According to Thomas Insel, Former NIMH Director, 10 million American adults (1 in 25) have serious functional impairment due to a mental illness, such as a psychotic or serious mood or anxiety disorder. Two specific types of mental illness portrayed in the films "To The Bone" and "Girl, Interrupted," are anorexia and borderline personality disorder.
Cheryl Pawlowski,
In the film "To The Bone," Ellen, a 20-year-old severely anorexic woman, tries a group home as a last ditch effort after many programs do not help her recover. Her bones are clearly visible through her skin, and her entire family is worried she is going to die from her mental illness.
The second mental illness portrayed in the films I am comparing is borderline personality disorder (BPD). In the Salem Press Encyclopedia of Health, Janine T. Ogden,
BPD is classified in section III in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (2013), which implies that the disorder is the result of permanent traits (such as personality) and requires sustained treatment."
In the film "Girl, Interrupted," Susanna Kaysen, an 18-year-old who has been diagnosed with borderline personality disorder is taken to Claymore, a private mental hospital where she stays for two years. In the film, when Susanna sees her patient files she is described by her doctor as having "an instability of self-image, relationships and mood... uncertain about goals, impulsive in activities that are self-damaging, such as casual sex. Social contrariness and a generally pessimistic attitude are often observed."
Honestly, this just sounds like a typical teenager who will eventually outgrow this stage, not someone with a severe mental illness. Both the films "Girl, Interrupted" and "To The Bone" are about a young woman’s journey with mental illness to rock bottom and back, the stigmas surrounding their illness and the lack of simplicity in the work of recovery. Both films also reveal that chronic illness and their stigmas do not have to be crippling.
In the films "Girl, Interrupted" and "To The Bone," both Ellen and Susanna are misunderstood and often stigmatized for their mental illness, which leads to having to constantly reassure people that they want to get better.
Ellen, who has anorexia, is stigmatized for being too skinny and not eating; she is constantly being met with criticism instead of compassion. Her family seems exhausted by her chronic illness and by the efforts that they have also put into her recovery.
Susanna, who has borderline personality disorder, is constantly stigmatized for being "crazy" and not sticking to social norms regarding sex; she is treated as irresponsible and shameful. However, it is more likely that she is a growing teenage woman going through the typical metamorphosis from teenager to adult and finding her own morals and desires.
In the film,"To The Bone," the key phrase that sums up how Ellen feels about herself in her relationship with her family is "I’ve become a problem instead of a person." She says this while in a family session with her mom, mom’s female partner, stepmom and half-sister. It appears that she feels like something to be fixed instead of someone to be loved. Her mom says, "You look like a ghost," and her half-sister says, "I don’t get it...just eat," during the counseling session. All of these comments are telling Ellen how she does not fit in and how she should stop fighting normalcy and just heal, through eating.
Similarly, in "Girl, Interrupted," the doctor who evaluates her at the beginning of the movie informs Susanna that she is "hurting everyone around" her. Instead of being met with compassion and solutions, he is telling her how much of a problem she is to everyone around her.
When meeting with Dr. Melvin, Susanna’s father asks "Just how long is my daughter going to be here? It is almost Christmas, what are we supposed to say to the people back home," which exemplifies the pressure that people with mental illness face, of ‘seeming’ normal for the sake of the family. In the ice cream parlor, Susanna is confronted by Mrs. Gilchrist who says, "You know I know all about you and I hope they put you away forever." This minimizes what Susanna is going through and makes her out to be a criminal to be put away, not a young woman seeking help through Claymore.
Jonathan Mond, in the article "Eating Disorders as 'Brain-Based Mental Illnesses': An Antidote to Stigma?" found in the Journal of Mental Health writes that it is not fair to say people with mental illness only have themselves to blame, "Individuals with eating disorders, like individuals with other mental disorders, are subject to stigmatizing attitudes and beliefs on the part of the public. Thus, many members of the public appear to believe that individuals with eating disorders are vain, self-centered, fragile, unreliable, attention-seeking, or even annoying, that these individuals ‘have only themselves to blame’ and that these individuals should ‘pull themselves together."
Both Ellen and Susanna have distant parents and have had other troublesome and traumatic things happen to them that they are attempting to cope with through their mental illnesses. They did not bring it upon themselves to get sick, nor is healing as easy as just pulling themselves together.
Thomas Szasz, in his article "The Myth of Mental Illness," found in the American Psychologist in 1960 writes "the idea that chronic hostility, vengefulness or divorce are indicative of mental illness would be illustrations of the use of ethical norms (that is, the desirability of love, kindness and a stable marriage relationship). Finally, the widespread psychiatric opinion that only a mentally ill person would commit homicide illustrates the use of a legal concept as a norm of mental health. The norm from which deviation is measured whenever one speaks of a mental illness is a psycho-social and ethical one.."
The main idea here is that stigma is derived from a deviation from psycho-social, ethical, and legal concepts. In the film "To The Bone," Ellen is judged for not conforming to the psycho-social norm that people are supposed to eat when they are hungry and not starve themselves when they have access to food, making her battle with anorexia is stigmatized.
She is also stigmatized because her drawings that she published on Tumblr were found and used to inspire a suicide. It seems like there is blame and shame placed on her for another person’s decision to end their life. In the other film, Susanna is judged for having sex among other things and these are ethical norms she is breaking and therefore stigmatized as being mentally ill.
Both girls feel varying degrees of stigma and are labeled "tainted" by society; they are being judged so harshly because other members of society believe the solution to Ellen and Susanna’s problems are simple if they would just change their behavior. The films "Girl, Interrupted" and "To The Bone" have themes of family, friends and doctors who all try to give Ellen and Susana a simple answer to a complex mental illness in an attempt to help them heal faster.
Ellen is constantly told to "just eat," and to tell the voice in her head that says she cannot stop to "fuck off." Susanna is constantly told that she needs to either lie, accept her fate like Lisa, or that she is not even sick. In the film "To The Bone," Ellen’s half-sister says "I don’t get it, just eat," in family counseling. She’s also told by the doctor, "Every time you hear that voice," telling you that you cannot stop, "I want you to tell it to fuck off."
This is just too simple an answer - it may be a stepping stone but it cannot be the only advice for healing.
In the film "Girl, Interrupted", Susanna has an interesting conversation with a hippie. He asks her, "do you see purple people? My friend, he saw purple people. And so the state came and took him away. He didn't like that. Some time went by and, and he told 'em he didn't see purple people no more."
The simple answer that is hidden in a story about someone else is to lie that you are better. Instead of admitting that she is still crazy, she should just act like a normal person.
D.L. Rosenhan writes, "The psychological stresses associated with hospitalization were considerable, and all but one of the pseudo patients desired to be discharged almost immediately after being admitted. They were, therefore, motivated not only to behave sanely but to be paragons of cooperation."
Maybe Susanna merely wanted to be discharged in the end, and that is why she is so cooperative. Perhaps she is not cured or sane, merely becoming a good actor at "behaving sanely." Nurse Valerie tells Susanna, "You are a lazy, self-indulgent, little girl, who is making herself crazy." This seems too simplistic. Earlier in the film, Susanna talks about time being nonlinear, and her bones leaving her body and growing back, and all of this seems more than just an indulgent girl.
In "The Myth of Mental Illness" by Thomas Szasz, he writes "for it seems to me that — at least in our scientific theories of behavior — we have failed to accept the simple fact that human relations are inherently fraught with difficulties and that to make them even relatively harmonious requires much patience and hard work."
Ellen could have been triggered into mental illness due to the difficulty of relationships with her parents, her mom turned out gay after being married to her dad, her dad being distant, her step mom being incredibly awkward, and everyone basically abandoning her when her eating disorder became extreme. Ellen’s family all said they could not handle it anymore when she was a problem not a person, and she just wanted to be treated as a human.
Szasz explains how the term mental illness has been warped to minimize how people have become mentally ill, explaining it as an issue of choices instead of chemical imbalances and harmful environmental and social factors. He writes, "the concept [of mental illness] functions as a disguise; for instead of calling attention to conflicting human needs, aspirations and values, the notion of mental illness provides an amoral and impersonal "thing" (an "illness") as an explanation for problems in living" (117). Both Ellen and Susanna were not merely ill due to problems in living, but they were often treated as such. Szasz is trying to dispel the use of mental illness for simplifying it into things like "problems in living," and explain that it is just another complex medical issue.
While both girls were stigmatized and given simple answers to their complex mental illness, the real battle was deciding to continue living or die. Both of the films depict self-discovery of young women coping with the struggle with wanting to live or die, which results in a need to hit rock bottom before they finally decide to live with their chronic illness.
At first, Ellen seems to acknowledge that life can be beautiful but takes a victimized approach, saying "Life’s beautiful and all that shit. And I know it can be, but I can’t stop." Later in the film though she finally gets the shock she needed in her hallucination in the desert, seeing her dead emaciated body on the ground and exclaiming "Oh my god is that me?" This seems to be what she needs to decide to live and work her recovery instead of being so hopeless. Her choice to live is exemplified when she tells her stepmom "I’m going to be okay," in the last line of the film, the last shot is her returning to the group home with a newfound courage to continue treatment.
In the film,"Girl, Interrupted," there is a similar progression beginning with Susanna saying ambivalence means she doesn’t care, again taking a hopeless victim stance like Ellen. Dr. Wick disagrees that Susanna does not care, "On the contrary, Susanna. Ambivalence suggests strong feelings... in opposition. The prefix, as in "ambidextrous," means "both." The rest of it, in Latin, means "vigor." The word suggests that you are torn... between two opposing courses of action."
The turning point, where the audience sees Susanna choose to be alive instead of hopeless is when she confronts Lisa in the last scenes saying, "I've wasted a year of my life. Maybe everybody out there is a liar. And maybe the whole world is "stupid" and "ignorant." But I'd rather be in it. I'd rather be fucking in it, then down here with you." While she gets released from Claymore, she expresses the tension between sanity and insanity quite beautifully in her last line, "Declared healthy and sent back into the world. My final diagnosis: a recovered borderline. What that means, I still don't know. Was I ever crazy? Maybe. Or maybe life is."
Ellen and Susanna are trying to figure out what it means to live with their mental illness, and the idea that mental illness is not some "disrupting influence" but something they will have to chronically live with forever. Thomas Szasz confirms this, writing "the myth of mental illness encourages us, moreover, to believe in its logical corollary: that social intercourse would be harmonious, satisfying, and the secure basis of a "good life" were it not for the disrupting influences of mental illness or "psychopathology" (118).
On the contrary, Ellen and Susanna have to learn how to live a fulfilling life with their illness, not despite it. In the article "On Being Sane in Insane Places," D.L. Rosenhan, a professor of law and psychology at Stanford University asks, "Do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environments and contexts in which observers find them?" This is an important question to ask because Ellen and Susanna both come from a troubled past; maybe their environments and contexts from which they came greatly influenced what was believed to be chronic illness. Maybe it was not genetic, but environmental - a coping response to chaos and stress.
Both Ellen and Susanna were treated poorly with their mental illnesses, but the ultimate victory was when they both decided to live despite all the trials they had faced. All people are going to face some form of stigma and simple answers to complex problems, but these two women are examples of how perseverance is the best answer.
When discussing the misuse of the term mental illness, Thomas Szasz makes the specific idea of mental illness a universal one when he writes "many people today take it for granted that living is an arduous process. Its hardship for modern man, moreover, derives not so much from a struggle for biological survival as from the stresses and strains inherent in the social intercourse of complex human personalities. In this context, the notion of mental illness is used to identify or describe some feature of an individual's so-called personality."
Mental illness, in this case, is often used in judging an individual's social discourse with others, and personal choices in living. Sometimes people act abnormal when attempting to cope with stress, trauma, anxiety, and depression, and Szasz is reminding that this shouldn’t be discounted.
Marie A . Yeh writes in the article "The Stigma of Mental Illness: Using Segmentation for Social Change." found in Journal of Public Policy & Marketing in Spring 2017 that it is incredibly important to realize the effect of mistreatment of individuals with mental illness because "despite the unequivocal incidence and burden that mental illnesses place on the world, those with mental illness remain not only neglected but also deeply stigmatized across societies. The stigma that surrounds mental illness serves as a barrier to treatment and recovery, leading to serious negative consequences such as school failure, job loss, and suicide."
In summary, the film "Girl, Interrupted" is more about accepting your crazy as a part of you, and learning to live with it. Susanna ends the film saying "Crazy is not being broken, or swallowing a dark secret. It's you, or me, amplified." The film,"To The Bone," on the other hand, is a film more focused on the courage of accepting help from medical professionals instead of being hyper independent and thinking you can survive purely on your own.
A common phrase in this film is "Your courage is a small coal you keep swallowing." Despite stigma and attempts at simple answers, mental illness is serious and should be treated with respect.
