800-pound-man-kicked-out-of-hospital-for-ordering-pizza
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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.
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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.
1 -
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.
0 -
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 -
-
"mccindy72 wrote: »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.
Yes. Very much so.
0 -
vivmom2014 wrote: »"mccindy72 wrote: »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.
Yes. Very much so.
+10 -
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, and fully agreed.0 -
Although I'm behind the times on my terminology, I didn't mean any offense, much as I'm sure you didn't mean any offense when you described people as ill.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.
We aren't supposed to describe people as mentally healthy or mentally ill any longer. No mental illness. That's offensive, too.
Welcome to the world of being offensive without meaning to offend.
If you'd like to know what you should say so that you can stop being so darned offensive, it is "wellness." Nobody is ill. Everyone is well. There are different levels of wellness.
I guess it makes sense and is nice, but I just got used to saying "mental health" and "mentally ill" instead of Psych. It's just a problem in that when you say, "Wellness Center," many people don't know, yet, what you mean. If you say "Psych" or "mental health," they understand.
I will take a while to get with the program, I'm sure. It always does. I'll catch up eventually.
1 -
Although I'm behind the times on my terminology, I didn't mean any offense, much as I'm sure you didn't mean any offense when you described people as ill.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.
We aren't supposed to describe people as mentally healthy or mentally ill any longer. No mental illness. That's offensive, too.
Welcome to the world of being offensive without meaning to offend.
If you'd like to know what you should say so that you can stop being so darned offensive, it is "wellness." Nobody is ill. Everyone is well. There are different levels of wellness.
I guess it makes sense and is nice, but I just got used to saying "mental health" and "mentally ill" instead of Psych. It's just a problem in that when you say, "Wellness Center," many people don't know, yet, what you mean. If you say "Psych" or "mental health," they understand.
I will take a while to get with the program, I'm sure. It always does. I'll catch up eventually.
The difference between what I said "people with mental illness" and what you said "depresseds," "paranoids," etc. is that I am not defining a person by their illness. The way you referred to people is not a matter of catching up, as it has not been acceptable for decades to refer to people that way.0 -
I'd like to clarify that I wasn't trying to shock anyone. Had I been trying, I could've done better.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.
I was also not trying to entertain, a la Dr. Phil.
If you are offended, I apologize for having offended you. Be assured it was not my intention.
It's different inside "the center" (which is the proper terminology now) than it is outside. Things are done differently. If things could be handled in the ways you might handle them, the center wouldn't have to be there. I'm sure there have been times where you've had a patient or client who needed more intensive treatment than you could provide. That's why those centers exist. Different ways of doing things.
While you encourage people to use the proper terms (which we totally should), remember that most of us are simply behind the times and mean no harm.0 -
Well, since this is the final day of Mental Health Awareness Week 2015, here are a few links for everyone. As well as this year's hashtag: #IAmStigmaFree (See the person, not the illness.) Last year's was #EveryMindMatters. Still true.
http://www.nami.org/[\url]
http://mhaweek.org/[\url]
http://everymindmatters.org/
http://www.eachmindmatters.org/
I see the effects every day of people being afraid to seek help, or being too embarrassed to seek help, or there not being enough resources to help those who do reach out. My hope is that things change. Soon.
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