Susanna Kaysen. Photo by Michael Lionstar.

When Susanna Kaysen set out to write a memoir of her time spent at the psychiatric hospital McLean, she wanted to write like “an anthropologist in the loony bin.” She had watched her husband, an anthropologist, conduct a study of Faroe Islands—“a standard anthropological thing, a study of a village, of who married and who didn’t and what were the feuds,” Kaysen told me. Her husband’s study made her realize that “McLean was sort of like a village but somewhat larger. Our ward was a tiny little village with our doctors and nurses and aides.”

Kaysen hired a lawyer and got ahold of her medical records and began writing. She pared down details about herself and her struggle with mental illness so that the resulting memoir, Girl, Interrupted, reads today like a comedic travelogue of an extended stay at a young women’s ward. Lines like this one, about restrictions on sharp flatware, are typical: “We ate with plastic. It was a perpetual picnic, our hospital.”

And yet the readers of twenty-five years ago—Girl, Interrupted was published in June 1993—were not quite ready to recognize the book’s detached perspective. Instead, Kaysen said, many took Girl, Interrupted as some sort of stigma-defying big-t Truth about life with mental illness. During the book tour, readers would line up to tell Kaysen how her book had spoken to them. The author recalls hearing things like “nobody else has ever said these things” and “I feel like I’m not alone.” Or: “You wrote this book for me.”

“I would say to myself, I didn’t. I don’t know you. I wasn’t try to reach you,” Kaysen said. “What had spurred me to write was rage and a desire to dissect this world. And that didn’t seem to register for a lot of these people.” 

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Kaysen had published two well-regarded novels, but she was unprepared for the success that would follow Girl, Interrupted. At readings, young women would come up to her and display evidence of self-harm. Letters poured in. Young women “would find my phone number somehow and ask to meet me,” Kaysen recalled. “They would say they felt that I was them, or something like that.”

This is one of the reasons for memoir’s success as a genre: readers felt an intense and personal identification with the book’s narrator, and because the book was labeled as true, they assumed that connection extended to the author as well. “There was very little sense that this book was an artifact,” Kaysen said. Kaysen’s memoir, with its nonlinear chronology and scans of her actual medical records, felt very postmodern. “People thought it was a transcription of reality or my brain,” Kaysen told me. “That’s an intrusive feeling to the person into whose brain you didn’t plug.”

Girl, Interrupted was an early entry in the publishing gold rush that would be termed the memoir boom. Autobiography had long held a place in American letters, but typically those books were told by the famous or powerful. However, in the wake of the personal-is-political progressive movements of the sixties, the life writing of unknown citizens became more marketable. Early examples from this genre, termed “memoir” to distinguish it from the high roller’s “autobiography,” include Vivian Gornick’s Fierce Attachments (1987), William Styron’s Darkness Visible (1990), and AIDS memoirs such as Paul Monette’s Borrowed Time (1988).

The few years after 1993 would see the books that marked the memoir boom’s apex: Mary Karr’s The Liars’ Club (1995), Frank McCourt’s Angela’s Ashes (1996), and Kathryn Harrison’s The Kiss (1997). But Kaysen’s book is still considered the progenitor of the now common mental-illness memoir. While Styron’s memoir on depression and Kate Millett’s The Loony-Bin Trip (1990) predate Girl, Interrupted, neither garnered such widespread popularity. “I do think that Girl, Interrupted was right at the forefront of the memoir wave,” said Julie Grau, who acquired Kaysen’s book as a young editor and now heads a Penguin Random House imprint that focuses on memoir. “Susanna’s memoir spawned many Girl, Interrupted–type memoirs of young women grappling with mental illness in various forms. We can all come up with lists of the nieces and nephews of Girl, Interrupted.” The following year would see the publication of two other successful memoirs by literary women, Lucy Grealy’s Autobiography of a Face and Elizabeth Wurtzel’s Prozac Nation.

Grau was working at the imprint Turtle Bay, an all-female “Utopian little imprint” housed in a brownstone, when Kaysen’s manuscript arrived on her desk. It wasn’t an obvious best seller. The manuscript was rejected by a number of publishers before Grau accepted it. “I presented it to Joni Evans”—the imprint’s director—“and said I wanted to buy it,” Grau, who also founded the imprint Riverhead, remembered. “We actually laugh about this now, but Joni said, ‘Oh, God, who would want to read a book about a girl in a mental institution?’ And I said, ‘Actually, I think a lot of people.’ ”

The book was a New York Times best seller for eleven weeks in hardcover and twenty-three weeks in paperback. Today there are 1.5 million copies in print in the United States. Prior to publication, though, Kaysen herself doubted that her book would make anything but a quiet debut. When advance copies were being distributed to critics, the author went to Italy, expecting little attention. “I started to get these completely crazy phone calls,” Kaysen told me. “Allure wants you to write about how you dress. Vogue wants to interview you. Harper’s Bazaar wants to run an excerpt.”

Laura Zigman, the former publishing publicity exec who worked on Girl, Interrupted, believes that Girl’s prominence was helped along by the fact that it was came amid a larger debate around mental health in America. Dr. Peter Kramer’s acclaimed Listening to Prozac also came out in 1993. Political headwinds were also in the book’s favor: the Clinton administration enacted antidiscrimination laws for those with mental illness, and the president’s health-care reform bill, introduced in the fall of 1993, called for improved public mental-health services. “Susanna’s book opened up a conversation on mental health,” Zigman said. “It was so visceral and poetic. Darkness Visible was published before, but I think Susanna’s book was such a success because it had a female voice and a younger voice and it was a lyrical book about that experience.”

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The dissonance between what the author calls “the intentions of the desk” and the public’s reception made our conversation difficult at first. Kaysen feels that her story, helped along by the Winona Ryder–starring movie adaptation, has taken on a life of its own. “I just feel like I didn’t even write this book,” Kaysen told me early on in our phone call. “I guess whatever that book is, it just has nothing to do with me anymore, if it ever did.” She hesitated. “It has become something else, and it doesn’t belong to me. I shouldn’t have any commentary on it anymore.”

Fearing she was about to hang up, I made my voice gentle and asked her what she’d intended the book to be. She told me about her anthropological moxie and the time she spent living on the Faroe Islands. She told me she felt her book was a failure and that she probably should’ve written a “better” one. She told me that the last thing she was trying to do was write about her own life.

“My book has two virtues,” Kaysen said. “It’s short, which is very important because people don’t have long attention spans, and it’s easy to read. It’s like a primer. There are no complicated words, no complicated sentences. I don’t think that it is totally straightforward, but it reads as if it is. And then there is this blankness and omission, a lot of omission. I don’t write about my family really. I don’t write that much about my internal state. It’s not about me.”

And yet Kaysen was willing to yield. She spoke in broad strokes about having “a kind of lonely childhood” and how books functioned as companions. “There are other books that have filled a role culturally, in some small way—like The Sorrows of Young Werther. And how many people thought they were Holden Caulfield? But I wasn’t thinking, I’m going to make a lot of people feel like I understand them.”

“I feel lucky in a way,” she conceded. “It doesn’t happen to that many people that you write something and lots and lots and lots of people find it extremely important and meaningful to them. People were loving a book I didn’t write, but maybe that doesn’t matter because they were able to see it the way they needed to see it. That’s a good thing.”

Kaysen was riffing now, her earlier hesitation evaporated. “It remains to me a mystery why people like my book, and it’s not with false modesty I say that. It’s mysterious why anyone loves any book. As an author, there’s nothing you can do but watch.” She laughed, fully, for perhaps the first time in our nearly hour-long call. And then, after exchanging pleasantries, she hung up.

Tara Wanda Merrigan is a freelance writer living in Philadelphia.