Analysis of Girl Interrupted

Girl interrupted is a gripping tale of a girl’s maladaptation to the challenges of life. The movie focuses on a young girl named Suzanna Kaysen growing up in the 1960s and struggling with the world around her. Suzanna is admitted to Clarmoore institution after she consumes a whole bottle of aspirin and alcohol to deal with her pain. When admitted to Clarmoore she claims she was not trying to commit suicide, but that she just had a headache. She is overwhelmed and apprehensive as she enters the institution and observes the people around her .

Suzanna is quickly introduced to many patients, including her roommate, a pathological liar named Georgina. Polly, a woman who burned herself as a child in attempts to remove the rash she was receiving from her dog so she would not have to part with him. Down the hall from Suzanna is Daisy, a girl suffering from various mental illnesses stemming from her over intimate relationship with her father. The most whirlwind introduction is the arrival of Lisa, a sociopath returning from her most recent escape from the hospital.

Suzanna is immediately intimidated by Lisa and her sociopathic ways. It is Suzanna first mediated apt with her very self-indulgent parents that her diagnosis is revealed. Suzanna is taking aback by the doctors words, borderline personality disorder. Suzanna exhibits her defiance and affirms the doctor’s diagnosis by becoming a side kick to Lisa’s maniac ways. Suzanna becomes an accomplice to Drugging a nurse to steal music supplies to cheer up Polly, breaking into the doctor’s office to view her medical records, and being noncompliant with her medications.

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Following Lisa’s return from her most recent treatment for a maniac episode Suzanna reveals her true dependence on Lisa by following Lisa in her escape from the institution. Lisa has planned for them to stop by the new house Daisy’s dad bought her when she got released, then head to Florida to work at the new Disney world. When they arrive at Daisy’s, Lisa further reveals her manipulative disorder by pushing daisy about her dad, how she is not recovered and pulling up Daisy’s sleeve revealing the cut marks along her forearms.

The next morning Suzanna goes upstairs to find Lisa’s twisted words had pushed daisy over the edge and she hung herself. Suzanna is devastated at the sight and the fact that list doesn’t seem supposed. She finally realizes she has been under Lisa’s spell and she will never recover this way. So while Lisa runs, Suzanna lets the doctor take her back to the intuition and focuses on her recovery. Suzanna’s return marks a change in the movie and she makes great strides towards recovering.. The day before her release, the one women who could tear it all down returns.

At the sound of commotion Suzanna looks out the window to see Lisa being brought in by an officer. That night Lisa steals Suzanna journal and reads aloud all her private thoughts, including remarks about the other patients Suzanna had befriended. When Suzanna hears her reading her private thoughts it seems Lisa may get her wish and tear all Suzanna progress apart. But in a twist so revealing of her recovery, Suzanna stands up to Lisa and tells her she is the one who needs help and she is dead inside.

It is this action of wanting to be out in the real world and standing up to this women who she has let control her that shows the strides she has made. Suzanna’s final departure is not a bitter one, it seems she has made a difference in every patient there and is ready to begin her new life, with her new diagnosis, borderline personality disorder, recovered. In my opinion this movie uses the main character, Suzanna, to illustrate the various ways a mental illness may present.

Suzanna’s chart states “ Psychoneurotic Depressive reaction, highly intelligent, but in denial of her condition and person pattern disturbance ,resistant, sixed type, r/o undifferential schizophrenia. Diagnosis: Borderline Personality Disorder. ” This diagnosis seems quite confusing if you don’t know the characteristics of a person with borderline personality disorder. Because in all honesty at first it just seems Suzanna is a young girl, growing up in a rough era and just struggling to cope. But this struggle to cope and maladaptation to the stressors in her life are the triggers to her illness and her attempt at suicide .

According to Townsend Borderline Personality disorder is described as “ A pattern of intense and chaotic relationships, with affective instability and fluctuating attitudes toward other people. These individuals are impulsive, are directly and indirectly self-destructive, and lack a clear sense of identity. ” (Townsend, 2011, Pg. 569) This is a broad definition but even at first glance I can pick out some of the behaviors Suzanna exhibited in this movie. Suzanna exhibited intense relationships with men, and she developed a very intense and beyond chaotic with the other patient on the ward, Lisa.

She exhibited constant acts of impulse and instead of coming up with these acts on her own, they were often thought out by Lisa and Suzanna just followed. This consistent following of Lisa and lack of personal decision making clearly revealed Suzanna’s devoid sense of a clear identity. According to the DSM IV a person suffering from Borderline Personality Disorder exhibits five or more of the following nine criterions.

1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. ) Identity disturbance: markedly and persistently unstable self-image or sense of self.
3. Impulsivity in at least two areas that are potentially self-damaging (e. g. , spending, sex, substance abuse, reckless driving, binge eating).
4. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior***.
5. Affective [mood] instability.
6. Chronic feelings of emptiness.
7. Inappropriate, intense anger or difficulty controlling anger (e. g. , frequent displays of temper, constant anger, recurrent physical fights).
8. Transient, stress-related paranoid ideation or severe dissociative symptoms. (NAMI)

Suzanna exhibits many of these symptoms throughout the film. A few very evident symptoms are her uncertainty about her identity that leads to her dependence on others and her impulsivity and self-damaging behaviors. On admission she seems to have a clear understanding of what’s right and wrong but is in denial of why she is there, yet by the middle of the movie she is throwing her beliefs and values to the wind and participating in Lisa’s schemes. She becomes very codependent on Lisa and when Lisa is transferred to another ward after the drug a nurse and steal music equipment, Suzanna spirals into a different person.

Suzanna becomes defiant, refuses to get out of bed and becomes easily angered. Her main thought is where is Lisa and when is she coming back. This demonstrates her lack of her own identity, without Lisa she is back to being confused about her life. Suzanna not only shows impulsivity with her actions with lisa, she shows impulsive sexual tendencies as well. Before her admission she was having sex with a married man who was a friend of her family. She also has a relationship with a man named toby who she met at a party after high school.

When toby surprises her at the institution her first actions toward him are sexual advances. He takes her outside and says he is going to Canada to avoid the draft and that she is going with him. She tells him she is not living and admits to trying to kill herself. That evening she starts kissing a male orderly she knows is very fond of her. Her sexual tendencies are clearly self-destructive and they show how every relationship is completely lacking emotion. Suzanna’s diagnosis of Borderline Personality disorder has no certain cause but several risk factors have been identified.

Genetic, family and social factors all play a role in the development of Borderline Personality Disorder. Suzanna’s mother clearly has some mental issues of her own although a diagnosis is not ultimately stated in the movie. Borderline personality disorder is also more common in women than men. Suzanna’s parent also show little regard for her condition and seemed to be more concerned about keeping up appearances. All these factors and the little to no communication with her family can account for factors that may have contributed to the development of her mental illnesses.

Borderline Personality disorder is diagnosed through a psychological evaluation and assessment of risk factors. In the movie Suzanna’s doctor is fairly quick to give her the diagnosis of Borderline Personality disorder after very few visits with her. Although throughout the movie Suzanna’s actions give evidence to her diagnosis. Common treatment for Borderline Personality Disorder consists of medication therapy to stabilize mood, decrease impulsivity and help the patient develop a more logical way of thinking.

Psychotherapy is used in combination with these medications and patients usually participate in therapy sessions several times a week. Suzanna’s treatment plan was not quite evident until the end of the movie when she finally opened herself up to the possibility of recovery. Although the medication names were not stated she received medication therapy along with therapy sessions with the Dr. Wick two to three times a week. Suzanna also used expressive therapy during her treatment. She wrote down her thoughts in a journal in order to clear her head and participated in expressive art.

One aspect that contributed to her recovery that is not presented is how the other patients affected her. Lisa’s actions were the most influential on her in the beginning but in the end she develops the ability to stand up to Lisa. Daisy’s suicide also played a big factor in her recovery, she realized you can’t want to die, but once Death is staring you in the face your perception of the world changes a little bit. Girl Interrupted is an eye opener to several regarding several different mental illnesses. By the end of this movie the stigma of mental illness and an institution is gone and replaced by an accepting attitude.

The main character Suzanna paints a picture of the various ways mental illness may present itself, but also that management and recovery of mental illness is attainable.

Borderline Personality Disorder Treatment Through Psychotherapy

What is Psychotherapy? Psychotherapy is the first line of preferred treatment for patients with borderline personality disorder. Psychotherapy is a one on one or group interaction with a therapist to address symptoms that occur with Borderline Personality Disorder. The most important factor in psychotherapy is developing a trusting bond with you therapist.

When a trusting relationship is established between patient and therapist, research shows Psychotherapy can relieve some symptoms of Borderline Personality Disorder. Types of Psychotherapy Cognitive Behavioral Therapy: This type of therapy can help identify and relieve beliefs and behaviors that cause inaccurate perception of themselves. This type of therapy can help reduce mood swings, control anxiety and can be helpful in reducing suicidal behaviors. Dialectical Behavior Therapy: This type of therapy focuses on being attentive and aware of the current situation.

The therapist teaches skills to help control overwhelming emotions and reduce self-destructive behaviors. This therapy is also helpful in helping clients improve relationships. Schema-focused Therapy: This therapy stems from the idea that borderline Personality Disorder stems from a person’s dysfunctional self-image. Therapy combines several different types of psychotherapy to help change a person’s self-image. This therapy is helpful in helping people interact with others; react appropriately to their environment and proper coping methods to problems and stress. Plan of Care for: Susanna Kaysen

Nursing Diagnosis: Ineffective Coping Risk Factors: Lack of impulse control, Anxiety, Denial of mental illness NOC Outcomes (Nursing Outcomes Classification) Client will verbally express feelings and actively participate in learning coping strategies. Therapeutic Interventions Encourage Client to participate in constructive outlets to address feelings. ( writing ,painting ,etc) Provide the client with positive feedback.  Teach effective coping strategies. Discuss clients diagnosis and address questions regarding diagnosis. Nursing Diagnosis: Personal Identity Disturbance

Related Factors: Symptoms related to diagnosis of Borderline Personality Disorder. NOC Outcomes (Nursing Outcomes Classification) Patient will discuss various aspects of individuality that make up their personality. Patient will be able to distinguish behaviors, thoughts and feelings that differentiate their personality from others. Therapeutic Interventions Work with client to recognize their own individual thoughts, values, and beliefs. Encourage client to discuss feelings and claim ownership over these feelings.  Use photographs to increase clients awareness of their individuality.

References

1. Encyclopedia, A. (2010, November 15th). PubMed Health. Retrieved September 1st, 2012, from Borderline Personaility Disorder: http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001931/ NAMI. (n. d. ).
2. Mental Illnesses: Borderline Personality Disorder. Retrieved September 2nd, 2012, from National Alliance On Mental Health: http://www. nami. org/Template. cfm? Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay. fm&TPLID=54&ContentID=44780 Townsend, M. C. (2011).
3. Essentiasl of Psychiatric Mental Health Nursing fifth edition. Philadelphia: F. A Davis Company.

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