When she enters McLean Hospital to undergo psychiatric treatment, Susanna Kaysen finds herself plunged into a world of women: wild women, wounded women, and women who are living at the edges of both society and their own lives. Over the course of the book, Kaysen, looking back twenty-five years after her hospitalization, takes time to remember several of her fellow patients—starkly, lovingly, inquisitively, and always with an empathetic eye and an understanding heart. These remembrances are contrasted with Kaysen’s critique of the disproportionate number of women who are diagnosed with mental illnesses compared to men, as well as the ways in which the mental health system unfairly scrutinizes and punishes women for engaging in the same behaviors as men. As Kaysen reflects on her experiences navigating two new worlds—both the world of the psychiatric ward and the world of womanhood—she argues that the double standards and mistreatment that women face are perhaps nowhere more acute than in the world of medicine and mental health. Susanna uses her own experiences and the experiences of her fellow patients to demonstrate how the behaviors which have earned so many women the label of “crazy” throughout the years are often simply part and parcel of the struggle to discern what it means to move through the world as a woman.
Reflecting on her own diagnosis in one crucial chapter, Susanna deconstructs the definition of Borderline Personality Disorder, noting that it is mostly diagnosed in women and that the behaviors that are said to characterize it are normal in adolescence, especially for young women: instability in self-image and interpersonal relationships, desire for reckless behavior, promiscuity, and self-harm. While pointing out that the deck is stacked against women, whose behavior is easily seen as hysterical, dangerous, and needful of treatment, Susanna considers the women she lived alongside in McLean: the ritualistic Daisy, who collected rotisserie chicken carcasses beneath her bed; the unpredictable Polly, whose failed self-immolation has trapped her in a body she no longer recognizes as her own; the fleeting visitor to the ward, Alice Calais, who, in the midst of a scatological episode in the seclusion room, described herself as feeling much better than she had before her admittance, thereby proving that “wellness” is always a relative term.
Lisa is the most memorable, dynamic, and meaningful friend Susanna makes during her stay at McLean. A proud sociopath, a loudmouth, and a nihilist, Lisa knows everything about everyone, and frequently runs away from the ward in grand, desperate attempts to escape forever. She is always caught, though, and “dragged back, dirty, with wild eyes that had seen freedom.” Lisa doesn’t sleep and eats only rarely, and Susanna describes her as emaciated and exhausted-looking. Nevertheless, Lisa is magnetic and queen-like. The other women admire her and even act subservient to her. “We are very rare,” Lisa says of people with her condition—sociopathy—“and mostly we are men.” Sociopathy is a more rarely diagnosed condition in women because women are seen—and stereotyped—as natural nurturers and empaths. The lack of empathy or care in a woman is stigmatized, and Lisa, throughout the course of the book, seems to embrace her diagnosis by fleeing the ward repeatedly, acting out when she is confined, and defying the staff tasked with controlling her in any way she can. At one point in Susanna’s stay, another Lisa arrives on the ward: Lisa Cody. After a month or so, Lisa Cody too, is diagnosed as a sociopath, and begins trying to be more like the “original” Lisa “in all things.” The “real” Lisa begins acting out even more, attempting to prove that Lisa Cody isn’t a true sociopath. The two Lisas devolve into violent arguments about their histories with drugs, instability, and promiscuity, each trying to prove to the other that she is the true outlaw, the true sociopath, and the true leader. Through witnessing the Lisas’ endless posturing and desire for dominance and proof of “realness,” Susanna learns about the need to “prove” one’s illness as real. In a world where women are called “crazy” for such small transgressions against the normal order of things, the diagnosis of sociopath is almost a badge of honor. Sociopathy is a deviation not only from traditional society, but from traditional womanhood, and as the Lisas contend to prove the truth of their sociopathy, Susanna witnesses a battle of wits between two women who feel pride in a diagnosis that defies everything that society expects of them as women.
As Susanna Kaysen reflects on the women she met during her time at McLean, she recalls the lasting impact that many of her fellow patients have had on her life, her perceptions, and her growth as a woman. Susanna and each of her fellow patients have had to face discrimination from their friends, families, and therapists as they navigate their experiences of womanhood in an increasingly unstable world. Women were—and are still—overwhelmingly seen as sensitive, malleable, and in need of control. For this reason, Kaysen argues, women are disproportionately singled out and even attacked when it comes to issues of mental health. As she relays her experience of life in McLean, Kaysen wonders whether the “interrupted” lives and youths of the women she encountered on the ward will ever be redeemed. She wonders whether there is hope for a future which embraces the complicated nature of womanhood without attempting to silence, institutionalize, or medicate women whose complex subjectivities place them in the crosshairs of an uncompassionate society.
Women and Medicine ThemeTracker
Women and Medicine Quotes in Girl, Interrupted
Take it from his point of view. It was 1967. Even in lives like his, professional lives lived out in the suburbs behind shrubbery, there was a strange undertow, a tug from the other world--the drifting, drugged-out, no-last-name youth universe--that knocked people off balance. One could call it "threatening," to use his language. What are these kids doing? And then one of them walks into his office wearing a skirt the size of a napkin, with a mottled chin and speaking in monosyllables. Doped up, he figures. He looks again at the name jotted on the notepad in front of him. Didn't he meet her parents at a party two years ago? Harvard faculty--or was it MIT? Her boots are worn down but her coat's a good one. It's a mean world out there, as Lisa would say. He can't in good conscience send her back into it, to become flotsam on the subsocietal tide that washes up now and then in his office, depositing others like her. A form of preventive medicine.
Swish, click. Before you knew it, she'd be back. Click, swish, "Checks," swish, click.
It never stopped, even at night; it was our lullaby. It was our metronome, our pulse. It was our lives measured out in doses slightly larger than those famous coffee spoons. Soup spoons, maybe? Dented tin spoons brimming with what should have been sweet but was sour, gone off, gone by without our savoring it: our lives.
“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.
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.
In the cab Valerie said, "I've got something for you." It was my tooth, cleaned up a bit but huge and foreign. "l snitched it for you," she said.
'Thanks, Valerie, that was nice of you." But the tooth wasn't what I really wanted. "l want to know how much time that was," I said. "See, Valerie, I've lost some time, and I need to know how much. I need to know."
Then I started crying. I didn't want to, but I couldn't help it.
He started asking me, "What are you thinking?" I never knew what to say. My head was empty and I liked it that way. Then he began to tell me what I might be thinking. "You seem sad today," he'd say, or “Today, you seem puzzled about something." Of course I was sad and puzzled. I was eighteen, it was spring, and I was behind bars.
In February I asked Melvin, "You know those tunnels?"
"Could you tell me more about the tunnels?" He didn't know about them. If he'd known about them, he would have said, "Yes?"
"There are tunnels under this entire hospital. Everything is connected by tunnels. You could get in them and go anywhere. It's warm and cozy and quiet."
"A womb," said Melvin.
"It's not a womb," I said.
"Yes." When Melvin said Yes without a questioning intonation, he meant No.
"It's the opposite of a womb," I said. "A womb doesn't go anywhere.”
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 have a few more annotations to my diagnosis. 'The disorder is more commonly diagnosed in women." Note the construction of that sentence. They did not write, 'The disorder is more common in women." It would still be suspect, but they didn't even bother trying to cover their tracks.
Many disorders, judging by the hospital population, were more commonly diagnosed in women. Take, for example, "compulsive promiscuity." How many girls do you think a seventeen-year-old boy would have to screw to earn the label "compulsively promiscuous?” Three? No, not enough. Six? Doubtful. Ten? That sounds more likely. Probably in the fifteen-to-twenty range, would be my guess--if they ever put that label on boys, which I don't recall their doing.
And for seventeen-year-old girls, how many boys?
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.