Girl, Interrupted and my Experience With Psych Wards
Trigger Warnings! Mentions of suicidal ideation, psych units, self-harm, and violence. Some graphic imagery (from film).
In the spring of 2016, I walked into the emergency room, desperate for a psychiatric evaluation. That afternoon, I had lingered over the idea of taking the entirety of my newly refilled bottle of Depakote, a mood stabilizer to regulate the symptoms of my bipolar disorder.
Such a large dose would have caused an abnormal heart rate, low blood pressure, a lowered breathing rate, fever, and, eventually, a heart attack. I’d most likely have been passed out or in a coma at the time, though, especially since I planned to take a bottle of Dramamine at the same time (both to help keep the Depakote down, and to help me fall unconscious quickly).
This, I knew, was called “suicidal ideation with a plan,” and some logical part of my mind, the part that was scared of dying and wanted to live, knew that I needed immediate attention, lest my thoughts become an irreversible reality.
Some hours later, the psychiatrist on duty paid me a visit. A portly man with a gray beard and a kind face, he listened to my feelings of overwhelm, anxiety, and despair without a hint of judgement. Looking back, he was probably glad that this conversation wasn’t taking place after having my stomach pumped or my wrists stitched.
He didn’t ask me much, probably because I was so open from the outset, but instead told me that, according to Massachusetts’ state laws, I would be involuntarily committed to “5 West,” the psychiatric ward, for a minimum of three days. I was considered a danger to myself, and needed to be evaluated by the staff for my own safety.
After a night of little rest and an anxious morning and afternoon (all on an Emergency Department hospital bed), I was moved to the inpatient unit, given a room, and began the work of figuring out what was wrong with me so I could figure out how to right it.
Luckily, it didn’t take much: just a minor tweak in my medication and some revelations about what sort of lifestyle would be best suited to my four mental illnesses. I walked out of the hospital four days after I walked in and I can easily say that my stay there was for the best.
I had encountered psychiatric wards only twice before in my life.
In high school, I was good friends with a girl who ended up in one due to a combination of suicidal ideation and an eating disorder. I visited her there when I was a teenager, my mother in tow for support. She was heavily medicated, noticeably ‘loopy,’ and our conversation was strained as a result. I only saw the common area of the ward. It looked like a very large, very nice living room — perhaps in a rich aunt’s house — where she had been decoratively placed. I didn’t go back to visit again.
The second encounter was much different.
A friend’s sister had tried to kill herself. She took a lot of Benadryl (causing sedation and what would have been eventual cardiovascular collapse) and Ativan (which inhibited her breathing, caused her to pass out, and eventually would have led to a coma and death).
At first, I saw her only in the hospital room where she made her initial recovery. She had a nurse watching her 24/7 to ensure she wouldn’t make another attempt, and her bed was equipped with an alarm that would sound if she tried to get up without authorization. That was difficult to watch, but ultimately no different than visiting my grandmother in the hospital when she was ill with pneumonia — if you didn’t think about it too much.
Eventually, though, she was moved to a long-term, inpatient ward that was much different. It wasn’t a pristine setting, like what I had witnessed as a teenager. Instead, it was marked by dingy linoleum, wooden doors with small windows and metal handles, beat up books on various shelves: the AA guidebook, the Bible, self-help books, and uplifting bestsellers. It looked like a public school in need of funding.
Before my stay on 5 West, these were my only experiences with psychiatric wards in the flesh. Of course, though, there were the movies.
Movies involving psych wards usually fall into two genres: horrific or inspirational. Movies like Gothika, and The Ward use psychiatric facilities as settings for ghost stories.
Asylum, and The Cabinet of Dr. Caligari use them as settings for murder and gore.
The Jacket and Session 9 use psychiatric facilities as backgrounds for supernatural events.
One Flew Over The Cuckoo’s Nest and Sucker Punch make the psych ward a place of human cruelty.
These films employ the audience’s fear of insanity by way of the setting, undermining real human experience for the sake of thrills and chills.
Other films, such as K-PAX and It’s Kind Of A Funny Story use inpatient psych wards as places for miraculous and inspiring events: love, new beginnings, reconciliation, and hope.
Until I saw Girl, Interrupted, I wasn’t aware that a movie would be willing to portray psychiatric wards realistically, to use them as reasonable backgrounds for stories about mental illness instead of fear or inspiration.
From what I can tell, Girl, Interrupted is the most recent and well-known movie about a psychiatric facility and its inmates. If you haven’t seen it, I won’t spoil it for you. But the basic premise is that Susanna goes into an expensive psychiatric facility at her parents’ urging after chasing a bottle of aspirin with vodka, and wrestles with the idea of whether or not she’s crazy, whether or not the facility is helpful, and whether or not she can trust Lisa, a long-term resident there.
The film is set in the 1960’s, which makes comparing my experience to it difficult. It is based on the lived experience of writer Susanna Kaysen, so some aspects must be taken at face value, but the adaptations of life to memoir to movie leaves room for artistic license on the parts of the author, screenwriters, director, and producer.
I cannot say for certain what was true and what was not, but there are certainly details that stood out in my mind as completely impossible — at least in today’s world.
In 1960s Massachusetts, Section 12, the law that confined me to 5 West for three days, did not exist. The law wasn’t passed until 2010, which strikes me as both surprising and all too familiar: one would think that an apparent suicide attempt or the plan of one would result in immediate transfer to a safe environment, but lawmakers tend to ignore the plight of the mentally ill in lieu of more “pressing” concerns. In any case, Susanna was pressured into entering her psychiatric facility, whereas I didn’t have a choice. Blame the ‘60s.
Blame the times, too, for the fact that a patient would have the opportunity to hang themselves with a volleyball net while under inpatient medical care. The ludicrousness of that fact stuck with me for far longer than the plot lingered on it, as did other seemingly small details:
- The fact that Susanna was allowed a pencil to write with when it could be used to stab herself or someone else (we were given skinny Crayola markers).
2. The idea that Lisa could grab a pen from a nurse and hold it to her neck after saying she would stab her aorta (all the pens were kept behind the nurse’s station desk and if we needed one to sign paperwork, we were supervised while using it).
3. The fact that characters were seen wearing clothes with strings (or belts!) when those could be used to strangle yourself or someone else (we had to remove all shoelaces, hoodie strings, etc. or else surrender the item of clothing).
4. The existence of glass mirrors which could be broken and made into shard-shaped weapons (we had surfaces of polished metal, instead).
Mental health professionals probably learned over time that such things were hazards, eventually resulting in the marker-abundant, stringless, mirrorless ward I stayed in, but apparently things were different in the ‘60s.
The way that medication was dispensed, for instance. Susanna takes what is given to her, and when she objects, the nurses make it clear that she’ll take her pills the easy way or the hard way, regardless of what they are.
Yes, you can get sleeping pills in a psych ward, but unless you’re already on them when you come in, you have to ask your nurse for them, who then has to call in the request to the attending physician, who then has to pass the request along to the pharmacy. In any case, you’re going to wait a while for relief, as opposed to Susanna, who is essentially drugged into unconsciousness her first night, and many nights afterward.
Yes, they still order Colace for everyone (except, I would imagine, to people with eating disorders), but you have the option to decline; I always did.
Obviously, there’s no smoking allowed anymore. Instead you get a nicotine patch based on how much you smoke on the outside. They take the edge off, but don’t stick well on your arm and the oral fixation aspect of smoking is left completely unattended.
You don’t get outings, grounds privileges, or anything of the kind — or at least I didn’t. Once you had been on the ward for 24 hours, you could go out (with one nurse for every three patients) into a concrete courtyard surrounded by the brick walls of the surrounding hospital. There was dilapidated lawn furniture to lounge on, a multicolored children’s ball in need of air, a football, and a basketball hoop with no netting to occupy your time out there. We got one hour.
Needless to say, there was no such thing as wandering the grounds unsupervised, or going into town to get ice cream.
Visitors weren’t allowed in our rooms. Other patients weren’t allowed in our rooms. If you had a visitor on 5 West, you had to be chaste in your interactions. Hand-holding was okay, and a light peck of a kiss when saying goodbye, but any kind of cuddling or more intense hugging or kissing and a nurse would speak to you about being “inappropriate.”
I got a talking-to once, and tried to be cautious from then on, but being in a place like that heightens your need for physical comfort. Good for you, Susanna, for getting some dry humping in, I say.
And good for you for being allowed a cat. These days, the benefits of therapy animals are becoming clear, so having a ward cat might be in the best interest of the women there, but in case of allergies or triggering memories, no such thing was permitted for us.
It still nags at me that we didn’t have an isolation room, in case someone started to act up or become violent. Obviously the empty white room of the ’60s would be replaced with something else, something more humane, but there were times when I wished we had a place separate from the general population for a “time out,” somewhere with a lock on the door.
One guy, who I nicknamed “Charles Manson” because of the physical resemblance, his kooky conspiracy theories (chem trails, government cover-ups, etc.), and penchant for hallucinogens, liked to cause trouble. He simultaneously loved and wanted to kill his girlfriend. He would demand strong medications and, when he wouldn’t get them, he’d bang his head against the wall (not unlike Daisy screaming when she couldn’t get laxatives). One night, he off-handedly said the N word in front of a black man, and they got into each other’s faces, triggering me (who heard the ruckus down the hall) and a girl who happened to be in the room at the time.
He was confined to his room with a large orderly for a babysitter, maybe strapped down, maybe not. I’m not sure if our beds came equipped with restraints. But his roommate had to wait outside until he was properly sedated and asleep before he too could go to bed. We could have used a “time out” room then, like the movie-nurses used on Lisa when she would pitch a fit.
Other things seemed strangely unchanged, as if everyone had gotten it wrong and institutions back then knew what they were doing.
When Susanna is told that she needs “to go somewhere where [she] can get a genuine rest,” it felt like deja vu. It was why I went in — part of why I went in — and the majority of what I did when I was there. I slept. I colored. I ate. I read. I went to group therapy. I watched TV. But I didn’t do much because I needed a break from thought and responsibility and the crush of feeling like the world didn’t want me and I didn’t want the world.
At the same time, people keep telling her not to get too comfortable in the ward, to rest, but not make it a home. It seems counter-intuitive — you would think that getting out of a psych ward would be priority number one — but once you’re in and all your needs are being tended to and cared for, once you’re not expected to do anything except recover and heal without strain, leaving can seem overwhelming.
Outside you have to fend for yourself and hope for the best. It’s safe inside.
But sometimes it isn’t. There are people who come with police escorts, though they’re strapped to a gurney instead of being led in handcuffed. There are those who scream and cause a commotion, and fight with the staff. If you want to shave, you need to request a razor and someone will watch you use it. I never got to the point where my hairy legs and armpits bothered me enough to allow a stranger to watch me shave, but many of the men (I lived in a mixed ward) opted to trim their scruff under supervision.
One of my friends inside asked a nurse if she could watch him shave to make sure he didn’t slit his throat. Dark humor was always appreciated on 5 West.
Although no touching was allowed — to prevent someone from being triggered — and patients and visitors weren’t allowed in rooms that weren’t their own — to protect what little privacy we were allowed — much of the interaction between patients felt true to life, or at least mine.
The first day inside feels completely surreal. Only one person talked to me apart from a quick “hello” from my roommate, and our conversation was brief, focusing mainly on my writing (I was scribbling in a notebook at the time) and his performance poetry. Ten minutes at most, followed by visitors of my own, and then a talk with my doctor. Afterward, I wandered between my bed and the lobby, unsure of what to do or where I belonged.
I was thankful for the availability of sleeping pills, delayed as their delivery was.
The next day, though, a bond began to form. There was small talk over breakfast while watching the news. One person would throw a comment out for anyone to answer, and eventually there would be something like conversation. Groups like “current events” always got a back and forth going, even if all we said was “I agree,” and “I don’t.” Eventually, we all discovered the allure of photocopied pages from adult coloring books, and we’d sit in the common area (another thing the film got right: everyone does hang out in the TV room), sharing colors like kindergartners, trading jokes, gossip, and surface talk about what we “were in for.”
What else is there to do, really?
Of course, there was no way to sneak out and bowl.
No one used last names because of HIPPA regulations — even nurses weren’t permitted to use them in common areas. Most of all, people wouldn’t dig into other patient’s issues. And why?
We were all too selfish.
We wanted to focus on our own issues, and move on as quickly as possible. In spite of promises to keep in touch once we got back to the real world, I haven’t heard from a single person since.
And that’s okay.
What happens in the psych ward stays there, I suppose.
But there is the desire to cheer someone up when they’re feeling low. I would have sung to someone I liked through a door, if the situation called for it.
When you’re all “crazy” together, you’re linked. It’s like elementary school all over again, and not just because of the coloring. If someone’s upset, there’s an instinct to fix it among your wounded selves rather than involve the staff.
Even for a short time, you’re a tribe and a tribe protects their own.
I can’t say what it would have been like if I had stayed on 5 West for an extended period. Then again, I didn’t go in like Susanna, refusing to believe that taking a bottle of aspirin was a suicide attempt, that nothing was wrong with me, that the place couldn’t help me.
I went in ready to “use the place,” as the film says, and that’s how I got out so quickly. In spite of that, though, I saw so much of reality in Girl, Interrupted, from the nightly checks to the communal phones to the way you feel like you can’t stand up to people inside when you normally would outside.
True, the film is a period piece, and much of the details have been left in the ’60s as healthcare reform took over. But by the end of the film, to my surprise and against my initial suspicions, I recognized my past in the plot. Fictionalized, stylized, adapted, and (in some ways) dated though it may be, I suspect that Girl, Interrupted is our best glimpse into the psychiatric wards of today, and that brings me comfort.
See it if you haven’t. Rewatch it if you have. Realize that for many of us, this is reality. In many ways, at least, it was mine.
