'The Hospital Fantasy': Why You Crave Escape And How To Do It Safely
'The Hospital Fantasy' - when you desire a minor accident just to catch a break. Newsflash: it's OK to prioritise your wellbeing.
A few months ago, I became seriously ill and had to take a few days off from work. As I lay in bed, found myself thinking, “Phew, finally a break. I wonder if it's serious - I could really use some time off.”
This realisation shocked me - I hadn't understood how much I needed a rest. How desperate I was to stop, even though I was spinning so many plates. Falling ill seemed like the only legitimate way to step back and take a breath. I knew I’d let people down one way or another, but this was the least terrible way to do it. Deep down, I wanted to be taken away to recover.
You might have seen similar build-up behaviour in yourself or others too. We're the ones who, even on the brink of collapse, are still logging on or dragging ourselves into the office to work on some random presentation - one that feels 'urgent' for reasons we barely remember.
We may believe we're being stoic, but this behaviour often masks deeper, underlying issues. I realised it’s a tendency I’ve had for most of my life, along with perfectionism and people-pleasing.
Secretly, we want to escape.
What pushes your Hospital Fantasy cravings?
The ‘Hospital Fantasy’ is a type of escape fantasy and little-known burnout symptom. It shows up when you're under extreme stress and need ‘permission’ to take a break or well-deserved rest.
If you struggle to voluntarily tear yourself away from work or other obligations, an escape fantasy takes it out of your hands. You don’t have to let others down, or put yourself first. That feels icky, selfish and drives guilty feelings. Nope - don’t want to feel any of that, please. Avoid!
In all seriousness though, it’s a wake up call to look at your chronic stress levels and burnout symptoms more closely. Burnout occurs when you’re feeling emotionally exhausted, detached/cynical, and lower personal achievement.
You might notice physical issues too, like tiredness, aches, pains, gut issues, skin conditions and more. These get louder as your body tries to grab your attention and do something different.
Your body is screaming - stop ignoring it
In modern neuroscience research, particularly in the stress, depression and anxiety space, the focus is on metabolic-related investigations. We’re pushed into such extreme lifestyle situations with reduced connection to others, minimal natural foods, and limited good quality rest, our minds and bodies are worn out and can’t recover.
Our adaptive brain works hard to keep our bodies safe and balanced - a process known as allostasis. However, our persistent stressed out state overwhelms this process, leading to symptoms like shallow breathing, a racing heart, heavy legs, and a constant 'tired but wired' feeling. Eventually, we’re forced to slow down or stop altogether.
The more we ignore the signs, the longer it takes for healthier practices to have an impact. This is why we need to catch the signs earlier where possible. Instead, we give away our agency to external factors due to lifelong internal causes which block self-care and boundary-setting habits.
If we feel like rubbish, but still ignore the signs, what’s going on? As with many burnout-related unhealthy coping strategies, early-life experiences and habits come into play.
The psychological impact of burnout and why you crave the Hospital Fantasy
There are a few theories at play here but common themes relate to regression into a childlike state, needing care and dependency on others. Sigmund Freud’s psychoanalytic theory explores expression of our unconscious desires or conflicts and regression to the past. If we’ve had inconsistent early-life caregiving, the desire to be cared for in a hospital might satisfy this unmet need when we’re overly stressed in adult life.
Object Relations Theory expanded on Freud’s ideas, diving into early relationships with primary caregivers. Donald Winnicott’s research into this defined the idea of a ‘holding environment’ - a psychological space where a child feels safe and understood. If this was missing in your childhood, you might fantasise about a hospital, or similar space, where you are finally being cared for and ‘held’.
An alternative perspective brings in Attachment Theory, developed by John Bowlby. He focused on the bonds and attachment styles formed between children and their primary caregivers, from secure to insecure (avoidant, anxious or fearful). Read a previous article I wrote on attachment to learn more.
Research into insecure attachment styles suggests how these manifest in adulthood, where feelings of insecurity, abandonment or unmet needs for affection are recreated by patterns of dependency, or seeking validation.
Our shaky self-worth and high-pressures from work are minimised by escape fantasies - someone swoops in to save and care for us. We don’t have to put ourselves first, which feels incredibly tough when you’re in burnout and self-sacrifice your needs.
We get the help we’ve craved for at last. Our inner emotional void receives the nurturing, care and affection it didn’t have to finally feel safe and secure.
When you’re emotionally and physically exhausted, looking after yourself and wilfully ‘dumping’ your overwhelming responsibilities feels like a step too far. Fantasising about being cared for because you ‘have to’ doesn’t seem so unreasonable after all.
Pay attention to your body and mind: recognise what’s really going on
You never want to get to the point where you’re yearning for minor injury so you switch off and get looked after. In my case, my illness continued beyond a normal recovery, and it took me months to feel better. I kicked myself for not acting sooner on what I know works - my immune system took a battering as a result.
Self-awareness is a crucial first step. If you don’t realise what’s going on, you can’t take the best action. But self-awareness is only part of the equation. I knew I was feeling unwell, but kept convincing myself things would improve. Just one more week. It’s only a phase. It’s not that bad.
It might be true temporarily, but if you keep making the same excuses, it’s time to be honest with yourself.
Why do you want to self-punish and not stop to recover?
For me, it’s often because I’ve overinflated the importance of certain tasks or projects, and my influence on them. “If I’m not here, it’ll all fall apart!”. It rarely does.
I understand this is tough, especially if you're a solopreneur or an executive leader. But when your body finally gives out and you're bedridden for months, who will step in then?
Better take smaller breaks and maintain boundaries as you go, versus a slash and burn approach and extreme action.
Practical strategies to look after yourself and rest safely
In my personal life and client work, I’ve seen how we continue to repeat unhealthy patterns and choices to satisfy an early-life unmet need.
Often, friends and colleagues notice this before we do. Listen when others tell you to slow down or it’s time for a break. I’ll be honest here - it irritates me when people say this to me. I’m annoyingly stubborn at times. Deep down though, I know they’re right and I feel shame which is why I don’t like hearing it.
Sometimes we need to get past our own unhelpful stuff. Being right is less important than being healthy.
Other practical strategies to rest and step back safely:
Sleep - are you getting enough? If not, start here. Sleep clears out waste products in the brain, helps us process emotional memories from the day, and consolidate learning. It’s an incredibly important process. If you can only handle one strategy, pick this one.
Nutrition and water - are you eating garbage? High sugar, ultra processed, fatty foods and comfort snacks the first thing you reach for? Give your mind and body a fighting chance and pick natural, minimally processed foods. Choose water for hydration. Eating well and taking time to feed and nourish yourself is an underrated act of self-care.
Restorative activities - passive and active - self-care and rest isn’t just sitting in a bubble bath (although that’s a good one). It could be meeting up with mates in the park for a kick-about. Reading your favourite book without interruption. Going to the gym for spin and sauna. Look at what worked in the past for inspiration.
Manage boundaries - reflect on where you’re being too flexible or overly amenable at work, home, or with friends and family. If this drains your precious mental and physical energy, and it isn’t urgent or important, push back. Be realistic with what’s urgent and important too - your ‘high-standards’ brain is going to give you a false impression here. Ask others for a balanced opinion.
Seek support - us prone-to-burnout types aren’t great at asking for help or support. It’s an excellent way to share the burden and get validation though. It doesn’t have to be someone you know. Find a trusted hobby or peer group, coach or therapist to open up to. Talking to someone helps makes sense of your inner experience - this is why it seems so obvious after the fact.
Reframe work and responsibilities - similar to managing boundaries, if you struggle to pull yourself away from obligations and expectations, the activities above will feel tough. It’s not impossible. Focus on small, manageable tasks, delegate or outsource, or delay when you can deliver. Fight against your assumptions and ask - make decisions from evidence not fear.
Key takeaways
When we’re chronically stressed and in burnout, hospital fantasies satisfy the psychological need for escape and care during extreme pressure and overwhelm.
These intrusive thoughts might feel scary or distressing but they are signals from the mind and body it’s time to address the underlying issues driving chronic stress and burnout. These could relate to unmet emotional needs, inconsistent comfort and care, or a safe environment you wanted as a child but didn’t quite get.
You don’t have to do it alone. Ask for help and support when you recognise what’s going on. A problem shared is indeed a problem halved.
Introduce practical strategies to improve your self care - sleep, diet, restorative activities, managing boundaries and reframing work and responsibilities are a good place to start.
Start small, and practice gratitude with each new improvement or choice you make. Remember, change takes effort.
When you take proactive steps to look after yourself, it boosts your self-worth and self-belief. These steps kickstart your burnout recovery, and over time, the improvements will compound powerfully.
Dear friends, share your hospital or escape fantasies when you’ve felt burnt out, overwhelmed or exhausted. What helped?
I had the hospital fantasy when I left my ex husband and moved into a new house with my, then, eight year old daughter.
Firstly, I needed a new roof as the building surveyor hadn’t checked it properly in the inspection. Then my car broke down, and a host of other small maintenance issues popped up.
I wanted to go somewhere where I’d be looked after, like Bette Davis’ rest home in Now Voyager. At the time, I didn’t know it was a common experience, so thanks for this article.
Wow. So insightful. This article does a great job of articulating when we push ourselves to the max and believe we owe so much to others and nothing to ourselves!