House Wisdom on Cooperating

“What exactly is the difference between pretending to cooperate and actually cooperating?”
– Season 6, Episode 1: Broken

House asked this brilliant (as usual) question in the season 6 premiere in regard to his treatment at a state psychiatric facility. Thinking about my recent stints in inpatient and partial hospitalization, and the answer I would give is the following: the difference is all in your head.

On the surface, they probably do look the same. For example, in inpatient (or PHP or IOP) cooperating means eating your meals, going to groups, and taking your meds as prescribed. But if the whole time you are just thinking about how you can lose the weight you are gaining, or get away with behaviors, are you really cooperating?  On the surface, yes, but in your head, no.

During most of my recent inpatient stays, I pretended to cooperate.  I ate my meals, went to groups, took my meds. But the whole time, I was trying to get away with what I could.  If something was missing on my tray, I didn’t say anything.  I ordered the lowest calorie food I could.  I paced back and forth in my room.  It should come as no surprise then that after those stays I relapsed.

This past time however, I would say I actually cooperated.  I wasn’t perfect, but I really did push myself to cooperate even when I could have gotten away with missing an exchange, or sneaking in a little exercise.  Rather than cooperating simply because there were negative consequences if I didn’t, I cooperated because I knew it was the right thing to do, and instead of just going through the motions, I put a lot of mental energy into my treatment.  Thus, I think a good way to look at it is:

Pretending to cooperate = Passive Cooperation and

Actually cooperating = Actively cooperating.

I think oftentimes with eating disorder treatment, you sometimes have to “fake it ’till you make it.” In other words, you don’t need to start out actually cooperating. You start by pretending…you eat your meals, you go to groups, even if you are not 100% on the recovery bandwagon. But the hope is that with time, it gets to the point where you are cooperating with the program not just because you have to, but because you want recovery.

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