Megan: [00:00:00] Hello this is the i'm triggered podcast i'm megan 

Jess: I'm Jess. 

Megan: Thank you so much for listening we are figuring out how one makes a podcast and we appreciate people tuning in and having patients as we are learning 

Jess: Yeah, and being very kind as we do it is very nice. We're trying. 

Megan: We are. When you start something new. You don't know what you don't know. And it's definitely a process of that. 

Jess: I think there are so many people who think creating a podcast is very easy. I, I mean, I would have to imagine that's why so many people do it, but it's actually very involved. 

Megan: And I'm glad that we have each other to split the tasks and, figure out who can do what. It's very helpful. 

Jess: It is. And it's a good like. little ego boost of like, okay, I'm good at these things. I don't have to be good at those things. You can be good at those things and we can be good at 

it together.

Megan: Yeah, exactly. Like [00:01:00] Jess, please do social media. It actually scares me. 

Jess: Scares me a little too, and I will still do it. In part because I really love making the silly little graphics on Canva. It's way too fun. 

Megan: All the ghosty graphics. So what's been going on in your world. 

Jess: Well, it is 95 degrees here today. 

I know after we had a handful of days that were like very lovely. Low 80s, high 70s, and now it is back to 95. So, I would like to lay down. That is what's going on in my world today. 

It's like, oh god. I'm hoping it, hoping it cools back down, but I'm, I am guessing it is much nicer on the west coast right now. Yes, it 

is. And I'm so sorry that you got tricked. You got, nicer weather, and then, just kidding!

Got duped. It's not cute, but yeah, how is [00:02:00] Bodhi? How is he healing up? 

Megan: Bodhi's recovered. He's good. He got his donut off now. He's no longer taking all of his sedatives. And we've got on a couple of walks and he's just been so stoked to go outside and sniff things so yeah pretty much back to normal. 

Jess: Oh, in my next life, I hope I am a dog or a cat that is just really well taken care of. I know. That would be so amazing. Like, you just get to sleep and sniff things. Incredible. 

Megan: Yeah, and get lots of attention and treats and all that. Yeah, he, he's got a good life. That's for sure. 

Jess: Yes, my cats have an amazing life.

I would absolutely want to be reincarnated as one of them. They're doing great. They have all the things. 

Megan: Yeah, yeah. It's like, what did you do today? Well, I slept, I looked out the window, I got some cuddles, got some treats. 

Jess: Saw a bird today. Do 

Megan: they do that thing when meh? Yep. 

Jess: Okay,

 I didn't [00:03:00] realize that, that that was like just a thing that they do. And that scared the absolute shit out of me. I was like, do you have a disease? What's going on? And my, I have one cat, he's an orange cat and I know that's like a meme, but, and he is very much like fits the meme. He is just one brain cell pinging around and he does not do very much.

He's not like the most active cat. He does a lot of hiding and sleeping. So it. It was very, alarming when he was in the window looking at birds and making this like horrific, guttural, the ring noise, I don't know. And as it turns out, this is very normal and this is just something they do. But yeah, he does it all the time.

I think i heard once That they do that because they're trying to sound like birds 

Megan: It must 

Jess: be. It must be. 

Megan: Has that ever worked for a cat where a bird's like oh hey look it's my friend let me go over there and say hi to my [00:04:00] friend 

Jess: it doesn't seem like they realize that they're Inside, and it's not like they can go through the window.

I mean, it's kind of funny. It's all, they're fine. They're fine. They're okay. It's all good.

But just, it is really bizarre. 

Megan: Yeah, animals are funny. We love the pets and, there is a kitty cat in today's movie. A lovely kitty cat. 

Jess: Ruby, a very sweet Scottish Fold, I think, kitty. Of course I know what kind of cat it is. 

Megan: Fancy cat. Okay. 

Jess: Yeah, not surprising given the character, 

But yeah, Today's movie is Girl Interrupted, 1999. It is based on a memoir by Susanna Kaysen it takes place in the late 1960s and, uh, follows her experience in a mental health facility, which I believe was McLean Hospital or McLean. In [00:05:00] Massachusetts.

 I re watched it yesterday after having not seen it in several years, and it's always an interesting re watch. Very of its time in a number of ways. 

Megan: I was thinking how interesting it is that it's a movie that's about the sixties, the late sixties. So lots of stuff happening back then. And then it was actually made in the nineties. So it really reflects a lot of what was going on in the sixties and also what was going on in the nineties, 

There's a lot of things in the movie that were like, ah, right when they were saying things a lot of, I think this goes right into, potential triggers.

Homophobic slurs. A lot of them anti fat comments, and, it really reminded me of like, that was just how people talked and how people saw things back then. 

Jess: Yeah, 

it was very it was so clear to me that it was made in the 90s, the haircuts, the clothing, as much as, yes, I'm [00:06:00] sure they tried to make it seem 1960s esque, it had a lot of 1990s energy, and, yeah, There's a lot of like, heroine chic look happening.

Megan: Oh, I was just thinking that. Like heroin, chic, Angelina Jolie with dirty pants and a little tank top. Now they did put whoopi goldberg in a poncho and i think that was really showing no this is the 1960s look she's in a poncho 

Jess: and it was like, rainbow colored, I believe. 

Megan: The sixties man 

Jess: It was incredible. And I had totally forgotten that Whoopi Goldberg was in the movie, so that was a treat. 

Megan: Talk about an ultimate nineties movie. So we have starring Winona Ryder, and then Angelina Jolie who is not the star, but basically it's the star takes over the whole movie for sure. Clay Duvall, such a nineties alternative icon, Brittany Murphy, Elisabeth Moss, Jared Leto. Back when he was still a heartthrob. [00:07:00] Jordan catalino known for that 

Jess: before he became a cult leader. 

 Yeah, before he became whatever we want to call him now. Very creepy. Jeffrey Tambor is one of the doctors, also somebody who ended up being pretty creepy. Vanessa redgrave another one of the doctors will be goldberg is the nurse and joanna Kerns, the mom from growing pains is in this 

Jess: oh 

my god, I did not catch that. Oh my god, you're right. 

Megan: She's barely in it. She's, uh, she's Susanna's mom. Yeah, she's barely in it.

I think like two scenes, maybe. 

Jess: She's a little dramatic. She's memorable, but 

yeah, she's memorable and not in it very much 

Megan: And that's kind of part of the mental health stuff we're talking about is this idea of like a women being dramatic. Then we have our triggers. It's a rated R movie. There's a lot. There's suicidality, suicide attempt. Self-harm. References to incest there's [00:08:00] institutionalization racist behaviors and statements and like i said before anti-fat newness and also a lot of homophobic statements But i miss anything Anything

Jess: I mean, it kind of goes with the anti fatness, but certainly like a lot of pro eating disorder stuff.

Like, they're not really talking about it in a negative way. The patients obviously, but yeah, I would say there's a yeah, eating disorder trigger warning. 

Megan: Yeah. And also considering that two of the patients we get to know have eating disorders. That eating disorders were barely understood at the time. How to treat them what they are how they can vary considerably just not really understood.

Jess: I think it was very reminiscent of One Flew Over the Cuckoo's Nest, here we have this institution, which is for mental health and mental illness, and there's no real discernment in treatment.

 Everyone is kind of in the same [00:09:00] space. No one's getting any specific care, and I think you also do see some intellectual disabilities represented and those folks are in there lumped in there as well. So it's, yeah, I think it speaks to just, especially in the 60s.

We did not have a really good handle on mental health and mental illness. 

Megan: Yeah, it's just kind of like everybody's house there and they're given medications and that's really the extent of the treatment. 

So a general overview, because there are a lot of similarities to one flew over the Cuckoo's nest. A lot of things that happened with all the characters this is a movie about a group of people living in a psychiatric institution, a great way to have a super solid ensemble cast, where there's lots of different things going on. 

 We might not get so much into the specifics because there's so much to talk about in terms of the depictions of mental health. So basically. This is a story. About susanna Kaysen played by Wynnona writer. who's 18 years old she just graduated from high school and she checked herself [00:10:00] into the psychiatric institution she's kind of tricked into it by her parents and a psychiatrist that they know she lives there for i believe about 18 months and while she's there she meets all the other residents and gets to know them especially lisa played by angelina jolie And susanna tries to come to terms with what brought her into the institution and what she needs to get back out into the world 

Jess: That was a very perfect and concise, like, TLDR. That was great. 

Megan: Yeah thank you because there's there's so many things we could have a separate podcast i think about every character because there's so much you know every character is almost like a caricature of certain mental health issues 

Jess: I agree.

Every, review that I read, there was a lot of the same critique, which was that there's not much of a plot there's not some big story arc there. Effectively it's a person's life and this particular chapter in their life and it's just [00:11:00] following them through it.

So naturally there's not going to be some huge plot point . I do think that there are plenty of moments throughout that make it worth watching. Even if just for some of the more dark humor, as an example, and this, yeah, trigger warning. The reason that Susanna is coerced into going to the hospital is because she attempts suicide and part of the suicide attempt includes aspirin and when asked why she took as much aspirin as she did, she said that she had a headache.

And I think that that is a, perhaps a deflection tool that she uses because ultimately she does. admit to having attempted, but I would say the first half of the movie, she's very committed to this story of, I wanted to feel something different.

I had a headache. It's just very, very flippant. 

Megan: Yeah and susanna she's always annoyed she'd get really annoyed like oh, i had a headache 

Jess: Yeah. And so adamant about [00:12:00] it, which. I don't know that it was supposed to be funny, but it is definitely, there's definitely that dark humor piece. And maybe this is just like me being a therapist. I can laugh at these things, but there's a number of moments in the movie that are similar to that where, people are saying things and it's just this is probably not funny to anyone else, but, this is.

Kind of funny to me. In particular, like the scenes with Janet, the, patient who has an eating disorder. 

Megan: Oh, Janet is really funny though. She's really funny. 

Jess: Yeah, she is really funny, but like very stereotypical, eating disorder presentation or like what they would have, Assumed as much in the, 60s and then also in the 90s, but, I feel like you could just pull her lines out of just a stereotypical representation of anorexia.

Megan: Yeah, totally. 

Jess: But I do appreciate her being a fucking shrub. She does say that at some point. 

Megan: What's a really funny one. You mentioned that when we were talking about when flew over the Cuckoo's nest and I hadn't seen this movie girl interrupted [00:13:00] for a really long time, it came out when I was in college and back then I read the book and saw the movie, but I didn't remember it very well. So i was like oh yeah just made a joke about janet saying that she's a fucking shrub now i get it weeks later i get the joke go me. 

Jess: Those are the best ones though. Those are the best jokes. 

Megan: A Little delay there 

No, I did want to say I actually had a different take on what Susanna was saying about her suicide attempt. Because I specialized in dialectical behavioral therapy for quite a while. I don't anymore, which maybe I'll talk about on here someday. So I've worked with a lot of people who have some similarities to what Suzanne was going through, where they're diagnosed with borderline personality disorder, and they've struggled with suicidality and maybe also a self-harm. And one thing I really learned through my training. And also just getting to know a lot of different people is that sometimes there would be what looked like a suicide attempt, like an overdose, for example. And it really wasn't that the person [00:14:00] had a strong intention to die. It was more that they had a desire to find some relief . It was very impulsive and people would come out of it and be like, I didn't really want to kill myself. I just felt awful. And I wanted it to stop very similar. To what Suzanne was saying. And towards the end, she said very clearly I tried to kill myself. And I interpreted that as she has taken on the narrative, that all the professionals have been putting on her because they didn't believe her. I don't think they really understood what was going on with her. And they weren't really willing to listen to what she was saying. That was really a theme throughout the movie, unless she did things the way that they wanted to do things, they didn't really listen to her. They just believe that, well, if you hurt yourself in this way, then you must've had this intention behind it. Sometimes that's also the belief about self harm to that. It's meant to be suicidal in nature and that's. [00:15:00] Often not the case. Now the problem here obviously is if someone could feel terrible and want to have a break and have an impulsive behavior. They could really harm themselves or even kill themselves so it's a huge issue that treatment providers take very seriously and should take very seriously 

Jess: yeah, that's such a good point and was certainly something that, I was thinking about through the film that all of these providers overlaid their interpretation of her life and her behavior with a particular label. Well, even initially they didn't want to tell her what her diagnosis was, which I thought was very curious,

Megan: also pretty common for BPD, especially like, don't tell the person that's because they're going to freak out and we don't want to deal with it.

It's so messed up. 

Jess: I'm still stuck on, and I wrote this in my notes. Does she actually have. [00:16:00] BPD, I went back to the diagnostic criteria. I was looking and I still don't know. Arguably, it doesn't matter. But the reason I even harped on that or thought more about that was I do think that BPD is a diagnosis that gets thrown around, especially for folks in psychiatric institutions. And it often gets thrown at women or femme identifying people. Even though it's not necessarily exclusive to, to women. I just thought that that was a curious thing. I was like, wow, was this even happening in the sixties that this diagnosis was just assigned kind of willy nilly to people who.

Came to the hospital after a suicide attempt, or what appeared to be a suicide attempt. 

Megan: Yeah, I agree with you. And I think Susanna Kaysen has said she doesn't believe that she had BPD. I think it's important that we really talk about BPD and all the implications here . There's not a lot of movies or books about people who have [00:17:00] this diagnosis. It's an extremely stigmatized diagnosis, even within the mental health world. . I've heard fellow providers say pretty horrendous things about people who have some characteristics of someone with BPD. Like don't call that person back. It sounds like they're borderline. I had a professor when I was in school, say something. Very judgmental about how people with personality disorders or you can tell that somebody has a personality disorder because they make you feel crazy when you're talking with them

Jess: That's so bizarre. 

Megan: It's so messed up. So bizarre, but you know, I'm like a student. I don't really, I'm just learning everything.

I'm like, okay, I'll be on the lookout for that, you know? And then later really reflected on that and realized how problematic it was. 

Megan: A little. Bit about the history. History. Of BPD. It was termed as borderline because it didn't fit into other types of diagnosis, like anxiety, [00:18:00] depression, schizophrenia. And so it was where a person had some characteristics of other diagnoses, but didn't fit completely into that category. And some of the symptoms of it, which Susanna actually reads. In the movie when she's looking at one of the books in the doctor's office the symptoms Of bpd It's an Instability City of self image relationships And mood uncertainty about Goals and impulse. Pulsivity and different activities that can The self damaging Such as Casual sex And susanna did have all. all of those characteristics and so. she comes in she'd had a suicide attempt she reports that she's had sex with some different people and she's grumpy she has this mood instability and so the professionals See this [00:19:00] and they decide yep

Jess: No, , I mean, she does refer to herself as a recovered borderline at the end, which also just interesting terminology, 

 I mean, it's so difficult to say and diagnostics is not a perfect.

Thing. So a lot of times this is gotten wrong. And I think this may have been one of those times where it was gotten wrong, but regardless, just so much information was not given to her and there was no real treatment provided. I did think that was just an interesting part of this we really don't see a whole lot of treatment.

We see her in talk therapy. And there is a lot of, in the mental health world, there's a lot of. [00:20:00] tension around whether or not talk therapy is even effective for folks with BPD. So it's just a, yeah, just an interesting, I think, presentation of how this might've been treated back then, but I think also is still sometimes it's treated this way, because DBT is not always like the frontline.

It should be, the frontline, approach, but it's, it isn't always, unfortunately. 

Megan: And this is pre DBT. You know, Marsha Linehan came out with all the research on dialectical behavioral therapy. That's what's happening. Late eighties, early nineties, and then for decades on, and this movie takes place way before that. And so there's a lot more diagnostic, clarity, more research, just more understanding that's come out since the late sixties. And I think just in general with diagnosis, it's really important that we recognize that you could have 10 different clinicians assess a person. And [00:21:00] come up with 10 different diagnoses. This is not like getting a blood test and being diagnosed with a medical condition. It's very subjective in many ways. And there are a lot of people who don't fit cleanly into diagnostic categories. In the way that they're delineated in the diagnostic and statistical manual for mental health disorders or the DSM is what it's usually called. 

Jess: Right.

Megan: Now. BPD is also a rather complicated one because it has a very high level of co-morbidity. So it's very common. That somebody who has BPD characteristics may also have some kind of anxiety or PTSD is very common. Depression can be very common along with it too. There's a huge association between BPD and, early trauma. And, you know, I wouldn't be surprised if down the road we saw this diagnosis revamped. And we see it as more of a complex trauma response. [00:22:00] And we're really seeing some evolution with all of this i know in the dbt realm there's been a push for some years now for dbt specialists to get specific training in the treatment of trauma specifically with prolonged exposure treatment because it's very common for people who struggle with bpd to have a trauma history and they need treatment for that and it makes sense for them to get that with the same clinician that they were working with while doing their dbt work 

Jess: my understanding, cause I also do have, DBT training. A lot of my Internship and early training was in dbt and what I really took away from dbt is that pretty much every person with borderline personality has an experience in early life.

That is traumatic. That is registered as trauma. They have an invalidating experience in early life and whether that is objectively identified as trauma is not the point. It's. The person has experienced it as [00:23:00] trauma. So, in reality, it is a trauma borne disorder very much in the same way.

A lot of diagnoses are, but I, unfortunately, of course, that often gets missed because people are very focused on the behaviors because. Borderline personality does present with, depending, can be very behavioral and that is often a lot of what people see and get upset about and don't want to treat.

Similarly to Megan, I had a professor in graduate school, so this is my graduate training, who said that, he never worked with people with borderline and just gave them to the interns. Oh, my God, and I know this is also someone who told us in our psychopathology class that he didn't treat eating disorders.

So he didn't teach about them either. So the only reason really that my, cohort. Got any education about eating disorders is because I am [00:24:00] obnoxious and made sure that they had that education for you. You know, if I didn't have the history, probably wouldn't have, but just was such a strange thing to bear witness to and to reflect on that.

 There is just so much that is left out of these conversations around diagnostics and just about how we treat people. It's really diluting people to how they show up in your office instead of, Oh, this is, this is a person. This is not someone who's like, yeah, maybe they show up in a way that is really stressful to me as a clinician, but there's so infrequently an examination of why.

It's like, why is this happening for them? What is the function of this? Yeah. And I wish I had learned more about that in graduate school. That would have been nice. 

Megan: So I'm thinking about the bio-social theory, which is what the treatment approach of dialectical behavioral therapy or DBT is based on. And looking at this in [00:25:00] terms of Susanna's situation. I first of all, want to respect that this is not just a film it's based on her memoir. This is a real person. And the characters were also based on real people. I could see that perhaps Susanna. Could have had some characteristics of BPD. 

Jess: Right. 

Megan: You know, she's saying she doesn't think that she had that diagnosis. That's fine. I respect that. But just for the sake of exploring the biosocial model, if we look at her situation, the bio-social model considers certain types of biological vulnerabilities that people may have with their brain chemistry. And also with. Temperament and emotional sensitivity. And then that's combined with this invalidating environment. So you were saying that there's always this component of some kind of traumatic event. So the invalidating environment could be the family. It could also be things that happen with a friend group or at [00:26:00] school, or even just, we live in a society. That's. Pretty darn invalidating in so many ways. And this can result in issues with pervasive emotional dysregulation. And that's really because people have not been taught how to understand. And regulate their emotions. Now, most of the time, people who are diagnosed with BPD are really amazingly sensitive. People like to the point where it's like they have ESP, they're picking up on things that other people will not pick up on. And then they're treated like they're making things up and it's like, no, 

they're really noticing things. They're really sensitive to things. And because there's been confusion in relationships and with how the environment responds to them there, that's just going to increase their sensitivity. But then the consideration is how is that information interpreted? So there's a learning that happens for a lot of people with BPD that they have learned to push their emotions [00:27:00] down. And that only lasts for so long, you know, pushing emotion down for a while. And eventually it's going to pop out in some way. And then when they're the big behavioral outbursts, that's when the environment actually responds. 

It's not when there's the small, like I'm upset or this is difficult. The environment responds when there's a big outburst. And so the behavior gets shaped in that way. We could really see this with Susanna's character. And also when we look at her mom, how this might have come to be right. 

Jess: Right. 

Megan: Her mom and the family session is really upset, but she won't talk about it. She ends up leaving. Suzanne his dad is just pushing this down the whole time he doesn't want to get into what is actually happening and what's going to help his daughter he's more concerned about how this is going to look to the community when they have a christmas party 

Jess: Yeah, they're having a holiday, a holiday party crisis.

Megan: Yeah, I know. 

Yeah, this is a holiday party crisis. I love how dry Suzanne is.

Megan: She's so funny. 

Yeah.[00:28:00] 

And the doctor of course is going right along with this he even tells the mom let's talk about this later and there's a lot of reinforcement of emotional avoidance and this idea of not being hysterical or displaying what is actually going on when really there are times when it's completely legit and valid for someone to be upset for someone to cry and for someone to share what's going on especially in a therapist office if you can't do it there where else can you 

Jess: right. The depiction of the mom it does set you up for understanding, this is likely what is, contributed to the development of this disorder.

 Susanna has very clearly been invalidated in her life and not really allowed to be who she is, even though, who she is not offensive.

It's not, she's not bothering anybody, but they view it as offensive because, Any number of reasons, fill 

in the blank. 

Megan: Yeah, she's not fitting into that waspy expectation ,

she even said, she always felt like she didn't fit in. And maybe the first time she really did feel like she fit in was when she [00:29:00] was at the hospital and met the other, like misfits in there. There's a saying in DBT that I really love where it's not that there's something wrong with the person it's that they might be a two lip in a rose garden. This illustrates that they've been in an environment that they don't thrive in . But that doesn't mean that they can't fit in somewhere else it doesn't mean that they're not beautiful and worthy 

Jess: Did you read, uh, Marsha Linehan's autobiography or memoir? 

Megan: I did. Yes. Okay. Yeah. 

Jess: Cause she talks about that. Like that's the metaphor she uses is the tulip in the rose garden.

That was one of the quotes I really took from that. It's just a really love her. 

Megan: Yes well you know i've had dinner at marshall and a hands house before 

Jess: Stop it. 

Megan: Well, you know, she's here. She's, 

she's in Seattle.

Jess: She's in Seattle. Yeah. 

Megan: It used to be that these DBT intensive trainings were done within organizations because it's such a team [00:30:00] oriented training. I first learned DBT when I was working in a community mental health center. And then when I transitioned into running a private practice, I wanted to keep doing DBT. But I was solo, so I didn't. I know how to get trained in it. So her organization. Years ago started a training. It's still going on. It's a great training with behavioral tech to do an intensive in DBT, even though you're an individual practitioner. So we basically teamed all of us up and that was my first experience using zoom all those years ago. And people on my team were from all over the country and actually one person in Mexico city to. And we met a few times in Seattle to do some in-person training. And one of the times we met, she had all of us over to her house for dinner. So there were a lot of us over there. It wasn't like it was a little intimate dinner, over at Marsha Linehan's house. And so I've chatted with her a few times. I've seen her at a few different [00:31:00] events. She's very cool, very charismatic, and I am extremely intimidated by her. Yeah, she is. Amazing. Her body of work is phenomenal. I think it's really beautiful how she herself came out as a person who has borderline personality disorder and has struggled actually with a lot of the things happening in these films that we've been watching. She was institutionalized many times as a young adult. 

Jess: For long stretches.Long stretches of time. 

Megan: Long stretches. She had a lot of ECT and actually doesn't have great memories of her youth and young adulthood because of what she says, the brain damage that she had. From the ECT . What she did is she really created the treatment that she herself needed when she was younger. And it has helped so many people, it has literally saved so many lives. And no treatment is perfect. 

There are certainly things about DBT that aren't perfect. There's a [00:32:00] reason why I'm not specializing in it anymore. It's a very intense treatment. It's very amazing though. I think it's so well thought out. It's a skills-based treatment. And i believe that the dbt skills are life skills for all of us it's not just for people who have bpd or for people who are struggling with some of the big behaviors we're talking about like suicidality self-harm or as they're calling it in girl interrupted the promiscuity I think that there are things that all of us can learn and benefit from. 

Jess: When I learned about dbt, I was in graduate school. I had no context before then because, eating disorder treatment didn't. Absorb dbt until much later. So when I was in treatment as a teen, 

Skill based stuff was just not there. So when I learned about dbt, it was life changing for me. And this was also at a period of time where I was already in recovery. I was doing well, but it just changed the way that I thought about my life and my own behavior.[00:33:00] 

probably the first time that I felt in a non pathological way towards myself. It really is a transformative treatment. And I think what people also miss is it's not exclusively behavioral. Like there is just like the whole underpinning of the treatment is very important.

Like the least of which is. Do not view your client in a pejorative way. Do not speak about them in a pejorative way. It's like, all right, I'm on board for that. that's an a plus thing. Yes. That unfortunately, , lots of people don't follow. But that, yeah, again, like it was really profoundly life-changing for me to learn about it because it's just a very different way of viewing therapy.

It's a very different way of viewing clients, especially in comparison to the curriculum and a lot of counseling programs. 

Megan: Absolutely.

It creates a pathway to have i think a real authentic relationship with the people that you work with and to really respect them and understand them 

Jess: Right. And also just treating people like they're [00:34:00] autonomous capable people, I think this movie is a good showing of how that was not really the view at the time. In many ways still not the view, but there are a lot of like infantilization and just viewing these people struggling as people who couldn't take care of their own lives or like just could not be in their own lives and needed a lot of assistance.

And maybe they didn't need a lot of assistance, but They didn't need to be treated like children, which they definitely were. 

Megan: Yes, I agree. And you did mention before that there wasn't. Really any treatment going on and along with that in this movie, they don't do anything. There's nothing happening other than they get medications. . There's a lot of smoking, which you know, is probably exactly what people are really doing back then. There's no attempt to help people understand what their situation is and how it could get better. There's no coping skills learning. 

Jess: Right. 

Megan: And [00:35:00] Nowadays, if somebody is in a higher level of care, of course, these kinds of institutions don't exist anymore. But if somebody is in more of a short-term hospitalization or residential treatment or intensive outpatient, They are very scheduled it's like you are getting up in the morning and you're going to this group and then you have therapy and you might have a little bit of free time but probably not very much people are busy 

Jess: I can, speak to that from having been in treatment and residential treatment.

Oh, yeah, there is not a second of your life that is not very scheduled. And if you do have downtime, that's scheduled. So it's like this, I don't think was like a good representation of what treatment is like today, but the only, I don't know, therapeutic stuff that they were doing was, like, taking medications, having individual appointments, having outings, though it did not seem very therapeutic, so, for on the outings, and they had the, like, dance slash movement [00:36:00] therapy group where they were being a tree.

That was like the extent, I think, of treatment that was provided. 

Megan: Yep. That's it. That's it. 

Jess: And I, I do feel like there was a, tongue in cheek element to the being a tree thing. It very much seemed like, oh, like, yeah, this is what they do in treatment. They ask you to be a tree, or whatever.

Megan: And they did that one floor of the cuckoo's nest too. They had a movement group. And I do think that there is a yoga component and a lot of these treatment places now. 

There were a lot of statements throughout the movie from different characters about the lack of effectiveness of the treatment there was some commentary, especially coming from Lisa. Play dice, Angelina Jolie. Again, she stole the show in this movie. She won an Oscar for it, and we can all see why . And she set this part. I wrote the whole thing down because I thought it was great. This is about Daisy. Leaving. Daisy was played by Brittany Murphy. She was getting discharged [00:37:00] and everyone was pretty upset about it. Because Daisy was clearly not doing well. She wasn't making any improvements and promote. We saw, she spent most of her hospitalization in her room. Eating the chickens that her dad gave her trying to get as many laxatives as she could . She was struggling with bulemia and I think also OCD. And about her leaving. Lisa said she coughed up a big one. That's what their rape me is all about. That's why fucking Freud's picture is on every shrink's wall. He created an industry. You lie down, confess your secrets and your saved. Chit-chatting the more you confess, the more they think about setting you free. And Susanna asked, well, what if you don't have a secret and Lisa said, then your life, or like me. So it really disturbing, right. That you have to. Give yourself over and confess something in order for the doctors to think that you're well enough to leave and that means there's [00:38:00] not really a solid way of perceiving any of this there's no measurable shifts or changes to actually look for 

Jess: right. And to be fair, even operationalizing that is hard. Like, what are ways that indicate that a person is ready to be discharged? But it's very clear.

Based on Lisa's perspective that, she is not doing what they want her to do. She is not able to give them or not willing to give them what they want. So she's stuck there. She's just going to hang out there forever. 

Megan: And She is in the power struggle she's actively in the power struggle of i'm not going to give you what you want and so she's stuck and she lisa is diagnosed she says as a sociopath so that's antisocial personality disorder which i don't know about that one at all i don't know if i agree with that 

Jess: That seemed, again, tossing out, diagnoses that maybe didn't fit. 

Megan: Yep. 

And in another part susanna says to dr Wick, one of my theories is that you [00:39:00] people don't know what you're doing 

Jess: Oh, I 

laughed. She says. I laughed at that and I noted, to my spouse who I was watching the movie with. Yeah, that's true. It's probably still true in so many ways. that is like not feedback you really want to get from a client that, you know, that they think that you don't know what you're doing, even if it's not, even if it's not true, definitely not, not feedback you'd like to get.

Yeah. 

Megan: I mean, that's the fear. I think for a lot of us providers, is it someone's going to be like, oh, you're full of shit. You don't know what you're doing. And hopefully if that were to come out, there would be a conversation about it. What am i missing what am i w what's going on that i'm not tending to that you think i need to tend to 

Jess: I appreciate their commentary throughout about what they believe is ineffective because 

they're not wrong. 

Megan: They're not wrong at all. And this just fits into what was going on with institutions in general. Back then, this [00:40:00] is around the time that there was less and less funding and the institutions were really trying to get people stable on their meds and then out in the world, because. It was not sustainable to keep them in these institutions. There was less space. It was really hard to keep the places staffed, which we talked about a lot with Willowbrook. And it wasn't too long after this, that all of these hospitals started to close. There started to be a federal law requiring minimum standards for care, including things about. Treatment planning and staffing these regulations made it even harder to keep these places staffed. So there wasn't really treatment going on in these institutions. Again, I read the book, but I, I don't remember it. It was so long ago I was like, Susanna back then when I read it, it was grumpy and chain smoking. There's this commentary about the lack of effectiveness of the treatment. Yet [00:41:00] at the end, Susanna says she is a recovered borderline. So it seems like there are a few parts in this movie where she has an epiphany and just makes this decision to get with it. There's even a montage where she's like, Going and lying on the couch and she's in therapy. 

Jess: Right.

Megan: Yeah journaling and talking about things and she's getting better and then at the end there's this voiceover i'm assuming from the book she says was i ever crazy or Maybe life is crazy it isn't about being broken or swallowing a dark secret it's you or me amplified 

Jess: right. 

I will say at least in my experience, a pretty common sentiment upon leaving treatment, this like very strong feeling of I'm all better and I'm going to go and launch myself out into the world in part because that is something that gets sold to people that like, go to treatment for a little while, check a box and it's going to be great.

 That part didn't necessarily surprise me so [00:42:00] much. It was more of okay, like what's, what's going to be on the other side of that, hopefully nothing bad, 

Megan: Girl interrupted part two. 

Jess: But I agree. It's like, interesting that. Effectively, like, once she started being obedient and compliant with the, quote unquote treatment they were providing her, then it was better.

Then she was all of a sudden fixed and recovered. 

Megan: Yeah, 

I agree with you and doing what she needed to do. She was able to get out. And, you know, because this is based on her memoir. We know she does go on to be a very successful author. 

Jess: She does. 

Megan: Clearly her life went well. And so. Maybe that is it. I think when we look at the complexity of mental health and treatment, just not that simple, but if we want a happy ending, which that is what a lot of people want out of these stories, they want to know that somebody is all better and so that we can just move on and feel good about it 

Jess: yeah, I think it does tie it up [00:43:00] in the bow a little bit, I had read yesterday that the author is not particularly happy with the movie. I think she, described it as melodramatic drivel. 

 If the author is saying that, then maybe the movie isn't very well representing her experience, but also, yeah, maybe it's not ending in the best way. It's not very nuanced. 

Megan: He was thinking about it from a writer's perspective. It's hard to put one of your own stories out in the world and share that that's hard enough, but then having someone else's interpretation of it, put on film. This is kind of a classic thing that the writer doesn't like the depiction of the movie and it's not just a story this is actually the story of her life Or rather is a story about part of her life 

Jess: if you're writing a memoir, other people are going to get lumped in there and potentially be misrepresented and yeah, I think the movie did that. It did some, like, very strong caricaturing. It's a really interesting film. Um, [00:44:00] but I do think, there are a lot of critiques to be made.

Megan: Can we talk about how gay this film is now 

Jess: Oh my god, yes. Yes. 

Megan: When i rewatched it i was like if this movie was remade now it just 

Jess: everyone would be like, oh my god! , I copied and pasted a quote. The specter of homosexuality certainly exists in the film. 

Megan: The specter of homosexuality.

Wow. 

Jess: I took that from a, an article. I think that was written like in the. 90s, like shortly after the film came out. So I thought that was hilarious. Because okay, that's, that's a little aggressive, but also not untrue because there are overt discussions of gayness, even in that, there's one character who, Ostensibly is there because she's gay.

Like, she's in the institution because she's, she's gay. 

Megan: Yes, because, well, this is 1968 and until [00:45:00] 1972, homosexuality was in the DSM. Categorized as a mental health disorder. So there's a person in there. She's not in it a whole lot. Pretty funny character kind of in the background. But we know that she is in the institution because she is gay. That's all we know about her and Lisa Angelina Jolie's character. Said some pretty rude stuff to her about that a few times and lisa's character reads as Kind of queer to me. 

Jess: Definitely quite queer coded, even just in the way that she Yeah, queer coded, that's a good way to put it. Even just in the way she dresses and presents, but I think too, it's like, part of it I wonder if, if it's her energy.

There's a lot of, energy she commands in a room, so it doesn't matter if it's a woman or a man or fill in the blank. It's like She is commanding their attention and everyone's in love with her. I don't even know that it's like, sexuality oriented so much as just, this is a person who, if she's not in the room, the whole place is like [00:46:00] wilting.

 Winona Ryder's character is very queer coded in the way that she dresses and how her hair is styled, and I, and of course, like, fucking Clea Duvall is in the movie, so that just automatically makes it gay, like, just.

There you go. I would say the only like overt like, oh, maybe, maybe there's some gay shit happening is, Susanna kisses Lisa in a car when they're on the run from the hospital. And it's like very, like, chased. Very pure. And there's nothing else that comes of it. That's it.

Just like this one scene with it. And I, I, Don't really know what it added. I don't know what the point was, but it is a oft referenced scene as like evidence that the film is, is very gay. 

Megan: Yeah, they have that kiss. And it's strange because it's never talked about nothing else happens and okay, this is a sidetrack, but I have this thought and you know, [00:47:00] me, I go down the rabbit hole and I was thinking What if Lisa is actually part of Susanna's imagination. When Lisa is doing her Lisa things, Susanna is usually quiet and in the background, it rarely shows them at the same time, unless they're just dealing with each other. Like the part where they're in Daisy's apartment and Lisa saying all those horrible things to Daisy, which then leads Daisy played by Brittany Murphy to actually take her own life. It's just horrendous the whole scene. And while that's happening, Susanna's on the bed with a pillow over her head going stop. 

And I thought, well, What at this is actually Susanna doing these things. And, Lisa is this aggressive, direct part of her personality and it's fragmented . So I looked into it a little bit and I saw a bunch of posts on Reddit where other people had this theory too. And then I actually looked a little more and there is a book. I haven't [00:48:00] read it, but I think I will. It's called the magic mountain. By Thomas Mann. . It was a big influence apparently on the author of girl interrupted also the author of fight club. And guess what also on Ken Keesey when he wrote one flew over the Cuckoo's nest. 

Jess: Wow. Prolific book. 

Megan: Yeah. 

The narrator and magic mountain is in a sanatorium in the Swiss Alps it's pre world war one. The narrator goes to the sanitorium to visit. I think his cousin and he plans to stay there for a couple of weeks, but then he starts to have symptoms of tuberculosis and stays there for seven years. So it's about everything that's happening in the sanatorium. Anyway, I told you I went down the rabbit hole, but you know, With Susanna and Lisa Susanna is the one who will hold things in. She'll get grumpy and she'll talk back a little bit, but that's really the most she'll do. She tends to retreat more than anything. Now [00:49:00] lisa is the one who will get in your face and yell and scream so they have very different personalities and they're very drawn to one another so what if they are representing different parts of one personality Obviously that's not the case this is based on a true story but you know interesting to think about 

Jess: I did not have that thought, but I think that's an incredible potential interpretation. If this were a fictional story, .

I think people are conflating, Angelina Jolie the person with Lisa the character because, Angelina Jolie was, like, very openly queer and especially at that time had a lot of, , very public relationships. I think she had a public relationship with a woman. 

 Yeah, she's a queer person. So, like, is that coloring her portrayal? Or are people making assumptions because of who 

she is? 

But yeah, I. Yeah, I do think, Angelina Jolie as the person was, heavily conflated with this character.

And she was, like, viewed as, like, the, Hollywood wild child for a pretty [00:50:00] long time. God, talk about like a total pivot.

She's a completely different. 

Person. 

Megan: Yeah, that's been interesting. Her and Wynnona writer in a lot of ways. I loved Wynnona writer in this movie. 

They're both really different now. And Angelina Jolie, I think in some remarkable ways and with Winona Ryder, and it's very unfortunate what happened with her career? Right at the beginning the opening scene and the voiceover she says have you ever stolen something when you had the cash 

Jess: oh my 

god, I know Oh, 

no Have you ever confused a dream with life? 

Megan: That could definitely be one of my personal triggers from the movie, just thinking about Wynnona and what's happened with her career and how upsetting that is. 

I have a few others but i want to ask you what were your triggers from watching this movie

Jess: that's a really good question. I mentioned it earlier before we had started recording that, the first time I had seen the movie was probably as like a young teen.

So maybe [00:51:00] like 13, 14. I was in my, I'm reading memoirs of like depressed women era. 

Megan: Oh yeah i'm still in that era by the way 

Jess: I am too. And I was just, I don't know, I was an insufferable teenager. I watched the movie first, if I remember correctly, but I read the book not too long after.

And I was so traumatized by the scene with Daisy having taken her own life. It really stuck with me as a teenager. I had nightmares about it. Having seen it again this time, less impactful because I've seen the movie a number of times, but it's very graphic, and...

They're just showing this, really interesting dichotomy in, like, how Winona Ryder responds and how, Angelina Jolie responds, and it is massively triggering, on an objective level, but also just on the personal level of watching that at, 14, I had really no context , I had never seen anything like that, , It was very frightening.

[00:52:00] So I would say that. That's probably still my trigger. But also, yes, that Winona Ryder like, lost years of her career because she shoplifted . It's really infuriating. But, what about you? Tell me. 

Megan: Another one of my personal triggers was definitely Angelina Jolie's hair. Oh my god!

And like the baby beings, the like dumb and dumber beings. I really, no one can dispute what a gorgeous woman Angelina Jolie is. She always has been, she always will be she's striking and that hair it's it's bad. And I think the memories of this hairstyle, I admit I had this problem back then where I would cut my own bangs and like, they wouldn't look right. 

I have Calex all over my hair. If I have straight bangs, it's a lot of styling. It's a lot of work. That's why I'm growing them out right now. I just have to remind myself of this every few years, but my tactic back then not really [00:53:00] understanding how my hair worked. Was i would just keep cutting and the hair would get shorter and shorter and it would stick up all over the place and so her hair reminded me of that era and how i was trying to look but was not pulling it off whatsoever 

also so washed out with that hair color. I know it was probably very purposeful. Like just 

Definitely that hairy cheek. 

Jess: Yeah, it was. Yeah. But yes, it was like rough to look at. It was like, Oh, okay. Like you, you look like a ghost, really,

but I'm glad I'm not the only person that has also had baby bangs, but not because it was intentional. 

I, hand to God, I wore a hat for five months, Because of how just, I destroyed my bangs.

They were just such like teeny teeny. And it took that long. It took that long for them to grow out. 

Megan: Now a few years ago, it almost seemed like they were coming back. They were coming back. They're still kind of back. No, no, no, no. Please don't. It's horrible. 

Jess: Awful. 

Megan: What about [00:54:00] glimmers? The 

Jess: cat, I'm so predictable, but the second the cat came onto the screen, I was like, don't the cat cannot be hurt. Please. I hope nothing happens to it because I'd totally forgotten about the cat.

Because last time I watched it, I was probably not cat person, but now I am. To very thoroughly a cat person and was so excited to see the cat and very invested in its future. 

Megan: Yes, definitely. I actually had the cat listed as one of my glimmers, too. I think the role of the cat was actually really important in the movie and it offered this comfort and sweetness 

Jess: I really like that she, like at the end, she gives the cat to one of the residents who will likely be there for a very long time, and it's just like a very sweet handoff, why don't, do you think you could take care of the cat and I can play with him when I come back for sessions?

Or, it was just very, very sweet, and I think, Speaks to like relationships you develop with people [00:55:00] in those settings. It's it even if like you really just would never be friends with that person on the outside or even didn't like them that much on the inside. They're very like, it's just a special connection.

And it was very sweet. Yeah, that's one of my one of my glimmers too, I guess. 

Megan: That was so very sweet. How Susanna gave the cat also as a repair because she really blew out her relationships at the end before her discharge you know she was really kind of done and they all read her diary and read all the things she was saying about them total nightmare 

Jess: I should have said that that was one of my triggers. Like, that was 

Megan: terrible. That was awful. Can you imagine somebody like taking, yeah, that's someone taking your diary and reading it. 

Jess: It's like very Harriet the Spy. I don't know if you ever saw that movie, but that's like a big thing that happens in the film is like they're kids and they find her diary and they read it out loud.

It's like, 

Megan: ugh. Horrible. Such an awful thing. 

Mine now [00:56:00] would probably be very boring because there would be a lot of notes for this podcast. And also like my essay ideas, things I'm going to write about. So there are all these. Weird outlines. That would make any sense to anybody but me, but yeah, if it was from that age, woo. That would have been some embarrassing shit 

that's for sure. 

I know that Angelina Jolie won the Oscar and stole the show, but I think Winona was great in this movie.

I can't imagine anybody else playing this character. I love her little pixie haircut. I love her clothes. So cute. Her like button up shirts and baggy slacks, she's so stylish, she's so grumpy with her French cigarettes, 90s Winona Ryder amazing. And I might have to watch.

Heather's and Beetlejuice I love Heather's 

Jess: I had a, a teen client in God has many moons ago who told me I watched this movie [00:57:00] recently. It was, it's really old. It's called Heather's. And I was like, Oh God, please let me die right here. And then they're like, you look just like the main character.

I was like, Oh, who? And I'm like, Winona Ryder! But then I went and looked at younger photos of her where she has my length hair. I could see it. I was like, oh. Okay, 

Megan: thank you. 

Jess: Please stop referencing this as a very, very old movie. I would appreciate that. 

Megan: You know, people have told me that I look like Angelina Jolie.

No, I'm just kidding. No one has ever said that to me. 

Jess: I don't think anyone looks like, it's like such a unique and striking 

Megan: face. She's very unique. Her brother, she looks like her mother. That's about 

Jess: it. I looked at a photo of him. He is terrifying. A man having that face is just very, yeah, 

Megan: he looks like a vampire.

He was like an animal vampire. Yeah, 

Jess: he does. I agree with that. 

Megan: What are we going to watch next, Jess? What are we going to do? Oh, 

Jess: well, I'm, I don't [00:58:00] know. I think we were talking about doing a Breaking Bad episode 

Megan: After these institutional, these have been some heavy movies that we're starting with. And going into Breaking Bad does not necessarily mean that we're going into a particularly light story, 

Jess: if we were going to focus on the fugue state that happens, I think it's in season two or three season two.

 There is a little bit more of a humorous element around it. 

Megan: It's not nearly as dark as that show becomes, but because it's a TV show, we obviously can not talk about the whole thing. We will talk specifically about walter White's future state and what the heck is a few state and does the show represent it well and what we think of all of that and of course what is triggering 

Jess: and I already know like one of my triggers in that is just his nudity, but that's another more man, 

Megan: but yes, 

Jess: we'll get there next 

Megan: time. 

Okay well thank you everyone for listening to the i'm triggered [00:59:00] podcast please make sure that you like and follow us leave a review or whatever else you want to do we appreciate your support We could not do this without you 

Thank you. All right. Bye bye.