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Image by Ariel

we need to talk

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CW: suicide, eating disorder, ED hospitalization, NG tube feeding, restraints, self-harm, sexual assault

i spent my sixteenth birthday in an eating disorder inpatient unit. my assigned

dietician printed out a coloring page of a piece of birthday cake, left it on my bed, and told me, “here, this is for you, since you won’t eat it.”

we need to talk about the adolescents labeled “chronic” before their seventeenth birthdays.

we need to talk about the adolescents who spent more time in physical restraint holds than they ever did being held by someone who cared.

we need to talk about the adolescents who drink warm coffee for breakfast and cry at every “wow, you look great. what’s your secret?”

i was admitted for cardiac issues from my eating disorder for the first time when i was just thirteen, and i made all the nurses cry when they had to snake a nasogastric feeding tube down my nose and throat for the first time.

my doctor came the next morning. she asked, “and what happened when you didn’t drink the ensure we provided?” i told her, “you know what happened.” she said, “i want to hear you say it.”

i was force-fed from the ages of thirteen to nineteen, most times while being held down, restrained; counselors and nurses words bouncing off of me, “you did this to yourself”, “maybe you’ll eat next time”, and “this is the expectation.” i watched desensitized, emotionless faces as i scratched at my forearms and prayed that the feeding tube would not come out my mouth this time. please, god, not this time.

we need to talk about the adolescents who know the restraint protocol like the back of their hands.

we need to talk about the adolescents who are still amazed that they’re able to flush the toilet on their own now.

we need to talk about the adolescents that were told that this was normal, necessary, and life-saving. life-saving.

i tried to kill myself for the first time when i was just ten or eleven years old. i had read somewhere that there were poisonous pesticides on grapes, and in my mind, i thought if i ate enough of them, the pesticides would kill me. i laugh about that now, and most of my friends laugh with me.

at school, i couldn’t get the words to come out when they were supposed to. my teachers said i was “defiant.” one wrote me up. i came home with a green slip. the next morning, i came back to school unable to walk because of the burning between my legs. but, he brought me out for vanilla ice cream and told me he was sorry.

my pediatrician proposed generalized anxiety disorder. why didn’t they ask what was going on at home?

we need to talk about the adolescents who fit criteria to be diagnosed with everything in the DSM, who interacted with nursing students over lunch.

we need to talk about the adolescents that are now adults with white scars on their arms that they hide under long-sleeved blazers in the name of professionalism.

we need to talk about the adolescents who took rides after school with oblivious counselors that didn’t know the difference between a child who was sexually abused and a child who was a little bit anxious.

in middle school, i snuck off from lunch period to go throw up in the girl’s bathroom with the back of my paintbrush from art period. in high school, i survived off of half a granola bar, an 80-calorie greek yogurt, gum, coffee, and green tea. by the time i was nineteen, i fell asleep feeling the dips of my hipbones for comfort and tightening my ab muscles until it became too hard.

a counselor in the hospital pulled me into a side room and asked me if someone was hurting me. i was an adult by now, nineteen, and i didn’t owe my story to her. but she searched my eyes and spent her free time with me until i finally spilled over. she told me, “it’ll never be this bad, ever, ever again.”  in the end, it was. and she was just another entry-level positive-psychology enthusiast with a demanding, understaffed job and a raging savior complex. i don’t want to be like her.

now, almost-22, i study psychology to be like the school psychologist who sat right next to me as a held a blade to my wrist because she knew i would never hurt myself in front of her. her hands hovered, and the school fought her to call the police, but she always said, “just… give her a few minutes. just let me talk to her.” i wrote suicide notes that she wrote back to.

i study psychology to be like the group therapist who worked within the confines of an abusive system—sitting right next to me, eyes never leaving me as i was force-fed. she told me how angry she was at the system and would sit in silence with me. she always knelt-down to my level to speak to me.

we need to talk about the adolescents who felt the weight of the world before they even graduated high school. who are tired and angry of being complicit because somebody should be but nobody is.

we need to talk about the adolescents who say “abolish the police”, “abolish psychiatry”, and “stop hurting us”. we need to listen to them.


we need to talk to the adolescents who would have rather died in a treatment center so that someone would finally care, notice, and change something. anything. please. we need to talk.

CW: Depictions of tube feedings, eating disordered behaviors, institutional abuse and complex trauma

I Was Force-Fed For My Eating Disorder: Now, I’m Picking Up The Pieces

When I was just 13 years old, I was diagnosed with an eating disorder and entered an outpatient
program for children and adolescents with eating disorders. What should have been my last year
of middle school before entering high school that following year signaled the beginning of a
string of long-term institutionalization. The amount of complex trauma that long-term
institutionalization results in is not often talked about. We, as a society, tend to associate hospitals
with healing and recovery―places of hope and safety. For me, I now live with complex-PTSD
because of the neglect, mistreatment, abuse, and dehumanization that came along with long-term
psychiatric institutionalization.

I was first hospitalized when I was 14 years old, after about a year of not progressing on the
outpatient level. I had gone to the doctor to get my weight and vitals routinely monitored as part
of the eating disorder treatment protocols, and after my doctor noticed significant deterioration in
my vital signs and weight, she called an ambulance. The ambulance transported me to the local
children’s hospital where I was hospitalized on the medical psychiatric unit ―a unit for children
and adolescents with co-occurring psychiatric and medical diagnoses, one of the most common
diagnoses seen being eating disorders.

The refeeding process (learning how to physically and emotionally tolerate and adjust to proper
amounts of nutrition after prolonged starvation) was incredibly painful.
I struggled tremendously
with getting myself to physically walk into the dining room and sit down in front of food. On my
second day of the hospitalization, I was unable to complete a supplement to replace the food that
I didn’t eat, and a nurse ushered me into a side room labeled “the treatment room.” I sat down on
a cold, paper-clad table as the nurse spoke. I still remember every word she said to me. She
said, “You didn’t meet the expectation today at breakfast. We now have to help you.”
She held up a clear tube and told me it would be passed down my nose, down my throat, and into
my stomach, and then she would take a syringe, fill it up with nutritional supplement, and push it
into the tube into my stomach.

I panicked. I began to hyperventilate and remember vividly covering my nose with my hands and
even promising to drink the supplement. I was given no choice. The nurse told me, “If you can’t
be compliant and allow me to put in the tube, I’m going to have to get people to help.” She
gestured towards a restraint board propped up against the wall. “We’ll have to use that.”
I tried to calm myself down. She removed the tube from the packaging and held it up against my
nose to measure. She gave me a cup of water to hold on to. She lubricated the tube and began to
push it down my nose. When it reached my throat, she instructed me to sip water. My body and
mind were actively fighting back against the tube insertion and I kept gagging as the tube hit my

throat. She pushed the supplement as I cried. She said nothing reassuring or comforting. In fact,
she barely engaged with me at all.

I had never felt more dehumanized. My body didn’t feel like mine.

For years following that first tube feed, I spent years of my life in and out of hospitals being
force-fed for the treatment of my eating disorder. At one point in my life, I spent a multi-month-long admission

getting forcibly tube-fed six times a day to the point of physical damage. Now, I am left with nothing but grief.

As an abuse survivor, being force-fed as an adolescent took away any semblance of control that I
felt like I still had over my own body.
Today, I’m still picking up the pieces of extensive trauma
that these incidents caused me. I am still grieving what happened to me. I am still hurt by the
lack of dignity the staff spoke to me with. Being force-fed intrinsically changed my view of

Today, I am nearly 22 years old, and I am still grieving for the teenage version of me who never
got a chance to not be okay.
The teenager version of me ate out of fear of being restrained, not
because she felt worthy of food.
I am 21 years old, and I am still unlearning the terror and dehumanization that my
local children’s hospital instilled in me. I have learned to associate my body with shame. I have
learned to associate “care” with pain. I have learned that I must “comply.” I have learned to be
silent and stoic and to do what is “expected of me.”

I never got a chance to grieve. Where is the outrage for people like me?

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*This piece was originally published in The Mighty.

JOCE LEO (they/she) is a college student currently working towards a BA in psychology and a BA in visual arts, with the hopes of becoming an expressive arts therapist. They are a survivor of psychiatric abuse and institutionalization, and as a multi-media artist focusing on photography and sculpture, they strive to bring humanity and vulnerability back into the contemporary art scene. They enjoy the overlaps between language and visual art, and are constantly aiming to allow for their work to be less digestible or censored. Their photography work has been featured in a local New England gallery, and Joce is currently working on producing a magazine centering around community care in the contemporary art scene. You can find some of their art at @lynlightstheirway, and some of their advocacy work at @reformationlyn

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