Intervention: a look at dysphagia

I'm not sure how many of you watched Intervention on Monday, but it was a very interesting case with a young woman with dysphagia, a swallowing disorder. Dysphagia can occur at any age for a variety of reasons. It can be due to a congenital abnormality, a structural problem or damage, a medical condition like Parkinson's, or for a psychological problem.

In this case, dysphagia was psychological. This episode featured Nicole, a woman who had been molested at a young age. This prompted her descent into anorexia where she became very malnourished and eventually had to have a feeding tube placed in her stomach. The feeding tube has been in her stomach for fourteen years. During this time, she got married and had two beautiful children.

Her family has become increasingly worried about her children as they feel she has neglected them. They also fear that Nicole could overdose on the many medications she's on for depression, anxiety, and I believe her heart. Since Nicole fears swallowing food so intensely, stemming from her childhood molestation, she chews and spits her food as well as mashing it up and dissolving her medications through the feeding tube. Her rationale for the feeding tube is that without it, she would not live at all, simply starving.

Nicole has been in various treatment centers, including those specific for eating disorders but did not feel they helped her. When she reaches the point of talking about the molestation, she has much difficulty dealing with it and shuts down. Thus, she has not gotten that far in therapy. In the intervention, her family's and husband's hope was that she would accept receiving treatment at a residential eating disorders clinic. At the end of the show, it said she stayed in the treatment program for two months, and then went home. She learned to swallow baby food and had gained over 25 pounds.

What I found interesting about this episode was not only the fact that it presented dysphagia psychologically which I've known has occurred in some abuse cases, but also the reliance of the feeding tube from an eating disorder perspective. I've personally never experienced this, but I have heard of people both refusing a feeding tube and also fearing the removal of one as well.

In the case with Nicole, she had had the feeding tube for fourteen years which is an extremely long time, especially evident by the sores around her feeding tube site. Feeding tubes' initial purpose has always been as a temporary measure to help individuals with eating disorders or any other ailment receive the nourishment they needed for a short time. After that, it was to be removed with resumed feeding/learning to eat on one's own.

The other aspect I found surprising was how forthcoming Nicole was about her feeding tube. She publicly fed herself through the feeding tube. She figured this was how she was going to eat, and if people were repulsed by it, then they needed to not watch. In general, this goes almost completely against normal eating disorder characteristics. Eating disorders have always thrived on secrecy, but she puts hers out on display. It gives a feeling of "attention seeking" even if that is not her intention.

The show also featured the toll this swallowing disorder has taken on her family. Her oldest child felt like she did not love her, while the younger one held out hope but was still clearly hurt.

Overall, I'm glad that she accepted treatment and has found some success. I hope she continues on with recovery and will be able to overcome her abuse issues and mend her relationship with her daughters and family.

If anyone saw this episode, what were your thoughts?