Borderline Personality Disorder In Girl Interrupted Essays On Friendship

Susanna Kaysen - The author and narrator. A doctor diagnoses Kaysen with borderline personality disorder in 1967, when she is 17. The previous year, Kaysen attempted suicide by swallowing fifty aspirin. She voluntarily commits herself to McLean Hospital, a psychiatric facility in Belmont, Massachusetts. Over the next two years, Kaysen confronts her illness, experiences profound unhappiness, as well as the treachery and kindness of peers and authority figures, and finally meets the future that awaits her outside the confining but protective walls of the ward.

Read an in-depth analysis of Susanna Kaysen.

Lisa - Kaysen's fellow patient and the effective leader of the girls on the ward. Lisa is proud of her diagnosis as a sociopath, a personality driven by self-interest. Lisa is wildly unpredictable. She throws tantrums and plans escapes for others when she isn't making her own attempts to escape. Kaysen is initially in awe of Lisa's apparent confidence. Over time, though, she learns that Lisa cares little for the consequences of her actions and can be willfully cruel.

Read an in-depth analysis of Lisa.

Georgina - Kaysen’s roommate at McLean Hospital. Georgina suffers from depression and is a kind and constant companion to Kaysen. Georgina has a romantic relationship with Wade, a violent and unpredictable patient on another ward.

Read an in-depth analysis of Georgina.

Polly - A disfigured patient. Before entering McLean, Polly poured gasoline over her face and upper body and set herself aflame. Polly appears to be at peace, even cheerful, during her first year at the hospital. One day, Polly suddenly becomes aware of the awful extent of her injuries. She is inconsolable. Kaysen notes that although everyone at McLean is affected by sickness, Polly is the only patient trapped forever by the consequences of her illness.

Daisy - A patient who spends the period from Thanksgiving to Christmas at the hospital each year. Daisy lets no one into her room, emerging only for laxatives and the whole roast chickens her father brings twice weekly. Lisa discovers that Daisy’s room is filled with the picked-over carcasses of the chickens. Daisy leaves the hospital to live in an apartment her father has purchased for her. The girls later learn that Daisy committed suicide on her birthday.

Cynthia - A severe depressive on Kaysen’s ward. Cynthia undergoes months of electroshock therapy. The effects of the shock treatments change Cynthia’s personality, leaving her totally unable to assert herself. Cynthia is close to Polly.

Wade - Georgina’s boyfriend and a patient at McLean hospital. Wade is prone to violent outbursts, requiring several orderlies to subdue him. Wade fascinates the girls with stories of his father’s exploits as a CIA agent, including his associations with notorious figures from the Watergate scandal. Wade’s fits of uncontrollable rage ultimately land him in the maximum-security ward.

Lisa Cody - A patient who becomes fast friends with Lisa, only to be cruelly rejected. Diagnosed, like Lisa, as a sociopath, Lisa Cody emulates Lisa’s behavior. Feeling that her position among the girls is threatened, Lisa turns against her, and Lisa Cody leaves the hospital. Returning from an escape to Boston one day, Lisa tells the other girls that Lisa Cody has become a “real” junkie.

Torrey - A methamphetamine-addicted patient from Mexico. Torrey’s parents, embarrassed by their daughter’s condition, arrive to retrieve her after a short time. Lisa plans to help Torrey escape, but Valerie halts Lisa’s plan.

Alice Calais - A troubled patient who pronounces her last name “callous.” Alice’s mental breakdown results in her transfer to the maximum-security ward. Alice’s appearance and the frightening atmosphere of the ward appall the girls when they visit.

Valerie - The head nurse on Kaysen’s ward. The girls like and respect Valerie for her fairness and willingness to speak up on their behalf.

Melvin  - Kaysen’s therapist. Impressed by Kaysen’s intelligence, Melvin begins an advanced program of analysis with her. Kaysen finds the experience unconvincing and discovers that she was Melvin’s first analysis patient.

Mrs. McWeeney - The evening nurse on Kaysen’s ward. Mrs. McWeeney hails from the old school. Her old-fashioned uniform and values alienate the girls.

Dr. Wick - An older female psychiatrist on the hospital staff. Dr. Wick is from Africa and is entirely unfamiliar with the American youth culture of her patients. Vulgarity and frank discussion of sex embarrass Dr. Wick, whose efforts at treatment are not necessarily effective.

James Watson - Nobel Prize–winning friend of Kaysen’s family. Beloved by Kaysen for his unpredictable behavior, he visits Kaysen and offers to help her escape. She turns him down in the belief that she should continue treatment.

Kaysen’s Husband - Introduced to Kaysen prior to her hospitalization, he stays in touch with her throughout her time at McLean. His marriage proposal allows Kaysen to leave the hospital. They are married only a short time.

The English Teacher - Kaysen’s high school teacher and lover. He takes her to the Frick Museum in New York, where she first sees the Vermeer painting titled Girl, Interrupted at Her Music. Their affair is short-lived.

The Diagnosing Doctor - The psychiatrist who encourages Kaysen to enter McLean Hospital. He diagnoses her in a mere twenty minutes. Kaysen believes that his swift diagnosis expresses the psychiatrist’s misguided effort to save her from the wayward youth culture he disdains and cannot understand.

The Memoir, not the Movie with Winona Ryder and Angelina Jolie

Girl, Interrupted, an account of a young woman’s long-term stay at the famous McLean Hospital, provides a look into the institutionalized lives of women suffering with severe mental illness. Several treatments of the time were administered to ameliorate their symptoms, though the efficacy of such treatments was often debatable. Though brief, the memoir opens dialogue regarding misdiagnoses, the perception of nonconforming individuals as “crazy,” and the stigmatization of those receiving a mental health diagnosis.

Schizophrenic symptoms were common among McLean’s patients. Polly, left disfigured with burns after a suicide attempt, is void of emotion. Not happy, unhappy, or agitated, Polly’s emotional responses indicate a flat affect. She rarely speaks, even in stressful situations. For Polly, negative symptoms take hold. The indifferent viewers of the television set sit catatonic without response. Even when Lisa covers the couch with toilet paper, the catatonics remain still in their seats. The girl who claimed to be an alien’s girlfriend, as well as a proud penis owner, beams delusions of grandeur, calling ice cream vulgar names that all rhyme together. Wade, Georgina’s boyfriend, is a bit paranoid, and claims he was persecuted by two friends of his father, who he falsely reported to do dangerous work for the CIA. He is indifferent to Georgina’s burns.

Susanna Kaysen, admitted to the hospital for mental exhaustion and a suicide attempt, is diagnosed with borderline personality disorder. She is impulsive, her interactions jarred by routine splitting behaviors. It’s mainly black and white in Susanna’s world. She cries in front of a painting she finds relatable, much to the annoyance of a boyfriend. Frustrated, he remarks on her self-centered way of perceiving things. Susanna faces conflict within, perceiving herself as a terrible person to later identify as the venerated Angel of Death. She scratches her hands, desperately wanting to know if there’s still bone beneath. Banging her wrists on a butterfly chair, regardless of vein damage all can see, is how she bears the numbness. Scratches mark her face. As Susanna showed at least 5 of the criteria for borderline personality disorder, as listed in the DSM-IV-TR—(1) Tumultuous relationships where splitting is common, (2) An ever-changing self-image, (3) Impulsive behavior, (4) Frequent episodes of self-harm, and (5) Dissociative episodes spurred on by distress—it is reasonable to conclude that her diagnosis was valid.

Lisa, on the other hand, is diagnosed with antisocial personality disorder. Cold and insensitive, Lisa cares not for the feelings of others. She jeers at the catatonics sitting around the television set, even turns it off despite the possibility that someone may really like the show that’s played. Lisa does away with rules, scheming to escape Mclean. Even in exclusion, Lisa expresses no remorse for her bad behavior, continuing to plot other escapes and even the escapes of others. Of course, these plans lack authentic concern. Self-interest dictates her behavior. She wants to be liked among the girls, and indeed, she has an appealing sense of humor that brings color to a dull environment. However, while Lisa doesn’t struggle in making friendships, she doesn’t give them value. Stable relationships are impossibilities. Towards the end of the Kaysen’s memoir, Lisa raises her son, whose father she disowns.

Aggressive and provoked by perceived threats to popularity, Lisa takes measures to derail rivals. Her continuous bullying of Lisa Cody, a diagnosed sociopath who seems to only emulate Lisa’s behavior, only fuels the latter’s self-indulgence. Blame is the name of Lisa’s game. Various times, she bemoans her lack of rights, using her attorney to bully the hospital staff when her requests were ignored or unfulfilled. I’m sure we’ve encountered these sorts, in college, doctors’ offices, and popular tourist attractions. While at least 3 criteria in section A of the DSM IV-TR must be met to receive a diagnosis of antisocial personality disorder, Lisa meets 6, such as (1) Failure to adhere to social norms relating to lawful behaviors, (2) Deception in the name of self-interest, (3) Aggressiveness and frequent irritability, (4) Pervasive disregard for the wellbeing of others, (5) Repeated irresponsibility, as evidenced by a failure to fulfill her daily obligations, and (6) Lack of remorse for her cruelty towards others.

Reflections on Treatment

The drug treatments mentioned throughout the memoir had an inhibiting effect on the patients. Thorazine was a common resort for those with highly unstable behavior, such as the trembling Torey or Susanna, who experienced an episode of extreme agitation upon scratching her hand. Feeling heavier than usual, the patients would calm down and their agitation would cease. Other antipsychotic drugs, such as Stelazine and Mellaril, seemed to calm those with schizophrenia, although their movements grew more sluggish, as evidenced by Polly’s way of walking and the odd suspension of her hands. Periods of sleepiness may have been influenced by benzodiazepines such as Librium and Valium. The depressed woman, Cynthia, received electro-convulsive shock therapy once a week, with therapy twice a week. Her memory was noticeably impaired, with her speech disorganized after initial treatment. Daily, most patients were required to see three specialists. Sessions with doctors were uninformative and short, as were sessions with residents concerned with medication and the granting of privileges. Therapy was also described as unhelpful, with therapists expressing a lack of sympathy, refusing to discuss life in the hospital yet determining whether patients were to have increases in medication. This three-part regimen seemed more systematic and impersonal than helpful to the individual needs of each patient. Susanna, deemed capable of undergoing “analysis,” recalled the treatment as ineffective. It seemed that the treatment did little to benefit her, the specialists’ repetitive questions irritating her so much that she would simply fabricate answers to placate them.

Is She Crazy? 

Susanna explicitly questioned her diagnosis during her hospitalization. She felt that what others perceived as inappropriate, tiring behavior were hallmark characteristics of young adulthood. She criticized the DSM as a vague collection of generalizations, often subjectively applied to those who do not conform to social norms. The only person in her affluent high school to not attend college, Susanna was the black sheep of the family, defying expectations to attend a prestigious college and unable to handle the duties of simple jobs. Perhaps the shame her family experienced impacted their willingness to pay for her costly hospitalization for almost two years. They may have wished to maintain normalcy without directly dealing with her chaotic behavior. I feel that her inability to maintain her typing job may have related to sexist attitudes of the time. All the supervisors were men, while the typists were women. Strict regulations were placed on their behavior and dress. This could have been agitating for Susanna, who defied such rules. Although her behavior was erratic, “crazy” is not an accurate word to describe her.

Considering the aforementioned behaviors, it’s reasonable to say that Susanna showed striking characteristics of borderline personality disorder. The episodes of self-harm, the persisting interpersonal conflicts, and emotional instability indicate that psychologically, she just wasn’t healthy. However, these behaviors may have been byproducts of growing up in an environment with rigid, highly demanding expectations. Ultimately, “troubled” may be a more fitting description, as it does not dehumanize nor stigmatize, but emphasizes that Susanna is a person who at the time needed guidance and empathy.

Ultimately, Girl, Interrupted (the memoir, not the movie) gave me a glimpse of the impersonal and rushed nature of psychiatric care in these facilities, given the amount of patients who have to be treated. I observed how sexist attitudes of the time period may have influenced perceptions of women already struggling with a mental illness. Susanna was expected to be sexually modest, emotionally stable, and uncomplaining. The scorn she received, made salient in a doctor’s writing that she “might sell self or get pregnant” (11) shed light on the stigma imposed on women who rebelled against norms of conservatism. The title, inspired by the poignant painting Susanna saw at the Vermeer, is more than an allusion. It is a description of Susanna’s destabilizing experience—a long term hospitalization, a stigmatized diagnosis, and a lost sense of self—that prevented her from enjoying life in the way that most young women do. It was only after this hiatus that she could continue living, hopefully with a greater sense of stability.

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