Author:Paul Gilmartin

Hospitals, Self-Harm and Other Subjects: A guest blog by Jamie Casbon

Here’s a little trigger warning: depression, suicide, self-harm, that business. It’s how I roll.   Also,  I’m  trans male, this happened years before I transitioned. I considered myself female at the time and realising I was male was a gradual process that began about 4 yrs ago. My hospitalisation didn’t have anything to do with my gender identity.

This story starts the beginning of second semester in undergrad. I had just come back from an un-fun Christmas visit in Texas, the location of one of the worst times in my life. It wasn’t Texas’ fault, really, just bad timing. In addition to having to visit a place with a lot of difficult emotions tied to it, I also stayed for what seemed like two weeks (including New Year’s) when I can barely handle about 6 days with my parents. Bad idea on top of bad idea on top of bad idea. When I got back home to New York, I almost immediately fell into a hole.
The first inkling I had that things might be bad was the second or third day I was back. I stayed in one of my friend’s dorm rooms with our tight group, getting fucked up. Plenty of 40’s of Miller High Life, random liquors, and pot. Plenty of fucked up. The TV was on and we were half watching, half philosophizing. I was doodling and writing things in an empty crossword puzzle, things like, “I hate myself so much,” “I wish I could just die,” “I’m useless,” “I want to hurt myself,” and on and on. I wrote part of it in white-out and I think part in pen but I’m not sure. I don’t know if my friends ever saw it but I kind of hope not. I saw that there was a razor blade on my friend’s table and thought that maybe I would stay awake until everyone was asleep and slit my wrists.
I woke up the next morning and most of my friends were awake. Crisis averted, I guess. This was the first sign I noticed that something might be wrong with me. It’s tough to move on from something like that when you realize that the only thing that stood between you living and you dying was passing out from substances. So I didn’t move on. I tried to distract myself from what I was feeling by throwing myself into school. I was so goddamn productive in the next couple of months. I was always going above and beyond and making extra work for myself. Instead of making three pieces for my final garment I made five. I learned how to bake and got better at cooking. I smoked and drank and dropped acid to get away from myself.
When I was 15-16 I started self-harming by burning myself. It started semi-innocently: my best friend in Italy and I wanted to make matching permanent marks so we would always have that bond and we thought branding would be the best option. She did it but for whatever reason I wasn’t able to at the time. A couple months later I moved to Maryland and decided to uphold my end of the bargain so I tried to brand a cross on my wrist. I was sort of successful at that but what I really succeeded at was creating a fucking terrible coping mechanism.
If you’ve never self-harmed, or wanted to self-harm, it can be hard to explain because everyone has different reasons for doing it and frequently a person has different reasons at different times. When you self-harm you’re punishing, soothing, creating feelings, taking away feelings. It can keep you going for another week, release some self-hatred so you don’t go further and just kill yourself. I really felt like I was helping myself when I was burning my arm with a clothes iron. Then days later I had to burn myself with a heated safety pin or a cigarette. There was never a point where I thought, “Yup, that’s the last time I’ll ever need to burn myself! That really hit the spot!”
Everything became a secret. I was weak for being depressed, I was weak for hurting myself, I was weak for wanting help. Everyday I could keep people convinced I was doing fine was a day I was strong. The day I had a panic attack and nearly ran out of my Philosophy class because I thought everyone knew how fucked up I was became a pseudo-triumph. Just smiling became a task. My face was too heavy for it, I felt like a failure for not being able to function. I couldn’t handle anything, every minor annoyance became a personal attack from a world that was tired of having me in it.
It doesn’t stop either. There are millions of bottoms to be discovered once you start spiraling down. The week you keep track of your calories, trying to eat below 1,000 a day. The days after when you binge. Drinking booze that makes you dry heave hoping to pass out. Taking acid and spending the entire time walking around the block, smoking, and thinking of how to apologize the woman you accidentally blew smoke in the face of. The days and weeks and months you figure out how you’re going to die and how people will be so much happier without you.
This went on until April. I had been listening to Elliott Smith on a loop for three weeks, ‘A Fond Farewell’ in particular, and I was maybe a week away from killing myself. I had figured out which branch to tie the rope to and how I would tie it and jump from the patio. All I needed was the rope and for the guilt of having my landlords or my sister find me to go away. It was so fucking scary. When you’re suicidal you know someone is trying to kill you but you can’t run away because the person that wants to kill you is inside you all the time. I’ve wanted to die or kill myself many times, and accidentally been close, but that time was the nearest I came to consciously going through with it.
I don’t know how I managed but I took myself to the counseling office as my school. I think I spoke to the counselor for five minutes before we were out the door heading to a hospital. In an hour I had gone from not intending for anyone to know how intense my pain was to my sister, my parents being told that their sibling, child wanted to kill themselves and was going to be kept in the psych ward.
An Aside: I’m happy that psych wards exist. They help many, many people and prevent them from harming themselves and the people around them. They give people a chance to heal so they can go back out into the world and deal with life.
For me, being in a psych ward was a terrifying experience that I’ve yet to completely heal from.
I was 18 and put in an adult ward even though the majority of people were 10+ years older than me. The first day I was there I had to wear too big hospital clothes and only had patients to talk to. The shower in my room didn’t have hot water and the nurses basically treated you like you were actively hallucinating. You start to realize how tenuous reality is. Somebody asked where I grew up and after I explained the living in Europe and moving constantly due to the military a man told me he understood because his dad was an astronaut and had taken him to the moon. People mostly ignored me, I think they knew I wasn’t going to be there long-term. There was one guy who was nice to me. He was also in for depression, a student at Hunter, and actually made an effort to talk to me and explain things. I’m a little sad I never got his name so we could stay in contact but that may have been for the best honestly.
The patients on the whole were fairly nice if indifferent. My roommate very calmly told me that she had come to New York from Haiti because the devil was chasing her and the Lion King was her father. Then she told me she wanted to be transferred to a different hospital because she liked the staff better. A man spent maybe an hour teaching me how to play Spades then spent an equal amount of time going on a paranoid rant about how his family was sending him to the hospital to rob him. Another man on the ward was locked up all day and never stopped screaming. I would meet with the psychiatrist, et al, everyday but they barely talked to me and I went into, “Wow, I’m so much better mode!” as fast as I could. After my sister visited and gave me some books I spent all day reading until they let me out.
I wasn’t better, maybe even worse, but because I had been outed I had to get help. I went to a psychiatrist who told me I should be happy, I was “pretty and smart, why would you be sad?” I was forced to go the a therapist at the hospital I was committed to who yelled at me when I couldn’t tell him why I was crying. I went to another psychiatrist who was marginally less shitty and keeps me in my pills to this day. I found the therapist I’m still with who has helped me to my current state of relative equilibrium.

Being in the psych ward hurt me in a lot of ways but the really important thing to take away from this is that it kept me alive. I completely believe, and my therapist would support this, that if I hadn’t gone for help I would’ve been dead six years ago. The intervening years haven’t been easy, I’ve had several major depressive episodes.  I’ve wanted to die and I’ve wanted to kill myself many times. I was only able to stop self-harming a year ago.

I got help. I got to live. I got to get better. Life will kick the shit out of you and some of us are fucked just by being born. We don’t have a choice in a lot of things but luckily we have the choice to reach out and get help. It might be the hardest thing you will ever do and you may be right on the edge but you can get help. There are people who want to help you, who want you to be around, who love you and like being around you.

If you’re sad reach out to someone. Stick around because you’re needed.


Jamie Casbon is a textile conservator and occasional storyteller. You can read more by him at




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