From the start, even Winona Ryder had her doubts as to whether Susanna Kaysen’s Girl, Interrupted be translated onto the screen. In fact, despite being optioned within a year of the book’s release in 1993, no one thought it could be adapted.

The script went through two writers, Lisa Loomer and Anna Hamilton Phelan, and eventually the film’s director, James Mangold, took over the task of adapting the novel. Two years after he began, Mangold felt that he had captured something that could be both cinematically successful and remain true to the original work.

Kaysen’s novel took her three years to write, after avoiding the subject all together for nearly twenty years. Within the first few pages, Susanna is whisked off to McLean Hospital, after a doctor she has only just met informs her that she needs a rest. However, it isn’t until several chapters later, and after meeting the other women at the hospital with her, that Kaysen starts to dive into what was going on inside her mind. As Kaysen writes:

"But I wasn’t simply going nuts, tumbling down a shaft into Wonderland. It was my misfortune- or salvation- to be at all times perfectly conscious of my misperceptions of reality. I never “believed” anything I saw or thought I saw. Not only that, I correctly understood each new weird activity."

At the time of its release and the years that followed, Kaysen’s work received a wide range of acceptance. Many people, like Ryder, could easily relate to the story, and for some Kaysen became a cult-like figure. About her own reaction to reading the novel, Ryder once said:

"Susanna Kaysen’s book just really captured a mood - that time in your life that is so confusing and so lonely and so oddly funny and weird. She captured it with such honesty yet without being self-indulgent, which is something I hadn't seen captured since Salinger wrote Catcher in the Rye."

However, not everyone was enthralled with Girl, Interrupted. It was written at a time when memoirs were just starting to flood the literary market. Kate Harrison’s The Kiss, Frank McCourt’s Angela’s Ashes, Michael Ryan's Secret Life and a number of other memoirs all meet varying degrees of success in the 90’s, both as novels and as films. In many ways, the memoir is a literary equivalent to the recent voyeuristic obsession in American culture with the popular reality television programming. The authors open up their lives, for better or worse, to the eyes and imagination of the reader. Recent memoirs have been about everyday people, rather than historical figures as memoirs have largely been based around in the past, which allow the reader to have a different level of interaction with the characters.

Although her experience of being at McLean is the focus of the book, with mental illness as the centerpiece, the underlying themes that impressed Mangold the most and what he decided to explore in the film. While the earlier versions of the screenplay worked on adapting events in Kaysen’s novel, Mangold set to tackle something less tangible- the relationships and bonds that the women in the hospital formed and the emotions that the girl’s were working through. In a press conference before the film’s opening, Mangold said:

"It was just kind of these series of vignettes in a mental institution which were neither saying it was a terrible place or a great place but were just kind of events,… I felt like someone had to attack the material with vigor, also more loyalty to the feelings, themes and points of the book."

Mangold’s commentary on the film’s DVD provides a lot of insight into what he was trying to do with his adaptation. With no classical structure to follow, Mangold stared by looking for a concrete place to take the film. He talks at great lengths about wanting to avoid that traditional pit falls of “chick flicks,” while at the same time wanting to create something that transcends the genre of the mental illness films.

Many of the films he credits as inspiring his work with Girl, Interrupted are also literary adaptations. Mangold “hitched his thematic star to” The Wizard of Oz, which he felt provided him with something other than mental illness to draw upon. Not only did the film influence the structure and look certain shots (he compares Susanna entering the ward for the first time to images of Dorothy stepping into Oz for the first time), but it also influenced how the dynamics between different characters were constructed. He also saw The Wizard of Oz as a fable that could provide him with a solution to his adaptation.

Unlike other mental illness films, Mangold argues that there is no revelation of a secret in the third act that sums up Susanna’s problems. In Ordinary People, Conrad (played by Timothy Hutton) reveals that he feels great guilt over not trying to save his brother. In Good Will Hunting, Will (played by Matt Damon) reveals that his father beat him as a child. Staying true to Kaysen’s memoir, Mangold doesn’t create a secret for the sake of dramatization, but instead draws upon The Wizard of Oz again, and alludes to the similarities between Susanna’s illness and Dorothy’s ability to go home whenever she wanted with the secret imbedded in the journey itself. Mangold takes the connection even farther by using a clip of The Wizard of Oz in the film, and by closely tying the film to Susanna’s roommate, Georgina.

When Mangold first sent Girl, Interrupted to the editors, it was nearly three hours long. In the end, its final running time was a little over two hours. The DVD edition of the film provides the viewer with a look at some of the deleted scenes. Interestingly, it is these scenes the give a much stronger notion of the film being a memoir in and of itself, and truly capturing the essence of Susanna. Mangold allowed in these scenes for the viewer to see the effects of Susanna’s mental illness through her own eyes, without having to be told explicitly what she is feeling or thinking.

Some of these deleted scenes were additional flashbacks, originally intended to go after she turns the professor away. It is in these scenes that Mangold visually communicates the problems that Susanna was having at the time. Kaysen writes:

"I was having a problem with patterns - Oriental rugs, tiled floors, printed curtains - things like that. Supermarkets were especially bad because of the long, hypnotic, checkerboard aisles. When I looked at these things, I saw other things within them. That sounds as though I was hallucinating, and I wasn't. I knew I was looking at a floor or a curtain, but all patterns seemed to contain potential representations which, in a dizzying array, would flicker, briefly, to life. That could be a forest, a flock of birds, my second grade class picture. Well, it wasn't. It was a rug or whatever it was. But my glimpses of the other things it might be were exhausting. Reality was getting too dense."

Mangold shows the shadows of leaves on her wall mutating into the other things that Susanna saw, her hand mutating, the door knob of the bathroom turning when no one is there, and he shows Susanna looking at a bottle of aspirin. He later tries to do something similar with the final chapter, where Kaysen eloquently writes a description of seeing the Vermeer painting Girl Interrupted at Her Music. While in Boston with Lisa, there were several scenes that later were cut from the sequence, including Susanna at an art museum. Mangold seems nearly obsessed with not letting the movie drag, and often uses that has his excuse for cutting these scenes.

Susanna Kaysen and Borderline Personality Disorder

In the book Girl, Interrupted, the young female character Susanna Kaysen offers as herself meets the criteria for Borderline Personality Disorder (BPD) as outlined in the Diagnostic and Statistical Manual of Mental Disorders 4th Ed, although meets the relatively less crippling conditions of the disorder. Kaysen fits into basic age-range of the disorder as proposed in the DSM-IV, having BPD characteristics present by “early adulthood.” To be diagnosed with BPD, Kaysen must meet five of the nine decisive factors listed in the DSM-IV. Clues from her autobiographical account can be used to verify or dismiss each criterion.

Kaysen suffers from an identity disturbance as detailed in the DSM-IV. Her “unstable self-image” often oscillated between perceiving herself as having a mental disturbance and her not having one. During her short time as a professional typist, she found herself as the “one person who had trouble with the rules. Everyone else accepted them.” Yet, her strong beliefs against the rules contrasted with the social message that she was disruptive. She described her mental processes as a conversation between two interpreters, a conversation that is often contradictory. Even after leaving the hospital as a supposedly recovered patient, Kaysen questioned whether she had been perhaps purposely “flirting with madness” the way she flirted with others in her life. This instability of her understanding of herself supports Kayson meeting third criterion for BPD.

Kaysen also suffered from “recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.” Her persistent thoughts of suicide resulted in a serious attempt. The mental unrest that led to Kaysen’s attempted suicide manifested itself as self-mutilating behavior once she began in-patient treatment. “I spent hours in my butterfly chair banging my wrist.” She admitted this was self-mutilating behavior and discussed other behavior of this type, such as face scratching. This sort of activity accounts for the fifth criterion for BPD.

The DSM-IV calls for an “affective instability due to a marked reactivity of mood,” such as “intense episodic dysphoria, irritability, or anxiety usually lasting a few hours.” Kaysen often became irritated by customary stimulation of everyday life. For example, while visiting the ice cream parlor, and other places, she would become fixated and internally aggravated by the shape and contrast of the checkerboard tiles. “The contrast got under my skin. I always felt itchy at the ice cream parlor.” Kaysen also discussed an overexcited state of mind that she called “velocity.” She often reverted to this frenzied thought process when confronted with seemingly ordinary situations. This pattern of reactivity suggests Kaysen meets the sixth criterion for BPD.

Another criterion for BPD, as put forth in the DSM-IV, is “chronic feelings of emptiness.” Kaysen thought of her personality as broken, a notion associated with feelings of emptiness. “I imagined my character as a plate or shirt that had been manufactured incorrectly and was therefore useless.” In fact, Kaysen claimed her feelings were beyond emptiness: “Emptiness and boredom: what an understatement. What I felt was complete desolation. Desolation, despair, and depression.” These self-reported qualities strongly suggest Kaysen meets the seventh criterion for BPD.

Finally, Kaysen endured “transient, stress-related paranoid ideation or severe dissociative symptoms,” which the DSM-IV suggests as properties of the borderline personality. While debating to commit suicide in the period before her admittance, Kaysen explained, “Anything I thought or did was immediately drawn into the debate. Made a stupid remark—why not kill myself?” This sort of idea creation in the face of stress is typical of BPD. “Paranoid ideation” came to Kaysen not only as unhealthy thought formation, but also as ideas of reference. She believed the Vermeer painting in the museum had a special message just for her. “She was warning me of something—she had looked up from her work to warn me.” Still, her dissociative symptoms surpassed her paranoid ideation. Kaysen suffered from the dissociative mindset of depersonalization. She often dissociated her thoughts from her body and saw herself from an outside perspective, where she became to herself an object to be prodded and examined. In one such episode, her self-concept degraded into an understanding of herself as first a monkey, and then just ordinary matter. She became restlessly unsure as to her own material composition and whether or not she was in fact a human. “I started to get worried. Where were my bones? I put my hand in my mouth and bit it, to see if I crunched down on something hard… I was getting really nervous. Oh God, I thought, there aren’t any bones in there, nothing’s in there.” These exceedingly paranoid internalizations demonstrate Kayson meets the ninth criterion for BPD.

Ultimately, Kaysen meets the criteria for BPD because she qualifies for five of the disorder’s criteria. An example of a criterion her character as portrayed in Girl, Interrupted does not meet includes the first criterion, “frantic efforts to avoid real or imagined abandonment.” Kaysen often expressed wishes to be alone. After abandoning her husband, she avowed, “I wanted to be going on alone to my future.” Kaysen repeatedly articulated discomfort with being monitored in the hospital, a schedule of social affirmation others with BPD might find comforting. She also does not seem to meet the criterion that calls for “inappropriate, intense anger.” Perhaps the author left out accounts of her own displays of temper or instigation of physical fights. Still, her character meets the criteria for BPD, albeit a less aggressive and more internalized form of the disorder.

2nd of December, 2010 20:00 GMT+10:30

A fancy iron balustrade interrupted at intervals my vision of the rear half of three hundred persons seated on wooden pews. The front half which I could see clearly were formally or at least dressily attired, the front few rows of the left-hand side wearing long black gowns with brightly coloured ribbons draped over them. Behind and beside me sit nearly a hundred more, momentary flashes emanating from cameras in their hands every so often. The old hall's lights are dimmed bar those aimed at the large stage at the very front. Wooden partitions taller than human height stretch from one side of the stage to the other about halfway down, making it appear much smaller to those seated down below. The far left of the stage is occupied by a lectern manned by a distinguished but biologically unrelated man and woman. A bare nothingness separates them from a grand piano on the far right. The occupants of the hall, myself included, burst into a roar of applause as another figure rises from her seat and paces unsteadily forward on three inch heels. I consider a wolf-whistle, but refrain. I am here because she asked me to be. Well, here in this building because she asked me to be, here in this seat because I prefer the view.


Again the audience rises in a standing ovation as a tall brunette ends an inspiring but weirdly modulated three page summary of the year. My eyes shift immediately from the valedictorian to the third row of seats, and I watch in disbelief as a girl returns to her heels. The crowd billows like a mushroom, and the gowned group file out like gliders from Game of Life, leaving the rest to disperse like thrown confetti. My seating position at the front allowed me to maintain a good few metres distance ahead of the others flooding the narrow carpeted passage. I reached the ground floor, and wove through the throng congregating in the vestibule toward the main double oak doors that were over a hundred years old. I cut a parabola over the main stairs rather than walking down them, and dropped heavily to the old granite stone pavement. A figure streaked towards me from out of the moonlit shadows, and a moment later long dark hair covered my face, blotting out my view, arms engulfed me like a recovery claw, a pair of firm breasts pressed themselves against my chest, and weight equal to or greater than that of my own body mass skewed my centre of gravity. I stumbled sideways, regaining my balance, and swung my new payload round full circle.

We stood motionless, staring, grinning, speechless, having disentangled ourselves from each other's embrace. Where was the red-headed girl with the knee-high black goth boots, striped tights, denim mini-skirt, random tight-fitting t-shirt, tattered backpack and ridiculously overdone makeup? Where was that little girl she was always with, cuddled up together somewhere? Had she been stolen from me? Tonight stood before me instead a woman lady of the same build and height, except slightly taller due to the shoes, with dark flowing hair, close to perfectly chosen and applied makeup, black cardigan hiding the top of a floral print dress of various browns, and a respectable length, and semi-opaque black nylons. From her shoulder hung a handbag big enough to smuggle a small animal out of a zoo in, and in her hand she held a laminated A4 sheet with all official-like embossings on it.

"I... You... I almost can't believe tonight is... Thank you." She wrapped her arm tightly around me from the side and beamed, and pressed a face on the verge of tears into my shoulder, and walked silently back into the crowd with me in search of her mother.

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