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 -
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
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