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The Accuracy of the Depiction of Borderline Personality Disorder in Girl, Interrupted

 Mehek Kataria

        Girl, Interrupted is a 1999 film by James Mangold, starring Winona Ryder in the lead role of a young woman with Borderline Personality Disorder. It is generally accepted as the most popular work in mainstream cinema to depict BPD. The film is an autobiographical narrative by Susanna Kaysen, played by Ryder, of her 18-month stay at Claymoore psychiatric hospital, which is where she was first diagnosed with the disorder. Since the release of the film, there have been vastly varying opinions on the way that BPD has been shown in the film, with some believing that it doesn’t show much about living with the disorder at all. (Frtc, 2021) This article aims to analyse the depiction of BPD and consequently, the accuracy of Susanna’s diagnosis in the film. 

The DSM-5 requires that to be diagnosed with BPD, one must exhibit at least 5 out of the 9 types of behaviour that are commonly seen in patients who have the disorder. (Hooley et.al., 2021) One of these is recurrent suicidal behaviour, gestures, threats, or self-mutilating behaviour. (Hooley et. al., 2021) In line with this, the film begins with Susanna being rushed to a hospital after seemingly attempting suicide by consuming a bottle of aspirin and chasing it with a bottle of vodka. (Mangold, 1999) Through many instances in the film, we also find that she engages in self-harm. It is shown that she repeatedly bangs her wrists to the point where they are severely bruised and when in an emotionally intense argument, she picks on her skin till it starts bleeding. When in bed with her boyfriend, she also talks about fantasizing about suicide and the trivial situations that could lead up to it. (Mangold, 1999)

Another behaviour that Susanna exhibits which is a diagnostic criterion for the disorder, is impulsivity in at least two areas of life. (Hooley et. al., 2021; Mangold, 1999) The one explicitly addressed in the film is her tendency to be promiscuous in addition to being sexually impulsive. The difference between the two is that promiscuity refers to intentionally having multiple sexual partners and sexual impulsivity refers to having casual sex on a whim without considering the consequences. (Salters-Pedneault, 2020) Susanna’s promiscuity can be noted in the fact that she has an affair with an older married man, Professor Gilcrest and also has a casual sexual relationship with a young man, Toby, who she met at a graduation party. When Toby visits her at Claymoore, she engages in sexual activity with him and that very night, she also kisses an orderly at the hospital. (Mangold, 1999) Her sexual impulsivity is displayed when she does not consider the consequences of having an affair with a married man who is also a family friend. Additionally, when she kisses the orderly, she does so in front of the other patients and falls asleep on his shoulder right there, without considering the fact that both the orderly as well as she could be caught very easily and would have to face consequences. She also displays impulsivity in other aspects of her life such as running away from the hospital without a proper plan despite the high possibility of being found and brought back. (Mangold, 1999)

Another important behaviour of Susanna that is a diagnostic criterion for BPD is her self-image distortion. (Hooley et. al., 2021) When rushed to the hospital for attempted suicide, she tells the doctors that they should check her hands because she thinks she has no bones. (Mangold, 1999) This is a belief that Suzanna holds during the majority of the narrative, without any explanation for it. Such a belief is the manifestation of an unstable sense of self. When she notices that the orderly is taking a liking to her, she asks him why he likes her which shows her hampered self-esteem. Additionally, after Daisy’s suicide, she blames herself for it and says that a decent person in her place would have intervened and helped Daisy. 

While these three behaviours are very prominent in Suzanna’s character throughout the film, there are some others that are depicted very briefly. At first, despite being hesitant to sign herself into Claymoore and being unwelcoming of treatment, Suzanna was not rude or resistant. However, we soon begin to see a drastic shift in her emotions. She becomes disrespectful during therapy and even has an outburst of anger toward Valerie, the Resident Nurse, during which she is racist and spiteful. This episode appeared to be very out of character for the Suzanna we had seen at the beginning of the film. Such drastic and rapid shifts in emotions are called affective instability which is a common trait found in patients with BPD. (Hooley et. al., 2021) Chronic feelings of emptiness are also a DSM-5 diagnostic criterion for BPD and one can associate Suzanna’s depression with the same. 

Due to the above mentioned five behavioural traits of Suzanna’s character, her BPD diagnosis can possibly be considered an accurate one. However, this film fails to convey to the audience, the true nature of the disorder. For someone who has not read the DSM-5 diagnostic criteria for BPD, most of the scenes that reflect her symptoms can easily be written off as something any rebellious teenager would do. The film is an adaption of an autobiographical book of the same name, however, it misses out on some of the more important scenes from the book that truly depict the severity of the disorder. One such scene is when Suzanna bites open the flesh on her hand after being overcome with the thought that she doesn’t have bones. She also asks for X-rays of herself to verify that this belief of hers is in fact not true. (Kaysen, 1993) Such an episode, if depicted in the film, would immediately distinguish a patient with BPD from just another rebellious or troubled teenager. 





References

Frtc. (2021, September 15). BPD in girl, interrupted: DBT in the Denver Tech Center. Front Range Treatment Center. Retrieved April 10, 2022, from https://frtc.ltd/blog/borderline-personality-disorder-in-girl-interrupted  

Hooley, J. M., Nock, M., & Butcher, J. N. (2021). Abnormal psychology. Pearson.

Kaysen, S. (1993). Girl, Interrupted. Turtle Bay Books. 

Mangold, James. (1999). Girl, Interrupted [Film]

Salters-Pedneault, K. (2020, July 14). Borderline Personality Disorder and Your Sex Life. Verywell Mind. Retrieved April 10, 2022, from https://www.verywellmind.com/borderline-personality-disorder-and-sex-425370#:~:text=to%20impulsive%20sexuality.-,Promiscuity,casual%20sex%20on%20a%20whim).

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