The pathologization of socially non-conforming women and how that demonstrates the systematic flaws and gender biases of the 1960s in the film Girl, Interrupted
How does the film Girl, Interrupted portray the flaws within the women's psychiatric system in the 1960s?
Elena Clay
Girl, Interrupted, directed by James Mangold, explores the experiences of women in a psychiatric institution in the late 1960s, a period characterized by stringent social norms and gender expectations. Based on Susanna Kaysen’s memoir, the film critically examines how society pathologizes women who deviate from conventional roles, revealing underlying systemic flaws and gender biases.
The 1960s were a period of tremendous social upheaval in the United States, highlighted by the civil rights movement, second-wave feminism, and growing countercultural forces that challenged traditional norms. Despite these progressive movements, gender inequalities persisted, notably in medicine and psychiatry. During this time, women were labelled with psychological problems at a disproportionate frequency, particularly when they engaged in behaviours that deviated from conventional gender norms. This is particularly evident in the film Girl, Interrupted, as characters like Susanna Kaysen, diagnosed with Borderline Personality Disorder (BPD), and Lisa Rowe, diagnosed as a sociopath, along with other supporting characters, display these issues.
This gender bias was extremely apparent in psychiatric practices, where women were diagnosed with mental diseases such as hysteria, BPD, and depression at a disproportionate rate. These illnesses were usually associated with traditional conceptions of femininity and women’s “natural” emotional instability. Notably, feminist scholars of the time, such as Phyllis Chesler and Betty Friedan, highlighted how “the conventional picture of femininity” confined women to specific roles, and any deviation from “that pretty picture of femininity” was often medicalized as a psychological issue. The film Girl, Interrupted depicts this dynamic by portraying the treatment and perception of women in a psychiatric facility. The characters’ experiences mirror a larger social tendency to pathologize female nonconformity, notably using the lens of psychiatry, which was frequently employed to impose social conformity.
Mangold employs a range of cinematic techniques to emphasize these themes, including non-linear storytelling, sharp visual contrasts, and symbolic use of lighting to underscore the power dynamics between patients and staff. For instance, close-up shots of the female characters' emotional responses highlight their vulnerability, while the use of cold, clinical lighting reinforces the oppressive environment of the institution. Along with this, the incorporation of warm and harsh lighting creates juxtaposition in scenes between Susanna and Lisa, where the lighting and camera angles visually represent the characters’ complex relationship with societal norms. Through these techniques, Girl, Interrupted conveys the systemic oppression faced by women during this era, as their behaviours—such as Susanna’s rejection of traditional femininity—are pathologized by a male-dominated psychiatric system.
Susanna Kaysen and Borderline Personality Disorder
Susanna Kaysen, the main character of Girl Interrupted, was diagnosed with BPD following an aspirin and alcohol overdose. This diagnosis is hugely gendered since it frequently targets women, like Susanna, who demonstrate emotional instability or engage in behaviour that contradicts social norms. Throughout the film, Susanna’s diagnosis appears to be based on her failure to comply with customary expectations, such as obtaining further education or entering a stable romantic relationship. The pathologization of her desire for freedom and exploration reflects a wider societal dissatisfaction with women deviating from these prescribed roles. This sentiment is particularly highlighted during the given historical period of the 1960s.
To highlight the idea that Susanna's character is not innately mentally ill but rather was sent to the psychiatric hospital for defying social standards, filmmaker James Mangold used a non-linear storyline. For example, the film opens with fragments of Susanna’s life, laced with flashbacks that gradually expose what happened before she was admitted to the hospital. These non-linear sequences reveal how Susanna’s decisions—like choosing to forgo college—are seen as deviant rather than just out of the standard. Susanna meets with her high school counsellor in a pivotal scene to debate her choice, and the counsellor reminds her sternly that she is “the only one in her graduating class not attending college” (Girl, Interrupted, 00:13:45). This interaction, which is positioned in between the scenes of her admission, clarifies the reason behind her admission to the psychiatric ward and supports the theory that Susanna is an outlier, not because she is mentally ill, but because she defies expectations placed on women of her age and background.
Susanna’s sexual conduct plays a crucial role in her diagnosis, highlighting the pathologization of women who defy the customs of society. Her sexual interactions are shown in the movie as a key source for the contention in her treatment. For instance, Susanna's liaison with her married, older teacher is subsequently cited as proof of her alleged instability and promiscuity. This affair, while morally questionable, is less about Susanna's mental state and more about her rejection of societal expectations around female sexuality. In a powerful scene, Susanna confronts the unfair judgment placed on her actions; posing the question, “How many men do I have to sleep with to be considered promiscuous? And how many women does a man have to sleep with before he’s considered promiscuous?” (Girl, Interrupted, 00:38:00). This sequence, which takes place prior to her hospital admittance, emphasizes how gendered her diagnosis is. This is further supported by the non-linear structure of the movie, which shows Susanna’s interactions both before and after her admittance, obliquely hinting that her inability to fit in rather than a particular mental disorder is what led to her institutionalization. The juxtaposition between Susanna’s actions and the psychiatric labels imposed on her is further highlighted in a scene with Dr. Wick, where Susanna is chastised for having “semi-sexual interactions with two different men on the same day” (Girl, Interrupted, 01:03:10). This scene stands in stark contrast to a previous, seemingly light-hearted moment in which Susanna kisses a hospital guard following a string of feel-good exchanges, such as singing with Polly and cuddling up to her ex-boyfriend Toby. The abrupt change from these pleasant exchanges to Dr. Wick’s icy, clinical judgment highlights how Susanna’s behaviour, which may be seen as typical explorations of sexuality, is pathologized as they deviate from conventional notions of what a woman should be like.
This juxtaposition is further emphasized as the film uses visual cues to accentuate the contrast between how Susanna is perceived and her actual experiences. For instance, Susanna is seen in one scene sitting on Lisa’s bed with warm colours and gentle and soft, bright lighting that conveys a sense of security and comfort. But the scene’s mood is significantly harsher since Lisa, Susanna’s character counterpoint, who serves as a form of character foil, is rebellious, unrepentant, and utterly disinterested in fitting in with society’s standards. The visual components contribute to the description of how the system has damaged Lisa’s character and her lack of hope in this system, which stands in sharp contrast to Susanna’s newfound innocence in this system. This juxtaposition between the visual warmth of the scene and the underlying tension between Susanna and Lisa highlights the internal conflict Susanna faces: she is drawn to Lisa’s freedom from societal expectations but recognizes the destructive path that this freedom can lead to. Susanna is lured to Lisa’s independence from societal norms, but she is also aware of the potentially dangerous route this freedom might take. This is observed again at about minute 56 when Susanna disappears into an isolated room in the ward following a disagreement with Lisa. The room is bathed in a cold and sterile manner, with clinical lighting, contrasting sharply with the scenes’ warmer tones and softer lighting. This shift in lighting demonstrates the isolation and scrutiny Susanna faces as she grapples with her diagnosis, continuing to reinforce the idea that her true “illness” (Girl, Interrupted, 01:01:00) is her nonconformity.
Similarly, the power dynamics in this scene are highlighted when Susanna first encounters Dr. Wick by the sharp contrast between the doctor’s authoritative manner and Susanna's vulnerable position. The film uses several cinematic techniques to underscore this disparity. When Susanna first enters Dr. Wick’s office, the camera angle is crucial in establishing this power dynamic. These problems are a reflection of a larger institutional and societal failure to comprehend and support women’s mental health, choosing instead to restrict and control their behaviour. The difference is highlighted in the film using several cinematic devices. The camera perspective and positioning play a critical role in creating this power dynamic, for instance when Susanna walks into Dr. Wick’s office for the first time. In this scene, Susanna is frequently shot from a high viewpoint, which emphasizes her fragility and inferiority in this context, however, Dr. Wick is portrayed from a low position, perceiving her as dominating and authoritative. Dr. Wick’s office is meticulously organized, with formal, intimidating furniture that further symbolizes her control and the institutional power she wields. Susanna, on the other hand, seems out of place because of her messy hair and carefree attire—visually portraying her as out of place and powerless in this environment (Girl, Interrupted, 00:56:00). The lighting in the scene is also significant; Dr. Wick is often bathed in natural light coming from the large window behind her, symbolizing rationality and authority, while Susanna is in softer, dimmer light, suggesting her confused and vulnerable state. This visual contrast not only highlights the imbalance of power but also reinforces the theme of infantilization, as Susanna is portrayed as dependent and subordinate to Dr. Wick’s professional authority. Dr. Wick’s office is also decorated in a way that suggests order and control, with very prim furniture and being dressed quite formally, while Susanna’s dishevelled appearance and confused responses highlight how she is being forced into a narrative of illness that doesn’t truly fit her experience.
Lisa Rowe and Sociopathy
When considering a character like Lisa, it becomes clear that she consistently defies expectations and violates societal conventions throughout the film, which contributes to her diagnosis. The cinematography enhances this characterization, often casting Lisa in harsh, shadowed lighting that reflects her perceived dangerousness. For example, we find out that Lisa has been classified as a sociopath in the scene where the patients break into the office and read their diagnoses. The dim, shadowy lighting in this scene mirrors the secrecy and distrust surrounding psychiatric diagnoses. While the institution labels Lisa as a sociopath, the audience may perceive her stubborn independence, refusal to submit to authority, and protective instincts toward her friends—traits that most likely contributed to her diagnosis—quite differently. For example, in the scene where she blocks the nurse from conducting checks on Susanna while Susanna is in the ward with her boyfriend Toby, the nurse views Lisa’s behaviour as confrontational and inappropriate, even threatening self-harm.
However, the dramatic irony in this scene is in the audience’s comprehension that Lisa is not acting maliciously or with true sociopathy; rather, she is attempting to protect Susanna from being caught, exhibiting a compassionate side that defies her diagnosis. The soft, ambient lighting and lack of tense background music in this scene contrast with the institutional perception of Lisa, underscoring her complex character and defying her sociopathic label. The audience experiences cognitive dissonance as a result, and they start to wonder if Lisa’s diagnosis accurately describes her personality or if it is just another instance of the institution's tendency to pathologize women for defying societal norms. Furthermore, Lisa’s persona serves as an example of how the psychiatric establishment uses diagnoses to manage individuals who defy societal standards which is displayed through the frequent use of close-ups and lighting, visually separating her from the other patients and symbolizing her isolation within the institution.
In the scene where Lisa provokes a revolt among the patients (Girl, Interrupted, 00:58:15), the use of sound is particularly notable. The sudden increase in volume, coupled with chaotic camera movements, mimics the growing tension among the patients, capturing both their excitement and the rebellious energy Lisa inspires. As Bordwell and Thompson note, sound in film can “direct our attention to specific elements of the narrative,” which in this case emphasizes the patients’ collective emotional state and Lisa’s role as the catalyst for the revolt. She inspires them to deviate from the strict routine that the staff have enforced. Although the patients and audience find this act of disobedience intriguing Lisa’s severe treatment and incarceration are further justified by it. The way the institution responded to Lisa’s acts highlights the gendered dynamics at work: rather than being viewed as an expression of her desire for female independence and autonomy, Lisa’s actions were diagnosed as signs of a mental disorder, incarcerating her. The harsh, cold lighting in the scenes where Lisa is punished further reinforces the institution’s control over her, contrasting with the warmer, more natural lighting used in scenes where she exercises influence over the other patients. The audience interprets “Lisa's disobedience as a scream for agency rather than a sign of sociopathy,” which underscores the dramatic irony of how non-conforming behaviour is treated with a double standard depending on gender.
In an additional incident (Girl, Interrupted, 00:45:32), the staff saw Lisa’s nocturnal rule-breaking behaviour—sneaking out of her room—as more proof of her sociopathy. However, as described by Bordwell and Thompson, the use of “silence and dim lighting in this scene portrays a different tone, suggesting not defiance but desperation.” The “absence of non-diegetic sound here emphasizes the oppressive atmosphere of the institution,” symbolizing the emotional isolation Lisa feels. This adds further meaning when the audience is told that Lisa is characterized as a lifer, which means she won’t get better and won’t leave. Rather than being motivated by genuine anti-social and rebellious impulses, her activities are a protest against the degrading treatment she receives and the sense of captivity she experiences. She has the capacity to influence and direct others, especially in times when the patients band together to support one another. This implies that her “sociopathy” is more of a name the institution put on her to excuse its need to control her than a real representation of who she is.
In the scene where Lisa provokes a revolt among the patients (Girl, Interrupted, 00:58:15), the use of sound is particularly notable. The sudden increase in volume, coupled with chaotic camera movements, mimics the growing tension among the patients, capturing both their excitement and the rebellious energy Lisa inspires. The institution’s response to this revolt is severe, with Lisa being incarcerated as a result. The way the institution reacts to her behaviour highlights the gendered dynamics at play: instead of interpreting Lisa’s actions as an expression of her desire for autonomy and female independence, her rebellion is framed as a symptom of her mental disorder. The harsh, cold lighting in the scenes where Lisa is punished further reinforces the institution’s control over her, contrasting with the warmer, more natural lighting used in scenes where she exercises influence over the other patients. The audience views her defiance as a cry for agency, amplifying the dramatic irony that the institution fails to recognize this and instead pathologizes her behaviour.
In another key incident (Girl, Interrupted, 00:45:32), Lisa’s nocturnal rule-breaking—sneaking out of her room—is interpreted by the staff as more evidence of her sociopathy. However, the use of silence and dim lighting in this scene portrays a different tone, suggesting not defiance but desperation. The absence of non-diegetic sound here emphasizes the oppressive atmosphere of the institution, symbolizing the emotional isolation Lisa feels. Rather than being motivated by genuine anti-social impulses, her actions reflect her protest against the dehumanizing treatment she receives and the sense of captivity she experiences. Lisa’s ability to influence and lead others—especially in moments when the patients band together to support one another—is shown through the use of dynamic, low-angle shots that make her appear powerful in contrast to the institution’s oppressive environment. This suggests that Lisa’s “sociopathy” is more a label imposed by the institution to control her than an accurate reflection of who she is.
Systemic Gender Bias and Infantilization in Psychiatric Institutions
The film not only delves into individual characters like Susanna and Lisa to illustrate the misjudgment of women’s mental health but also uses their stories to critique the broader gender biases and systemic flaws. One of the most pervasive forms of gender bias depicted in the film is the infantilization of female patients, reinforced through both narrative and visual techniques. This is evident in the way women are treated by the predominantly male staff. For instance, patients are frequently not told the duration of their stay or course of treatment, nor are they informed about the drugs they are prescribed. This lack of communication is a reflection of the patronizing attitude that women frequently encountered in the 1960s from medical personnel, who “routinely undermined their independence and capacity to make knowledgeable decisions about their health by treating them with the idea of infantilization.”
A major example of this infantilization occurs when the patients are taken out for ice cream and must walk in a line behind the nurse, much like children on a school field trip (Girl, Interrupted, 00:48:20). The high-angle shots used in this scene further emphasize the women’s lack of agency, making them appear small and submissive under the nurse’s watchful eye. This scene symbolizes how women are deprived of their agency and treated as though they are unable to make their own decisions, which is a reflection of a larger social tendency that views women as helpless objects that must be controlled and managed. This visual infantilization is contrasted with the male authority figures in the institution, such as the guard, who escapes punishment for his inappropriate behaviour of kissing a vulnerable patient who was admitted to the medical facility and instead simply moved to the men’s ward.
In contrast, Susanna’s diagnosis of mental illness is amplified when she is labelled “promiscuous.” The use of close-up shots in moments where male staff assert dominance over female patients highlights this double standard, as the camera lingers on the women’s emotional reactions, underscoring their vulnerability. This technique exposes how the film visualizes the gender biases at work, punishing women for behaviour that men are able to engage in without consequence, and are characterized by the idea that women act emotionally and irrationally. This is also evident when Susanna’s diagnosis of BPD is categorized by her being viewed as “promiscuous,” while the male guard’s similarly irrational actions and behaviour go unnoticed.
These gender biases are also reflected in the systemic flaws of the psychiatric institution, where diagnoses are often vague and applied inconsistently. The film suggests that these diagnoses serve more as a means to control patients rather than to genuinely treat their conditions. For instance, the characters are often treated the same regardless of their specific diagnoses, reflecting a one-size-fits-all approach that fails to address their individual needs. This is further worsened when we learn how the ward is highly dependent on the money they are making off of these patients. For instance, the character Daisy gets released well before she is ready to leave, which is evident later in the film when we learn she is driven to commit suicide, only because her dad had stopped paying (Girl, Interrupted, 00:42:20). This suggests that the psych ward's primary goal is to help patients as long as they are able to pay for care rather than waiting until they get better. “As scholars have noted, institutions in this era often operated under economic incentives, prioritizing financial stability over patient well-being” (Busfield 263). This one-size-fits-all approach is evident in how Susanna, Lisa, and others are subjected to the same routines and treatments, despite their different backgrounds and reasons for being institutionalized. The system’s inability to offer individualized care draws attention to its more serious shortcomings, which include the fact that patients are admitted or discharged based not on their true mental health but rather on outside variables like their financial situation.
Girl, Interrupted serves as an impactful exploration of the intersection between gender, mental health, and societal expectations during the 1960s. The film examines; through the experiences of characters like Susanna Kaysen and Lisa Rowe, how the psychiatric system was utilized to compel social conformity, especially for women who deviated from the expected gender roles. This is done through its non-linear narrative structure and use of cinematic techniques such as lighting, camera angles, and sound. Gender biases deeply influenced the diagnosis of sociopathy and borderline personality disorder given to Susanna and Lisa, respectively. These labels reflect not just the medicalization of their nonconformity but also the broader societal discomfort with women who refused to fit neatly into the prescribed roles of wife, mother, and obedient daughter. The contrast between warm and cold lighting, especially in scenes involving power dynamics, underscores the tension between societal expectations and the personal struggles of characters like Susanna and Lisa. Sound and silence are also used effectively to illustrate emotional isolation and the oppressive atmosphere of the institution, while close-ups and dynamic camera movements capture the internal conflicts faced by the characters.
The film’s visual juxtapositions and non-linear narrative structure illustrate the contradiction between the characters’ actual experiences and the labels that the psychiatric system has placed on them. In particular, Susanna’s experience demonstrates how actions that may be viewed as typical explorations of one’s identity and sexuality are instead pathologized because they defy accepted norms of society. Lisa’s persona exemplifies the extremities of this pathologization as well; not only is her nonconforming behaviour classified as sociopathy, but it is also utilized as an excuse for severe measures that further her institutionalization.
Beyond individual stories, Girl, Interrupted also addresses the structural problems with the psychiatric institution, including the dehumanization of female patients, the ambiguity and inconsistency of diagnoses, and the tendency to prioritize profit above actual patient care. These issues reflect a broader societal and institutional failure to comprehend and support women’s mental health in a meaningful way, instead choosing to control and contain those who stepped outside the bounds of what was considered “acceptable” behaviour.
In conclusion, Girl, Interrupted is a narrative of personal struggle and a broader commentary on the societal and systemic forces that pathologize female nonconformity. By bringing these issues to light, the film challenges viewers to think critically about the historical and current prejudices in women’s mental health care as well as the ways that societal norms continue to influence our perception of what constitutes “normal” or “acceptable” behaviour, especially for women.
Citations provided upon request.
Elena Clay is a Grade 12 student at Mulgrave School. This essay was inspired by her interest in mental health and its historical impact. Reading the novel version of Girl, Interrupted sparked her curiosity, leading her to analyze the film—which she had not seen before this project—for her Extended Essay. She found the process really engaging, and it helped her better understand the gender biases present in the 60s.