Committed: An Interview With Suzanne Scanlon

Suzanne Scanlon, Committed: On Meaning and Madwomen—A Memoir

Source: Vintage Books / Used with permission

Suzanne Scanlon’s Committed: On Meaning and Madwomen—A Memoir, published today by Vintage Books, examines how three generations have tried to diagnose and treat what each has called madness. The book revisits a key chapter in American psychiatry—the start of the widespread prescribing of SSRIs and second-generation antipsychotics in the 1980s and 90s—through the lens of Scanlon’s personal experience.

Chris Lane: For several years, if we can begin with that difficult time, you lived in the New York State Psychiatric Institute on Manhattan’s Upper West Side—an institute central to the DSM [Diagnostic and Statistical Manual of Mental Disorders] story and the manual’s large-scale expansion at the time. What for you is most important that readers grasp from your time there?

Suzanne Scanlon: I want readers to understand that I had a wildly inappropriate and problematic treatment—that recovery from treatment was as difficult as recovery from my so-called illness. There were doctors who helped me understand my suffering and validated my enormous grief. At the same time, hospitalization taught me that I was seriously ill—that there was something almost irreparably wrong with me. I hope to show in the book that there are many ways to make sense of suffering, grief, and loss. Needing to recover from one’s treatment should not be part of the difficulty.

CL: What treatments were, from your perspective, least useful—for example, most obviously tied to adverse effects, mild or serious?

SS: Living in a hospital for that amount of time, I became terrified of living on my own. It was a complete regression. I was prescribed antipsychotics, sleeping pills, and tranquilizers on top of antidepressants and mood stabilizers, which made everything a haze and a blur. Over time, it became impossible to know which was worse—the medication I was prescribed, with its side effects, or the state of my unmedicated self, which, under the weight of all those drugs, had long since vanished.

CL: And which were more useful and productive? Let’s consider writing here as you convey powerfully that your book was, at times, “a bulwark against disintegration.”

SS: Yes, writing. And reading. And talking to people—patients and then the staff and others. It was helpful to be in a community. I mean, it’s quite rare in life—at least, it has been in my American life.

CL: If we could touch on the question of detainment and involuntary treatment, you write in the memoir that you “signed papers … agreed to something. They were not forcing me to be there, not really.” Did you consent to the duration of the stay? What would have happened if you had tried to leave earlier?

Suzanne Scanlon

Source: Brian McConkey 2023 / Used with permission

SS: No, I didn’t consent to the duration. Every time I asked to leave, I was told that I wasn’t ready. If I came close to appearing ready, the smallest thing wrong—even, simply, anxiety about leaving—was seen as symptomatic and a sign of illness regression or resurgence.

CL: You observe of the time, from the various diagnoses made, “I got better at being sick. I got better at being a mental patient.” Yet it almost seems as if your illness and symptoms were evolving alongside revisions to the DSM, as if you were symptomizing differently based on how each diagnosis tried to sum up your state of mind. Is that close?

SS: Yes, that is so smart—the problem you describe is very much under discussed. We were all symptomatizing differently in response to each other and the doctors—it wasn’t just the DSM setting out criteria my doctors were following to the letter. The definition of borderline (BPD) shifted at the time and, afterward, was meant to be included with other diagnoses. Bipolar 1 and 2 were altered as well. After some time there, I was told I had bipolar 2, which hadn’t existed before DSM-IV came out in 1994.

CL: If I could push on this thread a bit more, you write powerfully about the ward being filled with young women a similar age:

Many patients on our ward were diagnosed with borderline personality disorder. It was an expansive disease (if not a disease at all), allowing for a complicated narrative. Some took pride in this outlaw, ugly diagnosis. A few were prone to violent outbursts; others … would take drugs, cocaine, heroin, whatever [they] could get their hands on. All of this connected, or so the story went, to their chronic feelings of emptiness.

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Can you say more about these tensions and how they get worked out in the book?

SS: Many have written about the relief of receiving a diagnosis—how it can help them understand their suffering and receive care. At the same time, I don’t respect theoretical, inaccurate, or overly inclusive diagnoses that can worsen the stigma the mentally ill already encounter. I don’t respect diagnoses that are disproportionately given to young women when they are socialized to act in ways that reinforce it. A diagnosis of BPD is so stigmatizing and misogynistic that I simply cannot believe in it. I see it as a kind of fiction, though with painful real-world consequences.

CL: “After all, I read novels,” you write at one point. “I knew what emotions were. I read to know about other people’s emotions and so learned about my own.” Would you say more about the importance of the particular group of writers and thinkers you discuss (many, incidentally, from your mother’s generation) in helping you process loss and repair?

SS: I think about [French novelist Marguerite] Duras, [Egyptian feminist Nawal El] Saadawi, and Toni Morrison in particular here because they were writing about love, or so it seemed to me, and that love was maternal and involved maternal loss. It moved me deeply and validated my own loss. The same was true for me from reading [Virginia] Woolf and Audre Lorde.

It occurs to me that my reading was also evidence of an 'intense interpersonal relationship.' Because as I read, I absorbed them without boundaries. As I say with [Sylvia] Plath, I merged my story with hers. I wrote my grief through hers. Nowadays, I think that’s a radical way to become a writer—that boundaryless reading and selfhood can absorb and soften differences.

CL: Are these writers also useful in describing—perhaps even modeling—reactions to particular kinds of family dysfunction and social difficulty? Are they, in some ways, helping us find ways to “symptomatize” but also to work through similar kinds of conflict and distress?

SS: Yes, absolutely. Anger is generative. Plath was enraged by her father’s death and the silence surrounding it, and that anger fueled her writing. If it was a symptom, to some, it was also a productive way to reject all that I’d absorbed and internalized, particularly since my mom’s death.

CL: You write early in the book that mental illness is “what you can’t help.” How, for you, would such a perspective—of not being able to act otherwise—translate into a different model of care from the one you experienced?

SS: A different model of care would recognize that mental illness is as much a structural problem as an individual one. That structure might be the family, but there are larger ones at work as well—patriarchy, misogyny, and racism; capitalism and rampant individualism—and each contributes to a widespread devaluing of community.

I also want to rethink mental illness as a static position—the notion that it is a 'core' part of a person, perhaps their essence. I’d reframe it as 'something you are going through' rather than 'this is who you are.' That, say, you act this way because you 'are' borderline. It’s obviously much more complicated than that, tied to family, trauma, neglect, norms, and dysfunction. Let’s talk about the crisis, acute or chronic, but within that larger context.