window on Alcatraz has a view of San Francisco.
These words, from the opening chapter “Toward
a Topography of the Parallel Universe,” illustrate the “parallel
universe” inhabited by the mentally ill. Kaysen describes the ease
with which a person can slip into this other reality, tempted by
glimpses through the thin “membrane” that separates the sane from
the insane. Once inside, a new set of rules replaces the conventions
of life on the outside. The cruel irony of life in the “parallel
universe” is embodied by a person’s perfect awareness of the reality
left behind. The afflicted mind is still very much aware of the
world it has abandoned. Kaysen compares this alternate reality to
a prison, but notes that even the worst prisons occasionally allow
glimpses of something beautiful. Thus, being mentally ill can be
worse than being in prison.
was the price of privacy.
Kaysen describes the patients’ loss of freedom
in the chapter “Applied Topography.” Locked in the dehumanizing
world of the hospital ward, the girls are stripped of privacy. The
only private space on the ward is the seclusion room. The nurses
banish the violent or rowdy to seclusion, but Kaysen discovers that
the experience can be something other than punishment. The seclusion
room is the only place where a patient can find reprieve from the
relentless watch of nurses and the oppressive feeling of the wards.
The seclusion offers a brief reprieve from the ward in exchange
for the ability to move around freely.
said Lisa, “it passes the time.”
Lisa throws a tantrum in the “Security Room” chapter,
demanding that the nurses open her locked window. Lisa yells and
curses at the staff, promising to call her lawyer if her needs aren’t
met. This is a typical tactic for Lisa, who knows that the nurses
value calm and order; they will accommodate her if only to shut
her up. Once the window is open, Valerie realizes that Lisa never
cared about the window; she was simply entertaining herself. Trapped
in an airless hospital ward with nothing but familiar faces and
a television, Lisa’s energies require release. She is honest when
confronted. With no prospect of getting out of the hospital anytime
soon, Lisa is just trying to kill some time.
could it?” I asked. “Don’t let it,” said Georgina. “Don’t forget
In the chapter “Calais Is Engraved on My Heart,”
Kaysen recounts the arrival and swift departure of Alice Calais,
a seemingly quiet girl whose catastrophic breakdown prompts her
removal to maximum security. Both Alice and Daisy suffer from obvious
and profound mental illness, unlike most of the other girls on the
ward. The routine of life in the hospital lulls Kaysen and the others
into boredom and monotonous routine, but the sudden appearance of
full-blown mental illness shocks them. When the girls visit Alice,
they find her smeared in her own waste, a different creature from
the retiring girl they’d known only days before. Each of the girls
gains instant perspective on her own problems, and wonders whether
Alice’s fate could be in store for the others. Georgina’s firm command
never to forget what they have seen summarizes the uncertainty and
fear that Kaysen and her fellow patients feel.
fairly accurate portrait of me at eighteen, minus a few quirks like
reckless driving and eating binges. It’s accurate but it isn’t profound.
Speaking in the chapter “My Diagnosis,” Kaysen
confronts the judgment of her doctors some twenty-five years later.
Labeled a borderline personality, Kaysen considers the aptness of
the diagnosis. In responding to each of the elements of the borderline
personality disorder, she concedes that much of her adolescent behavior
fit the definition. Yet in her charge that the designation is “accurate”
but not “profound,” Kaysen explores the nature of mental illness
and how it is diagnosed. Fads rise and fall with the decades as
one diagnosis succeeds another as the popular illness of the day.
Many of the behaviors described could also, if examined outside
the scope of mental illness, be excused as typical or harmless.
Kaysen doesn’t argue that she was healthy; rather, she cautions
her readers that a diagnosis isn’t the sum of a personality.