CONTENT WARNING - descriptions of forced psychiatric treatment (CW will be placed around the paragraph so read with caution, I share because it is an essential part of my story.)
I first started making reclamation art with my medical records a number of years ago after an incredibly traumatic admission to a general psychiatric ward for my eating disorder and concurrent depression. I wanted the records because of what had happened to me and my lack of clear memory, but reading those documents at the time felt nearly as damaging - my experience was captured in cold and clinical language, told from one perspective that offered no context.
From that experience I was labelled with what is known as a “purple dot.” This “dot” indicates a history of violence and is a way of communicating a potential safety risk to healthcare providers which I understand as a registered nurse myself. (CW) However, what was essentially a trauma response and reaction to the very real threat of being forcibly detained by four large men, having my clothes removed, forced invasive care, being placed in 5 point restraints, and injected with sedative medications that my body reacted poorly to (resulting in a “code blue” event) and significant extrapyramidal symptoms that took days to recover from (CW). I was not violent towards others (though I was desperate to escape and resisted forced care), I was reacting to a very real threat, but I am the one who will forever be marked by this label and scarred by this experience.
I came back to creating art out of my medical records over this past year as I have come to fully separate from eating disorder services and the idea that I could ever fit within those narrowly defined conceptions of illness and healing. It is a grieving process that ebbs and flows; there is anger, there is pain, there is understanding, there is acceptance, there is hopelessness, and there is freedom. There is everything all at once.
I occupy many privileged identities, I will never fit within standardized eating disorder treatment models, and I am not remotely the exception. The difference now is that I am no longer willing to break myself to fit into spaces that cause me more harm than healing. This is not to say that those spaces must be perfect; it is simply the recognition that there are many complicated cost-to-benefit considerations when it comes to pursuing a higher level of care within the very limited options that are available through publicly-funded treatment in British Columbia.
Over the course of my experiences in treatment settings, both through voluntarily sought outpatient, residential, and inpatient eating disorder treatment options, as well as involuntary inpatient experiences on general psychiatric wards - primarily for suicidality related to my eating disorder, depression, and experiences of trauma (though these are rarely understood or treated in relation to one another) - I have come to collect a fair amount of clinical diagnoses, commentary, and associated labels from the healthcare system. Reading over my medical records and the various descriptions of who I am as a person has been brutal; however, it has felt healing to take that narrative and quite literally reclaim it. The visceral act of cutting these formal pages into pieces, taking each harmful phrase out of context (as I so often have been) has been empowering.
These words, phrases, and labels will forever remain on my medical records and continue to influence how I am perceived and treated whenever I am forced to interact with the healthcare system, but these are things I cannot change. While I may not be able to change my experiences and the things that have been said about who I am as a person and what I am capable (or incapable) of, I can reclaim my story in my own way - taking these incredibly damaging words, terms, and descriptions of my character back through creative means. I think this is worth pursuing although I also recommend people do so with caution because even as a healthcare worker who is familiar with using clinical terms in my own charting, the way it reads (particularly when it comes to psychiatric care) can be incredibly hurtful, but that is not who you are and the people who truly see you and you love in every state of being, know this.
The pieces I have created for this project contain charting from my experiences of inpatient eating disorder treatment through provincial adult tertiary eating disorder services in British Columbia. These are largely the words of psychiatrists, though there are also descriptions from dietitians, allied healthcare staff, and nurses - even those I thought I had good rapport with. While I felt devastated reading these records and spent time processing them with my psychiatrist (a clinician that has no background in eating disorders), I can look at them now and also understand how difficult I can be as a patient. This is not to agree with how I am described as a whole and complex human being in these records, but it is how I can present when I am entirely outside my window of tolerance, feeling highly unsafe, and reacting from a trauma response. That isn’t me as a person, but that is how I can react in highly abnormal and harmful settings when basic autonomy, respect, collaboration, and safety is lacking.
What is important is not locating the issue in myself as an inherently flawed person nor blaming individual clinicians - I was non-functional and completely dependent on my parents to look after me by the time I actually got the help I “reached out for.” Rather it is the important act of paying close attention to the way language can seriously harm people, affect every single care encounter they have in the future, and critique systems of “care” that replicate a lack of safety, paternalism, Western colonial values, and extreme black and white rigidity (which is rather ironic when that is what these models of care are supposed to be treating.)
While I can understand why I am described in these ways, the result is that I cannot picture ever pursuing eating disorder treatment through formal services (as they currently exist) ever again. While I believe and do see change occurring, I cannot imagine ever feeling safe enough to set foot in an environment where the people providing care for me see (or have seen) me as a toxic, selfish, manipulative person who chooses to be difficult. These pieces are not made to further an “us” versus “them” dynamic, they are meant to be a reply and hopefully, a conversation that follows. I cannot change the past, but reclaiming the charting that now affects every interaction with healthcare I have, or ever will have, is the form of healing I have available to me. I am more than the diagnostic labels applied to me. I am more than my worst moments. I have a voice and my healing work is to reclaim it even if I can’t change the past.
The first image is direct wording taken as it is used. The second image (“Where Have All the Good Patients Gone?”) includes some direct phrases alongside phrases that have been taken out of context. These latter words and phrases were fears that I expressed about the way I felt I was being perceived by this program and included things that were not said to me by clinical staff; however, alongside the words and phrases that were documented, it all blends together which is the point of this piece, because I felt my responses were taken entirely out of context. The final image is a follow up response to the first image.
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