800-pound-man-kicked-out-of-hospital-for-ordering-pizza
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nutmegoreo wrote: »While I am not a Dr. Phil fan, the man from the OP has clearly been struggling for some time, and seems to either walk away from help, or burn the bridges with people who have offered help. I was curious, so went digging around and found this:
https://www.youtube.com/watch?v=ASGkG7mdIs4
There comes a time when the individual must make the choice to take the help that is being offered and work with the professionals, or face the consequences. I don't know anything about the hospital program, but I would hope that the hospital offers counselling for underlying psychiatric/emotional issues that would contribute to his condition. As others have said, given the slow rate of loss, I would also suspect that this has not been the first time he has broken the care plan laid out by the program.
For those who are saying he needs help now, he was getting help. By the looks of it, he has been offered help on multiple occasions. Short of forced confinement into a program, I am unclear of what additional help he could be given.
ETA: I have not gone digging to see what happened with the support offered by the Dr. Phil show, and to be honest, I sometimes wonder if there is much help beyond what is said on camera. So there could be much more or less to this story.
In case anyone else was wondering, Assanti was on Dr Phil in 2007.0 -
Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.0 -
kshama2001 wrote: »nutmegoreo wrote: »While I am not a Dr. Phil fan, the man from the OP has clearly been struggling for some time, and seems to either walk away from help, or burn the bridges with people who have offered help. I was curious, so went digging around and found this:https://www.youtube.com/watch?v=ASGkG7mdIs4
There comes a time when the individual must make the choice to take the help that is being offered and work with the professionals, or face the consequences. I don't know anything about the hospital program, but I would hope that the hospital offers counselling for underlying psychiatric/emotional issues that would contribute to his condition. As others have said, given the slow rate of loss, I would also suspect that this has not been the first time he has broken the care plan laid out by the program.
For those who are saying he needs help now, he was getting help. By the looks of it, he has been offered help on multiple occasions. Short of forced confinement into a program, I am unclear of what additional help he could be given.
ETA: I have not gone digging to see what happened with the support offered by the Dr. Phil show, and to be honest, I sometimes wonder if there is much help beyond what is said on camera. So there could be much more or less to this story.
In case anyone else was wondering, Assanti was on Dr Phil in 2007.
Do you know what he weighed then?
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Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
That's not going to work with people who weigh over 500 pounds and are physically incapable of washing parts of their bodies properly and safely, as I described previously. I've helped hold back the flesh of people who can't wash themselves within their own folds.0 -
Reading this thread has made me VERY happy that I don't suffer from mental illness and very wary of checking a place out before I ever allow a loved one to be committed.
Jeeze.0 -
Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.0 -
nutmegoreo wrote: »This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
+1
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Oh wow, a really cynical answer just popped into my head: It's douche baggery when your douchey actions at least have a chance to gain something out of it that will enhance your life. It's mental illness when your douche baggery directly and inevitably hurts you as well as everyone around you.
No. You can be both mentally ill and manipulative. Mental illness does not mean you are free of all character flaws healthy people have. The difference is that mental illness is not a choice.0 -
nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
As someone who is not a professional, but who has more than one mentally ill relatives, actually no. For many mental illnesses, letting the patient give up, and not challenging them is the worst possible approach. Sometimes tough love can make all the difference between a hope to a future that is "normal" and getting deeper and deeper into the illness.0 -
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nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
As someone who is not a professional, but who has more than one mentally ill relatives, actually no. For many mental illnesses, letting the patient give up, and not challenging them is the worst possible approach. Sometimes tough love can make all the difference between a hope to a future that is "normal" and getting deeper and deeper into the illness.
One hopes you would recognize your lack of training in dealing with the mentally ill, and not try to handle them yourself with a 'tough love' approach. Ignorance of the condition can lead to serious consequences, when trying to use your own way of handling what you might see as 'giving up', or being 'manipulative'.
Letting those who know what they are doing is always the better option.0 -
nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
As someone who is not a professional, but who has more than one mentally ill relatives, actually no. For many mental illnesses, letting the patient give up, and not challenging them is the worst possible approach. Sometimes tough love can make all the difference between a hope to a future that is "normal" and getting deeper and deeper into the illness.
I'm not suggesting to let the individual give up, but there has to be another option which would encourage pushing them toward regaining control of their life.
I do work in health care, and I refuse to allow my patients to give up on themselves. Yes, I need to set realistic expectations and goals, but withholding food (yes, I know it's just dessert) and refusing to let them interact with others (which can be a huge emotional support), doesn't seem very productive toward developing coping skills for them.
ETA: I am not a mental health professional, but I work in an inner city hospital where there is a much higher incidence of mental health issues along with substance abuse and homeless/poverty stricken persons.
ETA2: Positive pushes towards making better choices, in my experience, is a much better way to help people regain the confidence they need to recognize that they can do things for themselves and that they can have a better life. We need to give them the tools to support their decision making process and let them know that we believe in them, even when they don't believe in themselves.0 -
Forcing him to leave the hospital is probably a death sentence. Yet, keeping him and depriving another of a shot at rehabilitation is even worse. Arguably, we could increase funding by funneling more taxpayer money into helping those like him. But the questions are: 1) Should we?; and 2) How so?
Should we help people who don't want to be helped? How much should we help them? What is the opportunity cost (e.g. less money for schools or increased taxes?)? I am on the fence here. Not sure if we should be wasting money on this when there are other programs that could use funding and other people more likely to make use of the limited assistance available.
As for the second question, it seems like the current style of programs don't work. If money is diverted to help people like him, it should probably be through some kind of forced mental health program and not a voluntary diet like program. Part of me wants to rebel a bit here since I am a big proponent of individual liberties. Yet, I am also a big proponent of limiting wasted resources. I don't see myself supporting the use of wasting public funds to keep treating his problem for years to come.
Not sure if my post is even worth posting, but I have written it so I will go ahead and post it. I am conflicted on what should be done in situations like this because I abhor wasting public funds uselessly (not saying we don't do this already), I dislike forcing people to do things, and I don't want us to turn into a society where allowing people to die for stupid decisions becomes the norm. These views are not easily reconciled in a situation like this, so I don't know what society should do.0 -
nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
As someone who is not a professional, but who has more than one mentally ill relatives, actually no. For many mental illnesses, letting the patient give up, and not challenging them is the worst possible approach. Sometimes tough love can make all the difference between a hope to a future that is "normal" and getting deeper and deeper into the illness.
One hopes you would recognize your lack of training in dealing with the mentally ill, and not try to handle them yourself with a 'tough love' approach. Ignorance of the condition can lead to serious consequences, when trying to use your own way of handling what you might see as 'giving up', or being 'manipulative'.
Letting those who know what they are doing is always the better option.
No, I do not interract with the people in my life who are ill without talking to a psychiatrist. In my family's case, it would be very dangerous for everyone involved to improvise.
But, regarding tough love, actually it is the opposite that often happens from what I have seen: relatives treating the patient as someone whose every wish must be catered immediately, regardless of the consequences, as if this person would die otherwise. Despite drs orders to stop. In my obviously limitied experience, usually the caretaker taking this approach has a lot of personal issues too, judging both from my family and from families of others I have met through the years in support groups.0 -
My brother is mentally ill. Punitive measures did not help him when he was hospitalized and in fact he now suffers from PTSD. What did help was when they finally found an anti-psychotic that worked for him (his old one had stopped working.)0
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nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
+1000 -
Oh wow, a really cynical answer just popped into my head: It's douche baggery when your douchey actions at least have a chance to gain something out of it that will enhance your life. It's mental illness when your douche baggery directly and inevitably hurts you as well as everyone around you.
No. You can be both mentally ill and manipulative. Mental illness does not mean you are free of all character flaws healthy people have. The difference is that mental illness is not a choice.
So how do you tell from a distance that one is mentally ill and not just a manipulative DB suffering the consequences of his actions?
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Oh wow, a really cynical answer just popped into my head: It's douche baggery when your douchey actions at least have a chance to gain something out of it that will enhance your life. It's mental illness when your douche baggery directly and inevitably hurts you as well as everyone around you.
No. You can be both mentally ill and manipulative. Mental illness does not mean you are free of all character flaws healthy people have. The difference is that mental illness is not a choice.
So how do you tell from a distance that one is mentally ill and not just a manipulative DB suffering the consequences of his actions?
I don't think you really can.0 -
It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
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It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
Thank you for clarifying. I was probably reading more into your previous post. I can see that if you have a group of people with poor impulse control and a tendency toward violence, that it is important to reduce noxious stimuli. I don't know if this is the case in the scenario you are talking about, but it sounds like it. I still do not support confining them to their room, but I am at a loss for suggestions in this situation.
In my experience, bathing someone who is capable of doing it themselves can promote a learned helplessness, which is why we teach nursing students (and family members) that they are not to do for patients what they can do for themselves. Of course this isn't applicable in all cases and doesn't work in all situations.
How much of this is a need to control their environment, or trying to obtain the human contact that would occur when someone is bathing another person? The stigma of mental illness can be socially isolating, and thereby reducing the likelihood of physical contact with others. I am not excusing the behavior, simply trying to understand it.
As for the man in the OP, I didn't get the sense that he was expecting someone else to wash him, just that he was refusing to do it himself. This could be used to further isolate himself from others, giving a false sense of control. There is also a codependency/enabler issue which seems to apply in this case (his father), but that is just conjecture on my part since I know nothing beyond what has been publicized.0 -
You can't understand most of the behavior you encounter. It defies logic. It's insane.nutmegoreo wrote: »
It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
Thank you for clarifying. I was probably reading more into your previous post. I can see that if you have a group of people with poor impulse control and a tendency toward violence, that it is important to reduce noxious stimuli. I don't know if this is the case in the scenario you are talking about, but it sounds like it. I still do not support confining them to their room, but I am at a loss for suggestions in this situation.
In my experience, bathing someone who is capable of doing it themselves can promote a learned helplessness, which is why we teach nursing students (and family members) that they are not to do for patients what they can do for themselves. Of course this isn't applicable in all cases and doesn't work in all situations.
How much of this is a need to control their environment, or trying to obtain the human contact that would occur when someone is bathing another person? The stigma of mental illness can be socially isolating, and thereby reducing the likelihood of physical contact with others. I am not excusing the behavior, simply trying to understand it.
As for the man in the OP, I didn't get the sense that he was expecting someone else to wash him, just that he was refusing to do it himself. This could be used to further isolate himself from others, giving a false sense of control. There is also a codependency/enabler issue which seems to apply in this case (his father), but that is just conjecture on my part since I know nothing beyond what has been publicized.
Rapists are very big on "I'm going to make you wash me" and the reasons there are obvious. They like power and they enjoy making people do what they want. Some people are just trying to be manipulative. It's part of their personality - it's what they do. They're mentally ill. There is no reasonable explanation.
Paranoids (as opposed to "paranoid schizophrenic") won't want to shower because maybe the shower will kill them or because they're just generally distrustful of anything anyone suggests. They're angry and on edge and scared. That makes sense. The meds kick in, they shower.
Schizophrenics coming off a break may not be able to agree or will agree and forget. You don't know what they're thinking, but often, it bears no resemblance to logic. Just neurons firing away in wacky ways. No sense there. When the meds kick in, more sense will return. Until then, there is no understanding.
The depressed agree to it because in the midst of a major depressive episode, people will almost always agree to anything, lol. They don't have the energy to refuse and don't really care, either way. It's the follow-through. Getting up, going to the shower - that's the hard part for them.
People who have had some traumatic event and cannot focus their eyes or hear - they're not even refusing, they just cannot bathe themselves.
People like chicken woman need help. They need to be guided in and washed. They aren't refusing or forgetting, they just aren't part of our world, but are living entirely in their own. There is nothing to understand. She's a chicken. Chickens can't be told to shower. That's the best way to think of it.
If you try to understand it, sometimes you'll be able to, but other times, you'll go mad, yourself, trying.
"I don't want to kill people. If it was up to me, I'd just beat them up. But the voices!" You can understand that.
"Bawk! Baaawwwk! Bawk! Bawk!" You're never going to understand that. There is nothing to understand. Something has gone wrong in that person's brain. Nobody knows what it is. It just is.
We know so little about the brain. There was a huge discovery a couple years ago, but what we learned from it is that there is tons and tons that we cannot figure out. So, now we know that we have a lower % of understanding than we thought we did.
But hopefully, one day, everyone can be helped. Until then, we just have to let them bawk, keep them safe, warm, dry and fed.
0 -
You can't understand most of the behavior you encounter. It defies logic. It's insane.nutmegoreo wrote: »
It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
Thank you for clarifying. I was probably reading more into your previous post. I can see that if you have a group of people with poor impulse control and a tendency toward violence, that it is important to reduce noxious stimuli. I don't know if this is the case in the scenario you are talking about, but it sounds like it. I still do not support confining them to their room, but I am at a loss for suggestions in this situation.
In my experience, bathing someone who is capable of doing it themselves can promote a learned helplessness, which is why we teach nursing students (and family members) that they are not to do for patients what they can do for themselves. Of course this isn't applicable in all cases and doesn't work in all situations.
How much of this is a need to control their environment, or trying to obtain the human contact that would occur when someone is bathing another person? The stigma of mental illness can be socially isolating, and thereby reducing the likelihood of physical contact with others. I am not excusing the behavior, simply trying to understand it.
As for the man in the OP, I didn't get the sense that he was expecting someone else to wash him, just that he was refusing to do it himself. This could be used to further isolate himself from others, giving a false sense of control. There is also a codependency/enabler issue which seems to apply in this case (his father), but that is just conjecture on my part since I know nothing beyond what has been publicized.
Rapists are very big on "I'm going to make you wash me" and the reasons there are obvious. They like power and they enjoy making people do what they want. Some people are just trying to be manipulative. It's part of their personality - it's what they do. They're mentally ill. There is no reasonable explanation.
Paranoids (as opposed to "paranoid schizophrenic") won't want to shower because maybe the shower will kill them or because they're just generally distrustful of anything anyone suggests. They're angry and on edge and scared. That makes sense. The meds kick in, they shower.
Schizophrenics coming off a break may not be able to agree or will agree and forget. You don't know what they're thinking, but often, it bears no resemblance to logic. Just neurons firing away in wacky ways. No sense there. When the meds kick in, more sense will return. Until then, there is no understanding.
The depressed agree to it because in the midst of a major depressive episode, people will almost always agree to anything, lol. They don't have the energy to refuse and don't really care, either way. It's the follow-through. Getting up, going to the shower - that's the hard part for them.
People who have had some traumatic event and cannot focus their eyes or hear - they're not even refusing, they just cannot bathe themselves.
People like chicken woman need help. They need to be guided in and washed. They aren't refusing or forgetting, they just aren't part of our world, but are living entirely in their own. There is nothing to understand. She's a chicken. Chickens can't be told to shower. That's the best way to think of it.
If you try to understand it, sometimes you'll be able to, but other times, you'll go mad, yourself, trying.
"I don't want to kill people. If it was up to me, I'd just beat them up. But the voices!" You can understand that.
"Bawk! Baaawwwk! Bawk! Bawk!" You're never going to understand that. There is nothing to understand. Something has gone wrong in that person's brain. Nobody knows what it is. It just is.
We know so little about the brain. There was a huge discovery a couple years ago, but what we learned from it is that there is tons and tons that we cannot figure out. So, now we know that we have a lower % of understanding than we thought we did.
But hopefully, one day, everyone can be helped. Until then, we just have to let them bawk, keep them safe, warm, dry and fed.
This is all very interesting, but has little to do with why the man in the OP was not cleaning himself. When he clearly had the ability (at least at the time of his appearance on the Dr. Phil show). You are comparing apples to oranges in this situation and taking more extreme circumstances and using that experience to apply it in a situation where the person in question has much more capacity for decision making than what you are describing above.
In all of the situations you describe (with the exception of the rapists), refusal to shower is not a manipulation technique, but rather a lack of comprehension of the need for bathing or an intense aversion for it. I can assure you that if I thought I would be showering in something that would kill me, I would not be climbing in there. It's the same reason there is little recourse when I get punched in the mouth by someone who thinks I am trying to kill him with the Heparin injection I am trying to give. Capacity for decision making.
At the end of the day, the reason I was reading so much into your post was simply because you were talking about the treatment of people who lack the capacity to make decisions or to recognize actions and consequences, which has nothing to do with this thread. I do appreciate your clarifications of my questions and concerns.0 -
You can't understand most of the behavior you encounter. It defies logic. It's insane.nutmegoreo wrote: »
It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
Thank you for clarifying. I was probably reading more into your previous post. I can see that if you have a group of people with poor impulse control and a tendency toward violence, that it is important to reduce noxious stimuli. I don't know if this is the case in the scenario you are talking about, but it sounds like it. I still do not support confining them to their room, but I am at a loss for suggestions in this situation.
In my experience, bathing someone who is capable of doing it themselves can promote a learned helplessness, which is why we teach nursing students (and family members) that they are not to do for patients what they can do for themselves. Of course this isn't applicable in all cases and doesn't work in all situations.
How much of this is a need to control their environment, or trying to obtain the human contact that would occur when someone is bathing another person? The stigma of mental illness can be socially isolating, and thereby reducing the likelihood of physical contact with others. I am not excusing the behavior, simply trying to understand it.
As for the man in the OP, I didn't get the sense that he was expecting someone else to wash him, just that he was refusing to do it himself. This could be used to further isolate himself from others, giving a false sense of control. There is also a codependency/enabler issue which seems to apply in this case (his father), but that is just conjecture on my part since I know nothing beyond what has been publicized.
Rapists are very big on "I'm going to make you wash me" and the reasons there are obvious. They like power and they enjoy making people do what they want. Some people are just trying to be manipulative. It's part of their personality - it's what they do. They're mentally ill. There is no reasonable explanation.
Paranoids (as opposed to "paranoid schizophrenic") won't want to shower because maybe the shower will kill them or because they're just generally distrustful of anything anyone suggests. They're angry and on edge and scared. That makes sense. The meds kick in, they shower.
Schizophrenics coming off a break may not be able to agree or will agree and forget. You don't know what they're thinking, but often, it bears no resemblance to logic. Just neurons firing away in wacky ways. No sense there. When the meds kick in, more sense will return. Until then, there is no understanding.
The depressed agree to it because in the midst of a major depressive episode, people will almost always agree to anything, lol. They don't have the energy to refuse and don't really care, either way. It's the follow-through. Getting up, going to the shower - that's the hard part for them.
People who have had some traumatic event and cannot focus their eyes or hear - they're not even refusing, they just cannot bathe themselves.
People like chicken woman need help. They need to be guided in and washed. They aren't refusing or forgetting, they just aren't part of our world, but are living entirely in their own. There is nothing to understand. She's a chicken. Chickens can't be told to shower. That's the best way to think of it.
If you try to understand it, sometimes you'll be able to, but other times, you'll go mad, yourself, trying.
"I don't want to kill people. If it was up to me, I'd just beat them up. But the voices!" You can understand that.
"Bawk! Baaawwwk! Bawk! Bawk!" You're never going to understand that. There is nothing to understand. Something has gone wrong in that person's brain. Nobody knows what it is. It just is.
We know so little about the brain. There was a huge discovery a couple years ago, but what we learned from it is that there is tons and tons that we cannot figure out. So, now we know that we have a lower % of understanding than we thought we did.
But hopefully, one day, everyone can be helped. Until then, we just have to let them bawk, keep them safe, warm, dry and fed.
Referring to individuals who have mental illness as their disease is disheartening and discouraged in training of mental health professionals. It's demeaning and hurtful to identify people as their illness, and your generalizations about individuals with these illnesses and their propensity to bathe is assumptive and made based on a small population you have experience with.0 -
nutmegoreo wrote: »
You can't understand most of the behavior you encounter. It defies logic. It's insane.nutmegoreo wrote: »
It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
Thank you for clarifying. I was probably reading more into your previous post. I can see that if you have a group of people with poor impulse control and a tendency toward violence, that it is important to reduce noxious stimuli. I don't know if this is the case in the scenario you are talking about, but it sounds like it. I still do not support confining them to their room, but I am at a loss for suggestions in this situation.
In my experience, bathing someone who is capable of doing it themselves can promote a learned helplessness, which is why we teach nursing students (and family members) that they are not to do for patients what they can do for themselves. Of course this isn't applicable in all cases and doesn't work in all situations.
How much of this is a need to control their environment, or trying to obtain the human contact that would occur when someone is bathing another person? The stigma of mental illness can be socially isolating, and thereby reducing the likelihood of physical contact with others. I am not excusing the behavior, simply trying to understand it.
As for the man in the OP, I didn't get the sense that he was expecting someone else to wash him, just that he was refusing to do it himself. This could be used to further isolate himself from others, giving a false sense of control. There is also a codependency/enabler issue which seems to apply in this case (his father), but that is just conjecture on my part since I know nothing beyond what has been publicized.
Rapists are very big on "I'm going to make you wash me" and the reasons there are obvious. They like power and they enjoy making people do what they want. Some people are just trying to be manipulative. It's part of their personality - it's what they do. They're mentally ill. There is no reasonable explanation.
Paranoids (as opposed to "paranoid schizophrenic") won't want to shower because maybe the shower will kill them or because they're just generally distrustful of anything anyone suggests. They're angry and on edge and scared. That makes sense. The meds kick in, they shower.
Schizophrenics coming off a break may not be able to agree or will agree and forget. You don't know what they're thinking, but often, it bears no resemblance to logic. Just neurons firing away in wacky ways. No sense there. When the meds kick in, more sense will return. Until then, there is no understanding.
The depressed agree to it because in the midst of a major depressive episode, people will almost always agree to anything, lol. They don't have the energy to refuse and don't really care, either way. It's the follow-through. Getting up, going to the shower - that's the hard part for them.
People who have had some traumatic event and cannot focus their eyes or hear - they're not even refusing, they just cannot bathe themselves.
People like chicken woman need help. They need to be guided in and washed. They aren't refusing or forgetting, they just aren't part of our world, but are living entirely in their own. There is nothing to understand. She's a chicken. Chickens can't be told to shower. That's the best way to think of it.
If you try to understand it, sometimes you'll be able to, but other times, you'll go mad, yourself, trying.
"I don't want to kill people. If it was up to me, I'd just beat them up. But the voices!" You can understand that.
"Bawk! Baaawwwk! Bawk! Bawk!" You're never going to understand that. There is nothing to understand. Something has gone wrong in that person's brain. Nobody knows what it is. It just is.
We know so little about the brain. There was a huge discovery a couple years ago, but what we learned from it is that there is tons and tons that we cannot figure out. So, now we know that we have a lower % of understanding than we thought we did.
But hopefully, one day, everyone can be helped. Until then, we just have to let them bawk, keep them safe, warm, dry and fed.
This is all very interesting, but has little to do with why the man in the OP was not cleaning himself. When he clearly had the ability (at least at the time of his appearance on the Dr. Phil show). You are comparing apples to oranges in this situation and taking more extreme circumstances and using that experience to apply it in a situation where the person in question has much more capacity for decision making than what you are describing above.
In all of the situations you describe (with the exception of the rapists), refusal to shower is not a manipulation technique, but rather a lack of comprehension of the need for bathing or an intense aversion for it. I can assure you that if I thought I would be showering in something that would kill me, I would not be climbing in there. It's the same reason there is little recourse when I get punched in the mouth by someone who thinks I am trying to kill him with the Heparin injection I am trying to give. Capacity for decision making.
At the end of the day, the reason I was reading so much into your post was simply because you were talking about the treatment of people who lack the capacity to make decisions or to recognize actions and consequences, which has nothing to do with this thread. I do appreciate your clarifications of my questions and concerns.
We don't know why that guy wouldn't bathe. Maybe there is a reason we'd understand and maybe he's just playing a manipulative game for no good reason because that's part of his mental illness and just what he does.
He may be well enough to chose to play games, but be sick enough to do it for no good reason. That happens.
You cannot always understand why these people do the things they do and you sure can't tell by watching Dr. Phil.
Sometimes, there is no explanation. If their brains made sense, it wouldn't be an illness.
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This content has been removed.
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nutmegoreo wrote: »
You can't understand most of the behavior you encounter. It defies logic. It's insane.nutmegoreo wrote: »
It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
Thank you for clarifying. I was probably reading more into your previous post. I can see that if you have a group of people with poor impulse control and a tendency toward violence, that it is important to reduce noxious stimuli. I don't know if this is the case in the scenario you are talking about, but it sounds like it. I still do not support confining them to their room, but I am at a loss for suggestions in this situation.
In my experience, bathing someone who is capable of doing it themselves can promote a learned helplessness, which is why we teach nursing students (and family members) that they are not to do for patients what they can do for themselves. Of course this isn't applicable in all cases and doesn't work in all situations.
How much of this is a need to control their environment, or trying to obtain the human contact that would occur when someone is bathing another person? The stigma of mental illness can be socially isolating, and thereby reducing the likelihood of physical contact with others. I am not excusing the behavior, simply trying to understand it.
As for the man in the OP, I didn't get the sense that he was expecting someone else to wash him, just that he was refusing to do it himself. This could be used to further isolate himself from others, giving a false sense of control. There is also a codependency/enabler issue which seems to apply in this case (his father), but that is just conjecture on my part since I know nothing beyond what has been publicized.
Rapists are very big on "I'm going to make you wash me" and the reasons there are obvious. They like power and they enjoy making people do what they want. Some people are just trying to be manipulative. It's part of their personality - it's what they do. They're mentally ill. There is no reasonable explanation.
Paranoids (as opposed to "paranoid schizophrenic") won't want to shower because maybe the shower will kill them or because they're just generally distrustful of anything anyone suggests. They're angry and on edge and scared. That makes sense. The meds kick in, they shower.
Schizophrenics coming off a break may not be able to agree or will agree and forget. You don't know what they're thinking, but often, it bears no resemblance to logic. Just neurons firing away in wacky ways. No sense there. When the meds kick in, more sense will return. Until then, there is no understanding.
The depressed agree to it because in the midst of a major depressive episode, people will almost always agree to anything, lol. They don't have the energy to refuse and don't really care, either way. It's the follow-through. Getting up, going to the shower - that's the hard part for them.
People who have had some traumatic event and cannot focus their eyes or hear - they're not even refusing, they just cannot bathe themselves.
People like chicken woman need help. They need to be guided in and washed. They aren't refusing or forgetting, they just aren't part of our world, but are living entirely in their own. There is nothing to understand. She's a chicken. Chickens can't be told to shower. That's the best way to think of it.
If you try to understand it, sometimes you'll be able to, but other times, you'll go mad, yourself, trying.
"I don't want to kill people. If it was up to me, I'd just beat them up. But the voices!" You can understand that.
"Bawk! Baaawwwk! Bawk! Bawk!" You're never going to understand that. There is nothing to understand. Something has gone wrong in that person's brain. Nobody knows what it is. It just is.
We know so little about the brain. There was a huge discovery a couple years ago, but what we learned from it is that there is tons and tons that we cannot figure out. So, now we know that we have a lower % of understanding than we thought we did.
But hopefully, one day, everyone can be helped. Until then, we just have to let them bawk, keep them safe, warm, dry and fed.
This is all very interesting, but has little to do with why the man in the OP was not cleaning himself. When he clearly had the ability (at least at the time of his appearance on the Dr. Phil show). You are comparing apples to oranges in this situation and taking more extreme circumstances and using that experience to apply it in a situation where the person in question has much more capacity for decision making than what you are describing above.
In all of the situations you describe (with the exception of the rapists), refusal to shower is not a manipulation technique, but rather a lack of comprehension of the need for bathing or an intense aversion for it. I can assure you that if I thought I would be showering in something that would kill me, I would not be climbing in there. It's the same reason there is little recourse when I get punched in the mouth by someone who thinks I am trying to kill him with the Heparin injection I am trying to give. Capacity for decision making.
At the end of the day, the reason I was reading so much into your post was simply because you were talking about the treatment of people who lack the capacity to make decisions or to recognize actions and consequences, which has nothing to do with this thread. I do appreciate your clarifications of my questions and concerns.
We don't know why that guy wouldn't bathe. Maybe there is a reason we'd understand and maybe he's just playing a manipulative game for no good reason because that's part of his mental illness and just what he does.
He may be well enough to chose to play games, but be sick enough to do it for no good reason. That happens.
You cannot always understand why these people do the things they do and you sure can't tell by watching Dr. Phil.
Sometimes, there is no explanation. If their brains made sense, it wouldn't be an illness.
Again, "these people" and "their brains."
Please watch your choice of words when referring to individuals with mental illness and not grouping individuals who may have similar symptoms or illnesses.0 -
We're talking about ill people in a hospital setting, not prisoners in a prison. Your analogy is offensive.
It's not really a punishment. There are many people there, all of whom have issues. If you allow someone who is horribly stinky out with others, there will be comments and it's very likely that a fight will break out. It's disruptive and dangerous.nutmegoreo wrote: »Refusing to bathe is not an uncommon tactic amongst the mentally ill who are able to interact with others. It's a stupid, manipulative game they play, much like a child who holds their breath. "I'm going to make you wash me" is the slang we used, as in, "Mr. Smith is playing 'I'm going to make you wash me' and may not have ice cream after dinner."
Much like children, if they're refused dessert for a couple meals, many will bathe. The ones who that doesn't work on are confined to their room until they bathe.
Old story.
This is really not sitting well with me, so I am asking for clarification.
Are you saying that confining people with mental health issues to their room (how is this enforced?) is an appropriate 'punishment' for them using the 'manipulation technique' of not bathing? Punishment here is placed in quotes for the fact that this, in my mind, is abusive. Manipulation technique is in quotes because for people with severe depression, basic daily activities are incredibly difficult to perform. Even with mild depression, a person's willingness to partake in self-care can be diminished.
Maybe it's the way I'm reading it, but your post is really sad and sounds horrifying.
Everyone has to bathe. Daily would be ideal, but at least every two or three days. If they refuse to bathe, they cannot be out and upsetting everyone else.
Everyone has to wear some kind of clothing. Nakedness will also mean you're confined to your room. That, too, upsets others. The accidentally naked will be reminded to dress or assisted with dressing. The manipulative, "I'm not wearing clothes and everyone can deal with it," will mean you need to stay in your room until you put on some type of clothing.
These are really the only two things required. You must bathe and you must wear some kind of clothing.
Some people are too far gone to bathe and are helped or relieved of the burden, but the manipulative, "You have to wash me" is just not complied with. When you begin bathing people who can bathe themselves because that's what they've insisted upon, you literally have the inmates running the asylum. Again, this is something that has to be assessed on a case-by-case basis.
If that young man was well enough to dust and vacuum, he was well enough to attempt to bathe himself. I don't know why he refused or if he was playing the manipulative "I'm going to make you wash me" game or not, but it happens and it happens all the time.
A person in the midst of a major depressive episode - I've never seen one do that. That would not be common. They always bathe. Usually, every day, with encouragement, but for sure every day or two. They're not out to force anyone to wash them. It's just not part of their deal.
It isn't common amongst the depressed (like I said, I've never seen it at all), but the game itself is played out every day. It's very frustrating for family members attempting to help these people at home. Those family members are encouraged to cease assistance until the person bathes. Some can, some cannot.
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I've spent my entire professional life as a licensed mental health practitioner working with individuals and populations generally assessed as being "high risk" for any number of reasons. I don't have any illusions left about the challenges people face, the balance between personal and social responsibility, or how much of a miracle it really is when someone is able to get free of their particular version of hell.
I had hoped that the example of this young man might spark some useful discussion around just how complex and heartbreaking it can be (for everyone - the individual suffering, family members, the care team) to deal with extreme obesity.
Instead, I'm just appalled at some of the talk here about how to tell whether someone is a "DB" as opposed to "really" having a mental disorder, implications that those with mental disorders must be having just a great time thanks to their "freedom" to "do/eat what they want" (REALLY?). And I'm seeing posts from others who apparently have some personal history working with the severely mentally ill who are telling stories designed to shock or entertain about their former clients, labeling people as their illness, and generalizing about people with mental disorders in ways that I find very questionable and offensive on a professional level.
Whether his illness led him to set himself up like this or not, there's no reason to treat this man and his family - or anyone with a mental disorder - like a freak show. I'm just so damned disappointed in a lot of what I am seeing here. People on these boards can do better than that.
Well said, @Caitwn . As compassionate people, we should all be able to find it in ourselves to see the humanity in all people and never forget about that - despite any medical/mental issues they may have. There but for the grace of God go I.0
This discussion has been closed.
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