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Girl, Interrupted—Cuckoo's Nest Redux

By Elaine Cassel

Almost twenty years after her two-year commitment to a psychiatric hospital, Susanna Kaysen wrote Girl, Interrupted (Vintage, 1994). The movie of the same name stars Winona Ryder as the 17-year-old depressed, rebellious, promiscuous, and suicidal Susanna. Diagnosed with borderline personality disorder, her parents committed her to a private Massachusetts psychiatric hospital. A combination of circumstances—failure to follow hospital rules, involvement with some of the hospital's "trouble-makers," repeated suicide attempts, and lack of progress in treatment, resulted in Susanna's two-year stay, a long time even in those days.

While the book focuses on Susanna's mental state while hospitalized, the movie depicts the interaction between Susanna and several teenage girl residents exhibiting a variety of maladaptive behaviors (self-mutilation, pathological lying, and antisocial personality disorder, to name a few), the residents' conflict with the hard-charging psychiatric nurse (played by Whoopi Goldberg), and the dehumanizing aspects of psychiatric hospitalization. Underlying the action is a social commentary straight from Thomas Szasz, who believes that society is insane—not mental patients.

Girl, Interrupted revisits the themes of Milos Forman's One Flew Over the Cuckoo's Nest. Whether the patients are men (Cuckoo's Nest) or women (Girl, Interrupted), the setting public (Cuckoo's Nest) or private (Girl, Interrupted), some things never change. The health care professionals have neither competence nor compassion and are at war with their "crazy" inmates. Girl, Interrupted, like One Flew Over the Cuckoo's Nest, contains some unfair stereotypes of patients and professionals and often strays beyond the bounds of credibility.

The release of Girl, Interrupted is uncannily timely. Ironically, while One Flew Over the Cuckoo's Nest played an important role in crystallizing public policy in favor of deinstitutionalization, Girl, Interrupted appears at a time when mental health professionals and policy makers are questioning the effects (if not the good intentions) of the release of tens of thousands of mentally ill people into an inadequate community mental health system. Recent high profile violent crimes committed by people with a history of schizophrenia, demands for mental health insurance parity, and the Surgeon General's report on the state of the nation's mental health are likely to lead to changes in the provision of services for the mentally ill.

To Kaysen's memoir, director James Mangold added plot, character development, and sociopolitical sermonizing. If you want to experience Kaysen's commitment as she remembered it, read the book of the same name. You can find a reading group study guide for the book online at

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