Susanna Kaysen's account of her two-year hospitalization at McLean Hospital in Belmont, Massachusetts, begins in the spring of 1967. Kaysen, the daughter of Ivy League academics, witnessed firsthand the widening generation gap developing in America in the late 1960s. Older generations viewed their children's world with alarm and confusion and embraced few of the cultural changes occurring around the nation. Nearly 70 million children born to the World War II generation came of age as teenagers and young adults during this period. These “baby boomers” would have a massive impact on the American cultural identity.

The Vietnam War and the deep divide it created in American culture defined 1967 and 1968, the years of Susanna Kaysen's stay at McLean Hospital. Gritty, uncensored battle footage, widely available for the first time, riveted the nation. Draft protests became common in cities across the country. Young people marched on Washington and burned their draft cards, taking part in protests that often ended in violent clashes with police. The emergent hippie movement preached a lifestyle of peace and love through the celebration of music, sex, and psychedelic drugs. In the summer of 1967, several months after Kaysen entered McLean, San Francisco hosted the Summer of Love. Thousands of young people and curious observers converged on the city in the largest counterculture celebration to date.

While an angrier movement of antiwar protests replaced the “flower power” generation, efforts to achieve equality for women in American society were in full force. Prominent activists and writers like Betty Friedan, Gloria Steinem, and Mary McCarthy worked to expand the opportunities available to women in a society that favored men. The introduction of the birth control pill, legal abortions, and a general loosening of social restrictions on women embodied a fundamental shift in American attitudes.

In the midst of this turmoil, hospitals like McLean were caught in an awkward transitional period. McLean Hospital, founded in the early 19th century, had long been a refuge for the troubled members of wealthy and aristocratic families. Through the 1950s, privileged patients lived in well-appointed residence halls with fireplaces, private bathrooms, and servants. Well-known residents included poets Robert Lowell and Sylvia Plath; Central Park designer Frederick Law Olmsted; Princeton mathematician and subject of A Beautiful Mind, John Forbes Nash; and, just prior to Kaysen's arrival, songwriter James Taylor. In the late 1960s, however, McLean had fallen into a period of benign neglect, no longer a luxurious refuge for the wealthy nor a cutting-edge mental health facility. This was due in large part to the changing face of the mental health care field.

Medical notions of mental illness had undergone a series of radical changes since the turn of the century. In the early 1900s, patients were often treated like incurable prisoners. “Talking cures,” developed by psychoanalysts like Sigmund Freud and Carl Jung, competed with physical therapies, such as electroshock therapy and surgical lobotomy, in which the frontal lobes of a patient’s brain are destroyed. Professionals became fierce advocates of preferred therapies and opponents of others. Controversy continued to roil the mental health field, as it does today. In the early 1950s, however, the synthesis and validation of the first clinically tested drugs to alter brain chemistry, such as Thorazine, introduced drastic changes in mental health practices. The widespread use of pharmaceutical treatments drastically reduced the demand for institutional commitment, a phenomenon that diminished the need for residential facilities like McLean. In the late 1960s, Susanna Kaysen resembled many other patients flooding mental health care facilities: young, relatively well-to-do, and very likely misunderstood by a mental health care establishment undergoing its own evolution.

Kaysen is deliberately ambiguous in addressing the issue of whether her hospitalization was medically necessary. She describes with scorn a physician’s twenty-minute diagnosis of her need for institutionalization but later recounts a number of frightening incidents that would seem to indicate that she genuinely needed help. Despite her difficulties as a teenager, Kaysen went on to a life as a successful writer. Besides Girl, Interrupted, for which she earned critical acclaim, Kaysen published the novels Asa, as I Knew Him (1987) and Far Afield (1990), as well as the memoir The Camera My Mother Gave Me (2001). A film adaptation of Girl, Interrupted appeared in 1999. Kaysen lives in Cambridge, Masschusetts.