Comfort and Fear

Few might have expected this brief, non-linear and strangely detached book to become a New York Times best seller – let alone a Hollywood film – but Kaysen’s story ignited a conversation around women’s mental health that almost at once became absorbed into a broader societal context. Writing about her confinement, aged 18, in one of America’s most elite private psychiatric institutions (McLean Hospital, roughly five miles west of Boston), Kaysen was economically lyrical and wryly funny, with a gallows humour that made even the most startling chapters sing.

Many of the same qualities of Kaysen’s writing are also found in the words and music of Aimee Mann, making her an obvious choice for an otherwise un-obvious challenge – to turn the story of “Girl, Interrupted” into a musical stage production. It’s hard to think of another artist who can write as sensitively as Mann does about people on the fringes of society and beyond. Often plainspoken, never mawkish, her records are peppered with disaffected down-and-outs, emotionally threadbare addicts, the going and the gone. Unlike Kaysen, who views her book as anthropological artifact, Mann seems to write upwards from rock bottom, meeting her protagonists – which are sometimes herself – on the downward slope and nudging them backwards to safety.

Mann signed on to the “Girl, Interrupted” project in 2018 – the 25th anniversary of the book’s release – but the production has since stalled. Mann, though, kept going, unable to imagine sitting on the songs she’d written for who knows how many more years. Though the songs were originally penned to be arranged for other voices, Mann’s writing flowed so quickly and intensely that she began to form her own fixed ideas of how they should sound. The result is Queens Of The Summer Hotel, a surprising diversion into lushly orchestrated waltzes and piano laments, influenced in part by classical composers and 1960s crooners. The album checks into Mann’s discography as a sort of unofficial companion to 2017’s Mental Illness (her first to win a major Grammy), a twin ode to unravelling.

The phrase “queens of the summer hotel” comes from the poem “You, Doctor Martin” by Anne Sexton, who worked as a poetry teacher at McLean in 1968, which places her there at the same time as Kaysen. Sexton was diagnosed as bipolar (not uncontroversially) in her mid-twenties, and, several years later, was admitted to McLean as a patient. Although Sexton is not mentioned in “Girl, Interrupted”, two other canonical American poets are: her mentor of sorts, Robert Lowell, and her friend and rival Sylvia Plath. Plath spent her 21st birthday in McLean after her first suicide attempt, and Lowell – who, like Sexton, was diagnosed bipolar – was a resident there on several occasions. “Our hospital was famous and housed many great poets and singers,” wrote Kaysen. “Did the hospital specialise in poets and singers or was it that poets and singers specialised in madness?”

Mann would hardly claim to be a specialist, but her understanding of mental health is nuanced through experience – both her own, and that of people close or lost to her. Because Kaysen microscoped into her characters’ lives as documentarian, Mann has had the creative freedom to fill in the gaps in the story, through the scratched and filmy lens of her own life experience. In interviews for Mental Illness, Mann opened up about the challenges of living with anxiety, depression and PTSD – hand-me-downs from a traumatic childhood – and has only recently felt enough emotional distance to talk about her own time spent in a rehab facility for extreme stress, almost 20 years ago.

“I felt like I would never work again because I just was not functioning,” she tells me over Zoom from her home in L.A. It’s a fear that reoccurred to her last year when she developed a neurological disorder that caused daily vestibular migraines and overloaded her senses to the point where she couldn’t listen to music or look at a screen without feeling dizzy and sick. The symptoms have only recently eased. Luckily for us, the recording of Queens Of The Summer Hotel was completed pre-pandemic and during mastering Mann was able to rely on her team to finish the record.

Like Sexton in her poem, Mann inhabits the writing from multiple angles. She is the I and the you and the we, giving voice to diagnosed, diagnoser and gatekeeper alike, each with their own roles in the patriarchal circus of mid-century psychiatric medicine. I wanted to know more about how Mann approached the huge challenge of adapting the book. We talked about what she had to bring to the table and what she had to take away, and where she might go next.

BEST FIT: “Girl, Interrupted” is quite an unexpected choice for a musical stage production but in many ways your involvement makes a lot of sense. I was actually reading the book again last night and had to smile when I saw a mention of ‘superego’ [the name of Mann’s own label since 1999]. What was your familiarity with the source material at the beginning?

AIMEE MANN: I don't think I had read the book before but for me it was a very interesting idea. Certainly right up my alley, having just written a record called Mental Illness. So I got hold of the book as soon as possible, and almost immediately I could start to picture how the music should sound, how it should be orchestrated. I could imagine the tone of it. I had a lot of ideas for songs right off the bat, just from reading the book. I was very inspired, not just because I have my own history. I’ve always been really interested in this subject and I’ve done a lot of reading around it. Of all the people in the team, I think I probably had the closest connection with the themes of the book. So I just went ahead and got to work and ended up with a lot of songs. I mean, a lot! To the point where I think I was kind of annoying. You know, I sort of felt the writer/director was sort of annoyed when I would come up with yet another song.

Hard to imagine that being a problem! One thing I found interesting is that Susanna Kaysen, the author of “Girl, Interrupted”, has kind of disowned the book in recent years, or rather what the book became once it was out of her hands. Can you as an artist relate to feeling a sort of loss of control over something you’ve created?

I can relate to it, but I do think that writing books or music kind of goes hand in hand with the understanding that other people are going to have their own interpretations of it. Also, because of the nature of that particular book and the way she wanted to think of herself as an anthropologist – somebody who’s just observing the behaviour of, you know, the animals in the zoo, or whatever – it’s sort of inevitable that people will want to put their own feelings and spin on it. Because the viewpoint in the book is so detached.

That’s what I had to do when writing the songs. There’s not a lot of guidance as to the characters’ internal worlds; what they are thinking, what they are feeling. Their back stories are left pretty vague. Susanna is obviously the main character but even she doesn’t give much away about herself. Reading it, you’re kind of like: Does she have parents? Do they even know that she is in there? Did they visit? Do they even care? It’s really an elementary thing, but there’s not much information about it.

Yeah, I read an interview with Kaysen where she talks about there being a blankness to the text. A lot of things are left out. Where these omissions are filled by the songs, has that come mainly from your own impressions or from the script of the play?

There wasn't really a script at the time. I mean, eventually there was a script but I’m pretty sure it’s still not final. I’ve heard it’s kind of up in the air. So most of the filling in the gaps comes from my impressions of the book, with a little bit coming from conversations that we had as a group: the three producers, the writer/director, and me. I brought in some ideas that came from my own experiences with mental illness and being in a treatment centre, and I think that really helped to shape the songs. You know, McLean is a real place, and in 1968 I think it was definitely more of a mental institution than a treatment centre, like it is now.

There’s actually very little said in the book about actual treatment. It’s kind of mentioned in passing but you get the impression that these young girls were not really taken seriously. How did anyone get better? I don’t even know. Treatment left a lot to be desired, it seems. From my own experience in a treatment centre, I did relate to the group dynamic of the girls in the book – how different people with various degrees of mental illness and difficulties interact within the same space.

I had forgotten how young Kaysen was when she was admitted to McLean. Was it a consideration for you, to write the songs in a believable way for teenage girls?

I think in 1968 an 18-year-old was probably a little more mature than an 18-year-old today. Women were already expected to start thinking about getting married and having children at that age, or possibly going to college, but very rarely getting a job. Even college was often seen as a stepping stone to maybe meeting a man who could provide for you. Women didn’t have much leeway, not much room to be independent or immature. For many, there weren’t a lot of options back then. Being allowed to find your own way or try to figure out who you were and what you wanted to do – that was the exception. Women weren’t even really allowed to want to do stuff. And you see it in the book, even just in the fact that Susanna says she wants to be a writer. I mean, that was almost enough of a reason to consider her mentally unwell in those days.

For me, one memorable part from Kaysen’s book is where she describes disease as “one of our languages”. I’d never thought of it like that before but it got me thinking about mental illness and the complexity of that language, and how our understanding of it is still really quite primitive.

I think there’s a connection between the mind and body that’s only just now starting to be understood as much more entwined than was previously thought. There was kind of a brief period where people talked about psychosomatic illnesses, but I think what we’re seeing now, in more practical terms, is a deeper understanding of the way that stress impacts the body. I’m especially interested in the research into how a history of childhood stress, or PTSD, has a long-term impact on your nervous system and how that impacts a person physically. We are maybe a bit too used to thinking of the body and the mind as two different things, but of course the brain controls everything. If the brain starts misinterpreting the language of what’s going on and sends out signals based on that misinterpretation, a lot can happen.

There’s a line in “You’re Lost” on the record that goes “You’re a balloon and all the world’s a pin”, and that struck me as something that maybe has an extra weight for you after your illness over the past year.

Yeah. I mean, I felt dizzy and almost like I had a concussion, every day, all the time. When I entered the world of migraine, it became apparent that it’s basically a neurological disorder that nobody really understands. Doctors just kind of throw a lot of different medications at it in the hopes that something will land. But it’s really chaotic, the more you go into it. People talk about all these potential triggers and suddenly there’s like four hundred foods you can’t eat. I started to feel like everything was a trigger. Like, oh, it’s a cloudy day.

There’s been a lot of research into chronic pain and one idea is that it’s often a neuroplastic problem rather than something physical. And as I was talking about before, stress can make your nervous system really reactive, to the point where it predisposes you to things like migraine. So it could be that stress underpins a lot more than we thought.

And of course the pandemic hasn’t been stressful at all…

Oh totally. Zero stress. Fear of dying, being completely isolated from your friends and having your career totally turned on its head because you can’t work or tour or anything… I’m sure there’s no stress associated with that.

Going back to the record, I know you said that the songs poured out of you quite quickly. I wonder, was there any particular character that was easiest or hardest to put into song?

I think the main character was probably easiest because I could put some of my own experience into hers. Like in the song “Robert Lowell & Sylvia Plath”, which comes from the passage in the book where she first gets to McLean and her roommate Georgina tells her that these famous people have also been patients there. I had this idea that these ghostly literary figures come to her in those first days. I imagined them walking through the halls beside her and giving her a kind of comfort. But she also feels very fragmented, almost split in two. There’s the side of her that wants to rest and another asking what is to become of me, you know?

Nobody goes into a treatment centre or mental institution feeling blasé about it. I think maybe her wanting to approach the book as an anthropologist was a real effort to contain the feelings of fear. I definitely remember feeling afraid. It’s not something that Kaysen talks about much in the book but, to me, it feels inevitable that she must have been scared of what was going to happen and what it might mean for her future. Especially in 1968. It’s one thing to come out in 2021 and say that you’ve been in a treatment centre for depression or anxiety or whatever, but in 1968 the stigma of it was unbelievable. There was just no going back to normal after that, if word got around. It just didn’t happen. You would absolutely just be more or less cut off from the rest of the world. You could not tell people, you just couldn’t.

People back then did not understand mental illness. I think they didn’t even understand the different categories of mental illness. They certainly didn’t understand PTSD, which – just in my own armchair analysis – I think was probably a factor for her and several of the other inmates.

Speaking of the other inmates, the character of Lisa Rowe is such a strong presence in the book, and even more so in the movie where she’s played by a young Angelina Jolie. Listening to the record, I wondered where she fits in to the songs.

I did try a couple of times to write songs for Lisa. The first one I was not fully satisfied with and the second one I didn’t like at all. I didn’t include the first one on the record because I felt it was maybe a little too specific. I wanted the songs on the record to work together more generally and not necessarily all sound like they were written for very specific characters.

Yeah, I think that even on songs like “Burn It Out” and “Home By Now”, which are obviously linked to the characters of Polly and Daisy in the book, people can appreciate the story on a broader level, without knowing the specifics.

Right. And Lisa is a difficult character, too. She refers to herself as a psychopath but I don’t think she really is. I think that she enjoyed hiding behind that label. Obviously she had a lot of problems but, to me, she doesn’t come across as a totally uncaring person without a conscience, which I guess is sort of the definition of a psychopath. So that made it a lot harder, having to make a leap and try to guess what was really going on with her.

There are some songs that seem less rooted to the source material, like “Little Chameleon”. Can you talk a bit about that one?

“Little Chameleon” came from an idea we discussed as a team. That maybe one of the characters could be a girl with no real sense of self, and constantly just adapting themselves to other people and taking on their characteristics to try to cover up that they didn’t really know who they were. I went home afterwards and just wrote the song, but then the next day everybody else was like, nope, we’ve gone off that idea.

Well, I liked the song so I kept it. I think it’s kind of germane to the themes of the record. You know, not having a real sense of self can be a big part of borderline personality disorder, which is what Susanna was diagnosed with. Also, with narcissism, I think a person can start to feel that their sense of self is comprised of outside things. Like it’s defined by how people react to you and your opinions and what you do for a living; things like that. And if that is ever threatened it can become really destabilising because you don’t have a core sense of self that can act as an anchor.

Right, that makes sense. So let’s talk a bit about the first single, “Suicide Is Murder”. There were a few ruffled feathers when that was first announced. I think some people didn’t realise that the main thrust of the song’s narrative comes from Kaysen’s writing about her own attempted suicide. I wonder, were you a bit taken aback by the response or did it not filter through to you?

I have to be honest and say I did not really follow it. I’m not really sure what people were accusing me of. I thought it was obvious from the song and from other songs that I’ve written that I would not be saying that if you feel suicidal that you’re an asshole. That’s not my relationship with suicide at all. I’ve known people who have committed suicide, and it’s obviously really terrible and sad.

I think we can also acknowledge that suicide can make the people left behind feel incredibly guilty, and that maybe not every song can have every viewpoint crammed into it. As you said, the initial thrust of the song came from Susanna Kaysen writing about her suicide attempt and how she knew she had to be really detached about it in order to go through with it. She had to look at it like a murder. So “suicide is murder” comes from her, and it’s a phrase and an idea that I thought was very interesting. Her suicide attempt and her feelings about suicide are very important to the plot of “Girl, Interrupted”, and also to the production.

I injected my own feelings about suicide into the second half of the song because I did not want the whole thing to come across as glib, almost like an instruction manual. So I think the song is balanced in that way.

“I See You” is the latest single from the record, and it’s one of the songs that I think reaches way beyond the scope of this project. I think the scene in the book where Susanna is out of McLean and revisits the Vermeer painting that gives the book its name [“Girl, Interrupted At Her Music”, on display at NYC’s Frick Museum since 1901] and sees a different side to it – when she sees the girl’s discomfort – is so powerful.

Yeah, I do too. That scene kind of gave me chills when I read it. I felt there were a lot of different things that she was recognising in that moment, and also feeling a lot of sadness for the time that was taken away from her while she was in McLean.

It’s the last song on the record, and it really has that sort of zooming out feel of a closing number of a musical.

Yeah, that's exactly what I had in mind, and I'm glad that that it comes through in the song. I liked the idea of the actors turning to the audience at the end and being a witness to whoever is out there.

You’ve said that the arrangements for this record were partly inspired by Bacharach and Sinatra standards. That era seems to be a regular touchstone for you, thinking back to songs like ‘Satellite’ and ‘It Takes All Kinds’ from Bachelor No. 2 and the piano numbers on The Forgotten Arm. What is it about that style of music that you think makes it so evergreen?

I think it’s that the songwriting was really crafted but still had a lot of feeling in it. I mean, take a song like “One For My Baby (And One More For The Road)”. It’s just brutal, but also very restrained. You know, as a singer, Sinatra was not really a showboat. Like, he really got out of the way of the song and let the song speak for itself. I find that combination of great songwriting and really restrained singing to be very moving, and it’s something that I always come back to.

It’s funny because it’s not like I grew up listening to this kind of music. I kind of came to it in my twenties while working in this giant record store in Boston. There were three different floors of records and I volunteered to work on the easy listening floor, which had hardly any customers. There was a turntable, though, so me and the other guy who worked in that section would just play records all day, and that’s how I kind of found my way to people like Frank Sinatra and Paul Anka.

There’s a record that Sinatra did with Brazilian artist Antonio Carlos Jobim in 1967 that, to my mind, is one of the greatest records of all time. That might be my next move, to make a record like that. Just go all the way, you know?

I remember years ago there was some talk about bringing The Forgotten Arm to the stage. Is that still an ambition of yours?

Oh yeah, that went way on the backburner for a while. I was kind of over it, but then I suddenly have had an idea about how to do it so it’s very recently back on. I’m working on it with my friend Jonathan Marc Sherman. I feel like we are on the same sort of wavelength and have the same goals in mind, so it’s just really, really fun to work with him.

So, like, ask me again in five years and we’ll see!