Participant 5
Interviewed by Molly Wilson
Biography
This interviewee works as a psychotherapist outside of Oxford. She has had several admissions to the Cotswold House Eating Disorder Unit as an adult. Here, she describes Cotswold House and its treatment programme, as well as her interactions with the staff, and her experience as a day patient. Her full interview (conducted by Molly Wilson) gives rich detail on her admissions, her relationship with her doctors, and how Cotswold House and its treatment differ from the Warneford Hospital more broadly. If you would like to access the full interview, it will be available at the Oxford Health Archive.
Transcript of audio excerpt
00:01:50 Interviewer
Could you tell us a little bit about what Cotswold House is?
00:02:00 Interviewee
Cotswold House is a specific eating, adult eating disorders unit. And at the time, when I first went along, they used to see outpatients there as well. I think since COVID they’ve shunted them down to Green Tree Lodge, and certainly when I came to the end of my most recent stay, I was being seen as an outpatient in Green Tree Lodge. But yeah, an outpatient, an inpatient, in and outpatient initially, and actually I think for the first time I went, it has, I don’t know, 16 beds, something like that. But they also used to have day patients and I went in as a day patient for at least one of those admissions. So I would go in, I used to have to arrive at 8.30 in the morning and would leave at 4 o’clock at night, or 4 o’clock in the afternoon, five days a week. I don’t think it ever really worked but it was an attempt to, well I guess it was also a lot cheaper to have people as day patients rather than inpatients.
00:03:17 Interviewer
Yeah, I’m sure. You say you don’t think it ever really worked…?
00:03:20 Interviewee
Well, there were, I mean, certainly when I was, when I went as a day patient, it didn’t because I’d go home and undo everything that I did. But also when I was an inpatient, at least the first time, there were day patients coming along and they were never really a part of anything. And actually when I was a, as a day patient, you kind of were something and nothing because you had nowhere to go except this communal room and all the inpatients would go to their rooms. So you as the four or five of you would sort of sit there almost twiddling your thumbs, waiting for either a meal, which was part of the purpose of being there, or to go home. And so you never really… And there were a couple of groups that were specific to the day patients, but they were- And they didn’t really, it sort of missed something somehow, but I understood its intent was to make it less kind of intrusive on your life because you could still carry out assembly, if you had a house or something, you were going back and you were sleeping in your own bed. But you didn’t, as I say, you were like something and nothing. You were- You weren’t a part of any particular group and you didn’t really get to know. And you also, as an inpatient, as a day patient, you felt like you were missing out because you didn’t know what happened. Not that you wanted to be there, but from four o’clock till eight o’clock the next morning, something might have happened. And sometimes things did happen. And so you’d come in and then you wouldn’t be able, you know, no one would tell you what had happened. patients would, but confidentiality being such that if something had happened to one of the patients, then they couldn’t say anything. So you were always, and that was particularly true if you went in on a Monday morning because there had been the weekends and all sorts of things could have happened or nothing. And likewise for you, it was a very odd existence.
00:05:30 Interviewer
Yeah, I can imagine. And are you happy to give me any examples of anything that happened? Or would you rather not?
00:05:39 Interviewee
Well, I mean, just literally, I mean…, people escaped, people ran off and you kind of didn’t, you sort of heard about it in drips and drabs. Or, there was one person who was, I remember at one time, she was forever having, I think she may have sort of been prone to seizures or things and so she would overnight she would disappear up to the JR because that’s pretty much what they always do in any kind of medical emergency. They send you off to A&E and you’d know that had happened but you wouldn’t know why or but then to be fair as a inpatient you didn’t supposedly you didn’t know why, but patients get to find out things but it’s… Or, and if there had been, if there had been, for instance, they were, they’re always allowed to search your rooms if they’ve got due cause. And if you as an inpatient, I mean, that was what was ridiculous actually, because if you were a day patient, you could bring things in and technically you couldn’t, but you could. And I know that it didn’t happen to me, but you know, people were persuaded to bring things in for inpatients and things. But if there was, they never, they never, they treated you differently. They always, they always sort of, yeah. I mean, you were, by definition, if you were a day patient, you were slightly, supposedly slightly better, less unwell, perhaps, than inpatients. And inevitably, I think the staff gave you less attention. Not that you wanted any attention, but they sort of assumed that you were, you didn’t need quite so much care somehow.
00:07:38 Interviewer
Which is almost ironic because you clearly needed an awful lot of care.
00:07:42 Interviewee
Yeah, which is perhaps why it didn’t work. But then with limited resources on the ward, they were necessarily devoted to people of the highest priority and they were always going to be people who were inpatients.
00:07:59 Interviewer
Yeah. And you said you ended up in just the one communal room kind of twiddling your thumbs…
00:08:02 Interviewee
Yeah, the TV room. So literally you sat and watched television all day. I mean, then I, you know, watching those kind of, well, cookery programmes, ironically, sometimes, or house doing upping programmes, you know, just real nonsense. It wasn’t a good time, so-
00:08:21 Interviewer
No, it doesn’t sound like it, frankly. And was there no, was there, what were treatments looking like throughout the days? Were you ever taken off for any therapy sessions?
00:08:33 Interviewee
Yeah, I mean, I think consistently, throughout all the times I’m here, they sort of have a treatment programme and there would be one group a day. The key things were these mealtimes, which were absolute. And then for an hour after the meal, you were meant to rest, but you didn’t have to rest in the communal- if you were an inpatient, you could go and be in your room. So you had to sort of sit. And I think there was always somebody, a member of staff in this communal room, but so you’d have to sit there for a watching these inane television programmes or whatever. And then there would usually be one, sometimes two groups a day. But these groups were… always felt to me like they were just filling time or going, [coughs] ticking a few boxes. Because I remember one time, one inpatient time that I was here. It was called, I can’t remember what it was called, but it was, you’d go up and there would be a group of, all these groups were voluntary. You were encouraged to go, but some people never went to any of them. I used to go to all of them because it just filled a bit of time, actually. But you’d go and I remember there were two members of staff and there were, let’s say, eight people. And they’d start to, it was a sort of family, it wasn’t a family group. It was kind of how are you? Let’s, you know, what’s going on? I think you had to, there was something like, what did you have to do? You had to talk about how you felt you were, how you felt you were getting on within, with the group on the ward and how you felt you were getting on with your family or something. All which could be quite deep and meaningful questions or responses. And so you’d all go around and you’d say “oh, I’m feeling miserable and I’d say, I’m” or whatever, you know, “the ward is not great, blah, blah, blah, blah, blah.” And we never dealt with any of the issues that were raised at all, because by the time you’d gone around the group, it was almost time. And you could, because of the profession I come from, you could see that their role really was to contain us, to make sure that nobody got hysterical or got to, you know, either riled everybody or got so upset themselves that they couldn’t be contained. So it was all… which on the one hand would surely be the purpose of the group is to actually deal with some of these issues, but no, and then we’d go away and say, “oh well I’ll see you next week.” So everything was, and there was a creative writing group one year at the time. And again, you were encouraged to, they’d give you some topics to write about. But if anything came up, it was kind of, well, that’s interesting. Go away, don’t talk about it. So there was never, you know, that in general on the ward, there was a sense, I had, a sense that actually there was rarely, I’m going to make it sound like I’m being very critical, but anyway, there was rarely any attempt to, because they didn’t have the resources or the expertise actually, to address any of the underlying issues, the whole experience was frustrating and just became about weight restoration. And less so the last time I was there, but in previous admissions there was always a sense that it was really important that you didn’t get too attached to any particular member of staff, that you could talk to anybody if you were upset or if you whatever, because this particular, if you got on well with somebody, they might not be there when you needed to talk to somebody at some other time. So you needed to be able to talk to everybody. But I used to find that incredibly frustrating and I hesitate to say wrong, but unhelpful because as humans you naturally get on with some people better than you do with others. And I became very adept at, you know, assessing whether anybody was not worth talking-, there were people there working who were genuinely wanted to help and were training and were, were good. And there were people there who were just doing a job because those kind of jobs are not well paid and they were just passing the time of day. So, they’d say the right things but had no real insight or were not helpful to me anyway. And so to try and have a meaningful conversation with them was not always going to be very helpful. So the experience could be quite frustrating.
