Kaysen elaborates through parts of the book on her thoughts about how mental illness is treated. She explains that families who are willing to pay the rather high costs of hospitalization do so to prove their own sanity. Once one member of the family is hospitalized, it becomes easier for the rest of the family to distance themselves from the problem and to create a clear boundary between the sane and the insane. Recognizing a family member or friend as insane makes others around them, says Kaysen, compare themselves to that individual. Hospitalization allows for distance from this questioning of self that makes us so uncomfortable. Her view that mental illness often includes the entire family means the hospitalized family member becomes an excuse for other family members not to look at their own problems. This explains the willingness to pay the high financial costs of hospitalization.

Susanna Kaysen