Themes are the fundamental and often universal ideas
explored in a literary work.
Confusion
of Social Nonconformity with Insanity
Kaysen carefully skirts around the issue of whether she
was ever truly ill. Her ambiguity exposes one of the central themes
of the memoir: the line between sane and insane, normal and deviant
is a blurry one. More importantly, it is a distinction that, except
in the most desperate instances of mental illness, scarcely captures
the personality it seeks to classify. The distinction between “normal”
and “crazy” can be so fine, she argues, that our insistence on making
it is shortsighted at best. After all, even in the case of the demonstrably insane,
“is a nonreality-recognizing brain truly as different from a reality-recognizing
brain as a foot, say, from a brain? This seems unlikely. Recognizing
the agreed-upon version of reality is only one of billions of brain
jobs.”
Kaysen confronts her diagnosis as a borderline personality
line by line, making its imprecision clear. Charged with “uncertainty about
long-term goals,” “instability of self-image,” and “social contrariness,”
Kaysen wonders whether every teenager might satisfy these classifications.
She admits to having been a troubled adolescent, behaving rebelliously
and rejecting the goals set out for her by parents and the educational
system. Yet these behaviors were clearly not predictive of her adult
life. Early in the memoir, Nobel laureate James Watson visits Kaysen
on the ward. She describes her warm feelings for him, derived primarily
from Watson’s refusal or inability to follow social convention.
His eccentricity does not impede his powerful intellect.
In several instances, Kaysen admits to self-destructive
behavior during adolescence and seems to concede that she was clinically
ill. In her portrayals of Alice, Daisy, and Polly, however, she
presents examples of people truly incapacitated by mental illness,
juxtaposing their predicaments with her own and others’. She argues
that a point exists at which people require treatment, hospitalization,
and even isolation from others. Yet we are far too quick to pass
this kind of judgment. Her two-year confinement, and the consequences
that resulted from it, convinced Kaysen of our profound need to
define people within conventional social norms. The costs of those
decisions are high.
Freedom vs. Captivity
When Kaysen enters McLean Hospital, she quickly comes
to understand that although captivity appears to require the surrender
of freedom, the opposite is often true. The ward is organized to
keep patients exposed to staff scrutiny at all times. With nurse
checks at frequent intervals, every room is essentially public except
for one. The “seclusion room” sits at farthest reach of the main
hallway, intended for out-of-control patients who pose harm to others
or simply make too much of a disturbance. Patients can also choose
to be placed in the room, prompting Kaysen to remark, “freedom was the
price of privacy.” Here, a patient can be blessedly alone for a period,
free from scrutiny and company but confined to even tighter quarters.
The seclusion room is a microcosm for the entire experience of confinement
to the hospital. Kaysen notes that McLean is “a refuge as much as
a prison.” Without school, a job, bills, parents, or the outside
world to deal with, the girls are free to ignore responsibility,
even as that responsibility has been taken from them. Kaysen finds
that this apparent paradox isn’t confined to the hospital. After nearly
two years at McLean, Kaysen looks for a means to leave but finds
that her hospital stay stigmatizes her in the eyes of employers. A
marriage proposal turns her circumstances on their head. “Everyone
could understand a marriage proposal,” she writes, despite nearly
total uncertainty about the appropriateness of her fiancé or the
appeal of marriage itself. The engagement frees Kaysen from the confinement
of the hospital, but it limits her opportunities.
Limited Choices
Available to Women
Women continue to face prejudice and discrimination today,
but these phenomena were more overtly evident during Kaysen’s adolescence.
She faces sexism of a crude kind in her typing job at Harvard, prior
to entering the hospital. The supervisory staff is comprised entirely
of men, and the typing staff is only women. Kaysen is bewildered
by the obvious inequities she faces in the workplace. She is forced
to obey a strict dress code and is particularly incensed by the
fact that women are allowed to smoke only in the bathroom, on breaks.
She faces job-related discrimination again when she tries to plot
her life post-hospitalization. Counselors urge her into intellectually
undemanding service jobs; she is startled when even Valerie, the
confident head nurse, seems to nudge her in this direction. Only
a marriage proposal, offering the most traditional kind of female
role, saves her from becoming a dental technician. Sexism also appears
in Kaysen’s diagnosis of borderline personality disorder. The illness,
she tells us, is most commonly diagnosed in women, and the symptoms
are almost universally identified in women. Shoplifting, compulsive
shopping, binge eating, and promiscuity are not usually characteristics
that are associated with compulsive male behavior. Although opportunities
for women began to expand rapidly in Kaysen’s youth, American society
was still full of the most vulgar of old-fashioned behaviors and prejudices.
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