Reading ‘Girl, Interrupted’ in the Psych Ward

Bringing Susanna Kaysen’s memoir into the mental hospital felt like bringing a smart friend who could tell me how to survive

I ’ve re-read Susanna Kaysen’s Girl, Interrupted nearly every spring since I was eighteen. She has a bit in there about how springtime is suicide weather, and the first time I read that line it was one of those revelatory sort of moments that casts the rest of your life in a different light. Because of that, the book has become forever linked with the season, and my yearly springtime sads send me scrambling through my bookshelves, praying that last year I was sensible enough to re-shelve it in its proper spot.

I know for certain that I reread Girl, Interrupted in April of this year, because I tried to work the “suicide weather” line into an essay about suicidal ideation. My editor took it out, with a note about how it seemed a bit trite to open with a Kaysen epigraph. She was right; the line added nothing to the piece and wasn’t meant to. It was there as a sort of secret note to myself, a reminder of the slippery, tricksy nature of this season. You think you’re watching the earth wake up from its deep freeze, all birdsong and warm breezes and snub little snowdrops pushing up through the soil, but really you’re feeling yourself coming out of your own cold storage, with every pain and misery and heartbreak the spring has ever brought you melting and rising in you like sap.

Two months after the publication of my suicide essay, I woke up one morning and knew I was going to kill myself that day. Or rather, I couldn’t think of any good reasons to put it off any longer. Why drag myself through another miserable day on the increasingly remote chance that things might get better? I’d been making that gamble for months, and not once had the cards come up in my favor.

By that point, I hadn’t slept in weeks. I’m not a good sleeper to begin with, and then one dose of Cymbalta — which my psychiatrist had prescribed in the hopes that it would help manage not just my moods but my increasingly debilitating joint pain — broke my brain. I stopped sleeping altogether; even an increased dose of my extra-strength prescription sleeping pill couldn’t touch it. I couldn’t eat. I couldn’t read. I couldn’t write. My mind moved in rapid circles, the same awful cycles of thought over and over again. My muscles ached from a body that was locked in constant state of fight-or-flight. Day bled into night bled into another day bled into another night bled into yet another day.

Two months after the publication of my suicide essay, I woke up one morning and knew I was going to kill myself.

I tried breaking my days and nights down into hour-long increments, then into quarter hours. I told myself that if I could survive from 3:15 am to 3:30 am, then I would be all right. But of course after that I always found myself staring down the barrel of another fifteen excruciating minutes.

Then one grey June afternoon I felt like I couldn’t survive even one more minute. I downed a bottle of sleeping pills and some whiskey, wrote a note, and got into bed. A few minutes later I got out of bed, shoved a few things into my backpack, stumbled down to the street and took a cab to the hospital.

I wound up on an involuntary 72-hour hold in the psychiatric ward of downtown hospital. As the nurse sorted through my hastily packed bag to remove anything forbidden — my pen, as it turned out, was a sharp, as were my bobby pins — she didn’t even pause when she pulled out my copy of Girl, Interrupted. Maybe she didn’t bother to read the title. Or, more likely, I wasn’t the first to bring this book in with me.

Kaysen’s account of her years spent in a mental hospital may seem like a strange choice for someone actually facing time in one, but to me it seemed like the most natural thing in the world. If I’d been traveling to Greece I would have brought a Lonely Planet guide or whatever, something that would give me the lay of the land and help me understand the local customs. Since no one has seen fit yet to print a patients’ guidebook to psychiatric wards, Girl, Interrupted — the first chapter of which is titled Toward a Topography of the Parallel Universe — would have to do.

I had a lot of time to read on the ward. Breakfast and morning meds happen at 8 am, and after that there’s a four-hour stretch before lunch. There’s usually some kind of programming in the afternoon, either art therapy or group therapy or walking group, the last of which involves walking circuits of the ward like a high school student who has to do laps for misbehaving during gym class. Dinner is at 5:30. There’s no official time for lights out, but unless you’re willing to go to bed at 8, the evening hours are even longer and emptier than the gulf between breakfast and lunch.

Since no one has seen fit yet to print a patients’ guidebook to psychiatric wards, Girl, Interrupted would have to do.

I spent my first two days in my bed, which was in a cozy sort of alcove up against a window, with the lights dimmed and my curtains drawn. I felt like the rest of the world was a stormy sea and my corner of the ward was a raft; as long as I clung to it and clung hard, then I could ride out my time in the hospital and go home to my family. I clung to my book, too, as both an insight into the strange new world I found myself in and a link to my other life, the one that existed somewhere outside the walls of the hospital. I didn’t talk to anyone except the nurses and doctors. I took all of my meals alone at my little bedside table, even though my nurse mentioned meaningfully that the staff “liked it” when patients ate together in the dining room. When I told her I’d rather not, she wrote something in my chart.

As Kaysen notes in Girl, Interrupted, everything a patient does or doesn’t do on a psychiatric ward is pathologized. The doctors “had a special language,” she writes: “regression, acting out, hostility, withdrawal, indulging in behavior. This last phrase could be attached to any activity and make it sound suspicious: indulging in eating behavior, talking behavior, writing behavior. In the outside world people ate and talked and wrote, but nothing we did was simple.”

Sure enough, during my next meeting with my psychiatric team (doctor, intern, and student), they told me that people had noticed that I wasn’t engaging much with other patients. Other meetings brought up other notes about my behavior: it had been noticed that I cried frequently, that I didn’t eat my breakfast, that I didn’t participate in group activities. A good portion of the half hour or so I had with the psych team every day seemed to be devoted to reviewing what I was and wasn’t doing on the ward.

I was tempted to say something very witty and cutting about how I was a suicide case in a hospital, not some ambitiously networking businesswoman at a social event. But as much as witty and cutting might rack up point with friends and admirers, they don’t tend to go over so well with doctors. And I knew that if I wanted to be considered well enough to get out of this place, then I needed to be someone who went over well with doctors.

The psychiatric field tends to value compliance above all other traits. A compliant patient, after all, is one who is likely to take her medication on time and show up to appointments and follow commands like “tell someone if you feel like you’re going to hurt yourself.” And yet a hospital is not an environment where compliance flourishes; patients have no access to fresh air or sunshine, they’re expected to follow arbitrary rules to the letter, and if they do things like question their medication or try to talk to hospital administration about conditions on the ward, they’re labelled “difficult” and medicated even more aggressively. While I was in the hospital I saw a situation escalate from a frustrated woman throwing a cup of (cold) tea on the floor to that same woman being pinned down by guards and injected with a tranquilizer.

It wasn’t hard to see that if I wanted to be released, I would have to learn to be compliant. Which meant learning to participate in day-to-day life on the ward.

Coming into the hospital, Girl, Interrupted had felt like a friend that I was allowed to bring with me — someone I’d known for more than a decade who knew the ins and outs of life on a psychiatric ward. Having this friend with me made it easy to spend hours alone in my alcove, flipping through the pages of my book by the humming fluorescent light above the bed. And yet as easy as it was to be alone with my book-friend, she spent hours patiently convincing me to get up and out of my room and talk to someone else. After all, Kaysen’s relationships with other patients form the core of Girl, Interrupted’s narrative; it’s their camaraderie that makes the book what it is. And a guidebook is a guidebook, by which I mean that you choose not to follow its advice at your own peril.

Coming into the hospital, Girl, Interrupted had felt like a friend that I was allowed to bring with me.

I started spending time in the patient lounge. I joined in a game of scrabble and offered to get snacks for movie night. I taught a regular yoga class every morning to help alleviate the post-breakfast boredom. I traded stories with other patients, and felt the giddy freedom of talking openly and candidly about mental illness with people who really got it. With them, having made a suicide attempt didn’t make me an object of pity or fear; it just made me one of the guys. It was the most normal I’d felt in months.

The doctors and nurses at the hospital were there to make sure that I was safe, that my medications were working, and that I had some sort of plan for what I’d do after I was discharged. All of the staff I encountered were kind to me and they all seemed to genuinely care about my welfare, but that was about the extent of our relationship. It was the other patients who sat with me while I cried, who listened to the litany of reasons why I was a bad person, who respected my space when I just wanted to be left alone. It was the other patients who devised a game to keep us busy over the weekend, one where we pretended we were at sleepaway camp complete with ugly crafts and late-night ghost stories.

Girl, Interrupted was what had made the idea of being in the hospital bearable. It was the other patients who helped me bear the hospital itself.

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