This post hit a little too close to home and I debated on how to approach the topic of communicative actions during an illness. I’m going to discuss something that is extremely difficult for me to disclose. I debated where I should share this information, as it makes me uncomfortable to discuss it, but for me to truly engage with this topic, I had to be completely open.
I have suffered from eating disorders, body dysmorphic disorder and exercise bulimia for much of my life. The issues arose when I was a teenager and I’ve experienced both recovery and relapse over the years.
I’ve been in denial for most of my life, but when I was 20 years old I was confronted about my illness from my manager. The communication actions from her displayed during illness were not helpful. Arnett, Harden Fritz, and Bell (2009) say that “the key is not to ‘tell’ but to learn from the Other, the historical moment, and reflective understanding of communicative action (2009, p.206). My manager called me into her office and put me on the spot by “diagnosing” me and making me feel as if I had a problem. Her communicative actions were “telling” me that I had an illness, rather than creating a moment of understanding. It would have been more helpful if she would have come from a place of concern or wanting to understand what I was experiencing. Instead, both her and a co-worker were discussing my symptoms, which not only felt like “telling” but it felt as if I wasn’t engaged in the conversation.
Arnett, Harden Fritz, and Bell (2009) state that listening without demand is an important component of communication ethics. When my manager confronted me, she placed too much demand on my communicative response. She desired a confession and acceptance of responsibility from me. I felt as if I had too much demand placed on me. My manager’s confrontation required a response from me. The solution required a response and sense of responsibility for my own health (196) . One can’t force an individual to take responsibility. The negation in the communication allows for both partners to not place any demand on each other.
Dougherty (1996) says, “The hallmark of health care need, at its most basic level, is therefore human vulnerability,” (as cited in Arnett, Harden Fritz, & Bell 2009). This defines the very challenge I had in this confrontation of my illness, because it made me feel completely vulnerable. In healthcare communication ethics, responsiveness looks at how we engage others when in need (Arnett, Harden Fritz, & Bell 2009, p.193). Others want to care for people and they don’t want to see them suffering. This was probably the viewpoint of my manager, who confronted me. However, I took this confrontation as an attack and an infringement on my private life. The giving of the communication action felt accusatory rather than helpful. I was completely vulnerable in this moment, and the fact that my manager mentioned that she and other co-workers discussed my “illness” prior to her confronting me made it worse.
Unhelpful communicative action doesn’t only come in the format of those who don’t understand the illness. As Keller, Rosenthal and Rosenthal (2005) described in their study of pro-anorexia and treatment sites, many pro-anorexia discussion forums promote self- efficacy, as the communicative actions help reinforce the eating disordered behavior. However, Keller, Rosenthal and Rosenthal also found that many medical treatment sites also promote self- efficacy by providing tips for anorexics to prolong their disease. Among the tips mentioned, 18 percent of treatment sites mentioned fasting, 15 percent mentioned diet drugs and 16 percent mentioned purging. These communicative actions are not helpful, as they encourage those with eating disorders to continue their disordered behaviors or possibly even pick up new habits. I remember my husband, who was worried about me, took me to Olive Garden to confront me about my illness. His solution was to order me a huge plate of spaghetti. He asked me to eat it, but I couldn’t. I experienced what Arnett, Harden Fritz, & Bell (2009) describe as a struggle when we refuse to conform to what would be hoped for in life. I wished, and still do wish, that I had a normal relationship with food. Why do I have to worry about everything I eat? Why do I care so much about being thin? I would like to say that I’m fully recovered, but I’m not. While I’m not dangerously thin, or thin at all, in my mind, I still have tendencies towards disordered eating. As Arnett, Harden Fritz, and Bell state, our health accounts for “beginnings, endings, and intermediate moments,” (2009, p.195). While I’m not completely healed, and may never be, there are moments throughout my illness that account for the beginning, intermediate and end. Each moment requires a different communicative response.
The communicative action that has worked the most with my illness is my own self-reflection. Only through self-reflection have I been able to achieve any movement in this area. While there is no ethic set in stone, recovery also isn’t set in stone and may require different negotiation over time.
Arnett, B.C., Harden Fritz, J.M.& Bell, L.M. (2009). Communication ethics Literacy: Dialogue and Difference. Los Angeles, CA: Sage Publications. Arnett, B.C., Harden Fritz, J.M.& Bell, L.M. (2009). Communication ethics Literacy: Dialogue and Difference. Los Angeles, CA: Sage Publications. Arnett, B.C., Harden Fritz, J.M.& Bell, L.M. (2009). Communication ethics Literacy: Dialogue and Difference. Los Angeles, CA: Sage Publications. Keller, S., Rosenthal. L. and Rosenthal P. (2005). A Comparison of Pro-Anorexia and Treatment Web Sites: A Look at the Health Belief and Stages of Change Models Online.Paper presented at International Communication Association, 2005 Annual Meeting, New York: NY (1-37). DC: International Communication Association Arnett, B.C., Harden Fritz, J.M.& Bell, L.M. (2009). Communication ethics Literacy: Dialogue and Difference. Los Angeles, CA: Sage Publications.