Girl, Interrupted: Chapter 32 Summary & Analysis

Susanna Kaysen did not read “the charges against [her]” until twenty-five years after her time at McLean. During her hospitalization, all her doctors and nurses had told her was that she had been diagnosed with a “character disorder.”

Susanna had to hire a lawyer who would help her obtain her records from the hospital, and even then locating her exact diagnosis required her to pore over her admission and discharge forms and cross-reference them with the Diagnostic and Statistical Manual of Mental Disorders. She considers her diagnosis a “fairly accurate picture of [herself] at eighteen,” minus a few behaviors such as reckless driving and binge-eating. She is tempted to refute the diagnosis, but notes that resistance and defensiveness are two hallmarks of BPD.

Rather than refute it outright—though she clearly is in some disagreement with it—Kaysen begins to annotate her diagnosis for her readers. She makes her way through the DSM entry on the disease, starting at the initial definition. She starts by noting that the “uncertainty about self-image, sexual orientation, goals, [and] types of friends or lovers to have” still manifests in her life sometimes. When meeting new people, she constantly asks herself if the person she’s bringing into her life is the right kind of person to bring into her life.

If the diagnosis had been bipolar illness or schizophrenia, Kaysen says, she would be “blameless” in falling ill, and would be seen as a “real” insane person. She wonders what “borderline personality” even means, and concludes that it seems to be a “way station” between neurosis and psychosis in which the psyche is “fractured but not disassembled.”

Kaysen notes that she sees what is diagnosed as “borderline personality disorder” as simply a description of what it is to be an adolescent. The only thing that took her by surprise about her diagnosis was the description of self-mutilation; as a teenager, Susanna would bang her wrist repeatedly on the edge of a metal butterfly chair she had in her childhood bedroom, creating a “cumulative injury.” She’d had an earlier fascination with face-scratching, but found that it was too noticeable. Wrist-banging became the only way that Susanna could communicate or demonstrate her interior pain.

Kaysen, as an adult, feels that her misery “has been transformed into common unhappiness,” and so she is classified as “recovered.” She wonders whether her personality has truly crossed back over whatever “border” it had approached during the time of her illness. Susanna argues that her self-image was never unstable: she recalls seeing herself, as a teenager, as “unfit for the educational and social systems” around her. In fact, it was her parents’ and teachers’ image of her which was unstable and out of sync with their wishes for her. Her teachers often told her she was a nihilist, and her parents fretted over how she would make a life for herself out of her only discernable interests: boyfriends and literature.

The result of such constant, overwhelming scrutiny, Kaysen says, was “chronic emptiness and boredom”—yet another major hallmark of BPD. Susanna felt anger at her being “shut out of life,” and while her classmates invested in their futures, Susanna become the first person in the history of her prestigious school not to go to college. Emptiness and boredom, Susanna says, is an understatement concerning the “complete desolation, despair, and depression” she felt as a teenager. Susanna concedes that she probably was crazy, though at the time she constantly belittled herself and told herself that all she needed was to pull herself together.

Announcing that she has a few more annotations to make, Kaysen considers the following sentence: “the disorder is more commonly diagnosed in women.” The DSM does not state that “the disorder is more common in women,” and Kaysen chastises the writers of the manual for not even bothering to try to “cover their tracks.” Many disorders are more commonly diagnosed in women, Kaysen argues, such as “compulsive promiscuity.” She observes that the gulf between the label of “promiscuous” in men and women is unfair.

Though Susanna avoided “premature death,” one of the major “complications” of her disorder, she admits that she thought about suicide almost constantly in order to make herself feel better about things. Susanna was never seriously suicidal, she maintains, but for someone like Daisy, she wonders if suicide is indeed a “premature” death. She doesn’t believe Daisy should have been made to sit in her “eat-in kitchen with her chicken and her anger for another fifty years.”

Kaysen wonders if she was just “flirting with madness,” the way she flirted with her teachers and classmates. Though she was often afraid she would become crazy, she was never actually convinced that she was, and she now wonders whether constantly questioning her insanity was and is a veritable mark of her sanity. To this day, Kaysen writes, she finds herself asking herself—and others around her—if she’s insane. She’ll wonder if she’s said something “crazy,” or preface a controversial line of thought by saying “Maybe I’ve gone totally nuts.” Though “crazy” is a common enough phrase, it is evocative and specific to Kaysen—it represents McLean, and it represents the “ever-shifting borderline” that continually beckons to be crossed. Susanna, at last, has no desire to cross it ever again.