What I Learned About Life on a Locked, Inpatient Unit of a Psychiatric Hospital

The summer after my freshman year in college, I landed my first job in mental health care. It was at a psychiatric hospital in western Connecticut, and, at the risk of sounding strange, I was really excited about it.

I’d been studying psychology informally since I was in the 7th grade (no joke: I was like the Doogie Howser of mental health), and I was the kind of kid who went to college knowing exactly what she’d major in. To have the opportunity to work with real people in the real world, to take abstract knowledge and put it to practical use, felt like a huge privilege. So I trotted off to the first job of my career with a lot of youthful naiveté – as well as a purse full of pet theories.

For example, I was half convinced that people with schizophrenia might not be “crazy” in the way that we define it, because they might just be able to hear things that other people can’t.

“Who are we to say we’re right?” I’d ask my professors. It seemed so arrogant to me that mental health professionals would deem a patient crazy just because we couldn’t hear the voices she heard, or see the visions she saw.

While that style of logic is still consistent with how I think today (i.e. that humility and an open mind are essential in this line of work), I learned that I was totally missing the point, because my question was completely abstract – and the kind of suffering I witnessed on those wards was anything but an abstraction.

I have memories from those months that haunt me to this day, seeing people who were plagued by menacing, internal voices, and having to tolerate the sense of powerlessness that I felt because there was nothing that I could do to truly help them. Relief only came in the form of chemical sedatives, which would knock a person out and leave her barely functioning.

There were times when I had to participate in getting people into four-point restraints – a measure of last resort that was only used when a person was so violent, and so unable to be rational, that we had to do it to protect him from himself. But try explaining that to someone who can’t hear you over the din of voices in his head.

One time I literally ran across a room to try to stop a man from eating the lit end of a cigarette. He was clearly just … confused.

The world inside those walls was chaos, and what I learned there is that the question of who’s “right” about where the voices come from is beyond meaningless. The suffering was too deep, too profound, and too real for anything else to matter.

Almost 20 years have since gone by, and I’m now a therapist in private practice, working with people whose problems are infinitely less dramatic than what I experienced on those wards. Among the questions I’m asked most often these days is, “Am I normal?” And I have to laugh because – much like my naiveté heading off to that first job – I’ve realized that it’s a silly (albeit well-intentioned) question to ask.

“Normal” is an abstraction. It’s meaningless. In fact, the word “normal” as it applies to mental health is extremely confusing. Sixty-five percent of women in America have an eating disorder. Statistically speaking, that makes it “normal.” Clearly, in this case, normal does not equate to healthy.

Furthermore, the notion of “normalcy” has never been adequately defined. Normal as opposed to what? Everyone has his or her quirks.

Being in the psych ward of the hospital showed me just how irrelevant my questions about “normal” were, and I try to remember that today. The only thing that matters is whether someone is suffering, and how to relieve it.

No one wins when we compare ourselves to others. Mental health isn’t a question of who’s right or who’s wrong, and it’s not a matter of being normal or abnormal. No one is the ultimate arbiter of what the truth is – not even me, with the license granted to me by the state of California to determine the distinction between “illness” and “health.”

So in my mind, the only questions worth asking are:

Are you suffering?

And, if so:

Do you have the courage to do something about it?


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