Girl, Interrupted

“I have often thought of the next ten minutes—my last ten minutes. I had the impulse, once, to get up and leave through the door I’d entered, to walk the several blocks to the trolley stop, and wait for the train that would take me back to my troublesome boyfriend, my job at the kitchen store. But I was too tired.”

Kaysen recalls waiting for the doctor to continue their appointment, when he would announce his consequential decision that she should go to McLean hospital. Kaysen refers to these moments as her “last ten minutes” to hint that her time at McLean was a distinct period in her life and akin to entering a parallel universe.

“Lisa had run away again. We were sad, because she kept our spirits up. She was funny. Lisa! I can’t think of her without smiling, even now. The worst was that she was always caught and dragged back, dirty, with wild eyes that had seen freedom.”

Kaysen elaborates on her positive feelings about Lisa as she describes her habit of running away. Lisa’s regular escapes and subsequent capture affirm that once people were admitted to McLean hospital, they were not allowed to leave without permission. The use of the word “freedom” illustrates that McLean’s residents felt imprisoned, and the violent language “dragged back” highlights the immense resistance that Lisa felt about returning to McLean.

“I asked the person on checks, ‘What’s she doing in the bathroom?’ This was a new person. ‘Am I supposed to open bathroom doors too?’ I did what we often did to new people. ‘Somebody could hang herself in there in a minute! Where do you think you are, anyhow? A boarding school?’ Then I put my face close to hers. They didn’t like that, touching us.”

Kaysen remembers her concern for Lisa, who was withdrawn and spending a lot of time in the washroom by herself. By divulging that she and the other residents had a common practice of intimidating and confusing new nurses, she illuminates the bond and common understanding she and the other young women developed by living together at McLean.

“As I walked the five blocks to the A&P I was gripped by humiliation and regret. I’d made a mistake and I was going to die because of it. Perhaps I even deserved to die because of it. I began to cry about my death. For a moment, I felt compassion for myself, and all the unhappiness I contained.”

Kaysen describes how she felt as she attempted suicide. By recalling her state of mind during this event, she reveals how being faced with her possible death changed her attitude towards herself. Rather than focusing on the parts of her life she wanted to escape or feeling badly about things she regretted, Kaysen’s attitude towards herself softened and she considered her decision a mistake.

“The only odd thing was that suddenly I was a vegetarian. I associated meat with suicide, because of passing out at the meat counter. But I knew there was more to it. The meat was bruised, bleeding, and imprisoned in a tight wrapping. And, though I had a six-month respite from thinking about it, so was I.”

Kaysen explains that after fainting at the meat counter of her grocery store, she went to the hospital where her stomach was pumped to save her life. After being revived, Kaysen felt ‘airier’ and less depressed, but she explains that this feeling did not last and did not address the root issue of her feelings of confinement in her life.

“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 were these kids doing?”

Kaysen examines the generational differences and social movements of the 1960s that played to her doctor’s perception of her as an 18-year-old. She reflects that as an older, suburban professional, he likely felt frightened of young people’s trends and protests. Kaysen’s objectivity and detached empathy are demonstrated as she ponders if his fear prompted him to believe sending her to McLean hospital would the safest option.

“All my integrity seemed to lie in saying No. So the opportunity to be incarcerated was just too good to resist. It was a very big No—the biggest No this side of suicide. Perverse reasoning. But back of that perversity, I knew I wasn’t mad and that they wouldn’t keep me there, locked up in a loony bin.”

Kaysen reveals why she consented to admission to McLean Hospital. As a teenager, she felt strongly that she had to resist conforming to others’ expectations of her and spurned the directives of her teachers and parents. Kaysen admits that even at this low point in her youth, she knew that she would not be diagnosed with a serious mental illness and would eventually be released from McLean.

“At the end of the terrible hall, the terrible TV room. We liked it. At least, we preferred it to the living room. It was messy, noisy, smoky, and, most important, it was on the left, lunatic side of things.”

The women’s ward in McLean was organized in an opposing way so that patients’ rooms were situated on the left and the nurses’ station was on the right. Kaysen remembers how, despite having a tidier and smoke-free living room to enjoy, the patients congregated in the TV room because they felt more at home there. She refers to the patient side as “lunatic” to reflect how they were perceived by nurses and the public. This quotation underscores the tensions between patients and staff at McLean.

“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.”

Kaysen’s diagnosis of Borderline Personality Disorder negatively affected her self-image, causing her to feel that her personality and character were inherently flawed. She reveals how well-intended diagnoses can prompt further self-image issues in patients, and shows how women with very different illnesses were grouped together at McLean.

“In contrast to viscosity’s cellular coma, velocity endows every platelet and muscle fiber with a mind of its own, a means of knowing and commenting on its own behavior. There is too much perception, and beyond the plethora of perceptions, a plethora of thoughts about the perceptions and about the fact of having perceptions.”

Kaysen illustrates how it feels when the mind produces a flurry of anxious, intrusive thoughts about your own body. She attributes this anxiety to “too much perception,” which feels as though every part of the body is contributing to a rapid-fire discussion about itself. She expands this idea by recording her own train of thought, giving insight into her own mental experience.

“Once, these thoughts must have had meaning. They must have meant what they said. But repetition has blunted them. They have become background music, a Muzak medley of self-hatred themes.”

Kaysen contemplates how negative thoughts can become repeated patterns that, once triggered, run through one’s mind from beginning to end. She compares these patterns to ‘background music’ to explain how, while the person may appear busy with other actions, their intrusive, negative thoughts haunt them constantly. This metaphor adds to the many descriptions of mental battles Kaysen paints in the novel, providing a look into what the struggles may look like for some.

“Valerie was strict and inflexible and she was the only staff person we trusted. We trusted her because she wasn’t afraid of us. She wasn’t afraid of doctors either. She didn’t have much to say about anything, and we liked her for that, too.”

While patients had a tense relationship with the staff at McLean, they valued Valerie’s steady demeanor and boundaries. Kaysen explains that Valerie’s confident approach contributed to her success with patients. Kaysen contrasts this with the other nurses who were afraid of the patients, which created distrust and soured their relationships, providing more context to the culture within the hospital.

“They had a special language: regression, acting out, hostility, withdrawal, indulging in behavior. This last phrase could be attached to anything to make it sound suspicious: indulging in eating behavior, talking behavior, writing behavior. In the outside world people ate and talked and wrote, but nothing we did was simple.”

Kaysen illustrates the inequality and frustration she felt with the medical jargon used to discuss patients. The language demonized everyday patient activities by making them seem “suspicious”, as if patients had an ulterior motive for engaging with them. This passage further explains why patients felt misunderstood by staff and were distrustful towards them.

“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.”

Kaysen describes drugs as “friends” of McLean’s therapists, since they provided an easy way to quickly transform patient behavior. She challenges the idea that patients became reliant on these medications by claiming that the staff needed them more than the patients. This quotation challenges the common practice of medicating mental illness and raises the question of whose interests are best served when patients are given medication.

“We did our best to control our snarls and mutterings and tears when they were around. Consequently, they learned nothing about psychiatric nursing. When they finished their rotation, all they took with them were improved versions of us, halfway between our miserable selves and the normality we saw embodied in them. For some of us, this was the closest we would ever come to a cure.”

The presence of student nurses had a pacifying effect on Kaysen and her fellow patients at McLean, since they felt a kind of kinship with these fellow young women. She demonstrates how the patients felt a latent peer pressure to behave in ways closer to the ‘normality’ because they admired their student nurses and felt more connected to nurses closer in age, as if they needed to impress their peers instead of viewing them as fully distrustful medical staff.

“‘I 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.”

This quotation continues Kaysen’s theme of lost time, which she references throughout the novel. Her desire to understand how much time she has ‘lost’ during her dental surgery demonstrates that she is trying to gain understanding and control of her situation, and that she does feel invested in how she spends her life.

“I went back to the ward flushed with the idea of my fairly well integrated personality. I didn’t tell anyone; that would have been bragging. If I’d said to Lisa, ‘I have a fairly well integrated personality and therefore I’m going into analysis with Melvin,’ she would have made retching sounds and said, ‘Assholes! They’ll say anything!’ and I wouldn’t have done it.”

Kaysen’s pleased reaction to her therapist’s pronouncement about her personality reveals that, while she did reject many authority figures in her life, she also longed for their validation. She also illustrates the extent of Lisa’s influence, since she admits that if Lisa criticized the notion of analysis, Kaysen would not have pursued it. Kaysen is still capable of thinking for herself and keeps her plans secret from Lisa to lessen the peer pressure.

“The question was, What could we do? Could we get up every morning and take showers and put on clothes and go to work? Could we think straight? Could we not say crazy things when they occurred to us? Some of us could; some of us couldn’t. In the world’s terms though, all of us were tainted.”

This quotation illustrates that while McLean’s patients had a variety of experiences after their time in the hospital, all of them faced stigma due to their admittance to McLean, no matter how well they functioned in society afterwards.

“I began to feel revulsion too. Insane people: I had a good nose for them and I didn’t want to have anything to do with them. I still don’t. I can’t come up with reassuring answers to the terrible questions they raise.”

Kaysen describes how her self-image changed after she was released from McLean. She acknowledges that while she once questioned her own sanity, she began to identify less with mentally ill people, and consciously avoided them. This quotation shows how adopting society’s stigmatization of the mentally ill was a part of Kaysen’s integration into the world outside McLean, though she admits that her revulsion of “insane people” required denial on her part.

“She didn’t like me because I was arrogant and uncooperative and probably still crazy for insisting on being a writer […] Luckily I got a marriage proposal and they let me out. In 1968, everybody could understand a marriage proposal.”

Kaysen’s social worker is another authority figure who misunderstands her skills, worldview, and self-image, and encourages her to pursue jobs that do not interest her. Kaysen is not released from McLean because she articulates her concrete ambitions to be a writer, but because she became engaged. This quotation shows how female patients’ marital status was very consequential to determining their freedom and quality of life in the late 1960s, upholding the narrow gender roles of the time.

“There is thought, and then there is thinking about thoughts, and they don’t feel the same. They must reflect quite different aspects of brain function. The point is, the brain talks to itself, and by talking to itself changes its perceptions.”

Kaysen tries to pinpoint the causes of common mental illnesses, which she attributes to failed messages within the brain. She especially emphasizes the importance of the brain’s ability to critique the thoughts it has produced as a marker of normal mental health.

“I was trying to explain my situation to myself. My situation was that I was in pain and nobody knew it; even I had trouble knowing it. So I told myself, over and over, You are in pain. It was the only way I could get through to myself […] I was demonstrating, externally and irrefutably, an inward condition.”

Kaysen reflects on why she engaged in self-harm as a teenager, during which time she banged her wrist repeatedly to feel the pain it caused. Her explanation helps to reveal her emotional state at the time and more about the psychological causes of physical self-harm.

“But my parents and teachers did not share my self-image. Their image of me was unstable, since it was out of kilter with reality and based on their needs and wishes. They did not put much value on my capacities, which were admittedly few, but genuine. I read everything, I wrote constantly, and I had boyfriends by the barrelful.”

The author again turns the tables on her own diagnosis, and on authority figures’ perceptions of her teenage self, by pointing out that she had a very good understanding of her own skills. The issue, Kaysen argues, is that her abilities were not valued by her parents and teachers who were frustrated by her lack of ability to assimilate to general societal expectations of academic excellence and other conventional markers of success. This lack of assimilation and its consequences for Kaysen further emphasizes the time and how it treated those who did not fully conform to others’ expectations.