Summary:
Borderline Personality Disorder
This chapter, an explanation of Kaysen’s diagnosis, is
taken from the Diagnostic and Statistical Manual of Mental
Disorders, third edition (DSM-III). The most prominent
characteristic of a borderline personality is an uneven sense of
identity. This instability manifests itself in conflicted relationships,
an inability to make ethical choices, confusion about sexual identity,
and a persistent sense that one’s life lacks meaning or direction.
Fear of abandonment is common, as are intense mood swings. Stress
can trigger suicidal or self-damaging impulses, including reckless
behavior, random sexual encounters, and petty crimes. People suffering
from borderline personality disorder typically have difficulty operating
in traditional social environments. Women are more likely to be
diagnosed as borderline than are men.
Summary: My Diagnosis
Kaysen responds to her diagnosis as a borderline personality. McLean
Hospital was reluctant to release her records, so Kaysen sought
the aid of an attorney. She believes that the DSM-defined diagnosis
describes her eighteen-year-old self fairly accurately. Kaysen questions
whether the definition’s allegation that borderline personalities
have difficulty choosing “friends or lovers” is evidence of illness.
She continues to struggle with this issue today and believes that
most people do. Kaysen thinks that a borderline personality is evidence
of a psyche damaged but not shattered. She notes that diagnoses
are often attributable to trends; each decade sees a popular diagnosis
come and go. Occasionally, a diagnosis, such as homosexuality, is
removed entirely from the annals of psychiatry. Reading further
through the definition of borderline personality disorder, Kaysen
points out that “uncertainty about . . . long-term goals or career
choice” seems to be applicable to most adolescents.
She stops here to warn the reader that some of her behavior
as a teenager likely was evidence of mental illness. She made a
practice of banging her wrists repeatedly against the hard metal
struts of a butterfly chair and scratched her face methodically.
Kaysen takes issue with the definition’s charge that “pessimism,”
“social contrariness,” or “chronic feelings of emptiness or boredom”
are anything other than descriptions of common teenage maladies.
Kaysen tells us that she was the first student in her school’s history
not to have attended college—a distinction that invited concern
from peers and parents. Most troubling to Kaysen, however, is the
fact that more women are diagnosed as borderline than are men. She
argues that women are often diagnosed with illnesses that appear
suspect when examined, such as “compulsive promiscuity,” a charge
not often leveled at men. A number of the behaviors noted in the
definition are also commonly identified with women, including shoplifting,
binge eating, and excessive shopping. Kaysen tells us that she is
vigilant about analyzing her behavior for signs that she might be
“crazy.” Having experienced the world of the mentally ill, she wants
never to return to it.
Summary:
Farther On, Down the Road, You Will Accompany Me
Kaysen sees two of her fellow patients some years after
she has left the hospital. Georgina visits Kaysen in Cambridge,
rudely interrupting Kaysen’s older neighbor, who is baking bread.
Georgina clearly has little grasp of social courtesies and shocks
the neighbor with her tactlessness. Georgina eventually marries,
and Kaysen visits her old roommate on the farm where she lives.
Kaysen also runs into Lisa one day. Lisa has a child now and describes,
to Kaysen’s surprise, the suburban life she has created for herself
and her son. Lisa mentions McLean in passing but seems to have changed
quite a bit as a person. However, quirks in her conversation and
behavior betray her new persona.
Summary: Girl,
Interrupted
Kaysen speaks about her relationship with her high school
English teacher. He takes her to New York to visit the Frick Museum,
where Kaysen expects that he will try to kiss her. In front of a
painting of a student seemingly trapped by a music teacher, Kaysen
imagines that the girl warns her not to pursue the relationship.
Kaysen ignores the imagined advice. Years later, Kaysen visits the
museum again with a wealthy, unkind boyfriend. She returns to the
painting but interprets it quite differently. The painting is titled Girl,
Interrupted at Her Music. Kaysen tears up as she recalls
how her own life was interrupted by illness and hospitalization.
She considers the light in the painting and compares it to the light
cast by life, which often fails to reveal to us the nature of ourselves
and other people.
Analysis
Kaysen “annotates” her diagnosis of borderline personality
disorder and the “charges against [her].” In this chapter, Kaysen acknowledges
that she was troubled as an adolescent, but she resists several
of the diagnostic interpretations of her behavior. She admits to
having exhibited several of the diagnosis’ features, including vagueness
of purpose or long-term goals, uncertainty in relation to friends
and romantic partners, and general instability. But these behaviors
do not necessarily indicate mental illness. Most teenagers waver
when pressed about long-term plans, and indecision on the matter
of friends and lovers might be universal. Further, Kaysen notes
that psychiatric diagnoses follow trends; some “disorders” are eventually
identified as normal behavior. Having called the very fact of her
mental illness into question, Kaysen then mentions some behavior
that must “irrefutably” have indicated “an inward condition.” Ritual
banging of the wrists and face scratching allowed Kaysen some visual
evidence of the pain and turmoil she felt inside. Having classified
at least some of her conduct as abnormal, Kaysen retreats into ambiguity
once again. Outwardly, her behavior at school was most likely the
mild rebellion of an unhappy teenager. She also notes the sexist
nature of the borderline diagnosis: many of the behaviors are female-identified,
and the illness is more often diagnosed in women than in men.
Kaysen wonders whether her time at McLean resulted in
recovery. Her doctors believed she was healed, but Kaysen confesses
to constant vigilance over her adult behavior. Perhaps she simply danced
on the edge of illness as a teenager. Whether she was truly “crazy”
matters, in the end, less than the consequences of being judged
“crazy.” Wherever the line between sanity and insanity lies, she
says, she “[does] not want to cross it again.”
Kaysen’s two perceptions of Vermeer’s Girl, Interrupted
at Her Music, first as a teenager and later as an adult,
provide a context for her experience at the hospital. Her initial
reaction was one of warning. She felt that her life was moving at
increasing speed toward some unpleasant climax, and the girl in
the painting seemed to shout out a warning to Kaysen. We know that
her life took a drastic turn in the following years. Kaysen’s perception
of the girl’s urgent warning was a kind of foreshadowing. Later,
recovered from her illness, Kaysen sees in the painting a distillation
of her own experience. Just as the girl is “interrupted,” so was
Kaysen’s youth, and for two years, the “music” of her life ceased
to play. Kaysen infuses the girl in the painting with her own feelings
of arrest and loss and wonders how anyone could recover from such
an experience. She imagines that the light around the girl in the
painting is akin to the metaphorical light in which we see ourselves
and those around us: it is an uneven light that reveals little,
casting shadows through which we struggle to see the truth.
payment page
