ONE BITE FELLOWSHIP | Anti-Male Sexism

CONSIDER YOURSELF CAUTIONED

While by no means it’s only focus, this essay includes a frank discussion of sexual matters, including sexual abuse. Please do not read any further if you find such a discussion offensive.

The Day Soft, Plain Yogurt
Became A Body Fluid
by Dave P. - Founder, One Bite Fellowship
Louisville, Kentucky

During the fall of 1995 I was a patient for fifteen days in a hospital-based eating disorder unit in Saint Louis, Missouri. This particular facility claimed to offer a 12 Step-based treatment regime for compulsive overeating, bulimia and anorexia. What I found instead was an eating disorder unit that was anything focused on eating disorders, let alone offering a 12 Step approach to dealing with eating disorders. "Worthless, idiotic psychobabble" is the nicest way to describe what I experienced.

Thankfully this particular eating disorder treatment facility (which will remain anonymous for purposes of this essay) went out of business several years ago. However, the same company that owned the facility in Saint Louis still operates other eating disorder units around the country (although under a slightly different corporate name).

Despite their claims to the contrary, this hospital unit was not 12 Step-focused. In fact, during my stay, I was allowed to attend only ONE 12 Step meeting. Real 12 Step-based treatment units (regardless of the addiction they are treating) allow -- or even require -- their patients to attend a minimum of three to five 12 Step meetings per week. Attendance at just one 12 Step meeting in a fifteen day period is simply unheard of, despite the fact that no less than three Overeaters Anonymous meetings were available EACH day of the week in the Saint Louis metropolitan area, many within just five miles of the hospital! So "lack of availability" was not the problem. The real “problem” was that the treatment program simply did NOT place a high value on helping their patients work through the 12 Steps -- which just happen to be the very heart any legitimate "12 Step treatment process".

Equally troubling is the fact that the first writing assignment given to patients is a type of Step 4 inventory – yet no real study or opportunity to work Steps 1, 2 and 3 was offered. Anyone who know how legitimate 12 Step recovery is structured will tell you that the Steps are to be worked in order (e.g., 1, 2, 3, 4, etc.), especially within a professional treatment setting.

I've come to believe that the treatment facility in question exploits its relationship with Overeaters Anonymous for marketing purposes: so they can borrow some "credibility" from the O.A. fellowship and can use their patients to recruit fellow O.A. members into treatment. From my first day in treatment the staff strongly encouraged urged me to do this.

So if this unit was not focused on a 12 Step-focused modality to specifically treat eating disorders, just what did they offer their patients? Once I arrived at the hospital, I was exposed to numerous brochures and other printed material which were used to promote the eating disorder unit and a separate program for "survivors of sexual abuse." We patients were repeatedly (i.e., almost daily) urged by the staff to take all of these promotional items they wanted to share them with their friends, especially friends who were part of Overeaters Anonymous.

Upon closer examination of two of these promotional pamphlets, it appeared that BOTH programs contained virtually identical elements (from group therapy to consultation with a nutritionist). Indeed, when I asked a staff member my suspicion was confirmed: only one program actually existed, but that program was being marketed under two names each with its own description. One program was marketed to persons struggling with eating disorders, while the other treatment program was pitched to survivors of sexual abuse. Marketing one program as two distinct ones: is this honest? No. Did the one program with two separate identities have any real “therapeutic value”? Probably not.

Are "most" persons who struggle with eating disorders victims of childhood sexual abuse? Probably a fairly high percentage is (when compared to the general population), at least this is the opinion of many researchers whose work I’ve studied since my eating disorder treatment experience. The research I’ve read indicates that that just over half of compulsive overeaters, bulimics and anorexics have suffered from childhood sexual abuse. But I've never seen any research suggest that anywhere close to "95 percent" (which is the statistic touted by at least one employee of the treatment center in question) of compulsive eaters have been victimized.

Legitimate treatment centers (e.g., those which treat addicts from a true 12 Step perspective) rarely probe deeply into issues like sexual abuse. This is because it is widely believed that long-term sobriety is needed before addicts can face such trauma without endangering their newly found sobriety. Stopping an addiction (to food or any other substance) is more than enough of an "issue" for most of us addicts to deal with in early recovery.

What about the quality of care patients who, like myself, received who are NOT victims of sexual abuse (which is anywhere from five to 50 percent, depending on who's statistics you believe)? Why waste our time looking for "skeletons" when none are to be found?

From day one of my "treatment experience" the primary focus was on "uncovering repressed memories" of sexual abuse. This despite the fact that I was told by the unit's "admissions consultants" that their program was SOLELY FOCUSED on eating disorders. At best, their treatment program was "dually focused" on sexual abuse AND eating disorders.

Was I the only patient who felt that s/he had been lied to? No! During the fourteen days I was in treatment two of the three patients who signed themselves out (against medical advice) did so because they also felt that "admission consultants" had been blatantly dishonest with them about the nature of the treatment program. Interestingly, both of the patients who left for the same reason I did happen were males.

If the treatment I received was not "12 Step-focused", then just what was the "psychotherapeutic approach" utilized by this facility?

Let me begin to answer this important question by sharing about an interesting conversation I had with a friend who visited me while I was in treatment. She was a recent "alumnus" of this facility who had just moved to the city where I reside. While it was wonderful to have a visitor from home my first weekend in Saint Louis, I was hopeful that she could shed some light on why this particular treatment unit did some of the bizarre things it did. My friend provided me with some important insights -- and what she told me was absolutely disgusting!

One of the first questions I asked my friend was "Why do they serve us so much gross food . . . like soft, plain Yogurt?" "Didn't they tell you about that when you were first admitted?" she asked. "Nope," I answered. It made little sense to me that this was served since many delicious flavors of fat-free and sugar-free soft Yogurt were on available. Plain Yogurt, at best, was pretty much taste-less. (Before I continue, please be aware that soft plain yogurt is smooth and creamy in texture and white in appearance.) "Well, that's because the treatment center believes that most of their patients have REPRESSED MEMORIES of sexual abuse . . . and that certain foods bring up (to one's consciousness) those memories!" my friend explained. "And," she continued "soft, plain Yogurt is supposed to remind you of (male) SEMEN."

I could NOT believe my ears! So I asked a staff member, soon after my friend left the unit, if the treatment program "really believed" in this "plain Yogurt = male semen" equation. The staff member just smiled and said, "Well all I'll admit is that some of the food you are served here is intended to bring up repressed memories of abuse."

Oh great! I'm in a treatment center that has as one of its core beliefs the nonsense (which, as best, is highly controversial among mental health professionals) that certain foods can trigger repressed memories! This made me wonder if the treatment staff might have been actually "sicker" than we patients might have been?!?

Now to the other examples of what I call the "anti-male sexism" of the treatment program in question. First, none of the treatment staff were men. I asked a unit nurse why they didn't have any male therapists on staff, let alone any other male treatment providers (e.g., nurses, dieticians, unit technicians, etc.). I was told that "if we allowed men to work here, the female patients would be in constant danger of once again becoming victims of sexual abuse." This employee's highly inflammatory comments made me wonder if some male job applicants might have been discriminated against on the basis of their gender?!? And I guess women are NEVER sexual abuse perpetrators, huh? Not quite.

I also experienced anti-male sexism in group therapy. When I didn't cry as expected during or following my sharing of a particular written assignment, my female therapist chided me in front of my fellow patients as being "too afraid to be emotionally vulnerable." I was accused of allowing my "machismo" to get in the way of my "need to cry." PLEASE! Good grief, even I joked that I had been known to cry at "supermarket grand openings! Maybe I didn't cry because I felt that to do so would not have been an appropriate emotional response, given the nature of the information I had shared. Besides, the truth is (to paraphrase a friend” that “I cry at supermarket grand openings”! So I’m hardly someone to inappropriately hold back tears.

Another issue had to do with the treatment of the husbands and boyfriends of the female patients who attended the "family therapy" sessions at this treatment facility. The therapists in charge (always women) always showed great hostility toward these men in front of the group. Whatever wrong they were accused of by their female counterpart, it just had to be so! I guess women are always right and men are always wrong? I don’t think so.

Whenever sexual abuse was brought up by therapists, it was presented in such a way to infer that MEN were ALWAYS the perpetrators. Please understand I am not saying that men "never" violate women (or men) sexually. I simply wish to point out that BOTH women and men have the potential to be sexual abusers. Which begs me to ask, since when is the promotion of stereotypes, on the basis of gender, ever "therapeutically appropriate?

I am no fan of the insurance industry, let alone HMO's. But after experiencing this particular "12 Step-focused eating disorder treatment" which really was neither 12 Step-oriented nor eating disorder-focused, I can definitely understand why it is extremely hard to convince insurance companies to pay for this type of hospitalization! During the intake process I was actually encouraged to embellish my symptoms (i.e., particularly depression and anxiety) in order to persuade my provider to pay for my treatment.

It seems to me that being coerced to exaggerate symptoms is clearly insurance fraud. I have a hard time respecting a treatment program that encourages potential patients to engage in dishonest and even illegal behavior in order to for them to remain in business.

Do I have any good things to say about my "treatment experience?" Not much. One therapist seemed to be less anti-mail than the others were. And I bonded well with many of the other patients. I sincerely wish I could share much more positive things (let alone none of the negative things) I've shared in this essay. After all, eating disorders kill over 300,000 American's each year (that is an average of 34 deaths every hour of every day!) which is why I firmly believe in the very legitimate need for 12 Step-focused, hospital-based treatment and various forms of legitimate psychotherapy to treat eating disorders, including food addiction. True 12 Step-centered treatment has a well-established reputation of helping multitudes of alcoholics and many other types of addicts to experience long-term recovery.

I think it is particularly pathetic, at best, that one of the largest "chains" of eating disorder treatment units has deceived thousands of compulsive eaters into its sub-standard treatment programs. Interestingly I’ve heard of at least one other national chain of eating disorder treatment centers was forced to close all of its hospital-based units after numerous indictments for insurance fraud.

I believe our food-obsessed/thin-obsessed society urgently needs 12 Step-oriented mental health therapists and medical practitioners to come forward to fill the void for legitimate eating disorder treatment. While 12 Step fellowships offer a tremendous amount of experience, strength and hope, much more support is often needed to help the still-suffering addict break free from their addiction.

If you're a MALE overeater, bulimic or anorexic who believes you need to be hospitalized to overcome your problem, rest assured that a few extremely ethical and male-friendly 12 Step-focused eating disorder units still exist! Some of the best treatment programs (like the one I experienced in 1986 at the former DePaul Rehabilitation Hospital in Milwaukee) were non-profit and have long ago closed due to the elimination of government funding that was previously available.

If you are considering eating disorder treatment, please feel free to contact me directly and I’ll be glad to tell you more about these facilities. I’m also always glad to hear from MALE food addicts who have experienced anti-male sexism in support groups, professional treatment programs, or in any other setting where they’ve sought help for their addiction. My e-mail address is: flamboyantbohemian@gmail.com.