Plot Summary
In 1967, 18-year-old Susanna Kaysen finds herself admitted to McLean Hospital after a suicide attempt. Her doctor concludes that she must be institutionalized after speaking to her for just 20 minutes. She agrees, mostly because she is exhausted. Although she denies it, doctors diagnose her with borderline personality disorder, leading to an unexpected 18-month stay in the psychiatric ward.
Surrounded by fellow patients like the childlike Polly, the rebellious Lisa, and the tragically lost Daisy, Susanna navigates the complex world of the institution. Each girl carries her own burden. Polly has self-inflicted burn wounds and scars, while Lisa, diagnosed with sociopathy, hates the hospital and constantly troubles the staff with elaborate pranks. Daisy struggles with a severe eating disorder, and Georgina is in an unstable relationship with Wade, a violent patient from the men’s ward.
As Susanna observes the treatment methods and staff interactions, she begins to question the very concept of "sanity" and the effectiveness of their care. One day, James Watson (a Nobel laureate and a family friend) visits her at Mclean and offers to get her out of the hospital. She declines his offer and reveals her failed suicide attempt during high school. Although she decides to stay because she feels the need to finish her treatment, Susanna still wonders to herself whether sanity is simply a construct designed to make the "normal" feel comfortable. Are doctors truly treating the mind, or just the brain as a physical object?
When a new patient, named Lisa Cody, is admitted to the ward, the “original” Lisa bullies her into leaving the hospital. Kaysen introduces us to other characters like Valerie, the young head nurse, whom the resident girls respect for her competence and willingness to question the doctors' methods of treatment. On the other hand, the older psychiatrist, Dr. Wick, feels out of place among her young patients. The girls despise the evening nurse, Mrs. McWeeney, who is old-fashioned and controlling.
One day, the girls of the ward watch the news of the year 1968 on television and realize they exist on the sidelines of the world and their own lives. As Susanna adjusts to life in the ward, she suffers from an episode of depersonalization, making her want to tear apart her hand to confirm that she has bones.
At one point, Susanna starts “analysis” with Melvin. Melvin misinterprets Susanna’s thoughts, feelings, and obsession with the tunnels beneath the ward. She believes that the tunnels represent Susanna’s desire to go back into the womb, while the tunnels actually provide Susanna with insight into the inefficient treatment she has been receiving and help her leave McLean Hospital.
A few months later, finally released from the psychiatric hospital, Susanna learns of society’s prejudice against former mental patients. She finds it hard to get a job. Susanna reflects on her experiences and wonders about the role of sexism in the fact that more women are diagnosed with BPD than men. She meets former patients in the outside world, like the seemingly recovered Lisa, a single mother navigating life with her child. Yet Susanna remains unsure of being "cured" and questions the rigid definitions of mental health.
