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Friday, December 2, 2011

Trauma-informed Treatment: Informational Article on the film "Girl Interrupted" -Brandon Dellario LMSW LASAC

The film, Girl Interrupted, is a poignant comment on recovery in America’s mental health system and in the family. The two primary characters are played by Winona Ryder and Angelina Jolie.

Winona plays a young woman who tries to commit suicide. Her therapist takes this as a sign of her instability and recommends her to a nearby mental hospital (Claymore). It is there she meets Angelina's character who makes herself out to be a wild, self-destructive woman. 'Angelina' considers herself to be mentally ill for a reason, and revels in it as a gift that makes her special. This rubs off on 'Winona.' When they become friends Winona indulges in the acting out right along beside her.

Angelina adapts to her environment in the way of aggressive dominance over the other patients. She has a strong spirit and appears to be self-directing, but underneath her personal qualities of rage, she has a poor relatedness with society and a weak competence in self care which manifest themselves as an unhealthy goodness of fit in the ward regarding her hositility.

When Winona arrives at Claymore, she attempts to build relatedness with the other patients by offering laxatives to Daisy, and befriending women she sees as having disempowerment in their lives. As things get hectic, she attempts to match these women with her own maladaptive actions, but actually, this is a way of seeking competence in a world she blames as unfair.

Winona heightens the stress in her awkward relationships with other patients, and rebels against authority figures. Later these perceived dominant actions awaken her to a mis-aimed self-direction. Winona escapes The Claymore Mental Health Facility with Angelina and finds Daisy hanging from a rope, she then returns to the hospital and opens her mind to the ways of recovery. Winona does what she can to find a goodness of fit in the hospital with her precious life future in mind. She fends off invitations to run away with her boyfriend, and refuses to participate in Angelina’s rebellion any longer.

Daisy is a perplexing character in this film. When Winona first sees her, Daisy stares her down out of the security of her room’s door jam. Daisy’s abrasive actions initially appear unwarranted as she angrily orders people around and locks the ward out of her room. This is displacement of emotions onto others, because of what we find out later to be Daisy’s victimization by her father in an incestuous relationship, which may have been all she’s known from him since childhood.

Trauma Specialist Dr. John Briere, Keck School Professor of Psychiatry and Psychology, University of Southern California, says that, “severe trauma associated with severe abuse causes repression.” Trauma Specialist Dr. James Henry, College of Health and Human Services, Western Michigan University found similarities,

“In a 1993 study of 450 adults in psychotherapy, 60% reported a period in their lives before age 18 where they had no memory of abuse. Those that could not remember were more likely to have greater current psychological symptoms, were molested at an earlier age, had been victims of extended and violent abuse, had been abused by more than one person, and feared disclosure.”(Henry, 10/16/08)

It is obvious that Daisy has trouble expressing herself, resorting to the compulsive eating habits and laxative abuse which make up her eating disorder. This is one of the many possible coping mechanisms that are characteristic of people suffering post traumatic stress disorder (PTSD). Daisy’s denial is abruptly challenged when Angelina tells her that everyone knows about Daisy having sex with her father. Daisy calmly walks up the stairs like a zombie without a spark of regard toward Angelina’s words. The next day they find her dead from her suicide, hanging in the bathroom. The record player repeating song lyrics such as, “I died the day you took your love away.” Daisy’s inability to communicate to others and take part in the therapeutic community was a contributor to her tragic act, as were her toxic friends. Sandra Bloom states that trauma recovering patients,

“. . . were trying to ‘get attention’ because their transcendence was dependent on a response from the social group, a shared experience of pain that would allow them to find a place back within the human community. They were desperately trying to engage the rest of us in a transformative ritual. It was the social group that needed to respond to their performance in a healing way, and it’s this response that we had repeatedly failed to give, creating instead a society that revolved around unconscious and repeated trauma instead of change, transcendence and transformation.”(Bloom, pg. 193)

The staff at the film's inpatient mental hospital (Claymore) did demonstrate a trauma informed environment of healing overall. They took the patients on small trips into the community and gave them access to outdoor environments. “We learned that human beings need settings that maintain a connection with the natural . . .”(Bloom, pg. 126) Patients had their own rooms and communal settings for fraternization. They also had lots of staff interaction,

“. . . patients and staff needed frequent opportunities to connect with each other. We needed the freedom to make our own choices about who we would connect with most strongly, and we needed other people to comfort us when we became very emotionally upset. But we also recognized that we needed other people to help us understand when we have crossed the line into too much connection, into over involvement with others.”(Bloom, pg. 127)

Staff showed values of compassion, empathy and education to the Claymore patients while working together to show distinctive boundaries, without abusing their authority.

“We evolved a position that simultaneously condemned the [destructive] behavior while supporting the person involved in the behavior. . . We each learned how to mediate these situations individually by demonstrating verbally and nonverbally that we understood that this escalation indicated that the patient did not feel that he or she was heard, at that we were willing to listen. Usually this was effective in bringing about a change in the dramatic scene.”(Bloom, pg. 143 & 152)

Winona’s Family was stereotypical of the stigma presented by society, in regards to perceptions of mental illness. According to Saterian theory, the way a family communicates self-esteem is a key concept. Winona’s mother and father want her to go to college like their family friend’s children. This is a classic example of the way American society classifies success or safety/security in financial and occupational directions. Winona’s desire to become a writer, or to more or less find an unconventional path in life, was not supported by her family. In fact, it was seen as a stain on their otherwise upper social class status. As was the suicide attempt.

Winona’s mother had an emotional breakdown as a result of hearing Winona’s diagnosis of borderline personality disorder. With her, ‘whatever I can do for you, just ask,’ personality, she could be seen as 'the placator.' This is a familial role of one who serves others with perceived selflessness. Winona’s mom also lived the role of ''the victim' in this situation. She acted overwhelmed by Winona’s suicide attempt, but avoids the subject by burying it whenever possible, which places her in the familial role of 'distracter.' The main 'distracter' is a family role played by Winona. Winona's character plays the role of 'the family clown' (or family problem) and reacts to them as such. Winona’s father plays the family role of 'the computer' in the ways he appears emotionally disengaged, however, his starring family role is that of 'the blamer.' He criticized Winona for falling asleep during her graduation day by commenting that she was, ‘pulling some kind of stunt.’ He portrays a displeased authoritarian figure in these roles.


Bloom, S. (1997). Creating Sanctuary. New York, NY: Routledge.

Henry, J. (2008). SWRK 6310 Lecture Notes. Western Michigan University, Fall Semester, 2008. 
*The premise of this paper was developed by Dr. James Henry.


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