In the ED unit, we went on a field trip. Except that the staff kept calling it an "altruistic outing." We went to a charity that specializes in organizing food production for hunger relief. The food they produce is then distributed to starving and malnourished communities by other charities that travel abroad to provide various forms of humanitarian relief. We filled bags with their very efficient recipe of ingredients. This use of the word "altruism" was annoying me. It is factually inaccurate.

At breakfast on the day of the field trip, I asked a staff member if we could please stop calling this an altruistic outing. She asked why and I said, "Because it isn't." To which she said, "Well, that's your opinion." So I told her I got my opinion from the dictionary. (I try so hard to be diplomatic, but if you tell me a definition is just my opinion, you are going to get sass.)

Now, it is a matter of opinion that I don't believe pure altruism actually exists (briefly, I think selfishness comes into play, at the very least, in the motivation to action). Another patient mentioned having been deeply offended in a class discussion on the existence of altruism, which she believes is fully possible, but her teacher did not. A third patient told me of a friend that takes in dogs that would otherwise be euthanized because it made her sad to see them die and asked how that is selfish. I didn't want to get into an argument with other patients, so I didn't tell her that she already told me how that was selfish: her friend prevented her own sadness by saving those dogs.

The staff member I sassed about the dictionary asked me, in a disingenuous way, what I would call our field trip. I told her I would say we were going to do something that would be of great benefit to others, but that we were doing it because it would also be of benefit to ourselves and that there is nothing wrong with that. She didn't look very happy with me.

Whether altruism exists or not, this field trip was specifically non-altruistic. It would have been equally altruistic for every patient to send $20 to this charity, but that would never happen. Sending $20 dollars, while it would benefit the charity just as much (really, I made up that number, but I'm assuming that is what our time volunteering was worth), would not give us the same experience in being confronted with the reality of involuntary starvation to contrast with our own voluntary starvation, the contrast of having no food to eat versus our wasting of food. If there were no therapeutic benefit to this field trip, it would be indefensible as part of an eating disorder treatment program, for the hospital and even more so for the insurance companies. The primary purpose of this field trip was our own benefit. That is definitively not altruism. After the field trip we sat together and discussed it. People talked about what they learned about poverty, how much fun they had, that they wanted to go do this again sometime. Then a staff member asked what we learned from the field trip in the context of our eating disorder.

My head nearly exploded.

For me, this situation started out being about the misuse of the word "altruism", but eventually became much bigger. This has happened to me a lot in mental health care: I ask about something relatively insignificant, but the staff respond in such an unreasonable or confounding way, that it turns into something much bigger. In this instance, the bigger frustration was the staff insistence that the staff is always right. There is no, "Well, yes, technically this isn't altruism, but we are still going to call it that because it sounds better and is shorter than your way of describing it," or any other similarly reasonable response. There is no concession that what I've said is true at all, with or without a caveat that their way of looking at things is also valid. My perspective is summarily dismissed (invalidation much?). There isn't much attempt to understand my position, which is something that should be taking place even if what I am saying is clearly delusional. True, this staff member did ask me how I would describe our field trip, but that was after I pressed the matter and after she said, "Well, that's your opinion," which is the sort of response that seems designed to end a conversation. Furthermore, I stood up for myself and I was assertive in this situation, something they constantly preach at us to do. If I was unsure about assertiveness at this point, this is not the sort of interaction that would have encouraged me to be assertive in the future. Rather, I would have learned that assertiveness is hard, doesn't do much good, and garners invalidation.


  1. This is very interesting. Critical thinking is something that should be encouraged in a mental health setting (what with "reality testing" and stuff), but just the opposite seems to happen.

    I often lament that we're not even allowed to CONSIDER whether life might not, after all, be worth living - it's set up as a conclusive presumption that life is worth living, and any critical thinking on this topic is labeled pathological. It sounds like what you're relating is any thinking that's not cheerful is seen as trouble-making.

    It's so humiliating and dehumanizing to be treated that way.

  2. @Curator -

    Yes. Absolutely. But I think it is worse than just anything not cheerful is rejected; more like anything THEY don't see as cheerful is rejected. I do not believe in fate and that "everything happens for a reason". But I do believe that I can use the experiences I have (often for no particular reason) in the future, quite possibly for good. I happen to think this is much more cheerful and lovely than fate. That this is more cheerful to me doesn't matter, they don't like it, end of story.

    Yes. This shutdown of critical thinking in the presence of people who really need help sorting out delusions/distortions from reality is terrible. I think that is why it seems so much like brainwashing, because so much of what patients are told simply isn't true.

    And yet, they do encourage critical thinking, but only in very limited sanctioned ways. Let's examine our black and white thinking when we think food bad, starving good. We need to think in the gray! Allow for nuance! But consider the gray in the life good, suicide bad, area? No, certainly not. We are putting you on one-to-one observation now.

    There is such limited perspective within mental health care. That is why I often derisively refer to what they teach as "The Gospel of Therapy". It is every bit as narrow minded as Fundamentalist Evangelical Christianity. When I don't feel like fighting them, I give them the answers they want to hear, which is like giving the "Sunday School answer" at church.

  3. I would have spontaneously combusted. Seriously, I remember this attitude from treatment. Did they have the "little smile" when you discussed it? A little tight smile that says "I am right because you are sick" That used to piss me right off.

    The fact of the matter is that your position in this debate is based on being a rational intelligent person. Their's seems to be based on the fact they read it in a handout and therefore it must be true.

    Besides, if food is a proxy, what can an anorexic person learn from someone who is starving unwillingly? It was only ever more cause for self beratement when I was restricting. Those starving kids in Africa used to haunt my dreams, and that guilt was more reason to starve my evil self. If starving is about bad feelings and atonement for being who I am, then giving me more cause to feel bad about myself is unlikely to be helpful.

    Lola x