It was then that the doctor told me that he didn’t believe that I would benefit from inpatient hospitalization. He stated that the criteria they use in the Crisis Response Center is to think about whether if they sent an individual home after the evaluation, would he or she die? He didn’t think I would die. He said that I wasn’t in any immediate danger and that obviously, my daily living skills were excellent. He mentioned that the other individuals on the unit were “sick.” He then offered to me and my husband to stay around for a few more minutes while he consulted with another psychiatrist on staff.

I recall the days prior to going to the hospital when I was supposed to be packing and getting emotionally prepared for this. My husband calls me on his way home from work.

“What are you doing?” he asked me.

“Oh, I have a 4:45 appointment to get my eyebrows waxed. I’ll be home a little bit after 5:00.”

(Who the hell worries about what their eyebrows look like two days before they go into a psychiatric hospital?)

“But that’s part of what makes you, you,” my husband tells me. He’s so right.

Now I will make a shift to one night before the hospitalization. My husband calls me from the train. He’s on his way home from New York.

“What are you doing?”

“Oh, just a little pre-mental hospitalization shopping. You’re never going to believe what I got! I found these socks with a sparkly, insane looking cat on them, holding a chainsaw — then they say on them — don’t make the crazy girl mad! How perfect is that?”

And so my husband and I sat in the waiting room of the Crisis Response Center — me with my perfectly shaped eyebrows, bag packed with my new socks that I was way too excited to wear, all of my beauty products, and my books: Yalom, Redfield-Jamison, Shakespeare, and Kafka.

The psychiatrist eventually returned and invited me and my husband into a small office, where we met another doctor. This doctor expressed his agreement with the evaluating psychiatrist — that I was not appropriate for inpatient hospitalization.

“Do you ever fear that the cutting will become dangerous?” he asked me.

“Doctor,” I answered him. “I believe it already has. But if you are speaking about a matter of life and death, all I can tell you is that sometimes I don’t know how deep I’m cutting, or where the cut is going to land. Sometimes I cut my wrist, but not deep enough to do any serious damage. What if, in one of my impulsive, out-of-my-mind times, it lands there really deep?”

“Yes,” he answered. “I would be concerned about that, too.”

The doctor then offered me the recommendation of partial hospitalization. I asked him, already knowing the answer, if he could please explain to me, the type of individuals that would show up in the partial-hospital program.

“Typically low-functioning clients,” he responded.

“Individuals who require assistance with their daily living skills?”

Both psychiatrists confirmed this. One stated that he only suggested it because he didn’t want to prejudice me against any treatment. He added that he hoped I had a good relationship with my therapist, and would be able to increase my sessions each week. I told him it was great — a great non-insurance relationship. He said, “Oh. Well, at least it’s a great relationship.” I left the hospital that night angry and defeated — and with no more intensive treatment than I had gone in with.

Once I left the hospital, I left a message for my therapist in a torrent of animated, angry words. I stated to him, “I got past a doctoral school interview, a therapist job interview, but I can’t get past a psychiatric hospital interview?”

That irony has a powerful truth to it. Those first two interviews had required me to dress well and speak intellectually and openly. Apparently I had done the same thing with the psychiatrist at the hospital, only the content was different — I was telling him of my pain, self-destructive behaviors, and suicidal ideation. I was also engaging the doctor in some light debate, based on a question he had asked me in regards to hypomanic mood and creativity.
I couldn’t get past a psychiatric hospital interview because I was acting too much like myself.

I came to this conclusion a couple of days later as I sat with the women in my borderline personality disorder support group. I recounted the story of my failed hospitalization and a couple of the women stated that perhaps I had been too intellectual and not enough emotional. As we talked about the possibility of trying admission into another hospital, the women suggested that I “leave the adult at home” next time I go for an evaluation.

I didn’t understand why I would have to leave an entire compartment of my personality at home, or put it to sleep. This was my true self. I felt it unfair that if I showed up as my true self, with all of the pain and need for help underneath, that I wouldn’t be perceived as “sick” enough to be in the hospital.

Obviously a stigma exists in within all aspects of mental illness. However, I have always been aware of a separate stigma for those who are mentally ill, but functioning at a high level. When I say functioning at a high level, I am referring to a variety of factors in any combination: these individuals may have graduate degrees or are actively involved in attending school, hold professional jobs, are of a middle to high economic status, and have optimal daily living skills (in regards to hygiene, dressing, grooming). They may present well, speak well, and not appear “sick” to even the most seasoned therapist or psychiatrist.