New York State Pyschiatric Institute

My internship this summer is at the New York State Psychiatric Institute on the eating disorder inpatient unit. NYSPI is part of Columbia University Medical Center and is a leading hospital in research and mental health discoveries. It is also a teaching hospital, which means, it throws you right in! On my second day I had to lead a psychotherapy group, facilitate a family session, and do individual therapy with patients. Yikes! It is intense. But, I love it. It is exactly what I need. I want to learn, be challenged, and forced to see what I can handle.

I currently have four patients with anorexia nervosa. This illness distorts the reality of one's body image and basically kills self-esteem and self-worth. It is extremely heart wrenching. They look in the mirror and see false and distorted images of themselves that turn in to negative, false beliefs about who they are. Not only does an eating disorder destroy one's self-image, but it can damage relationships, families, and one's ability to participate in the world. I have a patient that weighed 74 pounds when she was admitted to the unit. She was a walking skeleton. She could not walk upstairs, or sit in a chair without a pillow. She could not carry on a conversation that lasted more than five minutes, which is actually termed "skinny brain." Meaning, she was starving, and one cannot function on any level when the body is in starvation. It is very easy to start asking questions like, "Why are you doing this? Are you crazy? Do you understand how skinny you are?" Although questioning their motive is important, what's more important is trying to understand and grapple with the amount of pain they live with every day. To go through every moment of the day hating who you are has to be the most painful way to live.

As much as I love and believe in what I do, it's hard. Eating disorders are stubborn, and do not go away. They linger and manifest in the most harmful ways and it is painful to watch. There are days I leave feeling completely hopeless. So why am I doing this? I believe everyone has worth and everyone is loveable. And when I have a conversation with a patient where they begin to see their worth, or understand that they are worthy of something better and want to change, the light at the end of the tunnel gets bigger and brighter and makes all the hard stuff worth it. I want to love women that do not love themselves. And in so doing, hopefully they can learn how to do it, and pass it on.


I write this because today was a hard day. And sometimes I need to remind myself why I do what I do. Even social workers need perspective.