Mutual mistrust: the issue of manipulation
Most participants felt ‘manipulated’ by adolescents with
anorexia. Their definitions of ‘manipulation’ varied, some
feeling that it was ‘playing one nurse off against another’ or
that it was ‘lying’ or ‘twisting words around’ to gain ‘control’.
Others believed that ‘manipulation’ was ‘upsetting the
boat’ and ‘causing infighting’, so that patients could ‘get
away with blue murder’. Still others defined manipulation as
‘non-compliance’ with the treatment programme ‘because
they don’t agree with it and it’s not what they want to do’
(Lilly). Participants’ lack of knowledge about this complex
condition led them to ‘expect manipulation’, dread it and be
unwilling to give their charges ‘a clean slate again’ when it
happened. Unsurprisingly, the adolescents saw the participants
as ‘authority figures’. It was extremely difficult to gain
the adolescents’ trust, when participants had the roles of
‘baddy’, ‘enemy’, ‘policeman’, ‘parent figure’, ‘manipulator’,
‘army officer’, ‘spy’, ‘dibber dobber’ (someone who reported
their behaviour to senior staff), or ‘big brother’. Participants
felt that forming a trusting relationship was difficult for
them because these adolescents saw them as ‘taking control
away’, as inflictors of ‘punishment’, and as ‘invaders of
privacy’ when they followed and enforced the treatment
programme. Overall, they felt that ‘manipulation’ was a
way that these adolescents could gain ‘control’, while
causing them great frustration and grief. Mike was the only
participant to see manipulation in a positive light, as a
‘survival instinct’.
Mutual mistrust: the issue of manipulation
Most participants felt ‘manipulated’ by adolescents with
anorexia. Their definitions of ‘manipulation’ varied, some
feeling that it was ‘playing one nurse off against another’ or
that it was ‘lying’ or ‘twisting words around’ to gain ‘control’.
Others believed that ‘manipulation’ was ‘upsetting the
boat’ and ‘causing infighting’, so that patients could ‘get
away with blue murder’. Still others defined manipulation as
‘non-compliance’ with the treatment programme ‘because
they don’t agree with it and it’s not what they want to do’
(Lilly). Participants’ lack of knowledge about this complex
condition led them to ‘expect manipulation’, dread it and be
unwilling to give their charges ‘a clean slate again’ when it
happened. Unsurprisingly, the adolescents saw the participants
as ‘authority figures’. It was extremely difficult to gain
the adolescents’ trust, when participants had the roles of
‘baddy’, ‘enemy’, ‘policeman’, ‘parent figure’, ‘manipulator’,
‘army officer’, ‘spy’, ‘dibber dobber’ (someone who reported
their behaviour to senior staff), or ‘big brother’. Participants
felt that forming a trusting relationship was difficult for
them because these adolescents saw them as ‘taking control
away’, as inflictors of ‘punishment’, and as ‘invaders of
privacy’ when they followed and enforced the treatment
programme. Overall, they felt that ‘manipulation’ was a
way that these adolescents could gain ‘control’, while
causing them great frustration and grief. Mike was the only
participant to see manipulation in a positive light, as a
‘survival instinct’.
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