August 18, 2025: Toto, I’ve a Feeling We’re Not in the Psych Ward Anymore and The Psych Ward Grief Cycle
by Harmony Witte
If all goes according to plan, I will be released from McLean Hospital this afternoon after 27 time-warped days of inpatient treatment. This is by far my longest hospitalization, and it’s been quite a life-changing experience with long stretches of grinding routine, punctuated by unpredictable moments of acute trauma, and peppered with moments of intense human connection–those moments I will treasure. That is, until my brain inevitably forms a protective cocoon around my memories of this stay and leaves me only a few fuzzy highlights, turning most people here into vague faceless, nameless impressions. Eventually making their names and most details impossible to recall
That’s why I took the time to write down the names and occupations of 17 McLean staffers who left a huge impression with their large and small act of humanity–they are nurses, occupational therapists, mental health specialists, kitchen staff, and my social worker. I filled out compliment cards for each of them yesterday and made sure to write “Pay them more!” on each sheet. My intention at this point in time is to send monthly cards to update the staff on my progress–knowing they aren’t able to respond to any correspondence. These folks have made it clear that they root for us once we are on the outside and the “treatment actually begins.”
There’s a phenomenon in the hospital that I call “The Psych Ward Grief Cycle”. It’s sustained by the constant ebb and flow of patients tricking through the program. The reality of this cycle is that patients often form intense, quick bonds with each other based on the shared sadness that we are all mired in and the trauma that we all experience on the ward. These bonds of friendship are often intense and unlike anything that might be seen in the “real world.” We rely on each other to meet most social needs– taking classes together where we do the hard work of group therapy, socializing in the day room playing countless hands of rummy and scrabble, attending community meetings, and occasionally allowing ourselves to be openly goofy during karaoke, morning stretch, or line dancing. Patients might form friendships with people they would not otherwise interact with in their daily lives. In a place where politics, identity, age, and occupation do not hold the same stratifying effects that they do outside, these relationships burn bright and intense like a high school love affair.
The hard part comes when a patient in one of these friendships reaches the end of their stay. When word gets around that someone is about to be released and has gotten confirmation from their care team people might start to withdraw a bit from the relationship as an act of self-preservation. Patients gather around the nurse’s station during med times, discussing who might leave that day, like a group of theater kids waiting to see when the cast list for their school play is posted. Once the patient’s name goes on the “leaving” side of the white board in the nurse’s station everyone holds them at arm’s length, perhaps after first giving a quick (rule breaking) hug and exchanging phone numbers.
The sad reality is, very few of these friendships will survive outside the walls of the hospital. Even with the sincerest of intentions, people will find that returning to “normalcy” leaves their memories of their time in the inpatient unit in a liminal, dreamlike space. Even if people can manage to come together in person, they may find that the spark of friendship has given way to discomfort because the other people remind them too much of a painful period they would rather not think about. I currently have plans to spend time next weekend with a couple of friends from the hospital who gave me so much comfort during my hospitalization—it’s an uphill battle, but I feel like I have to give it my best try. Because if even one of those burgeoning friendships manages to survive this time period it has the potential to turn into a lifelong kind of relationship. I have a few friends from my previous hospitalizations 7 and 9 years ago that I absolutely cherish. They have been supportive through some of my toughest times, always out there rooting for me and me for them!
For the people who are left behind, still confined when their friends leave the ward, they experience real grief. They may have built parts of their routine around this other person. Stealing a few quiet hours every morning before the majority of the ward wakes up–chatting over cups of coffee and water-filled hospital sippy cups or playing a DnD campaign fueled by gummy worms and jalapeno Cheetos in the evenings. Sitting together during art therapy and group therapy–holding space for each other. Abruptly, this routine they have built around each other’s company is disrupted. Some people will isolate themselves for a few days in their grief. Others will reach out and rely on other friendships, starting the cycle over again.
The resulting effect is that at any given time, many of the patients may be acutely missing some of the people they have come to rely on while in the hospital. Especially during weekends when many people have left on Friday and new people are being added to the ward before Monday. If the patient is already struggling with grief from their home life this cycle of grief might be especially difficult.
Part of the chain of events that brought me to the hospital this time was a missed miscarriage that ended an “unexpected yet very much wanted” pregnancy in 2021. The “missed” part being crucial as it seemed especially cruel that my body was still convinced I was pregnant after the fetus had expired inside of me. Another cruelty was the pregnancy hormones that coursed through my body for weeks after the loss continuing the morning sickness. What had once been a promise of hope became a constant, sick reminder of pain.
The grief was unbearable and turned into an albatross around my neck that I couldn’t shake. My attempts to alleviate the pain by finding meaning by working with children just resulted in what felt like death by a thousand papercuts each day. I attempted to be hospitalized to deal with this grief in 2022, but the hospitals were still too overrun with patients as a result of the covid pandemic and my doctor was unable to secure me a bed anywhere. Since then, I’ve been white knuckling life until this 4-month long, unrelenting migraine left me in chronic pain and unable to successfully navigate the intrusive suicidal thoughts that have plagued me since I was 8 years old. My psych prescriber if 5 years completely ghosted me (for the 2nd time–what was it Dubyah used to say? Fool me once?) about 5 months before the hospitalization, leaving me without any psych meds. As someone diagnosed with Bipolar Disorder, PTSD, and potentially OCD this put me in a precarious place. It is a situation that turned out to be a perfect storm that I could have seen as inevitable if it were happening to any of my friends or family, but I was left unable to successfully navigate the process of finding a new prescriber while in the depths of the swirling storm of depression.
Every time one of my hospital friends gets discharged it kicks up feelings of abandonment from being rejected by my family, as well as stirring up the grief around the miscarriage. I think more about my loss here than I have allowed myself to do in years with only a small stuffed angry panda to squeeze at night when my womb, arms, and heart feel most empty. It was such a process to get approval for the panda.
I had to get 2 doctor’s notes, and it took until approximately a week after I was admitted before the stuffy finally materialized on my bed. To many, having a stuffed animal to hold might seem like a tiny thing. But in the hospital, even the smallest things take on a life of their own. Having the ability to squeeze something soft when having a difficult moment may be the difference between a day where a patient is able to cope and a day where they are held down and forcibly medicated by the oh-so- amazing staff.
There’s a delicate balance in the hospital of grief, of comings and goings. It has to be respected because if things get too out of balance then that amazing staff is left with 22 disregulated patients who currently lack strong self preservation instincts. Thankfully, the staff at McLean is very much aware of the cycle and most do the best they can not to upset the balance. They try to help where they can.
I expect most people will keep me at arm’s length this morning/-politely ignoring me after a few “goodbyes” while I wait to be discharged. Sitting in that liminal space where my belongings have all been packed and taken through security, while I finalize a safety plan, and say my goodbyes to people who may be already trying to forget I was ever here.