This book is amazingly interesting and provides many topics of discussion around eating disorder recovery, the structure/ climate of a residential unit and family dynamics of someone with an eating disorder. Would love people’s feedback who have actually experienced things similar to Jenifer.
There are many things about Jenifer’s story that emediately grab your attention that this is not going to be your typical memoir. First of all she does not at all go into detail of the ups and downs, and detailed “tricks” of maintaining an eating disorder. The book starts at the point where Jenifer really does want help. She’s tired of drinking, cutting herself, and the eating disorder itself. She calls it a “monster” that’s destroying her life and she needs to figure out a way to kill it.
As a side note this book is set in the eighties. So there isn’t nearly the wealth of resources, good and bad (as in people braging/ sharing eating disorder tips) that there is now. Which is a very good thing. Because Jenifer readily admits and comments astutely on how the memoirs and movies/ tv shows that were available to her only fuiled her disorder. She would watch them and file away ways to be bulimic anorexic ETC. She noted the chracter’s recovery as following a particular pattern. Family/ friends are terrified of the person’s destructive behavior. The person is in denial and doing everything they can to stay one step ahead of concerned others. They have a physical crisis/ accident and end up hospitalized. Where the physical effects of the disease can’t be ignored and eventually go to treatment. The atmosphere is pleasant. The nurses and doctors are friendly but firm. She still believes she doesn’t need help until dramatically another patient dies. Or she somehow gets it about just how her family is torn apart or some such dramatic moment of insight. She then works with her therapist and others and slowly gets on a good path. Everyone is happy.
So along these lines when Jenifer is ready for help she expects it to come in the form of this pattern. However from the start things defy these rules. First of all her parents are in complete denial that she has an eating disorder at all. They think because she has amazing grades and friends that there’s nothing to worry about. They have ignored her experiences of being drunk, and all the signs of an eating disorder. Her mother is reluctant to even make an intake appointment and denies the disorder even as the doctor, Dr. Wexler the director of the unit, confirms she has it.
She is admitted to the unit the next week. Again grudgingly by her parents. She is as expected very terrified/ having second thoughts. Right away she notices a cold condescending atmosphere about the things. Well firstly she has to do an interview with Dr. Prakam, a psychiatrist with a thick accent and less than a good command of English. It is hard to follow her questions in her anxious state but she tries to be polite as this could be, and turns out to be her doctor.
On the unit as mentioned she clearly notices that the staff is not as friendly as depicted on TV. The first thing a nurse does is go through her stuff checking for “contraband.” Having never experienced a mental health/ psychiatric hospitalization she has no idea for example that a razor would need to be taken away. She is shocked by the invasion of privacy especially with no kindness compassion about it.
The staff doesn’t seem to acknowledge her crying and how much distress she’s in and even calls it “attention seeking behavior” and they haven’t even bothered to get to know her yet.
She meets the other girls. She edmediately connects with Monica and Bronwynn who are outgoing and make an effort to show her the ropes. They explain that the only diagnosis that will be charted are anorexia, bulimia or compulsive overeating. Though many of the girls feel/ know that they have a combination of both. What supposedly is called in the lates eighties library books as bulimiarexia. Not called eating disorder not otherwise specified. It should be noted that the DSM of that time is DSM 3.
After a gross dinner which she is so hungry she eats very fast (in spite of wanting to act anorexic) she gets disoriented going to her room. Another nurse coldly says that she should know where it is and would put it in her file. Attention seeking apparently.
Her roommate is not friendly at all. She’s very angry and Jenifer tries to just stay away from her. That night a code is called on an agitated woman on the adult unit next door. This terrifies Jennifer as again she had no idea such illness existed and would be so close to where she was doing treatment. The one kind nurse is the night nurse Beverly.
Who allows her to use the bathroom unsupervised a “privilege” that she won’t get for a long time.
She is roughly awakened by a nurse Twendy. I don’t know if that’s her actual name, or a made up name (she makes up names for the others). But in any case this nurse doesn’t even bother to say good morning or say what she’s doing as she’s doing vitals. Steadier her when she stads and saying “don’t pass out” as blood pressure often drops for those with EDS. Talk about not compassionate.
She is told about the messy business of having to constantly collect her urine and put it in a jug in the bathroom and give it to the nurses every day! Gross!
She goes to weigh in where she meets Sheryl. Sheryl emediately reminds Jennifer of the nurse from One Flew over the Kok’s Nest Nurs Ratched. This is her nickname throughout the book by almost all the patients. Jenifer is intimidated right away and starts crying when Sheryl questions her about her weight. Saying she doesn’t “look like she should weigh” and getting upset in front of her that no one weighed her on admission. Then at some point she is accused of “tanking” drinking a lot of water to trick the scales, or putting quarters in her vagina! She, and I have never heard of such a thing and she’s horrified and beginning to panic about having to have a gyno exam.
Eventually she is coldly told to leave. She hides in her room again frozen with fear and complete disbelief that this is what she signed up for. That she’s assumed guilty on almost everything and not given any warmth by these staff.
She meets with Dr. Wexler who is the individual/ group therapist for everyone. This guy to me is the stereotypical therapist. The kind totally ignorant people think of when they picture a therapist, someone saying “and how do you feel about that?” to everything. That’s what this guy does. Every question is thrown back on her. She’s basically lead to certain conclussions about herself by him and the psychiatrist. But with him on that first day though she is so emotionally torn apart and overwhelmed he provides no compassion/ sympathy. Only tissues and a firm talk about “being honest.” And “working the program.” Again it is incredibly presumed that she is not honest.
In the middle of that day Dr. Prekash appear in her room. Her style is similar to Dr. Wexler in the therapy realm but she shows more compassion and wanting to connect with Jennifer. She sits on Jennifer’s bed while she’s buried in her covers and rubs her back coaxing her to take deep breaths. This is the biggest show of true warmth and wanting to actually connect with a patient on a human level. It opens Jennifer up to talk more about how much things were wearing on her and it’s only the first day. Dr. Prekash is firm though as the others are on certain things. When she was told by Dr. Wexler that Sheryl would be her primary nurse, she asked if she could switch nurses. The Dr. does give this a few moments thought before saying no. She doesn’t just say no and turn her back but explains her reasoning. Which is that to her Jennifer has a perfectionistic outlook towards herself and others. And that if people don’t fit her standards she pushes them away. How the Dr. came to this conclusion upone a half hour of interviewing plus this one session I don’t know. Due to Prekash’s slightly odd English she comes up with some interesting metaphors. Instead of saying idealizing someone is putting them on a pedestal, she says it’s putting them on the head of a pin. I’d never heard it explained that way and it really explains the concept well. Because nothing can balance on a pinhead. Jennifer understands the point but still hates it. This is acceptable to Dr. Prekash as well. She is allowed to have her feelings and her expressing them isn’t labeled and dismissed as with other staff.
The other sign of human caring is her relationship with Chuck. Chuck is her secondary nurse. He is just learning this job so only has her as his one patient. She emdiately sense this is an opportunity for the both of them to work together and learn a lot from each other. Chuck is a person first and a nurse/ clinical second. He has a creative sense of humor and true desire to walk alongside Jennifer. Giving her thoughtful perspective also allowing her to vent her feelings. Again having a close relationship with a staff member based on human connection is a cornerstone of her recovery on the unit.
Time goes on. As I said the therapy sessions with Prekash and Wexler are so rigid/ stiff that it’s crazy and often boring to read. But perhaps this is how it was really done. After all this is a memoir. Maybe this was therapy in the eighties and there’s truth to the stereotype of a distant pushy therapist.
Again with both Dr.s she is lead to certain isnights and issues. More told by them what the problem is and what she needs to do about it, and it seems takes in this information too quickly. It all seems as I said rather stiff and mechanical. For example by her first family therapy session, a week or so into things she’s come to the conclussions through therapy that she is an alcoholic. Also that there are negative family dynamics like her mom making fun of her dad with her joining in. And her dad being very angry with a bad temper that affects the family in a bad way. It is often talked about to the point of overrepeating that Jennifer’s eating disorder is caused by emeshment with her mother. And a poor relationship with her father. And she taking on all the problems of the family and being the peace maker. All this is pulled out by Jennifer within the first session. Which is quite dramatic. As it’s first lead by a social worker who literally says nothing. Then Dr. Prekash comes to the rescue when practically the whole can hear her father screaming. She is able to calm everyone down suficently to talk. The alcoholism thing brings her father to tears as his sister and I believe father were alcoholics. The parents are left confused and shaken by everything thrown in their laps and Jennifer is totally drained. I feel this was overkill for a first session and expecting her/ the family to absorb everything in one go is just not realistic. Along the same lines that Jennifer being lead/ taking in huge previously unknown insights just because Wexler and Prekash insist they are true and force her to them is unrealistic.
Life on the unit is far from supportive when it comes to other nurses. With food they demand everyone eat all of it. The people are allowed three “dislikes” foods they will not eat. But it has to be extremely specific and a person has to eat the disliked food once in order for it to be on the list. Also the numbers of proteens fats dary ETC are meticulously brought into the meal plan. They have to have a certain number of each food and it’s clearly specified which food meets which criteria. The girls start depending on their individual issues, on a certain amount of aclories. Then work their way up. Still the changes in amounts of food are hugely overwhelming for many girls. That and the fact that the food looks and tastes disgusting.
Sheryl and the other nurses besides Chuck make life hard as well. As Sheryl is a stickler for the rules to the point of being ridiculous. The girls make up a card game about lying when picking cards which is quite fun Sheryl storms in horrified that the girls are “playing games” during after meal supervision and labels it some kind of avoiding behavior. The same is true when the girls are dancing in the day room to a favorite song. It’s as if there is no fun allowed and everything is negatively labeled.
As previously mentioned there is constant conflict among the girls. Some say they’ve been there six months and ovten complain endlessly about everything in groups rather than discussing their own deeper issues. Elanor a girl close to graduating takes the time to privately share that this is not the way and that Jennifer can make progress and be out in two or so months which through struggles and victories she is.
Jennifer doesn’t quite get this for awhile how some of the girls would rather stay sick and be in competition around which ED is cooler or something than actually gets better. It becomes apparent when her roommate turns out to be a chronic stealer how bad things are. She’s from a terribly abusive home where believer it or not her father is planning to wire her jaw shut! And this is allowed and explained away by the staff. That really threw me.
Anyway with the nudging of Monica Heather does give the stolen items back. There is a bit of a tiff between Jenifer and the staff about why this wasn’t brought to people’s attention to protect their stuff. Prekash reminds her that the staff can only do so much and they did warn her to guard her stuff. Still Jennifer again feels like this place is hurting her and never thought stealing would factor in at all.
Group therapy is the same mess that individual with Wexler is. He basically waits for someone to speak up and it turns into girls calling others out on things and he does nothing to intervine. And then says well that’s all for today! Jennifer is struck that there was no resolution or anything to the meetings which seem to stir up everyone more.
Upone Prekash’s recommendation she attends a chemical dependency group on another ward. That ward is worse than ED with patients getting points taken away for even slouching in their chair! They watch movies about people affected by drugs and have discussion. It seems clear that Jenifer doesn’t really need this treatment. She gets what she can from it and then stands up to her team saying she will not do the worksheets anymore. It’s the first sign that actually standing up to staff and their arbiteray rules will be the best healing she gets from there.
Other therapy like art andmovement she finds more helpful. She likes the therapist Liz a lot. She considers in her own mind dropping dance as it triggers her old eating disorder mindset/ emotions. I was happy that she actually came to this conclusion on her own without a therapist shoving it down her throat. The sessions drag on. But Dr. Prekash in particular encourages her to ask for priveliges and move up the stages of treatment. So she is able to go for walks have unsupervised bathrooms ETC. And she never gets priviliges taken away which shows she is commited to things. As she gets stronger things fall apart for Monika. She is just totally going out of control even had to have a code called on her for cutting. She constantly talks about signing out. Seeing her going down hill gives Jennifer the strength she needs to stand up to the whole group and voice her concerns for everyone and to stop playing games as their lives are on the line. She makes somepeople very upset but knows it was the right thing to say.
She gets a new roommate after Heather who is also commited to recovery. The two form a deep connection and really get each other through hard times.
Chuck always is there no matter what the issue. Once she is in a depression and Chuck coaxes her to look out the window and make up stories about people walking by and what problems they might have. This makes her laugh and shifts her mood. When getting a soft drink for the first time, a real trigger for her he distracts her by having her chase a ping pong ball around the vending room. It’s his creativity and openness that also pushes Jennifer.
Due to all this she is able to return home in two months. Of course with outpatient services therapy with Dr. Prekash and Wexler. And group with Wexler. She is on a mood stabilizer but feels it did really not anything for her. Dr. Prekash says she could sense a positive change and that it could be the medicine or her own personal growth. You could sense though that she’s not likely to stay on the medication.
Another huge point in the book is finding out that nurse Ratched Sheryl has a severe eating disorder. Again it’s very strange that the patients were directly told this rather than just being told of her leaving. It gets everyone going about why she was allowed to work there in the first place and why was she allowed to boss everyone around. In the past when they tried politiely to call staff on lack of consistency they were shut down for being “passive aggressive.” Yet now that this has come out staff seem to be on the side of the patients.
Again it’s a case of the girls being treated like one mental disease and a prescribed program for treatment rather than each person being treated as a person.
A last comment Jennifer makes is again how her watching movies/ tv shows and reading ED memoir books did nothing but further entrench her disorder. This brings up the point of such memoirs/ media doing more harm than good. And that a change needs to be made to make the stories presentedmore focused on treatment/ recovery than the ins and outs of the triggering very issues the people are trying to avoid in the first place. I’m struck by the dynamics/ atmosphere of the place and soo hope that such does not exist in treatment centers today. When Jennifer remarks in an author’s note that all the political and rules issues were true it made me shiver as that was the worst of it to read.
In spite of the therapists/ nurses treatment of her and the mechanical therapy process I like how this book focuses on the treatment rather than the disorder and feel more books should. I also admire Jenniver Johnson for the courage in telling an honest raw account of the ups and downs, too many downs for my liking of her recovery journey.
She actually has a website:
I really would love discussion on the book. Awell as more impoantly questions it raises. The atmosphere on the unit, how therapy is condeucted procedures for getting cients to eat people’s thoughts on “recovery memoirs” and whatever else comes up!
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