As Susanna, diagnosed with Borderline Personality Disorder, enters the McLean psychiatric facility, she begins to question the nature of her own mind, and the minds of those around her. The women who are hospitalized alongside Susanna seem, at first, to have much deeper, more frightening problems than Susanna herself does. However, by the end of her eighteen-month stay, Susanna has come to recognize that perhaps “insanity [is] just a matter of dropping the act.” In her memoir’s final pages, the older Susanna reflects on her hospitalization, noting that she still often asks herself whether she’s crazy. Many of the actions people do on a daily basis, she suggests, threaten to cross “the shimmering, ever-shifting borderline” between sanity and sanity “that like all boundaries beckons to be crossed.” Though she does not want to cross it again, she understands the allure of “dropping the act.” Over the course of her memoir, Kaysen complicates her earlier argument that there is a wide gulf between the world of the sane and the world of the insane by showing how she came to eventually understand that “crazy” is not a far-flung destination or an unlikely state of mind. Instead, “crazy” is a “shimmering,” elusive, and often very close-at-hand state which simultaneously tempts and threatens to engulf anyone who strays near.
Susanna, prior to her hospitalization, struggles with problems of perception—she sees patterns in everything and has interpersonal troubles which stem from her inability to remember people’s faces. In other words, she finds herself, in the weeks before her hospitalization, thinking intensely about what other people are thinking during routine social interactions, and is unable to focus on the actual interaction before her. She wonders, as she investigates these peculiarities of perception, whether “insanity [is] just a matter of dropping the act”—whether everyone struggles with perception, with communication, and with the tiresome ins and outs of daily adult life.
As Susanna begins to witness the “crazy” behaviors of her fellow patients—Daisy’s chicken-hoarding, Polly’s incessant screaming, Lisa’s nihilistic acts of defiance—she sees the way the interact with one another and the little world around them not as the behavior of “crazy” people but as the behavior people who are not all that different from her. Though Susanna is often worried she will sink even deeper into madness, she never casts judgement on anyone else on the ward, and instead allows the odd and unpleasant behaviors she witnesses—such as one patient spreading her own fecal matter on the walls of her bedroom—to complicate her ideas of sanity and insanity. The women she meets in the ward are complicated people, full of hopes, fears, skills, and inadequacies. Susanna, although she entered the ward believing that she was in some capacity “saner” than anyone else around her, begins to realize that she is no more sane or insane than anyone else around her.
At one point in her stay, Susanna, seemingly out of nowhere, becomes convinced that there are no bones in her hand while sitting in the rec room watching televisions. She begins picking, gnawing, biting, and peeling the flesh of her own hand, trying to get inside and determine whether she has bones after all. When Valerie, the head nurse, stops Susanna and forces her to take a heavy sedative, Susanna begins to fall into a drowsy, lulled, state, and as she does she thinks to herself: “Now I was safe, now I was really crazy, and nobody could take me out of there.” Susanna had been afraid of crossing the “border” between sane and insane, seeing herself as someone whose character was flawed rather than whose mind was flawed, like her fellow patients. Having finally “crossed over” into being “really crazy,” she feels that she is finally “safe,” for she has approached her greatest fear and descended into it only to find that she has been lulled into comfort by those tasked with taking care of her. In many ways, Susanna finally realizes, the world of the hospital—the insane world—is safer and more navigable than the “sane” outside world.
Towards the end of the book, as she digs into a deeper investigation of what constitutes the “mind” and what constitutes the “brain,” Kaysen meditates on what it means to treat the psyche or the mind versus what it means to treat the brain. “Whatever we call it—mind, character, soul—we like to think we possess something that is greater than the sum of our neurons,” she writes. “A lot of mind, though, is turning out to be brain.” Kaysen takes issue with the distinction between the two entities, writing that “you can’t call a piece of fruit an apple when you want to eat it and a dandelion when you don’t.” She argues in this section that a major problem with mental health treatment is the ways in which professionals treat the “mind” and the “brain” as separate entities, fueling ineffective treatments and harmful preconceptions about the nature of “sanity.”
As Susanna’s stay at McLean progresses, she finds herself undergoing a transformation, though it is hardly a linear one from ill to well. Instead, Susanna’s journey has peaks and valleys, and forces her to reckon not only with her own psyche but with her preconceived notions of what constitutes insanity. She soon sees the “shimmering border” between sanity and insanity as permeable, suggesting to her readers that “sane” and “insane” are relatively valueless terms which don’t have ultimate power in defining anyone’s character, worth, or place in the world.
Related Themes from Other Texts
Sanity vs. Insanity ThemeTracker
Sanity vs. Insanity Quotes in Girl, Interrupted
People ask, How did you get in there? What they really want to know is if they are likely to end up in there as well. I can’t answer the real question. All I can tell them is, it’s easy. And it is easy to slip into a parallel universe. Most people pass over incrementally, making a series of perforations in the membrane between here and there until an opening exists. And who can resist an opening?
An odd feature of the parallel universe is that although it is invisible from this side, once you are in it you can easily see the world you came from. Sometimes the world you came from looks huge and menacing, quivering like a vast pile of jelly; at other times it is miniaturized and alluring, a-spin and shining in its orbit. Either way, it can’t be discounted. Every window on Alcatraz has a view of San Francisco.
Something also was happening to my perceptions of people. When I looked at someone's face, I often did not maintain an unbroken connection to the concept of a face. Once you start parsing a face, it's a peculiar item: squishy, pointy, with lots of air vents and wet spots. This was the reverse of my problem with patterns. Instead of seeing too much meaning, I didn't see any meaning. But I wasn't simply going nuts, tumbling down a shaft into Wonderland. It was my misfortune—or salvation—to be at all times perfectly conscious of my misperceptions of reality. I never "believed" anything I saw or thought I saw. Not only that, I correctly understood each new weird activity. Now, I would say to myself, you are feeling alienated from people and unlike other people, therefore you are projecting your discomfort onto them. When you look at a face, you see a blob of rubber because you are worried that your face is a blob of rubber. This clarity made me able to behave normally, which posed some interesting questions. Was everybody seeing this stuff and acting as though they weren't? Was insanity just a matter of dropping the act?
Cynthia was depressive; Polly and Georgina were schizophrenic; I had a character disorder. Sometimes they called it a personality disorder. When I got my diagnosis it didn't sound serious, but after a while it sounded more ominous than other people's. I imagined my character as a plate or shirt that had been manufactured incorrectly and was therefore useless.
“We'll find you a new [boyfriend] in the cafeteria," said Georgina. "I’m sure Wade knows somebody nice.”
"Let's forget it," I said. The truth was, I didn't want a crazy boyfriend.
Lisa looked at me. "l know what you're thinking," she said. "You don't want some crazy boyfriend, right?" I was embarrassed and didn't say anything. "You'll get over it," she told me. "What choice have you got?" Everybody laughed. Even I had to laugh.
Therapists had nothing to do with our everyday lives.
"Don't talk about the hospital," my therapist said if I complained about Daisy or a stupid nurse. "We're not here to talk about the hospital."
They couldn't grant or rescind privileges, help us get rid of smelly roommates, stop aides from pestering us. The only power they had was the power to dope us up. Thorazine, Stelazine, Mellaril, Librium, Valium, the therapists' friends. Once we were on it, it was hard to get off. A bit like heroin, except it was the staff who got addicted to our taking it.
"You're doing so well," [our doctors] would say.
That was because those things knocked the heart out of us.
The student nurses were about nineteen or twenty: our age. They had clean, eager faces and clean, ironed uniforms. Their innocence and incompetence aroused our pity, unlike the incompetence of aides, which aroused our scorn. This was partly because student nurses stayed only a few weeks, whereas aides were incompetent for years at a stretch. Mainly, though, it was because when we looked at the student nurses, we saw alternate versions of ourselves. They were living out lives we might have been living if we hadn't been occupied with being mental patients. They shared apartments and had boyfriends and talked about clothes. We wanted to protect them so that they could go on living these lives. They were our proxies.
For many of us, the hospital was as much a refuge as it was a prison. Though we were cut off from the world and all the trouble we enjoyed stirring up out there, we were also cut off from the demands and expectations that had driven us crazy. What could be expected of us now that we were stowed away in a loony bin? The hospital shielded us from all sorts of things. We’d tell the staff to refuse phone calls or visits from anyone we didn't want to talk to, including our parents.
"I'm too upset!" we'd wail, and we wouldn't have to talk to whoever it was.
As long as we were willing to be upset, we didn't have to get jobs or go to school. We could weasel out of anything except eating and taking our medication.
In a strange way we were free. We’d reached the end of the line. We had nothing more to lose. Our privacy, our liberty, our dignity: All of this was gone and we were stripped down to the bare bones of our selves.
Valerie and Georgina picked me up under the arms and steered me down the hall to our room. My legs and feet felt like mattresses, they were so huge and dense. Valerie and Georgina felt like mattresses too, big soft mattresses pressing on either side of me. It was comforting.
"It'll be okay, won't it?" I asked. My voice was far away from me and I hadn't said what I meant. What I meant was that now I was safe, now I was really crazy, and nobody could take me out of there.
[The mind is] full of claims and reasons. "You're a little depressed because of all the stress at work," it says. (It never says, "You're a little depressed because your serotonin level has dropped.")
Sometimes its interpretations are not credible, as when you cut your finger and it starts yelling, "You're gonna die!" Sometimes its claims are unlikely, as when it says, "Twenty-five chocolate chip cookies would be the perfect dinner."
Often, then, it doesn't know what it's talking about. And when you decide it's wrong, who or what is making that decision? A second, superior interpreter?
Why stop at two? That's the problem with this model. It's endless. Each interpreter needs a boss to report to.
The point is, the brain talks to itself, and by talking to itself changes its perceptions. To make a new version of the not-entirely-false model, imagine the first interpreter as a foreign correspondent, reporting from the world. The world in this case means everything out or inside our bodies, including serotonin levels in the brain. The second interpreter is a news analyst, who writes op-ed pieces. They read each other's work. One needs data, the other needs an overview, they influence each other. They get dialogues going.
If my diagnosis had been bipolar illness, for instance, the reaction to me and to this story would be slightly different. That's a chemical problem, you'd say to yourself, manic-depression, Lithium, all that. I would be blameless, somehow. And what about schizophrenia—that would send a chill up your spine. After all, that's real insanity. People don't "recover" from schizophrenia. You'd have to wonder how much of what I'm telling you is true and how much imagined.
I often ask myself if I'm crazy. I ask other people too.
"ls this a crazy thing to say?" I'll ask before saying something that probably isn't crazy.
I start a lot of sentences with "Maybe I'm totally nuts," or "Maybe I've gone 'round the bend."
If I do something out of the ordinary--take two baths in one day, for example--I say to myself: Are you crazy?
It's a common phrase, I know. But it means something particular to me: the tunnels, the security screens, the plastic forks, the shimmering, ever-shifting borderline that like all boundaries beckons and asks to be crossed. I do not want to cross it again.
She had changed a lot in sixteen years. She was no longer urgent. In fact, she was sad. She was young and distracted, and her teacher was bearing down on her, trying to get her to pay attention. But she was looking out, looking for some- one who would see her. This time I read the title of the painting: Girl Interrupted at Her Music. Interrupted at her music, as my life had been, interrupted in the music of being seventeen, as her life had been, snatched and fixed on canvas: one moment made to stand still and to stand for all the other moments, whatever they would be or might have been. What life can recover from that?
I had something to tell her now. "l see you," I said.
