they had information you would have wanted to know." Hospital-therapist said nothing, just letting me sit in the discomfort of the dietitian's surprise, letting it appear that I was responsible for the misunderstanding, or at the very least, not acknowledging that the misunderstanding was largely because she dropped the ball on communication.

When I reflected on the staffing, I thought it was absurd that the staff would react with surprise at my acting on my distrust of them and the hospital program. I made my distrust very clear; it would have been more reasonable than not for them to have expected me to act on my distrust. I thought about how I would have liked to have seen that situation handled: with empathy. I would have liked them to acknowledge that acting on my distrust was an understandable thing for me to have done, and perhaps that my distrust was reasonable given my past experiences. Empathy would have validated my feelings of distrust and made the whole confrontation feel less accusatory, but I did not feel any empathy from anyone in the room in response to my situation. This seemed inconsistent with what they taught me about the importance of empathy and validation and good skills for relating with those around me.

At the next staffing, I brought this up. I had already established with the staff individually that I had done my part in communicating my "behaviors". I told them that I did not feel any empathy from any of them, when it seemed like empathy would have been the proper response, especially within what they teach us of relating to others. My psychiatrist cut me off and accused me of black-and-white thinking when there wasn't any (more about black-and-white thinking later). Hospital-dietitian said that perhaps there wasn't any empathy in the room for my situation. I was shocked. Right away I did the logic to notice that, if I could assume that this was a genuine possibility from her perspective, she had just admitted to me that she personally had no empathy for my position (because if she had empathy, a lack of empathy in the room would not have been possible from her perspective). I did the logic, but the result was so egregiously awful and shocking that I didn't fully believe it until later when I could slow down and say to myself, "Yes. She really did say what I think she said." I think my psychiatrist may have noticed what hospital-dietitian had implied about her own lack of empathy, because she immediately followed what hospital-dietitian said to say that she had felt empathy for my position, although she had perhaps not expressed this. Hospital-therapist was, again, silent throughout. There was no recognition that the lack of expressed empathy on their part was perhaps a lapse in good relationship skills on their part. There was no recognition that it was reasonable of me to expect that they would have expressed empathy or that it was reasonable for me to feel slighted when that expectation of empathy went unfulfilled.

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* In the hospital, there is a lot of intentionally ambiguous talk about eating disorder "behaviors". I put it in quotation marks because it is a use of the word that is particular to that context. "Behaviors" include things like purging, restricting what you eat, weighing yourself, taking laxatives, over-exercising, etc.