cosmichroma

the experiences of neglect and of iatrogenic harm/overtreatment both deserve a voice; people deserve to be able to discuss every element of how their healthcare has failed them or harmed them, whether through the action or inaction of the people or systems involved, and whether it was a matter of ignorance, accident, habit, arrogance, or vested interest, e.g. prescription for profit. and while it’s often perceived as scaremongering to talk about these things (especially accounts of polypharmacy coming from mentally ill patients), i believe there is ALWAYS a place in the conversation for patients sharing their lived experiences of medical trauma.

but herein lies a further problem: sharing lived experience is very difficult unless you can identify and find words for what happened to you. ive been mulling this over and i think the common belief that neglect and overtreatment are mutually exclusive opposites (whereas actually, they overlap a lot) means that a lot of people never actually realise theyve been neglected or overtreated.

“it can’t have been neglect, the doctor was really friendly and they gave me 20 weeks of CBT and so many different mindfulness resources” but did they ever actually do a basic thyroid check when you came to them with textbook hyperthyroidism symptoms? when you told them you have a racing heart and constant sweats, did they even bother to take your pulse and do a blood test, or did they just announce that anxiety was the culprit without any physical investigation?

Some highlights (emphasis mine):

"As an autistic person, the ways in which I am required to communicate with services are more likely to be designed to meet the needs and resources of service providers, rather than patients like me."

“The lack of meaningful acknowledgement and responsiveness to past experiences of being harmed by mental healthcare has made it more difficult for me to engage in treatment again and has limited the ability of clinicians to help me. This has made treatment less effective and – at times – retraumatising.”

"iatrogenic harm – and specifically trauma sustained in mental health services themselves – features in literature on TIC [Trauma-Informed Care] largely as something to be prevented by trauma-informed approaches, rather than a reason a trauma-informed approach may be needed in the first place. This is reflected in my own experience; I have met a profound resistance to recognising that it is even possible that I may have been harmed by treatment."

"Over many years of mixing with other patients, I have found that my experiences are not unique, yet they rarely have a place in discourse about what it is to be trauma-informed among the mental health professionals treating us.

The marginalisation of some kinds of trauma in favour of others prescribes a hierarchy of harms, where some traumas are considered more reasonable, likely and valid than others."

"If not rooted in a more expansive and inclusive conceptualisation of trauma, TIC may perpetuate and even generate fresh harms.”

“The responsibility for repairing the harms of iatrogenic trauma is a shared one. Patients are doing their part by being willing to show up at all in settings that have previously harmed them. It is time that mental healthcare providers played their part alongside these patients."

Even if I could tell them what they did that hurt me, I doubt they'd even remember. It feels unfair that they get to forget while I'm stuck with those moments practically carved into my brain.

And I think there is a deep-seated belief I have that even if I knew their names, even if I knew how the hell one files a misconduct complaint in the first place, it wouldn't matter. They probably wouldn't read it and think 'oh no I should do better,' they'd just convince themselves I'm crazy. And maybe their colleagues would agree with them. Maybe everyone would agree with them, if they knew what happened, that I really am just an overreacting weirdo who was traumatized by things that normal people wouldn't think twice about.

Even if I am, that doesn't change how much every one of these incidents hurt me. It doesn't change the fact that they do haunt me, all the time, and taint every interaction I have with a medical professional.

I speak out because anyone who seeks out mental health services deserves to be treated with respect, kindness, compassion & love.

I speak out because being treated poorly by mental health practitioners should not be normalized.

I speak out because a large majority of “pro-therapy” folks will scream “everyone needs therapy” from the rooftops but are quiet when it comes to acknowledging bad practitioners & educating people on what good & bad practitioners look like.

I speak out because nobody deserves to be harmed by the people who were supposed to help.

I speak out because therapy harm/abuse isn’t being taken seriously enough and is usually being dismissed as incompatibility issues, which does a disservice to therapy abuse/harm survivors. (Example: a queer person describes being harmed by a homophobic/transphobic therapist and whoever they’re venting to just shrugs their shoulders and says “just a bad fit” instead of fully acknowledging how dangerous that therapist was/is, showing the harmed person compassion & validating the person’s experience)

I speak out because a lot more people than we know or realize have definitely been harmed by a bad practitioner at least once in their life, but don’t talk about it.

I speak out because we as a society need to be holding these bad practitioners accountable instead of putting them up on a pedestal, acting like they can do no wrong & that it’s the clients that they harmed that are actually the problem.

I speak out because clients who were genuinely harmed by bad practitioners deserve to be heard & believed instead of being dismissed & silenced because of the negative belief that people with mental health issues are not credible. (This mindset also harms domestic abuse/violence victims & survivors because whether they actually grapple with mental health issues or were falsely diagnosed, abusers use that as an advantage to discredit the abuse they are speaking out about so that they aren’t believed & helped.)

I speak out because people are not willing to acknowledge how traumatizing it is to be harmed by a bad practitioner and how scary it is to give therapy another shot after being harmed by a bad practitioner or having repeated instances of bad therapy.

I speak out because I’m tired of “just keep going from therapist to therapist until you find the right one” being normalized because it normalizes bad/abusive therapists, it’s dismissive to therapy abuse survivors, and does not acknowledge that not everyone has the privileges, money, energy or resources to do so.

I speak out because minors who are being dragged to therapy and forced to see therapists who are siding with their shitty or abusive parents & working on making them more compliant to abuse need more people willing to defend & advocate for them & speak out against their therapists who are being utilized as accessories to further abuse them.

I speak out because I’m tired of people who are rightfully distrustful of therapists & the mental health system & unwilling to go back to therapy because they don’t want to get hurt again being lumped in with genuinely bad humans who are not willing to work on themselves or change their ways and weaponize their trauma/mental health to justify their bad behavior while simultaneously refusing to go to therapy and change despite having the resources & money to do so.

I speak out because therapy abuse/harm has been normalized to the point where some people are being actively harmed & don’t realize it until it’s too late.

I speak out because it is jarring to seek out help for the abuse & trauma endured just to be re-traumatized AGAIN. Especially during multiple instances.

I speak out because I am tired of survivors being blamed for “picking the wrong therapist” the exact same way domestic abuse victims & survivors are blamed for picking their wrong partner.

I speak out because there is ABSOLUTELY NO excuse for a practitioner to harm their patients & refuse to apologize & take accountability.

I speak out because practitioners actively harming their patients do NOT deserve to have a job or career in a field that is supposed to be all about helping others.

I speak out because I refuse to allow bad practitioners to avoid accountability for all the harm they’ve done & the damage they have done; “they’re only human” is NOT a free pass to avoid accountability.

I speak out because I refuse to be silenced & let anyone else be silenced.

We need to start commenting under other people's posts about how to properly warn for flashing lights and eyestrain. We need to be emailing and calling companies about their possibly triggering advertisements that could induce seizures. We need to stop tolerating ableism and start speaking up for the more vulnerable.

Also, stop putting epilepsy warnings. That's like saying "warning: schizophrenia" on a post including unreality or "warning: dyslexia" on a post with a typing quirk. First off, the disability mentioned isn't the only group of people that this could trigger. Second, it doesn't truly get the message across and instead makes it worse for those with the disability-- scrolling through the epilepsy tag on Tumblr should get you to view the content of other epileptic people, but no, you just get a bunch of flashing lights and eyestrain, even though you could instead tag for, oh I dunno, flashing lights and eyestrain.

Let me just start by saying. Yes. It is ok to be fat.

There is nothing wrong with being fat just because you enjoy eating a lot of food. And let me continue by pointing out that literally all of the health issues that are correlated with increased weight also occur in thin populations.

Additionally, when we're evaluating people by their fitness levels, the weight differences wash out. Something that's been demonstrated over and over again.

A fat person who engages in fitness behaviors is quantitatively healthier than a thin person who does not. Fit fat people and fit thin people have similar health outcomes. Unfit fat people and unfit thin people have similar health outcomes.

But we don't moralize thin people who eat desserts for every meal and have never exercised. We don't question whether it's "ok" to exist as an unfit thin person, even though that's also correlated with poor health outcomes.

The reality is fat people are an oppressed class. Society encourages the marginalization of fat people, and it has nothing to do with health.

If it was about health, then society would treat sleep deprived people the same way.

Sleep deprivation is heavily associated with poor health outcomes including things we associate with weight like diabetes or heart disease.

But no one has ever walked up to their coworker who brags about running on 4 hours of sleep and ripped the coffee out of their hands saying "You don't need this, it's for your own good!"

No one has ever written think pieces about how disgusting and morally irresponsible it is to let yourself become sleep deprived. Or dehydrated. Or just extremely stressed out.

All of which are states that are more significantly and consistently associated with negative health outcomes than weight. But we don't ask if it's morally "ok" to be experiencing them.

We don't take it as a hall pass to bully someone just because they are neglecting sleep or hydration or relaxation even if it's on purpose.

No. Because it is, technically speaking, an asshole move to harass people for their victimless lifestyle choices, no matter how unhealthy they may be.

So to reiterate. Yes. It is ok to be fat for any reason. Being fat is not a moral failure. Being fat is not an indication of your health and your health is not an indication of your worth.

let me explain: in america at least, the lower class have significantly worse health outcomes, even when accounting for other factors. just being poor is enough to make your overall health worse. we don’t know that being fat makes your health directly worse, like the data just isn’t there, but for a moment, pretend it does.

imagine going to the doctor with a health problem and the doctor looking at your chart and saying well, this problem will be less severe if you go up an income bracket. have you thought about becoming rich? it would really help. start by saving a little money every month.

ridiculous, right?? very few people successfully go from working class to rich, it just doesn’t happen on a large scale in society. maybe for a time you pick up some overtime hours, spend a little beyond your means, and appear rich. but eventually you burn out, your car needs to be repaired, and you return to being working class.

we do have this data: only some people can successfully lose large amounts of weight, and only a tiny fraction of people who lose that weight actually keep it off for more than a year. telling people to lose weight for their health is just absurd because they almost certainly can’t do it any more than they can double their income for their health.