Girl, Interrupted

Girl, Interrupted is a best-selling^[1] 1993 memoir by American author Susanna Kaysen, relating her experiences as a young woman in a psychiatric hospital in the 1960s after being diagnosed with borderline personality disorder. The memoir's title is a reference to the Vermeer painting Girl Interrupted at her Music.^[2]

While writing the novel Far Afield, Kaysen began to recall her almost two years at McLean Hospital.^[3] She obtained her file from the hospital with the help of a lawyer.^[4]

In 1999, the memoir was adapted into a film of the same name starring Winona Ryder and Angelina Jolie. It was directed by James Mangold.

Plot introduction

The plot of Girl, Interrupted does not follow a linear storyline, but instead the author provides personal stories through a series of short descriptions of events and personal reflections on why she was placed in the hospital. She begins by talking about the concept of a parallel universe and how easy it is to slip into one, comparing insanity to an alternate world. She discusses how some people fall into insanity gradually and others just snap. Kaysen also details the doctor's visit before first going to the hospital and the taxi ride there at the beginning of the book before launching into the chronicles of her time at the hospital.

Plot summary

In April 1967, 18-year-old Susanna Kaysen is admitted to McLean Hospital, in Belmont, Massachusetts, after attempting suicide by overdosing on pills. She denies that it was a suicide attempt to a psychiatrist, who suggests she take time to regroup in McLean, a private mental hospital. Susanna is diagnosed with borderline personality disorder, and her stay extends to 18 months^[5] rather than the proposed couple of weeks.

Fellow patients Polly, Cynthia, Lisa, Lisa Cody, Georgina, and Daisy contribute to Susanna’s experiences at McLean as she describes their personal issues and how they come to cope with the time they must spend in the hospital. Susanna also introduces the reader to particular staff members, including Valerie, Dr. Wick and Mrs. McWeeney. Susanna and the other girls are eventually informed that the recently released Daisy, committed suicide on her birthday. Daisy's death deeply saddens the girls and they hold a prolonged moment of silence in her memory.

Susanna reflects on the nature of her illness, including difficulty making sense of visual patterns, and suggests that sanity is a falsehood constructed to help the "healthy" feel "normal" in comparison. She also questions how doctors treat mental illness, and whether they are treating the brain or the mind. During her stay in the ward, Susanna also undergoes a period of depersonalization, where she bites open the flesh on her hand after she becomes terrified that she has "lost her bones." She develops a frantic obsession with the verification of this proposed reality and even insists on seeing an X-ray of herself to make sure. This hectic moment is described with shorter, choppy sentences that show Kaysen's state of mind and thought processes as she went through them. Also, during a trip to the dentist with Valerie, Susanna becomes frantic after she wakes from the general anesthesia, when no one will tell her how long she was unconscious, and she fears that she has lost time. Like the incident with her bones, Kaysen here also rapidly spirals into a panicky and obsessive state that is only ultimately calmed with medication.

After leaving McLean, Susanna mentions that she kept in touch with Georgina and eventually saw Lisa, now a single mother who was about to board the subway with her adolescent son and seemed, although quirky, to be sane.

Characters

There are two main groups of characters, the patients and the staff. In addition to those there are her parents, her boyfriend and various other minor characters such as her former boss.

The patients

• Susanna Kaysen - The autobiographical main character, Susanna Kaysen is admitted to a psychiatric ward to be treated for borderline personality disorder following a suicide attempt. She voluntarily admits herself after a short consultation with a psychiatrist who is also an acquaintance of the family. She is told that she will only be staying there for a few weeks, but it turns out to be close to two years instead. Throughout the book, she frequently contrasts the time of the consultation, twenty minutes, to the time she ended up spending there.
• Lisa Rowe - Lisa is diagnosed as a sociopath, but whether she actually is one is left open to interpretation. Lisa periodically escapes from the hospital, only to be found a day or two later and re-admitted. She is usually happy enough to be back though she does put up a fight when restrained. She is an ex-junkie who never sleeps and barely eats, and enjoys making trouble for the staff. She apparently takes some pride in her diagnosis. Although she has a therapist assigned to her, she never actually sees him. Lisa is not in contact with her family except her brother, but the extent of their contact is not described. She also has a lawyer, though it appears he is mostly used to threaten the staff if she doesn't get what she wants. Her behavior is wildly unpredictable, and while she can be kind, she is also capable of cruelty towards the other patients. For example, Lisa has an ongoing rivalry with Lisa Cody that ends in Lisa Cody reverting to drugs.
• Polly Clark - A disfigured patient hospitalised for schizophrenia and depression. Polly has severe scarring on her body, the result of setting herself on fire. According to Kaysen, because of the sheer guts it took to actually do it, Polly is highly respected for her courage, to the extent that none of the patients will ask why she did it. During her first year at the hospital, she appears calm and even cheerful: "Life was hellish, she knew that. But, her smile hinted, she’d burned all that out of her."^[6] But one day she suddenly breaks down and begins to scream inconsolably, as if realizing for the first time her appearance and the permanency of it. Kaysen then realizes that while the other patients might be released from the hospital, Polly is trapped forever in her scarred body.
• Georgina Tuskin - Hospitalized because of schizophrenia,^[6] Georgina is Susanna's roommate at the institution. The two of them are considered the healthiest patients on the ward and are good friends throughout the book. Georgina apparently experienced her first symptoms after an episode in a movie theatre where she suddenly felt as if the darkness had surrounded her completely. It is not clear what the immediate reason for her diagnosis is. She also has a boyfriend in the hospital named Wade. Georgina identifies herself as a pathological liar.
• Lisa Cody - She is admitted while Kaysen is there and from the beginning looks up to Lisa Rowe. She is diagnosed as a sociopath too, though Rowe questions this and is clearly annoyed that she is no longer the only sociopath there. A former drug addict like Rowe, she tries hard to defend herself from Lisa Rowe's accusations that she isn't "real". She eventually escapes and is apparently found by Lisa Rowe during one of her escapes from the hospital. Lisa tells the other girls with pride that Lisa Cody has become a "real" drug addict. Her fate after her escape is not described any further.
• Daisy Randone - A thin girl who is admitted to the hospital seasonally, according to Susanna, coming before Thanksgiving and staying through Christmas every year. She has a single room, where she spends most of her time. The other girls think she is addicted to laxatives and will only eat chicken, and only in her room. However, after letting Lisa into her room, Lisa reports back to the rest of them that she only needs the laxatives because of all of the chicken. She peels off the meat and keeps the carcasses, saying that when she has 14 carcasses, it's time to leave the hospital, possibly due to obsessive compulsive disorder. Daisy's father visits her quite often, and it is implied he has incestuous feelings for her. Daisy eventually commits suicide on her birthday. Susanna describes her as "sexy" and says Daisy had a spark that the rest of the girls lack. Daisy is reclusive and often refuses to be social. She hates it when anyone goes near her and is hostile when people approach her. However, she does allow Lisa to enter her room. Sometimes they even share cigarettes, indicating that Daisy does respect Lisa out of all the other patients on the ward.
• Torrey - An ex-drug addict. She was put into the ward after her parents discovered her promiscuity. She is the best friend of all the fellow patients. Her parents take her out against her will, and take her back to Mexico, where she believes she will become an amphetamine addict again. She describes Mexico, saying "being in Mexico means being dead and shooting speed to feel like you're not quite dead" (Kaysen 97). The girls do try to help her with an escape plan and pool their money for her to help her, but eventually that plan is ruined, partly by Torrey herself as she is too afraid to do it and partly by Valerie after she gives her a cup of thorazine just prior to her departure to calm her down. Though she only appears for a short time she is an important character. Kaysen distinguishes between those put there indefinitely by parents willing to pay without questioning the progress of their treatment and those whose parents are not willing to do so. Torrey is used as an example of the latter group.
• Alice Calais - At first she seems quiet and, in Kaysen's own words, "not too crazy" but she eventually breaks down and is taken to maximum security after about a month. When the girls go to visit her they find that she has painted herself and the walls in her seclusion room with her own feces. Most of the other patients believe she was "raised in a closet" because she is ignorant about the trivial things in life. For example, she has never tasted honey and doesn't know how it tastes. She is also completely unaware that her last name is a well-known location in France and is overwhelmed in awe when she hears of the Hundred Years' War. It is not explained what happens to her after the girls visit her.
• Wade - Georgina's boyfriend, also a patient. Wade entertains the female patients with stories about his father, who he claims to be a CIA agent. He is prone to violent outbursts, which eventually results in his being moved to the maximum-security ward.
• Cynthia Crowley - a severely depressive patient, who undergoes weekly electro-convulsive therapy.^[6] There are only a few references to her in the book and she isn't a major character in it.

The staff

• Valerie - The head nurse on the ward. She works there during the day and though she can be strict she is generally liked by the patients and Kaysen in particular. She is described as down to earth and rarely uses the psychiatric terms used by the therapists, which is something that Susanna herself despises. Kaysen recalls her as honest and direct. Kaysen also mentioned that Valerie's hair is very, very long and that the girls all love it. Sometimes, they are able to coax her into taking it out of its stiff braid-bun and show them how she braids it.
• Mrs. McWeeney - The evening nurse on the ward. Described as the exact opposite of Valerie and very much disliked by the patients. Kaysen recalls her as "clearly nuts." Valerie does not like her and tends to ignore her, although she does describe her as a professional when the patients complain to her. Although the patients don't like her, they recognize that she needs to earn a living and that she has to work somewhere for that to happen.
• Dr. Wick - The consultant psychiatrist. She is described as very old-fashioned and easy to embarrass. Susanna purposely tries to embarrass her, deliberately saying things that she knows Dr. Wick will react to, during their sessions together. She has previously worked in Africa and her direct contact with the patients is very limited, talking to them for only a matter of minutes in a session.
• Melvin - Kaysen's late therapist and analyst. Susanna says that the two of them used to be good friends and that she once enjoyed sessions with him. According to her, he was old, balding, and slightly unattractive. Susanna would go into his office sometimes and just sit there in silence because there wasn't very much silence in the hospital and she needed a break. However, this relationship was short-lived; Melvin rolled into the hospital parking lot, and, when greeted enthusiastically by Susanna, refused to entertain her. Her opinion of him spiraled downward from that point.

Themes

The book explores several themes related to mental illness and society's interpretation of it.

Mental illness vs. conformity

Although Kaysen does admit that she was going through a very difficult time, she questions the validity of her diagnosis and to what degree it could be applied universally to anyone showing nonconformist behavior. She recalls the other patients' mental conditions and finds it hard to relate them to her own problems. She also describes the stigma that follows from having been hospitalized for mental illness and how she eventually stopped telling people in order to avoid the negative reaction.

Hospitalization as treatment

Kaysen elaborates through parts of the book on her thoughts about how mental illness is treated. She explains that families who are willing to pay the rather high costs of hospitalization do so to prove their own sanity. Once one member of the family is hospitalized, it becomes easier for the rest of the family to distance themselves from the problem and to create a clear boundary between the sane and the insane. Recognizing a family member or friend as insane makes others around them, says Kaysen, compare themselves to that individual. Hospitalization allows for distance from this questioning of self that makes us so uncomfortable. Her view that mental illness often includes the entire family means the hospitalized family member becomes an excuse for other family members not to look at their own problems. This explains the willingness to pay the high financial costs of hospitalization.

Treating the brain vs. the mind

An important issue in Kaysen's view is the distinction between the treatment of the brain versus the treatment of the mind. She uses an example with two interpreters, one reacting to one's senses and another that processes and evaluates the results from the first interpreter. She describes mental illness as the failure of the second interpreter to correctly dismiss false interpretations made by the first interpreter. She compares this with the chemical reactions of the brain and concludes that those who treat mental illness with drugs are treating the brain whereas therapy is aimed at treating the mind. Though she does not dismiss the use of drugs, she is critical of them.

Freedom

Through parts of the book she describes the trade-off between being a patient in a mental institution and being free in the conventional sense of the word. Though restricted by a complex set of rules she also describes how not being out in the real world sets her free from the expectations of parents and society when it comes to education and work. Though she describes the hospital as a womb you can't get out of, she also explains the difficulties she had prior to being hospitalized and how the pressure increasingly got to her. She evaluates the benefits of being in the hospital and being in the outside world - two parallel universes, as she said in the introduction, that each present one with many freedoms of different kinds. The hospital provides freedom from responsibility, but is also a prison in that many freedoms and choices that the patients would have outside the hospital are taken away.

Freedom vs. captivity

When Kaysen enters McLean Hospital, she quickly comes to understand that although captivity appears to require the surrender of freedom, the opposite is often true. The ward is organized to keep patients exposed to staff scrutiny at all times. With nurse checks at frequent intervals, every room is essentially public except for one. The “seclusion room” sits at farthest reach of the main hallway, intended for out-of-control patients who pose harm to others or simply make too much of a disturbance. Patients can also choose to be placed in the room, prompting Kaysen to remark, “freedom was the price of privacy”. Here, a patient can be blessedly alone for a period, free from scrutiny and company but, like the hospital in comparison to the outside world, confined to even tighter quarters. The seclusion room is a microcosm for the entire experience of confinement to the hospital. Kaysen notes that McLean is “a refuge as much as a prison.” Without school, a job, bills, parents, or the outside world to deal with, the girls are free to ignore responsibility, even as that responsibility has been taken from them. Kaysen finds that this apparent paradox isn't confined to the hospital. After nearly two years at McLean, Kaysen looks for a means to leave but finds that her hospital stay stigmatizes her in the eyes of employers. A marriage proposal turns her circumstances on their head. “Everyone could understand a marriage proposal,” she writes, despite nearly total uncertainty about the appropriateness of her fiancé or the appeal of marriage itself. The engagement frees Kaysen from the confinement of the hospital, but it limits her opportunities.

See also

• Mental illness in fiction

Book reviews

"Poignant, honest and triumphantly funny... A compelling and heartbreaking story." — Cheever, Susan, The New York Times Book Review ^[7]

"Searing... Girl, Interrupted captures an exquisite range of self-awareness between madness and insight." — The Boston Globe

"Tough-minded... darkly comic... written with indelible clarity." — Newsweek

"Ingenious... designed to provoke unanswerable questions. Kaysen does not point morals or impose insights, but lets adroit imagery, powerful scene-writing and the silence between chapters do the work of judgement... [It is] an account of a disturbed girl's unwilling passage into womanhood... and here is the girl, looking into our faces with urgent eyes." — Middlebrook, Diane, The Washington Post Book World 

References

External links

• Girl, Interrupted on SparkNotes