Symbols are objects, characters, figures, or colors used to represent abstract ideas or concepts.

Hospital Records

Kaysen intersperses the essays in the book with copies of internal McLean Hospital records. These records represent what Kaysen describes as the “accurate but . . . not profound” nature of her doctors’ understanding of her problems. The records report Kaysen’s name, address, details of her suicide attempt, and other facts, but they provide little context and even less interpretation. The records are reminders of who she was and what she faced during those difficult years. The unreliability of the records becomes apparent when Kaysen discloses the contradictory accounts of her admission to the hospital.


The tunnels Kaysen discovers under McLean represent the “essence” of the hospital, stripped of its doors, bars, and signs. They reveal to Kaysen the nature of her own treatment. She understands, in the warm simplicity of the tunnels, that she and the doctors have been approaching her problems the wrong way, confused by “all the bother.” The tunnels, which allow access to every part of the hospital, grant Kaysen insight into her illness. She leaves the “shadowy” world of analysis behind to confront life on her own terms.