Girl, Interrupted | Etiology | Summary

Summary

The field of etiology, from which this chapter takes its name, is the study of what causes diseases. The chapter offers a mock questionnaire with 10 questions about the causes of an imaginary patient's illness, most of them absurd by today's standards of psychiatry. Some of the questions relate mental illness to the supernatural; others discuss historical treatment options such as electroshock and purging with leeches. While much of the questionnaire echoes old-fashioned notions of witchcraft and devil worship, the last two questions hit the heart of the matters explored in the memoir: Has the world gone mad, or is Susanna, in fact, insane? And is she, in fact, suicidal?

Analysis

The mock questionnaire is poignant and funny at the same time, highlighting absurd explanations of mental illness that have long been revealed as absurd. Today's medical establishment acknowledges that neither witchcraft nor devil worship have anything to do with mental illness. However, expressing notions of mental illness through historical and social values implies that modern ideas of mental illness may also be biased by historical and social preconceptions. Suddenly, the idea that promiscuity is a symptom of mental illness no longer seems absolute or scientific but rather the result of the social values of the 1960s. The questionnaire draws parallels between perceiving mental illness as caused by demonic possession and believing a sexually experienced woman is promiscuous and, hence, insane.

The questionnaire places in doubt the idea that the medical establishment has all the answers regarding diagnosis and treatment of mental illness. Bloodletting, a medieval treatment based on the idea that a fluid imbalance causes mental illness, has long been discarded. However, McLean in the 1960s still uses shock therapy (popular in the 1930s) and Thorazine (popular in the 1950s). Comparing these treatments to medieval bloodletting suggests that even modern treatment options might deserve more scrutiny. There is no simple explanation or treatment option for as complex a diagnosis as mental illness.