In 1967, after a session with a psychiatrist she'd never seen before, eighteen-year-old Susanna Kaysen was put in a taxi and sent to McLean Hospital. She spent most of the next two years in the ward for teenage girls in a psychiatric hospital as renowned for its famous clientele—Sylvia Plath, Robert Lowell, James Taylor, and Ray Charles—as for its progressive methods of treating those who could afford its sanctuary.
Kaysen's memoir encompasses horror and razor-edged perception while providing vivid portraits of her fellow patients and their keepers. It is a brilliant evocation of a "parallel universe" set within the kaleidoscopically shifting landscape of the late sixties. Girl, Interrupted is a clear-sighted, unflinching document that gives lasting and specific dimension to our definitions of sane and insane, mental illness and recovery.
About the Author
Susanna Kaysen has written the novels Asa, As I Knew Him and Far Afield and the memoirs Girl, Interrupted and The Camera My Mother Gave Me. She lives in Cambridge, Massachusetts.
Read an Excerpt
Toward a Topography of the Parallel Universe
People ask, How did you get in there? What they really want to know is if they are likely to end up in there as well. I can't answer the real question. All I can tell them is, It's easy.
And it is easy to slip into a parallel universe. There are so many of them: worlds of the insane, the criminal, the cnp-pled, the dying, perhaps of the dead as well. These worlds exist alongside this world and resemble it, but are not in it.
My roommate Georgina came in swiftly and totally, dur-ing her junior year at Vassar. She was in a theater watching a movie when a tidal wave of blackness broke over her head. The entire world was obliteratedfor a few minutes. She knew she had gone crazy. She looked around the theater to see if it had happened to everyone, but all the other people were engrossed in the movie. She rushed out, because the darkness in the theater was too much when combined with the darkness in her head.
And after that? I asked her.
A lot of darkness, she said.
But most people pass over incrementally, making a series of perforations in the membrane between here and there until an opening exists. And who can resist an opening? In the parallel universe the laws of physics are suspended. What goes up does not necessarily come down1 a body at rest does not tend to stay at rest1 and not every action can be counted on to provoke an equal and opposite reaction. Time, too, is different. It may run in circles, flow backward, skip about from now to then. The very arrangement of molecules is fluid: Tables can be clocks; faces, flowers.
These are facts you find out later, though.
Another odd feature of the parallel universe is that al-though it is invisible from this side, once you are in it you can easily see the world you came from. Sometimes the world you came from looks huge and menacing, quivering like a vast pile of jelly1 at other times it is miniaturized and alluring, a-spin and shining in its orbit. Either way, it can't be discounted.
Every window on Alcatraz has a view of San Francisco.
"You have a pimple," said the doctor.
I'd hoped nobody would notice.
"You've been picking it," he went on.
When I'd woken that morningearly, so as to get to this appointmentthe pimple had reached the stage of hard expectancy in which it begs to be picked. It was yearning for release. Freeing it from its little white dome, pressing until the blood ran, I felt a sense of accomplishment: I'd done all that could be done for this pimple.
"You've been picking at yourself," the doctor said.
I nodded. He was going to keep talking about it until I agreed with him, so I nodded.
"Have a boyfriend?" he asked.
I nodded to this too.
'Trouble with the boyfriend?" It wasn't a question, actu-ally1 he was already nodding for me. "Picking at yourself," he repeated. He popped out from behind his desk and lunged toward me. He was a taut fat man, tight-bellied and dark.
"You need a rest," he announced.
I did need a rest, particularly since I'd gotten up so early that morning in order to see this doctor, who lived out in the suburbs. I'd changed trains twice. And I would have to retrace my steps to get to my job. Just thinking of it made me tired.
"Don't you think?" He was still standing in front of me. "Don't you think you need a rest?
"Yes," I said.
He strode off to the adjacent room, where I could hear him talking on the phone.
I have thought often of the next ten minutesmy 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.
He strutted back into the room, busy, pleased with himself.
"I've got a bed for you," he said. "It'll be a rest. Just for a couple of weeks, okay?" He sounded conciliatory, or plead-ing, and I was afraid.
"I'll go Friday," I said. It was Tuesday, maybe by Friday I wouldn't want to go.
He bore down on me with his belly. "No. You go now.
I thought this was unreasonable. "I have a lunch date," I said.
"Forget it," he said. "You aren't going to lunch. You're going to the hospital." He looked triumphant.
It was very quiet out in the suburbs before eight in the morning. And neither of us had anything more to say. I heard the taxi pulling up in the doctor's driveway.
He took me by the elbowpinched me between his large stout fingersand steered me outside. Keeping hold of my arm, he opened the back door of the taxi and pushed me in. His big head was in the backseat with me for a moment. Then he slammed the door shut.
The driver rolled his window down halfway.
Coatless in the chilly morning, planted on his sturdy legs in his driveway, the doctor lifted one arm to point at me.
'Take her to McLean," he said, "and don't let her out till you get there."
I let my head fall back against the seat and shut my eyes. I was glad to be riding in a taxi instead of having to wait for the train.
This person is (pick one):
1. on a perilous journey from which we can learn much when he or she returns,
2. possessed by (pick one):
a) the gods,
b) God (that is, a prophet),
c) some bad spirits, demons, or devils,
d) the Devil1
3. a witch
Velocity vs. Viscosity
Insanity comes in two basic varieties: slow and fast.
I'm not talking about onset or duration. I mean the quality of the insanity, the day-to-day business of being nuts.
There are a lot of names: depression, catatonia, mania, anxiety, agitation. They don't tell you much.
The predominant quality of the slow form is viscosity.
Experience is thick. Perceptions are thickened and dulled. Time is slow, dripping slowly through the clogged filter of thickened perception. The body temperature is low. The pulse is sluggish. The immune system is half-asleep. The organism is torpid and brackish. Even the reflexes are di-minished, as if the lower leg couldn't be bothered to jerk itself out of its stupor when the knee is tapped.
Viscosity occurs on a cellular level. And so does velocity.
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. Digestion could kill you! What I mean is the unceasing awareness of the processes of digestion could exhaust you to death. And digestion is just an involuntary sideline to thinking, which is where the real trouble begins.
Take a thoughtanything1 it doesn't matter. I'm tired of sitting here in front of the nursing station: a perfectly rea-sonable thought. Here's what velocity does to it.
First, break down the sentence: I'm tiredwell, are you really tired, exactly? Is that like sleepy? You have to check all your body parts for sleepiness, and while you're doing that, there's a bombardment of images of sleepiness, along these lines: head falling onto pillow, head hitting pillow, Wynken, Blynken, and Nod, Little Nemo rubbing sleep from his eyes, a sea monster. Uh-oh, a sea monster. If you're lucky, you can avoid the sea monster and stick with sleep-iness. Back to the pillow, memories of having mumps at age five, sensation of swollen cheeks on pillows and pain on salivationstop. Go back to sleepiness.
But the salivation notion is too alluring, and now there's an excursion into the mouth. You've been here before and it's bad. It's the tongue: Once you think of the tongue it becomes an intrusion. Why is the tongue so large? Why is it scratchy on the sides? Is that a vitamin deficiency? Could you remove the tongue? Wouldn't your mouth be less both-ersome without it? There'd be more room in there. The tongue, now, every cell of the tongue, is enormous. It's a vast foreign object in your mouth.
Trying to diminish the size of your tongue, you focus your attention on its components: tip, smooth, back, bumpy, sides, scratchy, as noted earlier (vitamin defi-ciency), rootstrouble. There are roots to the tongue. You've seen them, and if you put your finger in your mouth you can feel them, but you can't feel them with the tongue. It's a paradox.
Paradox. The tortoise and the hare. Achilles and the what? The tortoise? The tendon? The tongue?
Back to tongue. While you weren't thinking of it, it got a little smaller. But thinking of it makes it big again. Why is it scratchy on the sides? Is that a vitamin deficiency? You've thought these thoughts already, but now these thoughts have been stuck onto your tongue. They adhere to the existence of your tongue.
All of that took less than a minute, and there's still the rest of the sentence to figure out. And all you wanted, really, was to decide whether or not to stand up.
Viscosity and velocity are opposites, yet they can look the same. Viscosity causes the stillness of disinclination, velocity causes the stillness of fascination. An observer can't tell if a person is silent and still because inner life has stalled or because inner life is transfixingly busy.
Something common to both is repetitive thought. Expe-riences seem prerecorded, stylized. Particular patterns of thought get attached to particular movements or activities, and before you know it, it's impossible to approach that movement or activity without dislodging an avalanche of prethought thoughts.
A lethargic avalanche of synthetic thought can take days to fall. Part of the mute paralysis of viscosity comes from knowing every detail of what's ahead and having to wait for its arrival. Here comes the I'm-no-good thought. That takes care of today. All day the insistent dripping of I'm no good. The next thought, the next day, is I'm the Angel of Death. This thought has a glittering expanse of panic behind it, which is unreachable. Viscosity flattens the effervescence of panic.
These thoughts have no meaning. They are idiot mantras that exist in a prearranged cycle: I'm no good, I'm the Angel of Death, I'm stupid, I can't do anything. Thinking the first thought triggers the whole circuit. It's like the flu: first a sore throat, then, inevitably, a stuffy nose and a cough.
Once, these thoughts must have had a meaning. They must have meant what they said. But repetition has blunted them. They have become background music, a Muzak med-ley of self-hatred themes.
Which is worse, overload or underload? Luckily, I never had to choose. One or the other would assert itself, rush or dribble through me, and pass on.
Pass on to where? Back into my cells to lurk like a virus waiting for the next opportunity? Out into the ether of the world to wait for the circumstances that would provoke its reappearance? Endogenous or exogenous, nature or nur-tureit's the great mystery of mental illness.
Reading Group Guide
The questions that follow are designed to enhance your group's reading of Susanna Kaysen's Girl, Interrupted. We hope they will provide you with new ways of looking atand talking abouta book whose style and subject matter are equally provocative.
1. The voice that narrates Girl, Interrupted may at first strike readers as cool, intellectual, rational, and controlled, qualities normally associated with sanity. It is a voice full of humor, characterized by an understatement that leaves much to the imagination. How, as we go deeper into the book, does the voice play against what it is describingor heighten it? What is the overall effect of this voice?
2. At what point, if any, does your perception of the narrator (whom for convenience we call "Susanna") change? Does Susanna's "unreliability" as the narrator suggest something about the nature of madness itself?
3. What does the author accomplish by juxtaposing her actual medical records and case notes with the narrative? How do these documents contribute to your impression of Susanna's psychic state? How would this book be different without them?
4. The narrator reveals little about her life before entering McLean Hospital, and the only biographical information we receive appears rather late in the book. Why do you think Kaysen has chosen to do this?
5. The narrator describes her sojourn in McLean as a journey into a "parallel universe," one of many that "exist alongside this world and resemble it, but are not in it." What resemblances or analogies does Kaysen find between madness and everyday reality? How are the laws of these two universes different? How does one pass from one universe into another?
6. Kaysen gives us two ways of experiencing her parallel universe. One way is to make us understand how madness feels; another is to show how madness is treated (or, more accurately, controlled). What effect does she create by giving us two opposing ways of understanding insanity?
7. Most of the early sections of Girl, Interrupted are devoted to the narrator's observations of her fellow patients. To what extent, if any, do these women seem "crazy" to you? What difference do you see in the book's treatment of "Susanna," the character, and its treatment of the other patients?
8. How does Kaysen describe McLean's "keepers"its nurses, doctors, and therapists? How do you account for the difference between the hard-bitten full-time staff and the wide-eyed student nurses?
9. In many ways McLean seems like an orderly place whose patients might easily be bored, slightly neurotic college students killing time in the dorm. Madness, real madness, creeps in insidiously, taking both reader and patients by surprise. At what points do we see madness intruding into McLean?
10. At certain points the author suggests that there is something comforting, and even seductive, about insanity. What might make madness comforting to a young girl in the late 1960sor, for that matter, to anyone at any time?
11. A girl named Daisy kills herself in between hospital stays. Is this foreshadowed by what we already know about her? Why this patient, rather than another? To what extent is the behavior of any of these characters foreseeable?
12. Susanna has no apparent reaction to Daisy's death, but after Torrey, another patient, is released into the custody of her neglectful parents, she has an episode of what her case report calls "depersonalization" [p.105] and mutilates her hands to see if "there are any bones in there" [p.103]. Why? What is she looking for underneath her skin? What is the effect of the graphic physicality of this chapter?
13. The narrator sums up her release from McLean in the following way: "Luckily, I got a marriage proposal and they let me out. In 1968, everybody could understand a marriage proposal." What does this passage say about the choices available to female psychiatric patientsand, by extension, to any womanat the time this book takes place?
14. The narrator describes 1968 as a time when "people [outside the hospital] were doing the kinds of things we [the patients] had fantasies of doing" [p.92]; a patient's paranoid "delusions" might turn out to be accurate descriptions of the U.S. government's clandestine activities. What other connections does Kaysen draw between her characters' disturbance and the social paroxysms of their time? In what way is this book a document of the 1960s?
15. How does the narrator feel when she meets Georgina and Lisa in the outside world, years after her release? What comparison can we make between the way Susanna sees their lives and the way she sees her own?
16. How does the madness of the 1960s compare to the private and collective neuroses of Freud's Viennaor to the spectacular symptoms (Multiple Personality Disorder, False Memory Syndrome) of the 1980s and '90s?
17. One reviewer has noted that someone with Susanna's symptoms would today be given "60 days in-patient [treatment] and a psychotropic magic bullet. In 25 years, the cultural metaphor...has changed from incarceration to neglect." Is "neglect" preferable to "incarceration"? How do you think Kaysen might answer such a question?
18. Another critic begins her review of Girl, Interrupted with the observation: "When women are angry at men, they call them heartless. When men are angry at women, they call them crazy" (Susan Cheever, "A Designated Crazy," The New York Times Book Review, June 20, 1993). In what ways is Girl, Interrupted a book about the sexual constructs of madness? What role does the narrator's gender appear to have played in her diagnosis and treatment? How do gender relations inside McLean mirror those in the outside world?
19. What is the significance of the Vermeer painting "Girl Interrupted at Her Music" that appears in the last chapter? How did Susanna feel about the painting the first time she saw it? And how did she feel about it later, after her hospitalization? Why does the gaze of the music student in the painting so haunt her?