Girl, Interrupted | Study Guide

Susanna Kaysen

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Girl, Interrupted | Themes


Susanna Kaysen's memoir explores moral ambiguities—the gray zones between true and false, real and imagined, right and wrong, good and bad. The book argues that truth and lies depend on one's perspective, and its themes illustrate that values are relative and absolutes don't exist. The memoir also presents a candid view of the struggles faced by patients in a mental hospital.

Nonconformity Versus Insanity

Diagnosed after only a short interview with a psychiatrist who had never seen her before, Susanna wonders whether her prolonged stay at McLean Psychiatric Hospital is justified. The doctor's conclusions seem hasty and overzealous, not based on careful examination but on gender bias—preconceived ideas of a woman's proper and sane behavior. Susanna had a boyfriend and then had an affair with her English teacher, wore miniskirts, and showed little interest in school. These character traits seem insufficient to define her as promiscuous, depressed, and detached in today's more permissive society. The diagnosis seems rooted in a misunderstanding of the youth culture of the 1960s. Teenagers are supposed to experiment, seek change, and rebel against old-fashioned values in an effort to find the path that's right for them; this idea was particularly true in the 1960s.

Her diagnosis suggests that "normal" is relative, as is insanity. Susanna admits to self-destructive behavior, which to her is a hallmark of a mental disorder, yet not all mental disorders are the same. Although she has comparatively mild symptoms, Susanna is locked up at McLean with fellow patients such as Polly and Lisa, who show far more severe signs of mental disturbance. Other patients, like Daisy and Torrey, are released despite the severity of their issues—prematurely, as Daisy's suicide shows.

What is sane and what is not? Who is "crazy" and who is not? The memoir shows that the definitions of sane and crazy are too complex to make with certainty, and the consequences of a mistaken diagnosis are too grave to make a judgment hastily.

Deciphering the Truth

The memoir uses actual documents from Susanna's case file to illustrate and offset Susanna's narrative. The documents serve as evidence that her story is firmly based in factual reality, although it is told by a woman who has been diagnosed with a mental illness. The forms provide the data: her age, address, religion, family background, physical examination notes, and therapy session notes. Contrasting these forms with her own narrative, Susanna shows that facts are only part of the story. Facts alone cannot capture an experience, and they can be interpreted in many different ways.

For example, Susanna remembers that the initial session with the psychiatrist who referred her to McLean took about 20 minutes; the psychiatrist, however, claims it took three hours. Susanna provides two admissions forms, one from the admitting doctor and one from an admitting nurse. The doctor's form claims she was admitted at 11:30 a.m., which supports Susanna's version of events. The nurse's form, however, states that she was admitted at 1:30 p.m., which supports the psychiatrist's version of events. Because both versions of events have factual evidence, it is impossible to know which one is the truth. Truth, the memoir suggests, depends on one's perspective.

Susanna also struggles with sensory perception. Looking at anything with a pattern in it, such as a rug, is a challenge. She might see a mountain range in the folds of a curtain; when she sees black and white tiles on a floor she becomes paralyzed. She interprets contrasting colors as opposites, such as good and bad, right and wrong, true and false. Susanna cannot decide which is which, for what is true to one person may be false to another. The memoir suggests that because sensory perception can play tricks on a person, it is impossible to decide who is right or wrong, good or bad, and sane or mad. In a world full of moral ambiguities, the lines between these opposites are forever blurred.


The description of the mental ward at McLean is eerily reminiscent of a prison ward. The windows are covered with security screens similar to prison bars; the girls are subject to regular room inspections and not allowed to use anything that could cause physical harm; and most important, the girls cannot leave at their whim. The patients are at the mercy of the staff who supervise their every move, including bathroom breaks, and control their medication and privileges. There is no freedom on the ward, not even the freedom of time alone. The only way to get some privacy is to submit to the seclusion room, which the girls can enter but not leave at their own discretion. In short, the girls are incarcerated and isolated from the outside world.

Being mentally ill isolates the patients in other ways. Susanna's family never comes to see her at McLean, and her boyfriend stops visiting her there after a few attempts. Even those patients who are in touch with their families, like Torrey or Daisy, remain isolated because their loved ones fail to understand them. And while there is camaraderie among the girls, the constant supervision and scrutiny makes true intimacy between them impossible. The girls are also isolated from one other by their mental disorders, which, in varying degrees, make emotional bonds impossible. Lisa Rowe can never genuinely bond with the other girls because self-interest is part of her pathology as a sociopath. Her fast friendship with Lisa Cody is designed to gain Lisa Cody's trust so that Lisa can humiliate and destroy the other girl.

Isolation has positive aspects, however. On the ward, the girls have no responsibilities. They do not have to do homework or chores, deal with parents, look for a job, or make money. They do not have to fulfill any expectations because nobody expects an insane person to be a productive member of society. After all, their inability to function in society is part of the reason why they have ended up at McLean in the first place. In short, locked up at McLean, they are free to be who they truly are: mad.

Throughout, the memoir suggests that McLean provides shelter and reprieve from a dangerous world outside. Every time Lisa returns from a runaway stint, she is relieved because "there's nobody to take care of you out there." On the ward, Torrey feels safe from an emotionally abusive family and an environment that pushes drugs. Even Daisy's suicide, Kaysen suggests, could have been prevented had she stayed at McLean.

Women's Liberation

In the 1960s, women's liberation was an emerging movement. Women faced openly different rights, standards, and expectations. Most positions of power were filled by men. At McLean all doctors but one are male, and all but one nurse is female. When Susanna worked as a typist, supervisors were male while all typists were female, and the supervisors had more privileges and fewer restrictions; for example, the men could smoke and didn't have to follow a strict dress code. Women were relegated to submissive roles, poignantly illustrated in the memoir when Susanna is released from McLean after she accepts a marriage proposal. Once she submits to a stereotypical role, she is thought to have recovered.

However, the memoir foreshadows a different future for Susanna in particular and women in general. Susanna's marriage does not last, and she becomes an independent writer, very much in charge of her own life.

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