The Cinematic Exploration of Mental Illness in Girl,

Interrupted

Research question: How does the use of dialogue and cinematic techniques in the film “Girl,

Interrupted” contribute to the portrayal of mental health issues like Borderline Personality

Disorder, and how does it impact the audience’s perception and interpretation of the protagonist's

journey?

Subject: English Language and Literature (Higher Level)

Word Count:
 This essay will examine how Girl, Interrupted uses language and cinematic techniques to

depict mental health issues, focusing mainly on BPD, and how these elements affect the

audience’s perceptions and interpretations of the protagonist’s journey throughout the film. By

analyzing these key components such as dialogue, narrative structure, cinematography, and

visual storytelling, the essay will explore the layers of meaning that are woven into the film’s

portrayal of mental illness. This essay is structured to answer the research question through an

analysis of the film’s use of language through dialogue, then an exploration into the cinematic

techniques used in the film, analyzing visual elements and how they enhance the storytelling and

portrayal of the protagonist's mental state.

Girl, Interrupted is a captivating and emotionally intense film directed by James

Mangold set in the late 1960s. It investigates the intricacy of mental illness and the hunt for self

discovery and is based on the memoir of Susanna Kaysen which depicts her experience as a

young woman in a psychiatric hospital, where she is diagnosed with borderline personality

disorder. The film features a passionate performance by Winona Ryder, as Susanna, alongside

Angelina Jolie, who plays the charming and unsettling character of Lisa. The film focuses on the

protagonist’s relationship with other patients, each fighting their own mental health issues, and

her pursuit of a journey of the discovery of herself and the world around her. As the plot of the

film comes to light, the viewer is dragged into a realm that challenges their perceptions of

normalcy and delivers a clear image of the state of humanity. The novel clearly addresses the

delicate line between sanity and insanity, women's societal demands, and the hunt for identity in

an unpredictable and dangerous world. The title of the film reflects the disjointed lives of the

young females in the mental health facility, each of whom seeks both treatment and

understanding.

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 Borderline Personality Disorder (BPD) is a complicated and often misunderstood mental

health condition and according to the Diagnostic and Statistical Manual of Mental Disorders

(DSM-5) it is characterized based on specific criteria. These criteria include “a persuasive pattern

of instability of interpersonal relationships, self-image and affects, and marked by impulsivity,

beginning by early adulthood and present in a variety of contexts…” (DSM-5) Symptoms

relating to BPD can range from mild to severe and include an intense fear of abandonment, rapid

changes in self-identity, periods of stress-related paranoia and self-destructive behavior (GPT-4).

Childhood trauma such as abuse, neglect, or prolonged exposure to hostile environments as well

as structural and functional changes in the brain are often linked to the development of BPD.

Some of the treatment options for this disorder include psychotherapy, such as Dialectical

Behavior Therapy (DBT), which focuses on teaching patients coping skills, emotional regulation,

and improving relationships (clevelandclinic.org) and medications, which can be used to treat

co-occurring conditions or specific symptoms like depression or mood swings. This disorder is

often stigmatized and misunderstood, leading to a lack of support and adequate care for those

affected and could lead to misdiagnosis for many reasons. These reasons include the prevalence

of overlapping symptoms with other disorders as well as the stigma and ill judgment regarding

the disorder.

Girl, Interrupted uses its linguistic and cinematic techniques as integral components that

shape the viewer’s understanding of mental health, they also work together to create a clear and

empathetic portrayal of the protagonist’s experience with BPD which influence’s emotional

engagement and perception of the complicated and intricate realities of living with mental

illness. The script of the movie will be used to analyze the dialogue and the film itself will be

used for the cinematography technique

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 Through the narrative of Girl, Interrupted, Susanna Kaysen’s use of language evolves

which reflects her journey towards self-awareness and the understanding of her mental health

condition. This can be seen through multiple moments in the film, for example, after she

swallows a bottle of aspirin followed by a bottle of vodka which ended her up in the hospital

recovering from an overdose, she declares, “I didn’t try to kill myself,” (14) which is a classic

example of denial, a psychological defense mechanism (Catchpole 2017). She continues to deny

the need for psychiatric care as she is trying to preserve a sense of normalcy and resist the stigma

associated with mental illness. This can be seen as irony and a reaction to a situation that

threatens her identity and perception of herself and her reality (SparkNotes). The statement also

mirrors the broader theme of resisting a label or a category, which is common among individuals

facing diagnoses relating to their mental health (Meray 2023). Her words also symbolize a

struggle to maintain her sense of reality and self in the face of a label that she sees as degrading

or that she believes defines her in a way that she is unwilling to accept. Susanna’s inability to

acknowledge her need for psychiatric care also reflects the social attitudes towards mental health

that are relevant during the era that the film is set in; the late 60s (Bansinath 2023). During this

time, there was a prevalent stigma and misunderstanding relating to mental health and mental

illnesses. The cultural context further intensifies this idea as it was a time when the

understanding of mental health was not as advanced, and being subjected to treatments or

admitted to a psychiatric facility was often followed by a social penalty (Rössler, 2016).

Therefore, Susanna’s resistance to her diagnosis and treatment can be interpreted as a defense

against the negative perceptions, stigma, as well as the harsh realities of psychiatric care of the

era. This line also plays a role in foreshadowing the journey Susanna goes through to discover

herself as well as the acceptance she experiences throughout the film. It sets a baseline from

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which her character evolves. Her exploration of her inner self takes her from denial and

resistance against her mental health condition to a deeper understanding and acceptance of

herself (LitCharts 2023). Overall, Susanna’s statement at the beginning of the film not only

establishes her initial resistance to her diagnosis and her option of treatment, it also mirrors the

broader social perception of her mental illness and psychiatric care as a whole. This line, while

simple, shows the defensive nature that the protagonist starts off with as well as lays the

groundwork for her character development and the progression of her understanding and

acceptance of herself and her condition.

The mid-film phase marks a critical shift in Susanna’s character development, where

soul-searching and confrontation are evident. This period in the film is crucial in her journey as it

presents a move from a phase of denial and resistance to one of deeper self-awareness and

acknowledgement. Her voluntary admission to the McLean psychiatric facility, as she grapples

with Borderline Personality Disorder, symbolizes her initial steps towards understanding her

mental state and the societal influences on it (LitCharts). The quote, “Maybe I was just crazy.

Maybe it was the 60s. Or maybe I was just a girl… interrupted,” (2) presents a significant

moment of self-reflection for Susanna, mirroring her battle with societal and personal factors

contributing to her condition (SparkNotes). Through her repetition of “maybe”, she wonders

whether her mental state results in her actions and feelings, or whether it's due to the era in which

she exists. This reflects a shift in her viewing her situation as caused purely by external factors to

consider herself within it, specifically regarding her role and identity. This act of soul-searching

is an important step in her journey because it symbolizes the beginning of her coming to terms

with her condition rather than outright denying it. In a confrontation with Lisa, Susanna declares,

“That’s why you keep coming back here. You’re not free. You need this place,” (141) marking a

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realization about the persistence of mental health issues and her own role in confronting them

(LitCharts; SparkNotes). This quote uses situational irony as there's a contrast between

expectation and reality. The ironic element here is seen from the juxtaposition of the concepts of

‘freedom’ and ‘need’. It is expected that a person would return to a certain place because they are

free to do so and choose it willingly, however, this statement suggests that Lisa keeps coming

back not out of freedom, but because of need, which implies the lack of freedom. This

confrontation is not just directed towards Lisa, but also with the reality of mental illness.

Susanna finally realizes the destructive path that Lisa presents to her, this recognition is seen in

her own understanding of mental illness. This line also acknowledges the severity and

persistence of mental health issues. Through her confrontation with Lisa, Susanna confronts

herself, more specifically the part that is represented by Lisa, rebellious, defiant, and deeply

troubled. We can see that there is a growing awareness in Susanna that mental illness is not

something that simply fades away but a serious condition that remains within the individual for

the rest of their lives. These moments of introspection, soul-searching, and confrontation are

crucial in the transition of Susanna’s character from a state of denial and confusion to a state of

acceptance and understanding. They also mark her journey towards acknowledging her illness

and taking steps to address it. These quotes enhance the viewer’s understanding and empathy

regarding Susanna and her character. We can also gain a deeper understanding and insight into

the intricacies of living with mental health conditions like BPD. Ultimately, the mid-film

soul-searching and confrontation in Girl, Interrupted play a key role in furthering the narrative

and character development for the protagonist as they effectively represent the internal conflict

and awareness that are crucial to the journey of someone accepting their mental health condition.

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 Throughout the film, there is a transformation in Susanna Kaysen’s character which

shows a shift from denial and confusion regarding her identity and mental illness, BPD. Susanna

says, “I know what it’s like to want to die. How it hurts to smile. How you try to fit in but you

can’t. How you hurt yourself on the outside to try to kill the thing on the inside,” (122) and it is a

candid acknowledgement of her own inner turmoil and pain. This use of pathos allows Susanna

to appeal to the audience’s emotions as her vivid and raw expression of pain and struggle is

specifically aimed to evoke empathy and an emotional response from the viewer. The quote also

utilizes anaphora, as her use of ‘how’ at the beginning of the sentences creates rhythm and

emphasizes the heavy weight of each statement. The statement presents deep self-awareness and

understanding of her struggles with BPD and symbolizes a turning point where she surpasses the

point of mere acknowledgement of her condition and shows herself and her experiences empathy

(Jones. et al, 2012). By articulating and communicating her internal and external pain, she

demonstrates a level of self-recognition that replaces the denial and self-hatred she experienced

at the beginning of the film, which suggests that she reconciled with her mental state and

acknowledged her pain without self-judgment, which is a crucial step in her healing process

(Roger Ebert, 2000). Nearing the end of the film she says, “I saw the great and wonderful Dr.

Wick three times a week and I let her hear every thought in my head,” (126) this is seen as

closure to her stay at the psychiatric hospital and symbolizes her new beginning (Wolf). The

statement is filled with hope and the yearning to move forward and it reflects her growth and

understanding of her experiences. The language usage, while simple and profound, indicates a

clear shift from the complex, intricate, and often chaotic thought patterns that characterized her

at the start of the narrative (Jones. et al, 2012) The act of her leaving the hospital is seen as the

end of a significant chapter and the beginning of a new one as her physical departure from the

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hospital parallels her emotional journey and represents her moving away from a period of intense

emotional turmoil and confusion to a phase where she is more in tune with her feelings and

needs (Roger Ebert, 2000). These quotes present the essence of Susanna’s character arc, going

from a state of resistance and confusion to a state of self-forgiveness and empathy towards

herself and her struggles. This transformation is of the utmost importance when portraying BPD

as not just a mental health disorder but as an intricate human experience (Wolf). As for the

audience, her journey and language use expresses a more clear understanding of BPD and the

protagonist's evolution from turmoil to acceptance which offers a message of resilience and

hope, therefore challenging the stigma that is often associated with mental health disorders, and

more specifically, BPD (Jones. et al, 2012). All-in-all, the evolution in Susanna Kaysen’s

language from the beginning of the film compared to the end is a narrative tool that captures the

complexities and challenges of living with BPD and also demonstrates a journey of

self-discovery, acceptance, and hope, which resonates deeply with audiences and offers a more

empathetic view of mental health (Roger Ebert, 2000; Wolf).

Throughout the film, there is a use of temporal fluidity, achieved through a non-linear

narrative structure. This cinematic technique relates significantly to exploring BPD in the film.

The creation of a narrative not bound by strict temporal order reflects the disjoint and fluid

perception of time experienced by individuals with BPD (DeGuzman 2022). Multiple instances

of temporal fluidity are present, for example, when the film begins with Susanna in the hospital

after her suicide attempt, followed by a flashback. This sets the tone for the film’s non-linear

approach, indicating Susanna’s story will be told through memories and experiences rather than a

chronological narrative (DeGuzman 2022). The shift from the present to a flashback mirrors the

non-linear thought processes associated with BPD, symbolizing how individuals with BPD might

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experience and recall memories and emotions, which can be fragmented and influenced by their

current emotional state (Masterclass 2021). By contextualizing the present and past, the film

allows viewers to slowly piece together Susanna’s story and glimpse her emotional complexity,

adding layers to her character (DeGuzman 2022). This approach engages viewers in Susanna’s

psyche, creating an immersive and impactful experience. The opening sequence introduces the

subjective nature of memory and perception, suggesting understanding Susanna’s story and

mental health journey requires delving into her emotional journey (DeGuzman, 2022). Through

blending past and present, the film highlights the persuasive impact of Susanna’s past on her

present state, showing her past experiences and emotions as integral to her current identity and

situation. Therefore, the opening sequence of Girl, Interrupted is more than a narrative device;

it’s an entrance into the protagonist’s mind and a reflection of the film’s focus on memory and

perception. The portrayal of the non-linear journey of coping with mental illness presents a story

complex and intricate as BPD itself, inviting the audience to engage with Susanna’s journey in a

way that is emotionally and psychologically insightful (Hagan, 2013).

The use of lighting and the color palette also play a key role in visually converting the

film’s emotional and psychological themes as they not only set the tone of the scenes but also

deepen the audience’s understanding of the characters’ mental and emotional states. Most scenes

set within the psychiatric hospital or during moments of introspection often use muted and cool

color palettes, such as the use of white for the walls of the hospital, a pastel pink color for

Daisy’s room, and pastel blue in Susanna’s room. (Risk 2020) These colors create an

atmosphere of melancholy and sadness, which reflect the characters’ feelings of sadness and

loneliness. These tones visually represent the lack of vibrancy in their lives at those moments,

making their emotional struggles more readable to the audience. On the other hand, flashbacks or

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moments of peace as happiness contrast with scenes from the psychiatric hospital as there is a

use of warmer tones such as brown and orange and yellow. This is seen in a flashback scene

where Susanna lays in bed with her boyfriend, Tobias Jacobs, after having relations of a sexual

nature with him. The colors used for the room evoke a sense of nostalgia, warmth and longing,

which highlights the disconnectedness between Susanna's current and past experiences. The use

of these warmer tones in the flashback suggests that the protagonist is yearning for intimacy and

comfort. The color scheme in the scene represents a time in Susanna’s life where everything was

less complicated and more fulfilling. In the second meeting between Tobias and Susanna in the

film, the mood and tone of the scene are notably different as the warmer tones are replaced with

colder and harsher lighting, which reflect the reality of her current situation. The shift in color

symbolizes the loss of intimacy and comfort, replaced by a sense of emotional disconnection

(Chapman 2021). The cold mood of the scene during his visit to the hospital foreshadows the

eventual end of their relationship when he offers to help her run away to Canada with him.

(Harley, et al.). This highlights the growing gap between her past and present life and her

evolving understanding of what she needs for her own future. The use of these contrasting colors

presents itself as a visual storytelling device as it not only represents the change in time and

setting but also reflects the internal changes that are going on within Susanna. The warmth of her

past and the coldness of her present visually present her emotional journey and the change in her

relationships. This enhances the audience’s relationship and engagement with the film as it

provides an understanding of the emotional landscape of the scene, deepening the emotional

impact and helping the reader understand Susanna’s complex journey. In summary, the use of

contrasting color palettes in Girl, Interrupted in both the flashbacks and present scenes are a key

element in portraying the film’s emotional narrative as they help to visually represent Susanna’s

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journey and relationships from a past filled with warmth and intimacy, to a present filled with

emotional turmoil, pain, and a struggle for emotional clarity. This helps to enrich the storytelling

and provide depth and insight into Susanna’s character and her growth.

The lighting in various scenes and the way the characters are lit can also provide insights

into their mental states and personalities. In scenes where the characters, and more particularly

Susanna, are shown in soft lighting, there is an immediate sense of vulnerability and emotional

turmoil. This type of lighting appears in moments that symbolize pain or adrenaline within the

characters. For example, after Susanna is separated from Lisa after they’d been written up for

singing to their fellow patient, she experiences an episode of dark thoughts and depression,

where she is unable to get out of bed and unable to properly communicate with her doctors and

other patients. This type of lighting highlights Susanna’s inner fragility in that moment, which

helps to invite empathy from the audience. By drawing in empathy from the audience, the

lighting also serves to create a closer emotional connection between the character and the viewer

as it tends to soften the characters’ features, making them appear sympathetic. This technique is

key in this film as it deals with complex characters who might otherwise be difficult to

comprehend or empathize with. Some scenes feature harsh and dark lighting and are often used

to highlight moments of crisis. This can create sharp contrast of light and shadow which

symbolize the internal conflict or emotional turmoil that the character is experiencing. We can

see this when Susanna experiences a manic episode while running away from the psychiatric

care hospital with Lisa. This emphasizes a moment of an episode of mental health crisis as the

use of harsh lighting visually amplifies the intensity of the situation which makes the character’s

struggle more understandable. This use of lighting can be a visual indicator of conflict within the

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character or between characters and can cast deep shadows which creates a dramatic and tense

atmosphere filled with adrenaline. The strategic use of lighting to characterize emotional states in

Girl, Interrupted reinforces the film’s broader themes of vulnerability and mentally. Through the

visual representation of these themes through lighting the film adds an additional layer of

narrative depth and emotional connection between the character and the audience. These lighting

choices provide the audience with important visual cues that enhance the understanding of the

characters and their experiences which is of the utmost importance in the firm as the characters’

internal and emotional states are as important as their actions and dialogue.

This essay, the film Girl, Interrupted depicts mental health, particularly with the focus on

Borderline Personality Disorder (BPD) through the use of language, dialogue, and cinematic

techniques. By using dialogue, the film portrays the protagonist’s internal struggle, emotional

turmoil, and evolution, starting off with feelings and expressions of denial and resistance, to

understanding and acceptance of her mental health condition. This journey is key to the

identification of broader themes such as identity, self-discovery, and the stigma surrounding

mental illness which allows the audience and viewers to empathize with Susanna Kaysen. The

film also uses a non-linear narrative structure and a clever use of lighting and color to enrich the

storytelling. This provides a representation of the emotional and psychological atmosphere

surrounding BPD and the struggles that individual’s with that mental disorder face. The use of

temporal fluidity along with contrasting color palettes and lighting techniques represents the

protagonist’s emotional states which adds depth to the character and enhances the engagement of

the audience with the character and their understanding of Susanna. Girl, Interrupted is more

than just a story about a young woman’s struggle with Borderline Personality disorder, it is also a

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view into the complexities of mental illness which challenges societal stigmas. Through the

combination of narrative, linguistic, and visual elements, the film presents a powerful depiction

of mental health and encourages the viewer to consider the intricate, and often misunderstood,

realities of living with mental illness. Through the journey of Susanna Kaysen, the film captures

the essence of her struggle and emotional battle and also offers a message of hope, which

contributes to the stigma around mental health and its representation in cinema and the media as

a whole.

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● “Girl Interrupted.” Through the Lens: Reel Reading,
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● “Girl, Interrupted.” Sparknotes, SparkNotes,

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