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Girl, Interrupted | Study Guide

Susanna Kaysen

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Girl, Interrupted | Summary

See Plot Diagram


Signing into McLean

In April 1967, at age 18 Susanna Kaysen admits herself to the McLean Hospital, a psychiatric facility in Belmont, Massachusetts, at the insistence of a psychiatrist who has interviewed her for only 20 minutes, interpreting her nonconformist behavior as borderline personality disorder. Although she plans to stay for only a few weeks, she ends up staying for almost two years. The memoir questions whether her prolonged stay was medically necessary or a result of the overreaction of a zealous medical establishment.

The Girls

The memoir comprises a series of seemingly unconnected vignettes interspersed with official documents and forms, chronicling life on the ward for teenage girls. Susanna introduces some of these girls. Polly, who is disfigured from having set herself on fire, enjoys hero status on the ward until it becomes clear that her disfigurement will forever define her. Lisa Rowe, a self-involved sociopath with a strong personality, regularly tries to escape, and, once caught and returned, plays pranks on the staff to show her contempt. Considered the one with the most severe diagnosis, Lisa is the leader of the pack. Georgina, Susanna's roommate—like Susanna, diagnosed with depression—entertains a sexual relationship with Wade, another patient at McLean. Wade's father supposedly works for the CIA and has inside information about John F. Kennedy's assassination. Daisy is a regularly returning temporary patient with an obsessive penchant for chicken and laxatives. She seems to get a chance to permanently escape the ward when her father buys her an apartment, yet she ends up killing herself on her birthday.

What is Madness?

James Watson, a family friend who received the Nobel Prize in Physiology or Medicine for his work on DNA, comes to McLean and suggests that Susanna run away with him to England. Susanna, taken aback by the absurd notion of living in England, decides to stay at McLean to recover. She recalls her suicide attempt by comparing the preparation, planning, and determination needed to succeed in suicide to the qualities needed for premeditated murder. She concludes that she failed to kill herself because she didn't have a strong enough motive. She made the attempt because she didn't want to do her homework and sought to escape the existentialist questions bombarding her mind. She admits that her perception of reality is not like that of others, explaining that she sees things that are not there when she looks at patterns in rugs and tiles, making it difficult for her to distinguish reality from illusion. Wondering whether others see similar patterns, she suggests that insanity might just be "dropping the act." Given that many former patients of McLean have been poets and songwriters, she wonders whether poetry drives people mad or whether mad people express themselves in poetry and song.

Life at McLean

The rhythm of life at McLean Hospital and the rules regulating it seem like a well-choreographed dance or a carefully structured poem. It is shaped by regular room inspections at timed intervals, a complicated nurse-to-patient ratio during outings off the hospital grounds, and the confiscation of everyday items (such as hairpins or belts) for fear they might be used by the patients to hurt themselves or each other. All these rules and routines restrict the girls' freedom, privacy, and dignity. The lack of regular interaction with outside visitors adds a sense of isolation; the girls have only each other.

When a new patient named Lisa Cody arrives and is diagnosed as a sociopath, the other Lisa (Lisa Rowe) feels threatened in her position as the girls' leader. Lisa befriends Lisa Cody at first but turns against her, manipulating her to run away. Lisa takes pride in having turned Lisa Cody into a "real junkie," like herself.

Susanna offers a closer look at her own mental illness, taking issue with the fact that the psychiatrist who admitted her claims to have interviewed her for three hours while she remembers only a 20-minute consultation. The hospital records available support either claim. The question of what is true seems unanswerable. She goes on to describe two different manifestations of madness, one characterized by viscosity, where the patient feels as if she is slowly wading through a swamp; and the other characterized by siege, where the patient feels under attack by a never-ending series of thoughts and questions. Both manifestations render the patient immobile, unable to make decisions.

The Staff

The girls share their life on the ward with their keepers: the nurses and doctors treating and caring for them. Valerie, the head nurse, is close to the girls in age, relates well to them, and speaks her mind, even against the authorities, earning their respect. Dr. Wick, on the other hand, an older woman from a different country, has little understanding of American youth culture; in her prudishness, she cannot communicate with the girls. Mrs. McWeeney, the night nurse, runs the floor like a prison ward, and the girls stay on their best behavior to avoid her unpredictable rants and rages. The student nurses working the ward occasionally live the lives the girls could have led and thus act as proxies for them. Wishing to protect their proxy lives, the girls act on their best behavior with the student nurses. The staff reflects the gender bias of the era: all the nurses except one are female, while all the doctors except one are male.

Things Must Get Worse Before They Get Better

A year has passed, and the girls watch the events of 1969 unfold on TV. They feel a kinship with the student unrest and civil rights movement—the underdog revolting against the establishment. This gives them a sense of hope, yet they realize quickly that in actuality, as mental patients confined to McLean, history is passing them by.

To Torrey, a new patient suffering from an amphetamine addiction, the ward at McLean is a refuge from an emotionally abusive family in Mexico. When her family comes to pick her up, the girls try to help her escape, but Valerie drugs Torrey. Realizing that they are utterly powerless, the girls hit rock bottom. Susanna suffers a mental breakdown, and in an episode of depersonalization, tears open her skin in search for her bones. A similar episode occurs when she desperately tries to account for the time she lost when a dentist removed her wisdom tooth.

Alice Calais, a new patient who at first seems rather well adjusted, suffers a mental breakdown and is moved to the maximum security ward. There the patients are isolated in cells, lost in their own world, and live under horrible, even unsanitary conditions. Realizing that their situation can get far worse, the girls rededicate themselves to recovery. Susanna begins therapy sessions with Melvin, and soon she's allowed to go to and from these sessions without supervision.


Preparing for her release, Susanna applies for jobs. Thinking back to a job she held as a typist before her stay at McLean, she contemplates gender inequality in the workplace. Thinking ahead, she is concerned about the stigma that goes with mental illness. Applying for a job, an apartment, a driver's license, and even telephone service requires medical clearance. Discussing her diagnosis of borderline personality disorder, she rejects some of the supposed symptoms (such as promiscuity and other nonconformist behavior), noting that such labels are relative. A man, for example, would likely not be called promiscuous as quickly as a woman would. She concludes that insanity, like most everything else, is defined by historical and social circumstances.

Life Beyond McLean

After her release, Susanna runs into Georgina and Lisa. The two illustrate different levels of social integration. Georgina is socially awkward. Now married, she lives on an isolated farm in Colorado. Lisa is raising a child on her own in Brookline, an upscale suburb of Boston. Susanna reveals that she herself got divorced.

Susanna revisits the Vermeer painting she saw years before while visiting New York City with her English teacher. She interprets the meaning of the scene very differently this time. Back in high school, she was teetering on the brink of an affair with her teacher, of graduating, and of going to McLean. She thought the woman in the painting was telling her not to head in any of those directions. Sixteen years later, she interprets the meaning of the scene very differently, seeing it as the image of a woman held back by a male proprietor. Susanna recognizes her own vulnerability at age 17, how her life was "interrupted" by the circumstances in which she lived. Susanna's different interpretations of the painting depend on her own circumstances, suggesting that the meaning of art, like most everything else, is relative and lies in the eye of the beholder.

Girl, Interrupted Plot Diagram

Falling ActionRising ActionResolutionClimax123456789101112Introduction


1 Susanna is diagnosed with a borderline personality.

Rising Action

2 Susanna signs herself into the McLean Hospital.

3 Polly realizes she is trapped in her scarred skin forever.

4 Lisa Rowe runs away, is brought back, and plays a prank.

5 Daisy commits suicide.

6 Lisa Cody runs away and becomes a junkie.

7 Alice is moved to the maximum security ward.

8 Susanna suffers a mental breakdown.


9 Susanna undergoes therapy with Melvin.

Falling Action

10 Susanna accepts a marriage proposal.

11 Susanna is released.


12 Susanna revisits the Vermeer painting.

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