Girl, Interrupted Analysis

Girl, Interrupted is a film set in the 1960’s that tells the story of 18-year-old Susanna Kaysen. She suffers a nervous breakdown and harms herself by overdosing. Her family sends her to Claymoore, a psychiatric hospital with a ward full of adolescent female patients. During her say, Susanna gets to know several of the young ladies and witnesses their various mental conditions and how they manifest. She also sees their reaction to their treatment and how they grasped for control of their situations by rebelling against their care under the leadership of Lisa Rowe, a young sociopath. Susanna’s perspective provides an unfiltered look at the treatment of psychological disorders in adolescents at that point in time, and many improvements to their care protocol could have been made (Mangold, 1999).

Primary Issue

Susanna’s primary issue is a case of borderline personality disorder. This is defined as emotional instability, long-term unstable relationships. A distorted sense of self and strong emotional reactions to life’s circumstances. Those suffering form this disorder often cause harm to themselves and are attracted to other dangerous behavior. Triggers for this disorder may include discomfort feeling empty inside, fear of being abandoned and passing detachment from reality. Triggers may be normal life occurrences that these individuals are just unable to process with calm and ease. Sadly, eating disorders, depression and substance abuse are common co-disorders with borderline personality disorder (NAMI, 2017).

Throughout the film, Susanna questions her diagnosis and she attempts to determine if she is different, or less crazy than her peers in the ward. Her therapist and the ward nurse both indicate is their own way, that she is driving herself crazy, versus being actually crazy like many of the other young ladies. Yet, Susanna is in the ward due to a suicide attempt and clearly experienced excessive pain and sadness to get her to that point. Several of her behaviors while admitted show that she is somewhere in the middle of normal and crazy. She had choices for her improvement, but she also struggled with more elusive issues that required thoughtful therapy (Mangold, 1999).

Critique of Diagnosing Professionals

Susanna presented with depression, self-harm, emotional fluctuations and instability, as well as unhealthy relationships with others. She had an inappropriate relationship with an English teacher from her High School and an overly impassioned relationship with another young man. While at Claymoore, she demonstrated an unhealthy fascination with Lisa’s rebellious ways, becoming another unhealthy fixation and relationship for Susanna. The therapy for all the young women was centered on a philosophy of tough love. The therapists and handlers of the patients considered them lazy and self-indulgent. They regularly communicated that they could let themselves go crazy or figure out how to get over it. They considered the conditions of the patients to be a matter of choice instead of unintentional mental illness and treated them as such (Mangold, 1999).

The attempts by professionals and other adults to help Susanna could have been more effective. She eventually figured out for herself that she didn’t want to become like the other young women in the ward, especially Lisa. Perhaps tough love and witnessing mental illness that surpassed her own helped her decide to choose another path (Mangold, 1999). However, tough love was not the only option that could have worked. And alone it did not address her full state of mental illness or what her future may hold. To improve her prognosis, help reduce her confusion about her diagnosis and its ramifications, her therapists could have included the following counseling goals.

Three Counseling Goals

Susanna and her fellow patients no longer identified as children, though their maturity levels suggested otherwise at times. This dynamic requires a special angle from therapists to achieve engagement with adolescents on their level and with sincerity. The patients at Claymoore, especially Lisa were fully aware of the motives of the therapists and other employees. They did not appreciate any communication that treated them like children and robbed them of their independence. To achieve more compliance from the young women in opening up about their emotions and issues, the therapists should have put more energy into developing an honest and caring rapport. If an adolescent patient feels like a medical chart. patient number, or diagnosis they will see through the hypocrisy and rebel (Prout et al., 2015, p. 11).

In one of Susanna’s therapy sessions, her therapist fell asleep. The film tried to be a commentary on the dismal state of psychiatric care in the 1960’s and it succeeded in painting this picture. Also absent from the film is any indication of a treatment plan outside of useless therapy sessions and medication to induce patient compliance while in the facility. Susanna’s therapist should have completed their research of her and developed a treatment plan conducive to building her motivation for change, and truly teaching her about her illness and her options. Susanna wanted understanding and potential solutions for the pain she felt and the weaknesses she perceived in herself. A validation of sorts. With an organized and personalized treatment plan, Susanna would have specific goals and counseling with focus that directed her toward wellness. This is also a protocol that could follow her out of the facility and into her normal life (Burlingame, Wells, Lambert & Cox, 2004, p. 335). She could have felt supported as she transitioned instead of feeling when she left, that her diagnosis was still possibly inaccurate.

Last, another missed opportunity on behalf of the therapists in the film was the chance to clarify Susanna’s diagnosis. She grappled with this issue before, during and after her stay at Claymoore. Her therapists failed to consider the concept of developmental issues when working with her. Today it is better understood that some of what children and adolescents demonstrate as problematic in society, is actually just a developmental deviation. This of course excludes cases of extreme behaviors and psychosis. The therapists need more knowledge about these tangents in development and what are normal ranges of deviation for adolescents as they develop and live through life’s challenges (Prout, 2015, p. 5-6). Susanna could have been educated about this differentiation and it may have helped her comprehend herself better and forgive some of her actions and emotions.

Conclusion

Psychological treatment for adolescents has improved a good deal since the 1960’s. There is more comprehension and the word has begun to spread that variances of mental illness are great and very common. There is less stigma and more acceptance of those needing aid to manage mental strain. Fictional Susanna did not have the luck of living in this time, however, her story is an important commentary on where psychology once was, and how far it has come.

Her treatment today would have included more engagement and genuine therapy, more of a treatment plan with attainable goals for her to work through and take with her when she left the psychiatric facility, and finally, more context so that she could understand her diagnosis. This should determine where she fit in the many layers of mental issues and how to move forward without judging herself or the world around her, rather focusing on her development, progress and a more hopeful future. Susanna deserved the care appropriate for a developing adolescent instead of one with a more serious psychosis. Fortunately, her exposure to those with more severe cases, helped her to clarify her own situation and potential.

References

Burlingame, G. M., Wells, M. G., Lambert, M. J., & Cox, J. C. (2004). Youth outcome questionnaire (Y-OQ). In The use of psychological testing for treatment planning and outcome assessment (3rd Ed.), 235-274.

Mangold, J. (Dir.) (1999). Girl Interrupted. Columbia Pictures.

NAMI. (2017, December). Borderline personality disorder. Retrieved from https://www.nami.org/learn-more/mental-health-conditions/borderline-personality-disorder.

Prout, H. T., Fedewa, A. L., Prout, S. M., Bratton, S., Purswell, K., & Jayne, K. (2015). Counseling and psychotherapy with children and adolescents historical, developmental, integrative, and effectiveness perspectives. Retrieved from http://ebookcentral.proquest.com/lib/empire-ebooks/detail.action?docID=1889212