There are many movies that depict mental disorders such as schizophrenia, anxiety disorders, personality disorders, and many more. Girl Interrupted portrays several women with different disorders. How precise is this movies to the actual symptoms, diagnosis, and treatment, to the disorder? We will discuss and compare these issues.
Susanna Kaysen spent two years in a psychiatric hospital, McLean. Twenty-five years after her release she began to write a memoir about her stay. Once it was completed her memoir was converted into a movie called Girl Interrupted. This movie reveals Kaysen's passage from adolescence to adulthood. This movie is based on actual events.
Winona Ryder stars as Susanna Kaysen, who is struggling to find independence, and integrity. In 1967, 17 year young Susanna, attempted suicide by combining a bottle of asprin with a bottle of vodka. She was sent away in a taxicab, after a session with a psychiatrist. The taxi's destination was Clay Moore, a mental institution.
A short period of rest was recommended. Once at the hospital she meets a wide range of people including Daisy, who has a predilection for rotisserie chicken and laxatives, Polly, who is a burn victim, Georgina, who is a compulsive liar, and Lisa, who is a fascinating sociopath. Lisa and Susanna form a tight friendship bond during her stay. Kaysen meets with her parents and a different psychiatrist, while in Clay Moore. It was during that meeting that she found out she had a disorder. She thought she was just an ordinary girl, trying to make sense of her life, and was only there for a short rest. Borderline Personality Disorder was her diagnosis. Susanna recovered from her condition after staying there for one year. This movie questions the boundaries of freedom and confinement, madness and sanity, and friendship and betrayal.
The disorder that Kaysen has is very well portrayed in this movie. As defined in our textbook, Borderline Personality Disorder is 'a personality disorder in which an individual displays repeated instability in internal relationships, self-image, and mood, as week as impulsive behavior'.
We will explore the cause, symptoms, and treatment of Borderline Personality disorder (BPD) and how they are presented in Girl Interrupted.
Why is this disorder called "borderline"? People with this disorder feel they are living on the border of life and death, between being and not being competent in the world, and between sanity and insanity. The life of someone with borderline personality disorder may look normal to others, but the person with this disorder doesn't feel normal.
Only two percent of the general population suffers from this disorder and seventy-five percent of those are women (Comer). What causes the disorder? We will view several different theories. Some believe that the exact cause for this disorder in unknown. Others like John Oldham, believe it is caused by a combination of environmental circumstances and genetic influences, and many believe that it always stems from their childhood of sexual abuse and physical abuse. In the movie, Susanna showed no signs of neglect in her childhood. Why then, did she obtain this disorder? Psychiatrist Kenneth Silk may be able to answer this question. He suggests that BPD behavior may be influenced by neurotransmitter disturbances, which is a viewpoint of a biological theorist.
Biological abnormalities have been connected to BPD. 'Neurotransmitters carry the signals between all the nerve cells in the brain. They underlie every thought and emotion, as well as memory and learning. About fifty different neurotransmitters have been discovered thus far. The neurotransmitter dopamine involves thinking. Impulsivity and aggression are associated with serotonin, mood stability with acetylcholine, and sensitivity to the environment with norepine-phrine. People with BPD may have difficulties in all of these areas' (Kreger). BPD patients are found to have lower brain serotonin activity. If someone in your family is diagnosed with BPD, you are five times more likely to be diagnosed with it.
Psychodynamic theorist concentrate on early parental relationships. They propose the BPD patients lacked acceptance by their parents, which lead to low self-esteem, increased independence, and unable to cope with separation. Research has shown that the patients that are diagnosed with this disorder are consistent with this view. The childhoods were marked with divorce, trauma, and death. The parents of the individual rejected or neglected. The patterns were almost the same through many of the diagnosed patients.
Another theory of the cause is the environmental approach. The rapidly changing environment causes instability. Which in change, leave the society with problems of identity, heightened anxiety, a sense of emptiness, and fear of abandonment.
The exact cause for Susanna Kaysen was unknown; the movie didn't go into detail about her childhood. From what was observed through her parent interactions, there was no sign that it could have stemmed from her childhood.
How do you tell if someone has BPD? There are symptoms that occur, they can range from mood instability to suicide. According to Borderline Syndrome: A personality Disorder of Our Time, some of the symptoms are as followed:
ÃÂ·Relationships with others are intense and unstable
ÃÂ·Self destructive activities
ÃÂ·Express mood instability
ÃÂ·Express inappropriate anger
ÃÂ·Fear of abandonment
ÃÂ·Unstable sense of self
Usually patients with BPD see things in terms of extremes, either all good or all bad. They usually view themselves as the victims and take little responsibility for their actions. Stress is higher in patients with BPD than any other personality disorder, 56% vs. 22% (Livsley). They are prone to feelings of depression and emptiness. They may attempt suicide. Our textbook explains seventy percent attempt suicide and six to nine percent actually commit suicide.
In the movie, it was a suicide attempt that landed Kaysen in the psychiatric hospital. She consumed fifty aspirins and a bottle of vodka. The suicide attempt was only one of the symptoms; she showed several more. She took no responsibility for her actions and she saw herself as the victim. She said she had a headache and that was the only reason she had taken the aspirins. She was also having delusions. She thought that there were no bones in her hand or wrist, the bones disappeared and then they would reappear. She was involved in an unstable relationship. She was having an affair with the husband of her parent's friend. She also showed another symptom, she was uncertain about her career path. She was the only graduate in her class that was not going to attend college. Susanna said, "I know what it's like to want to die. How it hurts to smile. How you try to fit in but you can't. How you hurt yourself on the outside to try to kill the thing on the inside". She had a sense of emptiness and depression. As you can see, she showed several symptoms in order for her to be diagnosed with BPD.
What is the treatment for BPD? This disorder is very hard to treat. There is not no universal treatment method. Medication can be used to treat symptoms, such as anxiety and depression. Using mood stabilizers such as carbamaxepine and lithium, anti-depressants, and low-dose neoroleptics are common forms of drug therapy. Self-destructive behaviors such as suicide attempts, self-cutting and burning can me treated with short hospital stays. Psychotherapy is offered, helping a relationship form, in order for the patient to feel cared about. When the patient makes this bond and shows signs of improvement, it is hard to end the therapy, because the fear of abandonment they still have. There are programs that offer educational training for coping strategies. It will help the patient to find an alternate route of coping, for example instead of cutting their self under stress they can do something of pleasure. Day treatment programs are offered, to help the patients to engage in every day activities and group therapy.
Kaysen was sent to the hospital for a short stay due to a self-destructive behavior. Which is known as a form of treatment. It was there in the hospital that she was diagnosed with BPD. While in the hospital, she was given medication, but the exact med's were not named. There were group activities, on certain days, to help her focus on more than one event or person. She was forced to form bonds and interact with more than one person. She had weekly sessions with her psychiatrist, to talk about her problems. She stayed at Clay Moore for one year, two years in real life, and was released because her file was stamped with one word, 'recovered'.
Susanna Kaysen portrayed a patient with BPD very well. The diagnosis, symptoms, and treatment for BPD in this movie are accurate. Susanna Kaysen was living in parallel universes. She always wondered if the door was half open or half closed. Does anyone really know? Maybe she was crazy, maybe it was just the sixties, or maybe she was just a girl? interrupted!
Borderline Syndrome: A personality Disorder of Our Time, Oliver Tree Production, Inc. 1989.
Comer, R.J., Fundamentals of Abnormal Psychology: 3rd ed. New York, Worth Publishers and W.H. Freeman, 2002.
Kreger and Maskon, From Stop Waling on Eggshells, New Harbinger, 1998.
Livesley, John, Handbook of Personality Disorders, Guilford Press, 2001.