Girl, Interrupted

1. Parallel Universes Exist and Are Easily Entered

And it is easy to slip into a parallel universe.

Alternate realities. Kaysen introduces the idea that parallel universes exist alongside our own, inhabited by those deemed "insane, criminal, crippled, or dying." These worlds mirror our own but operate under different rules, where the laws of physics and time are suspended. The transition into these universes can be sudden or gradual, marked by a series of "perforations" in the membrane between worlds.

Georgina's experience. Kaysen illustrates this concept through her roommate Georgina, who experienced a sudden descent into madness during a movie, highlighting the ease with which one can be thrust into an alternate reality. This experience underscores the fragility of the boundary between sanity and insanity.

Alcatraz analogy. Kaysen uses the metaphor of Alcatraz, where every window offers a view of San Francisco, to emphasize that even within these parallel universes, the world we came from remains visible and influential. This constant reminder of the "normal" world can be both alluring and menacing, shaping the experiences of those within the parallel universe.

2. The Psychiatric System Can Be Both Refuge and Prison

At turns wry, sardonic, witty … an unusual glimpse of a young woman’s experience with insanity. Kaysen presents a meaningful analysis of the dual and contradictory nature of psychiatric hospitalization as both refuge and prison.

Dual nature of hospitalization. Kaysen explores the paradoxical nature of psychiatric hospitalization, portraying it as both a sanctuary and a confinement. While the hospital offers protection from the demands and expectations of the outside world, it also strips individuals of their freedom, privacy, and dignity.

Protection from the outside world. The hospital shields patients from external pressures, allowing them to avoid responsibilities like work or school. Patients can use their "upset" state as a shield, refusing phone calls or visits from those they wish to avoid. This creates a strange sense of freedom, as patients are no longer bound by societal expectations.

Loss of autonomy. Despite the refuge it provides, the hospital environment is highly controlled. Patients are subject to constant surveillance, medication schedules, and restricted access to personal items. This loss of autonomy can be both disorienting and dehumanizing, blurring the line between care and control.

3. Madness Can Be a Matter of Perspective and Definition

A bitter, funny, insightful memoir … A minimalist relative of One Flew Over the Cuckoo’s Nest, Kaysen’s spare, elegant book raises angry questions about just who’s crazy, and who’s in charge of figuring it out.

Subjectivity of diagnosis. Kaysen questions the objectivity of psychiatric diagnoses, suggesting that madness is often a matter of perspective and societal tolerance for deviant behavior. The "Etiology" section presents a list of possible interpretations of mental illness, ranging from divine possession to societal intolerance, highlighting the shifting definitions of madness throughout history.

The doctor's perspective. Kaysen reflects on her initial encounter with the doctor who committed her, considering his possible motivations and biases. She acknowledges the societal pressures and anxieties of the 1960s, suggesting that her doctor may have been influenced by a fear of the "drifting, drugged-out youth universe." This challenges the notion of a purely objective medical assessment.

Contrariety and negation. Kaysen admits to a state of "contrariety," where she actively resisted societal expectations and norms. This resistance, coupled with her ability to recognize her own "misperceptions of reality," led her to question her own sanity and ultimately accept incarceration as a form of rebellion. This highlights the complex interplay between individual agency and societal labeling.

4. Hospitalization Strips You Bare, Offering a Strange Freedom

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.

Loss of identity. Kaysen describes how hospitalization strips patients of their identities, reducing them to their diagnoses and behaviors. The constant surveillance, medication, and therapy sessions create an environment where individuality is suppressed. This stripping away of the self can be both terrifying and liberating.

Protection and dependence. The hospital provides a strange form of protection, shielding patients from the demands and expectations of the outside world. However, this protection comes at the cost of dependence. Patients become reliant on the hospital for basic needs, losing their ability to function independently.

Bare bones existence. Stripped of their former lives, patients are reduced to their "bare bones selves." This can be a moment of profound vulnerability, but also an opportunity for self-discovery. With nothing left to lose, patients are free to explore their inner landscapes and confront their deepest fears.

5. The Internal World Can Be More Real Than External Reality

Kaysen finds her reality in writing, inside.

Subjective experience. Kaysen emphasizes the power of the internal world, suggesting that for many patients, their subjective experiences are more real than external reality. The "Mind vs. Brain" section explores the complex relationship between neurological activity and conscious thought, questioning the nature of reality and the validity of sensory impressions.

The tunnels as a metaphor. The tunnels beneath the hospital serve as a metaphor for the internal world, offering a sense of connection and escape from the confines of the ward. Kaysen's obsession with the tunnels highlights her desire to explore the hidden depths of her own mind.

The shadow of the real. Kaysen references Plato's allegory of the cave, suggesting that our perceptions of reality are merely shadows of a deeper, more fundamental truth. This reinforces the idea that the internal world, with its complexities and contradictions, may be closer to the "real" than the external world.

6. Diagnosis Can Be a Label, a Trap, or a Tool

My Diagnosis

The power of labels. Kaysen reflects on her diagnosis of Borderline Personality Disorder, questioning its accuracy and impact on her life. She acknowledges that the diagnosis provides a framework for understanding her behavior, but also recognizes its potential to become a self-fulfilling prophecy.

Borderline Personality Disorder. Kaysen provides an annotated diagnosis, dissecting the criteria for Borderline Personality Disorder and applying them to her own experiences. She challenges the validity of certain criteria, such as "social contrariness," and questions the overall usefulness of the diagnosis.

Stigmatography. Kaysen explores the stigma associated with mental illness, describing the challenges she faced when trying to re-enter society after her hospitalization. She notes that the label of "insane" can be a barrier to employment, relationships, and overall acceptance.

7. Sanity and Insanity Are Closer Than We Think

Girl, Interrupted is about the borders between the world inside the hospital and the world outside, between sanity and insanity, between freedom and captivity, between self and other, between dignity and shame, between power and powerlessness.

Fluid boundaries. Kaysen blurs the lines between sanity and insanity, suggesting that the distinction is often arbitrary and socially constructed. She questions the criteria used to define mental illness, highlighting the subjectivity of diagnosis and the potential for misinterpretation.

The "normal" vs. the "insane." Kaysen challenges the notion of a clear divide between the "normal" and the "insane," suggesting that everyone experiences moments of doubt, anxiety, and irrationality. The difference, she implies, lies in the degree to which these experiences disrupt one's ability to function in society.

The power of perspective. Kaysen emphasizes the importance of perspective, suggesting that what is considered "madness" in one context may be seen as "eccentricity" or "creativity" in another. She encourages readers to question their own assumptions about mental illness and to recognize the shared humanity of those who are labeled "insane."

8. The Search for Identity Is a Lifelong Journey

A marked and persistent identity disturbance is almost invariably present. This is often pervasive, and is manifested by uncertainty about several life issues, such as self-image, sexual orientation, long-term goals or career choice, types of friends or lovers to have, and which values to adopt.

Identity disturbance. Kaysen's diagnosis of Borderline Personality Disorder highlights the theme of identity disturbance, characterized by uncertainty about self-image, goals, and values. This uncertainty is a common experience for many young adults, but it is often amplified in those who are struggling with mental illness.

The influence of external factors. Kaysen explores the ways in which external factors, such as societal expectations and family pressures, can shape one's sense of self. She questions the validity of her parents' and teachers' expectations, suggesting that they may have contributed to her feelings of inadequacy and alienation.

The power of self-definition. Despite the challenges she faces, Kaysen ultimately asserts the power of self-definition. She embraces her identity as a writer, rejecting the expectations of others and forging her own path. This act of self-assertion is a testament to the resilience of the human spirit.

9. Hope and Connection Can Be Found in the Darkest Places

She was kind and comforting to those who were unhappy. She never complained. She always had time to listen to other people’s complaints. She was faultless, in her impermeable tight pink-and-white casing.

Polly's resilience. Kaysen introduces Polly, a girl who set herself on fire, as an example of resilience and hope. Despite her physical and emotional scars, Polly remains kind, compassionate, and understanding. Her presence offers comfort to those who are struggling with their own demons.

Lisa's humor and defiance. Lisa, the rebellious sociopath, provides moments of humor and defiance in the face of adversity. Her antics and witty remarks offer a counterpoint to the often grim realities of the hospital environment.

The power of connection. Despite their differences, the patients on South Belknap Two form a unique bond, offering each other support, understanding, and companionship. These connections provide a sense of belonging and purpose in a world that often feels isolating and alienating.

10. The Line Between Mind and Brain Is Blurry

Whatever we call it—mind, character, soul—we like to think we possess something that is greater than the sum of our neurons and that “animates” us.

The mind-brain problem. Kaysen delves into the complex relationship between the mind and the brain, questioning the nature of consciousness and the extent to which our thoughts and feelings are determined by neurological processes. She explores the limitations of both psychoanalysis and neurobiology, suggesting that a more holistic approach is needed to understand mental illness.

Interpreters one and two. Kaysen introduces the concept of "interpreters one and two" to illustrate the internal dialogue that shapes our perceptions of reality. She suggests that mental illness may be a result of miscommunication between these interpreters, leading to distorted perceptions and irrational beliefs.

The search for meaning. Ultimately, Kaysen acknowledges the limitations of scientific explanations, emphasizing the importance of meaning and purpose in human life. She suggests that even if we can map the neural pathways of thought, we will still need to grapple with the fundamental questions of existence.

Last updated: March 27, 2025