I read Girl, Interrupted a number of times, once as part of a discussion group. In that instance, we were given a list of topics for discussion. One of those was the gradual revelation that the narrator, though she seems “normal” at first, really is mentally ill.
Well, you know how those discussion groups go, and we never did get around to that subject. I just now opened the book again, and the topic list fell out. I have to admit, I still don’t see that “revelation”: the narrator doesn’t seem mentally ill to me. Disturbed, yeah, but to me, she just has an odd way of looking at things, and was probably born too early. The closest she gets to truly aberrant behavior (IMO) is when she bites her hand. But that was when she was upset about something that happened to a fellow inmate, and as a (former) biter myself, I’m reluctant to condemn her based only on that.
So what am I missing (and what does this say about me)?
Please note: I do not wish to discuss the film. I haven’t seen it, and from what I understand, I has as much to do with Kaysen’s account as Sunny Delight has to do with fresh-squeezed orange juice. I only want to discuss what actually happened to Susanna Kaysen, and what she thought and how she felt. Leave that sticky-fingered egotist out of it.
My impression was that she was actually mentally ill, although I don’t think that was the impression the author was trying to convey. She says that she wasn’t, and she certainly tailors her narrative to support that conclusion, but I was not particularly convinced. For one thing, if she was just a non-conformist and not actually sick, you think she could have behaved “normally” long enough to get out of the mental institution. And, in general, without the influence of the authorial voice, who are you going to give more credence to: mental patient or the doctor who diagnosed her?
Part of what made me question the reliablity of the narrator was an unrelated reading experience I’d had shortly before hand. I’d just read Lenny Bruce’s autobiography, followed by a posthumous Bruce biography whose name escapes me. It was an illuminating exercise in how two people, writing earnestly and honestly, can come to two radically different interpretations of the same events. And of the powers of self-deception, especially when someone doesn’t want to admit that they have a sickness.
Well, I tend to agree with Dangerosa and kiz, but you have a good point, Miller: people do see things their own way.
Still. The doctor could have made an incorrect diagnosis. I’ve heard unpleasant things about how easy it is to get committed, and how difficult it is to get released…until the money runs out. I got the impression that after a while, she wasn’t much inclined to try to get out, because she’d become institutionalized. It happens.
Also, bear in mind that this happened in the '60s. Think of that word—“non-conformist”—in that context. We don’t even use that word any more! We talk of rebellion, which is usually aggressive behavior, but it’s moot to call someone a non-conformist, because conformity is not pushed on people as it was then. The norm was so narrow back then…I saw a documentary once where a high-school girl was called on the carpet because her skirt was too short. The principal (or dean?) couldn’t just say “Go and change” (as I was told in the '80s; I had to go to the gym and rent sweatpants), and she wasn’t concerned with the alleged indecency of showing a bit of thigh. She told the girl, repeatedly and in a very hectoring tone, “You can’t be a non-conformist.” (“But I’m not being a non-conformist…It’s not that short…”) It wasn’t just a matter of obeying the rules; the idea was to mold you so you wouldn’t even think independently.
The way I saw it, Kaysen was committed because she took an overdose. Okay, that’s a cry for help. But a person can be suicidal without being mentally ill. And did you read the chapter where she disputes the amount of time it took the doctor to diagnose her? Well, she’s talking about minutes and hours. I say, eff that. It should take days of examination and more than one opinion before someone gets committed; it’s not like writing a prescription.
They can’t do a test for serum schizophrenase, you know. A diagnosis of “mental illness” (of this or that specific type) is made on the basis of behavior by a psychiatrist, many of whom have a tendency to see in most nonconformity symptoms of mental illness.
The cold hard reality of “under what circumstances can you be held against your will and treated involuntarily” is that you are as “mentally ill” as they say you are.
When I was an inpatient I made sense to me, but the scary thing was that so did the other people on the ward. Even the most “disturbed” people were mostly just very upset about stuff.
It’s been a long time since I’ve read the book, and I’ve only read it once, but I seem to remember being surprised that there were a few lines that, for me, undermined the narrator’s case that she wasn’t mentally ill. Something to the effect of “just because I know I can’t live on my own as an adult without completely breaking down doesn’t mean I should be in an institution.” Obviously not a direct quote, but there were a few of these moments where I was like “what are you talking about?”
AHunter3, I do agree with what you said in your post, so my complaint (I guess it’s a complaint) with this book is really a criticism of the author’s failure to communicate her stance – if she feels she can’t live on her own due to her mental/emotional health issues, yet she shouldn’t be in an institution, her writing would have been more effective if she had provided some indication of what she would propose as an alternative.
I’m pretty sure she was mentally ill. I mean, it never occured to me that she wasn’t, anyway. Remember the dresser and tiger? And she wasn’t biting to relieve stress or sadness; she bit herself because she suddenly questioned whether she had bones. And in the length of time she was hospitalized, surely her parents at least would have had concerns about whether she should be there.
It can be easy to get held for observation for a short time (i.e., a few days). It’s a lot harder to be committed. It varies by juresdiction. The people making the commitment decision have experience differentiating between people who are upset or high and people who are a danger to themselves or others or unable to make good judgements on their own behalf. My state has an additional standard of immanence–if you have suicidal thoughts but aren’t going right out to kill yourself, they’re unlikely to hold you.
A post above pointed out that Kaysen’s action occurred in the 60’s, when the standards were different. For that matter, until recently a lot of gay youth were incarcerated by their parents. Next time anybody bitches about the DSM, you might want to remind them that the operationalizing of current plus historical behaviors (as opposed to describing mental illness as related to ego maturity or symbolic developmental phenomena) has made it harder to call someone “mentally ill” without observable behavioral evidence.
I worked 8 hours today on a locked psychiatric unit. I don’t need to read charts or look at room numbers to get a pretty good sense of who’s basically okay but having a difficult time and who’s in really bad shape. People who are basically okay may wonder about whether they have bones, and might even worry about it some, but they wouldn’t be biting themselves or weeping about it or screaming for the doctor or what have you.
DSM is the Diagnostic and Statistical Manual. It is a codebook that describes each mental disorder (at least, as we understand this in the US) and numbers them. The numbers also appear in the International Classification of Diseases (ICD) which World Health Organization uses.
At the time Kaysen was about writing, a psychologist, psychiatrist, or other expert could argue that there was a psychodynamic (read: Freudian-like) explanation of your symptoms or personality, and this was a sufficient diagnosis. Not acting like everybody else was a sign of abnormality. (I’m giving you the most extreme version of it.)
While there are certainly still many people who use psychodynamic theory in diagnosis (including me), the DSM has moved from talking about internal psychodynamics (e.g., “She has an unresolved father complex, and this is why she steals things–to capture the phallus–and we call this X”) to more behavioral descriptions (“she steals things–if she also does A, B, and C, we call this X”).
You can still argue that the DSM categorizes unpopular behaviors as mental disorders, or that it’s very culturally bound, or that the only mental disorders are those that have a chemical marker, or that the DSM isn’t atheoretical but behavioral, or that psychodynamic or other theories do a better job of describing certain problems.
I’m just saying that when you’re in front of the judge arguing to commit someone these days, it’s generally not sufficient to say “He has an unresolved X complex.” Rather, you must say, “Whatever he has (and here is at least one diagnostic impression), he appears to be hearing voices that tell him to dance in traffic, as evinced by his making statements that appear to respond to these voices (e.g., “Shut up all of you! I can’t hear the music!”) and THEREFORE he appears to present a clear danger to himself or others.” Or “Ms. Shoshana has a history of bipolar disorder and was observed with X behavior and Y signs and reported symptoms while in her dormitory. She appears to have stopped taking her Lithium and is manic. Her speech contains many clangs and neologisms (etc., etc.). Ms. Shoshana has become suicidal during previous episodes.”
I think another problem is that many people who read the book have no clear conception of what mental illness really is. Many people I’ve spoken to do not seem to grasp that there is not one specific over-arching form of mental illness. Not everyone who is mentaly ill can be described as stark raving mad. Most people with a form of mental illness, even those with severe problems, can appear completely rational and functional at times. Every in-patient is not just like that homeless guy who scares you at the bus stop.
The problems start at the level of functioning. You may have a lot of bizarre thoughts, but if you are capable of caring for yourself and do not pose a threat to yourself or others, you’re really not in a position to be committed. It tends to be one’s actions which entail committment, either volunatrily or involuntarily.
Susanna Kaysen did not seem capable of caring for herself, at least IMO from reading the book. She could not hold a job, she was largely incapable of establishing a meaningful relationship or relating to other people in a meaningful way, and she repeatedly refused to compromise on seemingly trivial points- her stockings, her smoking, etc. While I agree that this may have had more to do with the time period and the cultural perceptions, it was quite obvious in the beignning of the book that she was in bad shape and heading for a major break with reality.
There is a major difference, as has been pointed out, between injuring yourself in a highly-charged emotional state, and injuring yourself out of more-or-less curiosity. She speaks about banging her wrist- if you do this a few times when you’re upset, you’re most likely a completely normal person. If you spend hours at it, you’ve got some problems. But as Shoshana pointed out, a diagnosis seldom comes down to one isolated behavior. It’s rather a collage of various behaviors which point towards mental illness. Thus:
wrist banging = girl’s having a bad day
wrist banging + suicide attempt + inability to form or sustain meaningful relationships + inability to care for oneself = girl needs some serious help