Dirty Dirty Lizzie: Visualizing Midcentury Narratives of Psychoanalysis and Intimacy

By Emily Naser-Hall

Emily Naser-Hall is an Assistant Professor of Film and New Media Studies and coordinator of the Film Program at Western Carolina University. Her research focuses on post-1945 literature, film, and cultural narratives of women's sexuality and domesticity and has been published or is forthcoming in journals such as Journal of Cinema and Media Studies, Arizona Quarterly, New Review of Film and Television Studies, and Studies in the American Short Story.
“I have had a letter from Arabel Porter,” Shirley Jackson writes in a February 20, 1957 letter to Bernice Baumgarten, her editor at Brandt & Brandt, “asking if Bird’s Nest is a fictionalization of Three Faces of Eve. I am not going to answer her until I have cooled off some” (“Bernice Letter” 331). Jackson’s frustration with the editor at the New American Library foregrounds the author’s complicated relationship with cinematic representations of women’s mental health and Hollywood’s adaptation of her novel The Bird’s Nest (1954) in Hugo Haas’s 1957 film Lizzie. In adapting Jackson’s novel, Haas faced the challenge of visualizing Elizabeth’s (Eleanor Parker) deviant intimacies and the therapeutic model in a way that would be culturally cogent to contemporary audiences. Jackson critiqued the film’s confused depictions of this model and reviewers’ misinterpretation of protagonist Elizabeth’s mental illness: “[T]hey made her into a lunatic, which she can’t be, by definition” (Franklin 354). The Bird’s Nest excoriates the misogyny underlying psychoanalytic theories concerning female sexuality and sociality in the American midcentury. Lizzie, however, rewrites Jackson’s critique as an endorsement of cultural narratives of women’s mental health that link wellness with the performance of socially recognizable intimacies. In visualizing Elizabeth’s intimate disjunctures and dis-integration in Lizzie, Haas experiments with cinematography and the boundaries of the frame in order to complicate the relationship between what appears on screen and what the audience can perceive—the unseen or unfocused invisibly directs the seen. Haas communicates Elizabeth’s broken psyche and tenuous intimacies through continuous juxtaposition of cinematic styles. If midcentury therapeutic narratives link intimacies and sexuality inextricably with health or deviance, then Lizzie renders those narratives visibly legible and their underlying anxieties justified through Haas’s cinematographic technique.

The Bird’s Nest narrativizes the illness and path to wellness of Elizabeth Richmond, a shy woman with multiple personality disorder. Elizabeth undergoes hypnotic therapy with the vehemently not-a-psychoanalyst Dr. Wright, who discovers that Elizabeth is merely one of four personalities, which also include weak Beth, tricksy Betsy, and miserly Bess. Elizabeth’s disintegration can be traced, Jackson reveals, to two events: her sexual abuse by her mother’s boyfriend, Robin, and her mother’s death, for which Jackson implies Bess was responsible. With the help of Elizabeth’s Aunt Morgen, Dr. Victor Wright coaxes the personalities into a final, singular iteration, who at the end of the novel is called either Victoria Morgen or Morgen Victoria, after her ersatz parents. By dividing her novel into chapters with different narrators—only one of which is even a fragment of Elizabeth—Jackson both represents Elizabeth’s pathology and ironically enacts the psychoanalytic talking cure, revealing the gendered and familial sociality underlying this cure. As in the rest of Jackson’s canon, constructions of the monstrous mother, here “crafted as a dramatization of psychoanalytic theories of female subjectivity,” are central to understanding and understanding Elizabeth’s cure (Evans 26). In Lizzie, however, Haas converts Elizabeth’s four personalities into three—sickly Elizabeth, licentious Lizzie, and kind Beth. Elizabeth undergoes psychotherapy with Dr. Wright, who employs what Jackson called in a 1957 letter to her parents “a very interesting combination of freudian analysis, pre-freudian hypnosis, jungian word-association, and rorshak inkblots [sic]” (“Geraldine Letter” 335). Wright helps Beth emerge as the final personality who vanquishes the others after confronting the repressed memory that Robin raped her after her mother died on Elizabeth’s birthday.

A historically specific reading of Lizzie within the context of postwar psychiatric narratives demonstrates how 1950s preoccupation with gender roles and sexual normativity mandate the performance of an intimate doubleness. Psychoanalysis and the therapeutic model informed dominant attitudes towards normativity and deviant sexuality in an era in which nonconforming behavior could be—and often was—construed as a national security threat.  When Sigmund Freud introduced American audiences to psychoanalysis in his 1909 lectures at Clark University, he signaled the advent of an entirely new therapeutic style. The psychoanalytic imagination intertwines language, science, and interpersonal relationships in a method of managing and comprehending the patient’s emotional interiority. “Intimacy,” Eva Illouz argues, “became a code word for health; an absence of intimacy now pointed to a fear of intimacy” (46). This model places sex, pleasure, and the nuclear family at the epicenter of cultural understandings about women’s mental health. Wellness required both healthy intimacies—familial and sexual—and the performance of those intimacies in the form of open discussion. In the two decades following the Second World War, the psychiatric profession grew rapidly alongside increased attention to questions of mental health in popular culture. The 1946 National Mental Health Act expanded the purview of psychologists beyond the army, corporations, and individuals with intense mental disorders to ordinary citizens, all of whom, under Freud’s psychoanalytic model of repression, could be—and likely were—rendered neurotic from childhood trauma and early experiences with sex. The American Psychiatric Association’s 1952 first edition of its Diagnostic and Statistical Manual of Mental Disorders established social nonconformity as a medical condition requiring professional intervention. A diagnosis of sociopathic personality disturbance, for example, indicated that a patient was “ill primarily in terms of society and conformity with the prevailing cultural milieu” (Committee 38; see: Cooper and Blashfield 451).

Postwar films such as Spellbound (1945) and The Three Faces of Eve (1957), which was released five months after Lizzie, depicted Freud’s talking cure on screen to critical acclaim. Lizzie, however, transcodes Jackson’s preoccupation with the vagaries and menaces of the fractured mind by engaging directly with midcentury anxieties about the centrality of female sexuality and domesticity to the nation’s mental health, largely by reinscribing these anxieties and reinforcing their validity. When Dr. Wright refers to Elizabeth, in both the book and the film, as suffering from a “disintegrated” personality, he not only gestures toward Jackson’s source material—Dr. Morton Prince’s The Dissociation of a Personality (1905)—but also indicates that Elizabeth’s multiple personalities manifested from her failure to form healthy intimacies, a failing that has rendered her dis-integrated. Her pathology, then, is not personal but social. If emotion functions as both a psychological entity and a socio-cultural one, then postwar therapy constructs the cultural definition of personhood as inextricably linked in concrete and immediate ways with culturally and socially defined relationships. Therapeutic language conflates narratives of the self and identity with the family narrative. The family provides the locus for understanding pathologies of the self, as childhood trauma and parental neglect operate in psychoanalysis as the stoppages that prevent healthy social and personal maturation. The notion of intimacy, then, draws from both domestic and sexual narratives of emotional health and social adjustment. The therapeutic episteme positions the individual within a tenuously maintained public-private borderland, an emotional ontology that diagnoses personal health based on one’s healthy attachments in the intimate social sphere. The disintegrated personality is both psychologically fractured and insufficiently enfolded within society; it is, then, dis-integrated.

The particular focus on dissociative identity disorder (DID)—at the time called multiple personality disorder—in both psychiatric and literary texts reflects cultural anxieties surrounding these multiple and often conflicting roles that women were expected to play.  “The idea that a woman’s identity might comfortably encompass more than one persona—wife, mother, and professional, for instance,” Ruth Franklin argues, “threatened a male-dominated culture invested in glorifying the stability of family life” (332-333). This anxiety lies at the heart of The Bird’s Nest and Lizzie. In both, a male doctor battles for the disposition of Elizabeth Richmond’s “true” identity against multiple personalities who are not easily subdued. However, Nest specifically critiques both cultural expectations of women’s roles and the dual construction of women’s mental health as simultaneously sexual and social, with Elizabeth’s disintegration framed within thematics of domestic, and particularly maternal, trauma. Jackson, then, “points a finger at the world surrounding her madwomen, reproaching a fatuous society for inciting this loss” (Young 40). She critiques dominant models of psychological health by ironically casting Elizabeth’s dissociation as simultaneously caused and cured by dysfunctional, patriarchal cultural constructions of the family as the psycho-social model of health. She depicts Elizabeth as lacking healthy intimacies but excoriates the narrative of mental health as mandating sociality as itself ideologically motivated. Jackson reinforces the misogyny of the therapeutic model in her narrative structure; she recounts Elizabeth’s treatment in chapters narrated from pseudo-scientifically objective third person perspectives, only one of which belongs to a personality. The reader’s knowledge of psychotherapy, then, echoes the personalities’ autonomy over their own cure—manipulated and filtered by the dual agents of social and domestic control (Wright and Morgen), reaching resolution only when permitted and on their terms.

The novel’s opening implicitly links Elizabeth’s fracturing identity with the crumbling museum in which she works; the museum’s sagging foundation brings to the museum’s founders “infinite shame and a tendency to blame one another,” while the clerks “made little wry jokes about disintegration” (Jackson 1-2). Elizabeth’s mental state, like the museum’s foundation, are a matter of both public concern and social neglect. The first indication that Elizabeth contains multitudes comes in the form of a letter, later revealed to have been written by the personality Betsy, addressed not to Elizabeth but to “lizzie.” But Elizabeth responds to the sender’s threat to “watch out for me” not with apprehension, but with pleasure that someone—even an enemy—seeks to connect: “[T]he most exciting thing about it was probably its lingering familiarity…it was an act of intimacy from a stranger impossible to picture” (3, 5-6). She hides the letter in an old Valentine’s Day candy box alongside a letter that her mother wrote to Robin. Jackson uses italics to highlight the speaker’s intentional separation of self from other. Upon receiving a letter from Betsy, Elizabeth thinks, “Someone…is writing letters to me” (17). This link between Elizabeth’s dissociation, her longing for intimacy, and her traumatic childhood drives her therapeutic narrative.

Elizabeth’s behavior worsens in the following days—she receives more anonymous letters, experiences blackouts, and spews vulgarities that the reader, experiencing Elizabeth’s breakdown from her third-person limited perspective, learns of from a scandalized Aunt Morgen. An outburst of foul language at a social call with the neighboring Arrows convinces Morgen that Elizabeth needs professional treatment, although the family physician attributes Elizabeth’s illness to sexual anxiety: “‘I think she’s worried about something. Boys, maybe. You ever ask her about boy friends?’” (29). Morgen agrees to consider a psychiatrist after confirming that Wright is not the kind of practitioner with “a couch,” metonymically linking therapy (and the therapist) with the sexual neuroses the process uncovers (29). When he meets his new patient, Wright observes Elizabeth’s prudishness, calling her a “decent and modest girl” (33). Betsy’s letters foreground the slippage in nomenclature that Jackson employs throughout the narrative to distinguish among, and then intentionally confuse, the four personalities. Dr. Wright quotes a passage from Price that informs his diagnosis of Elizabeth’s disintegrated personality: “By a breaking up of the original personality at different moments along different lines of cleavage, there may be formed several different secondary personalities which may take turns with one another” (58). But as Wright’s own notes show, the personalities do not “alternate,” as Prince contends, nor does Elizabeth display an “original undisintegrated personality,” but rather the four Miss Rs, while only one may speak at a time, always coexist, the boundaries separating them indistinct (58).

Wright employs scientific naming conventions to distinguish between the personalities—R1 for Elizabeth, R2 for Beth, R3 for Betsy, and R4 for Bess—until he and Betsy assign each personality a name. However, even after the other personalities reveal themselves, Dr. Wright frequently refers to “Miss R,” initially his name for Elizabeth before Beth and Betsy revealed themselves under hypnosis but which subsequently acquires a subject in opposition to the other personalities that he names with more specificity. “I never met R2 without a strong impulsive regret for the person Miss R. might well have been for all this time,” he observes, simultaneously invoking his original usage of  “Miss R” as Elizabeth and constructing another, unrevealed yet distinctive Miss R—a personality at once both Elizabeth and an imagined, singular iteration of the four personalities that is at once neither R2 nor Elizabeth yet inclusive of both (53). Darryl Hattenhauer refers to “the self as a heteroglossia of introjected Others” (1119). Miss R., as a hybridized supplement containing both self and other(s), signifies both Elizabeth and not-Elizabeth, or not-only-Elizabeth. She is, in Wright’s notes, the patient whom he initially diagnosed as “a hysteric” but who ceased to exist when Beth and Betsy appeared, living only as a unified being hypothetically against the reality of her disunity: “My immediate attempt must be, I thought, to discover the point at which the unfortunate Miss R. had subdivided, as it were, and permitted a creature like Betsy to assume a separate identity” (32, 62). Wright’s failure to draw definitive boundaries between names and the personalities they signify highlights their concurrent simultaneity and distinctiveness. Instead, the performance of appropriate propriety distinguishes the personalities to Wright. He identifies Betsy, for example, by her vulgarity: “…Betsy’s voice shout[ed] a song which surprised me only in that I could not imagine how she came to learn the words during Miss R.’s limited experience” (72). But Jackson echoes her earlier use of italics to emphasize the distinctions that Wright elides in his case notes; for example, Betsy pouts during a session with Wright, “Why should I think of them just because you care more for them than you do for me? You expect me to give up just because you decide you’d rather have them?” (75).

Wright relies on hypnosis to elicit, and then control, the four personalities, although he notes Elizabeth’s apprehension that he will ask “embarrassing” questions during hypnosis (40). Wright induces levels of hypnotic suggestion to call forth the personality whom he believes will be best suited to revealing the information he requires, and the personalities chafe under Wright’s command even when they, in the early stages of therapy, know that they can only communicate while Wright keeps their eyes shut. Even compliant Beth complains, “‘But I want to open them”—petulantly…‘If I could open my eyes…then I could look at you, dear Doctor Wright’” (47). Betsy refers to her freedom as “‘when I have my eyes open all the time’,” a threat that Dr. Wright quiets: “‘Do you realize, young lady, that if I find that you are of no use to me in my investigations, I will surely send you away and never let you come again?’” (61, 67). The personalities, however, recognize Wright’s restrictions of their vision as a sign of the masculinist surveillance that defines the therapeutic model. They exist as fully formed entities only when they regain their sight—“‘[J]ust as when I first saw Betsy with her eyes open I recognized suddenly that she was an independent personality…I saw that Beth now, looking about her and drawing herself together, was endeavoring to form herself’”—and therefore must be controlled more forcefully (135). Elizabeth’s visual recognition of herself and the personalities she contains is only permissible, then, under controlled, observable—and carceral—conditions. Betsy refers to the synthesis of a final personality in therapeutic language, arguing that when the final iteration emerges, she and the other personalities will “go under” (166).

Wright’s inability to differentiate among the personalities emphasizes not merely the impossibility of separating one Miss R. from another, but also the artificiality of borders between self and other. Betsy’s narrative in particular exemplifies the social model of mental health; she absconds to New York to “go somewhere where people love me,” yet her ignorance of social relationships and eagerness to belong drive her to a psychotic break that elicits Bess, the most antisocial personality (83). She arrives in New York hoping to be “among friends who were waiting for her here in the stirring crowds of the city,” looking for her mother whom she believes alive and searching for her (95). While Jackson uses italicized distinction frequently with pronouns, two instances in Betsy’s narrative take an ironic turn. First, Betsy sees a man walking along a ledge from her hotel window and thinks “he may someday be a friend of mine,” and later, after allowing an unsuspecting Elizabeth to come to the forefront and find herself in a strange hotel, Betsy thinks, “I wish I had a real sister” (96, 99). For Betsy, there is no “mine” any more than there is a “real.”

Betsy’s escape highlights her alienation, driven by her unfamiliarity with the boundaries of acceptable social behavior. Betsy survives by heeding warnings intended to preserve her propriety—‘‘I’m sure I wouldn’t send you any place you shouldn’t go’”—and mimicking others’ verbal cues—“‘Of course I always look for unusual things.’ ‘Of course I do too,’ Betsy said” (109, 117). Betsy’s attempted cure for loneliness only reveals her disconnection and drives her psyche to strengthen the only intimacies she enjoys—those she shares with her other personalities. She searches a telephone book for her mother’s name, which she shares. “RICHMOND, ELIZABETH. It stood out from the page, blackly, and then below it, RICHMOND, ELIZABETH, and below that, RICHMOND, ELIZABETH, and, again, RICHMOND, ELIZABETH. Who, Betsy thought, staring, who?” (119). Betsy’s mother becomes indistinguishable from every other Elizabeth Richmond, which includes herself, such that Betsy loses the ability to separate herself from her mother, and therefore from all other possible Elizabeth Richmonds, such that she is both all Elizabeth Richmonds and none of them—“who?” The personalities respond violently to this indistinctiveness, attacking each other to the point of needing medical care.But the nurse at the hospital reinforces the indeterminacy of Elizabeth’s personalities, employing a royal “we” that deepens Elizabeth’s crisis of differentiation: “‘We’re going to be in trouble…if Doctor comes in and find us talking” (129).

But although Wright pities Elizabeth’s friendlessness and even Betsy’s vulgar desperation to be loved, he devotes himself more fully to bringing about “the entire final form of the personality” after Bess appears (139). Obsessed with protecting her inheritance from Wright and Morgen, whom she believes conspiring to deprive her, Bess denies needing neither family connections nor psychiatric care. Bess complains, “‘[A]ll I want is to be left alone and not bothered and I would be so happy,’” leaving ambiguous whether she wishes the other personalities, her caretakers, or the world at large to leave her be (161). But it is only after Bess confronts Morgen and Wright and contends, “‘I…am going to get along very much better without you two” that Wright abandons the case (186). Wright retorts, “‘How long do you think you will survive, alone, without a guide or a friend, or an ally? You are at best, young lady, only a slight, only a poor and partial creature’” and recommences Elizabeth’s care only to authorize commitment at Morgen’s request (187). Jackson implies that Elizabeth’s disintegration is not only understandable, but inevitable, the only outcome for women who are expected to juggle conflicting roles and social expectations. “[I]t must be recalled,” Jackson observes, “that the girl had spent many years with the many Morgens and so, perhaps, deserved a turn of her own” (199). Morgen, in fact, congratulates Elizabeth: “[S]he was more pleased than not with her niece’s unexpected variety of imagination” (199). Wright, however, describes Bess as a “corrupted” iteration of the original Elizabeth R., invoking language that implies the moral failings of an improperly socialized woman whose paradoxically simultaneous antisociality and desperation for love render her equally ill. Institutional confinement, away from society and family, ironically remains the last resort for re-integrating Elizabeth, although Morgen does question the social acceptability of commitment: “I’ll tell everyone she’s gone off to have an illegitimate child…it’s better than admitting I had her locked up” (218).

Jackson writes her strongest critique of the therapeutic model and its patriarchal underpinnings in the final chapter, titled “The Naming of an Heiress.” The woman formerly known as Elizabeth is referred to only as “Doctor Wright’s patient” and “Aunt Morgen’s niece,” suggesting that the eponymous heiress has been named by virtue of her medical and familial associations—the sole remaining identity has been constructed to serve social and domestic ideologies (232). She recalls that, upon awakening in the hospital, “her first clear thought was that she was all alone…the second thought that she ever phrased clearly she phrased almost aloud: I haven’t any name” (234-235). But unlike the initial namelessness of the personalities in Wright’s notes and Betsy’s fractured self-identification in New York, the empty anonymity of the heiress is not a failing of sociality but a blankness to be filled intentionally by her ersatz gender-bent parents: “Morgen said disagreeably, ‘You can be her mommy, and I’ll be her daddy’” (249). Wright refers to the heiress as an empty vessel who it is “‘our responsibility…to people” and voices clearly the objective he has held since commencing treatment: “‘[W]e are able, as few others have ever been, to re-create, entire, a human being, in the most proper and reasonable mold, to select what is finest and most elevating from our own experience and bestow!’” (249). Back at the Arrows’, Wright alludes to the sacrificial communion whose rituals Jackson had earlier explored in her 1948 short “The Lottery,” reiterating the story’s portrayal of sacrifice as social and extending this linkage to the act of creation. “‘Each life, I think,’” Wright argues, “‘asks the devouring of other lives for its own continuance,’” alluding to the heiress’s integration as a sacrificial offering in which the personalities died to enable her rebirth (254). “‘[T]he radical aspect of ritual sacrifice,’” Wright continues, “‘the performance of a group, its great step ahead, was in organization; sharing the victim was so eminently practical’” (254). The heiress’s birth, then, resulted not solely from an act of destruction, but from an act of communal creation. Yet, as Judy Oppenheimer argues, “it is actually the reintegration into ‘sanity’ which somehow feels like a loss—of potential, of self” (164). With his talk of sacrifice and the individual’s responsibility to conform to their environment, Wright congratulates himself on what he earlier called his obligation to “bring a new being into the world,” yet he never discovers the crucial event that caused Elizabeth’s disintegration—her childhood sexual abuse by her mother’s boyfriend (177). Wright and Morgen, in a dual act of therapeutic-familial creation, craft a new personality not so she can form independent intimacies, but so she can serve their financial and intellectual purposes. By christening the heiress either Victoria Morgen or Morgen Victoria, the doctor and the aunt reveal themselves to be the agents of psychoanalytic and domestic coercion that undergird midcentury narratives of mental illness as a failure of social and familial relationships.

Jackson leaves open, however, the possibility of an alternative reading of the final chapter—that Elizabeth could, throughout her institutionalization and treatment, have retained her autonomy and plans to name herself. “Doctor Wright’s patient,” the section titled “The Heiress” opens, “who had been his patient for a little more than two years, Aunt Morgen’s niece, who had been her niece for a little more than twenty-five years, found unexpectedly that she wanted to run down the sidewalk” (232). Although the sentence’s subject remains unnamed, identified only by her relationship and its duration with her medical and family contacts, the action suggests that one of the personalities has survived the supposed integration. Specifically, the unexpected discovery that the Heiress wants to run down the sidewalk hints that Betsy, the most childlike and impulsive of the personalities, remains. Jackson peppers “The Heiress” with clues that, despite the outward performance of integration into a new, unnamed personality, Betsy survives: “Her first clear thought was that she was all alone; it had been preceded by a rebellious, not-clear feeling that she had succeeded in remembering absolutely all her mind would hold” (234). Even Wright doubts the Heiress’s total cure: “‘Do you think they are gone?’” (238) (emphasis in original). If, as Wright proclaims at dinner, “[t]he human creature at odds with its environment...must change either its own protective coloration, or the shape of the world in which it lives,” then perhaps Betsy has not vanished entirely, but rather adapted to perform integration within a socio-medical therapeutic framework that demands disclosures (255). The Heiress’s few words of spoken dialogue, combined with hints at an interiority in which she experiences sudden impulses and rebellious feelings, demonstrates not that Elizabeth is cured, but that she has learned to perform psychiatric and social health by manipulating and controlling her public disclosures. Both interpretations conclude that Jackson depicts the psychiatric cure as a failure, such that psychoanalysis either erases the patient’s sense of self—thereby failing the patient—or teaches the patient to mediate her own therapeutic disclosures and thereby circumvent the patriarchal and social strictures by which the model is governed—thereby undercutting the cure’s supporting logic.

Although Lizzie similarly blames Elizabeth’s mother for her daughter’s psychological fracture, it reinscribes the social-sexual models of familial trauma and the therapeutic relationship that Jackson treats with irony. In translating Jackson’s literary style into the visual language of cinema, Haas opens Lizzie with a clear nod to both the psychiatric concerns that drive the narrative and gendered dynamics of midcentury mental health care. The film commences with close-up shot of Dr. Wright’s (Richard Boone) hands dripping ink from a stopper onto blank paper, then folding and unfolding the paper to create a Rorschach inkblot. The hands then open another page to reveal the title—Lizzie. The novel’s Betsy and the film’s Lizzie play on the homophonic “Wright-Right” to tease the doctor with the nickname “Dr. Wrong,” but Haas’s title sequence invokes another set of homophones—Wright and Write. By visualizing how the novel’s Wright enacts an artificial distinction between the four personalities with his naming conventions as the film’s Wright’s disembodied hands literally writing the name of the most troublesome personality in the same manner he creates the inkblots, the film suggests that “Lizzie” is a construction, and an implicitly masculinist one at that.

Throughout the film, the camera mimics Jackson’s simultaneous erasure and multiplication of Elizabeth. The film’s cinematography and mise-en-scène emphasize Elizabeth’s loneliness by isolating her from her surroundings through deep focus and deep space composition. The film opens with a deep focus tracking shot of Elizabeth’s coworker Ruth and the other clerks entering the museum. The camera follows as they walk through a dinosaur exhibit so that the audience develops camaraderie with the women, but while tracking the camera is positioned on the other side of the exhibit so skeletons enter the frame between the camera and the women. The camera cuts to a deep space composition sequence in which Ruth and a coworker discuss Elizabeth’s illness in the foreground as Elizabeth enters the frame in the background, clearly visible within the spacious museum lobby yet separated from her colleagues by a vastness that the shot’s mise-en-scène emphasizes. Visualizing Elizabeth’s disintegration as her physical isolation within social spaces emphasizes the film’s narrative emphasis on Elizabeth’s unhealthy attachments. As Elizabeth approaches Ruth in the initial museum sequence, Ruth accuses her, “Why don’t you give us a chance to be friends? You act like you don’t want any friends.” Elizabeth counters, “Oh, but I do,” but refuses Ruth’s offer of a birthday dinner.

This sustained experimentation with deep focus and deep space composition demonstrates how characters can share the frame but remain alienated. Returning home after she discovers the first Lizzie letter, Elizabeth prepares hot cocoa while talking with Morgen, who sits in the adjacent room. Morgen appears in the foreground and Elizabeth in the background, her height and distance from the camera underscoring her emotional isolation even from her family. Furthermore, the first shot in this scene is a medium shot of Morgen in a rocking chair, moving constantly yet remaining within the frame. The camera then cuts to a low angle close-up of Morgen. Elizabeth remains static in the background while Morgen rocks in a chair, abruptly entering and leaving the frame in the fore. The clarity of Elizabeth’s separation—physical and emotional—from Morgen and the instability of their pseudo-maternal relationship is made visible through the film’s formal style. This scene exemplifies Haas’s visualization of the therapeutic mode as both visual and haptic, a relationship that in Jackson’s novel consists of patriarchal control but in Lizzie communicates the centrality of human connection implicit within the talking cure. Walter (Hugo Haas), Elizabeth’s neighbor who recommends Wright to Morgen, describes Elizabeth as “a sad girl who never laughs.” Recommending that Elizabeth seek therapy, Walter articulates the midcentury psychoanalytic model’s underlying logic: “The whole world is in such a mess. Insecurity and panic and frustration. We all need help sometimes.” The public-private binary, parodied in Jackson as a social fiction with ideologically patriarchal underpinnings, becomes both disease and cure in Lizzie.

In representing the disintegrated personality, Haas transcodes Jackson’s linguistic separation—and frequent befuddlement—of four personalities into the cinematic visualization of three. Elizabeth speaks of her illness as a form of disorienting visual misrecognition: “It’s as though somebody else is staring back at me.” The most evident cinematic signifier of Elizabeth’s disintegration is the three-way mirror in her bedroom, which both reflects and fractures the woman shown in it. Elizabeth frequently lingers on her reflection, filmed from behind with Elizabeth’s tripartite reflection facing the camera. The audience first sees Elizabeth transform into Lizzie before the mirror. Lizzie, however, recognizes herself through the visual recognition of others; she tells a group of men at a bar, for example, “Hope you got your eyes full, boys.” The film maintains Jackson’s emphasis on hypnosis and its required eye-closing; sequences of Wright’s therapy sessions consist of soft-focus close-ups of Elizabeth, Lizzie, or Beth—whoever Wright happens to have evoked at the time—with her eyes firmly closed. However, Lizzie communicates a complex relationship between surveillance and the psychiatric cure. By training the camera on Elizabeth’s face during hypnosis, Haas recenters Elizabeth and grants her the potentiality for introspection; Wright enables, not forces. However, in softening Wright’s control over Elizabeth’s hypnotic states, Haas reestablishes the camera as the surveilling mechanism of the therapeutic gaze. Frequent over-the-shoulder downshots emphasize Elizabeth’s submission, maintaining her presence within the frame as the object of paternalistic care.  During a session, for example, the camera trains on Wright as he hypnotizes Elizabeth from behind the chair where Elizabeth sits, her head peeking atop the chair in the lower corner of the frame. Elizabeth herself meets Lizzie when Wright forces her to consider her appearance in the sane mirror—although Elizabeth cannot truly meet Lizzie, and instead merely sees the makeup and hairstyle that are Lizzie’s traces. Haas’s camera, then, inscribes the cinematic gaze not only as the traditional voyeur, but more specifically as an agent of therapeutic surveillance—while Elizabeth gazes inward, the camera forces the audience to observe, and thereby to control, her.

But if Haas’s cinematography rewrites the visual domination of psychoanalysis as the camera’s purview, how does Wright coax Elizabeth and Lizzie into Beth? The psychoanalytic cure in Lizzie is enacted not through control of what the personalities can observe of the world, but rather by means of social connections to that world, a shift that Haas communicates by emphasizing the haptic relationship between therapist and patient. Echoing an analogy of Elizabeth’s mind as a clogged pipe that the novel’s Wright employs to explain Elizabeth’s disintegration, the filmic Wright claims, “There’s been a stoppage. Somehow the girl has stopped up the main pipeline of her mind, probably with some incident or experience in her youth.” To identify and clear this stoppage, Wright asks Elizabeth to hold his hand, summon a memory of her mother, and squeeze as the memory becomes more painful. Elizabeth recalls a day at the beach with her mother and her mother’s boyfriend, Robin. Elizabeth’s mother talks of the burdens of motherhood while young Elizabeth eavesdrops. “The adolescent girl,” Catherine Driscoll claims, “also became…a standard reference point” for changing discourses of the emerging social order (18). Haas recalls the shot of Elizabeth and her coworkers at the museum; Elizabeth’s mother and Robin lie on the sand in the foreground while Elizabeth, sharply framed with the shot’s deep focus, observes from behind a rock that partially conceals her. As Elizabeth becomes more upset, she smears mud on her dress, leaving dirty handprints across her body that recall the inkblots that opened the film. Young Elizabeth, then, serves “at once [as] a marker of modernity and its dangers, which, according to the socio-scientific imagination included sexual depravity and an excess of worldliness, putting at risk the ideal of the family” (Fernández 27). In Wright’s office, the camera cuts to a close-up of Elizabeth’s hand squeezing Wright’s. This tactile connection, then, facilitates not only the patient-therapist connection, but also the recollection and release of a memory, a stoppage in the pipeline of Elizabeth’s integrated identity. The film frequently depicts Wright and Elizabeth as reaching for one another or connected by touch; during hypnosis, for example, Elizabeth’s hands enter the frame to reach for Wright, and Wright holds Elizabeth’s face to reassure her when she fears for her sanity. Touch, in Haas’s interpretation of the therapeutic model, communicates emotions and trauma and enables healing or release.

The film’s climax arrives on Elizabeth’s birthday. The sequence commences with a split diopter shot of Ruth in Elizabeth’s office, clearly irritated that Elizabeth has refused the offer of a birthday dinner. Ruth leaves and Elizabeth, in a daze, climbs to the roof, where the camera repeats the over-the-shoulder shot from Wright’s office as if prepared to push her. Ruth returns to Elizabeth’s office, finds it empty, and rushes to find Elizabeth. The shot of Ruth running to the stairs recalls the initial deep composition of Elizabeth entering the museum at the film’s beginning. Ruth finds Elizabeth and leads her to the lobby, where Wright waits to escort her to a birthday party that he, Morgen, and Walter hope will unlock Elizabeth’s repressed memories of her mother. In a soft focus shot of Elizabeth’s face lit from below by birthday candles, Elizabeth finally remembers the sexual assault that precipitated her disintegration. She runs to her bedroom, where she confronts the three personalities simultaneously in the three sides of her mirror. Elizabeth enters her darkened bedroom and sees herself in the center mirror. As she approaches the mirror, her reflection splits into three, but the audience sees four Elizabeths—the faces of the three reflections and the back of the real Elizabeth. The scene devolves into a hallucination in which Elizabeth runs through the museum where she works searching for her mother. Haas communicates Elizabeth’s breakdown with chaotic visuality—canted angles, dizzying upshots, superimpositions and dissolves, soft focus close-ups of the three faces of Elizabeth. The breakdown ends with a literal break; the woman looking in the mirror, whom the audience can no longer conclude is Elizabeth, slams the mirror shut, shattering it, and collapses, awakening as Beth.

Lizzie most clearly reiterates cultural narratives about mental health as visible in healthy social behavior by making Beth, not the unnamed heiress, the final personality. Wright describes Beth as “a normal, lovely girl,” a “wonderful person, the person you’re meant to be.” Beth tells Wright under hypnosis, “There’s nothing I want more than to be alive, to be liked,” linking her very existence to her social reception. But the impossible balance between modesty and intimacy, between Elizabeth and Lizzie, prevents Beth from becoming fully alive until she confronts her demons. Beth, Haas articulates, or the possibility of Beth, was always within Elizabeth and Lizzie; by confronting her maternal trauma and sexual abuse through the therapeutic connection, she can exist as a healthy, socially adjusted woman. She is, as Wright claims, “the person you’re meant to be.” Whereas the heiress remains an empty vessel to be peopled by the forceful manipulation of Wright and Morgen, Beth emerges a fully formed personality, a synthesis of Elizabeth’s modesty and Lizzie’s gregariousness. When he commenced treatment, Wright claimed, “I have to try to develop Beth…to the point where she can dominate the others,” then nevertheless implies at the film’s conclusion that Beth has always been the “true” personality: “[A]ll that’s left is you.” Beth, then, does not need to be created; she needs to overpower the other personalities. Wright promises, “I’ll help you every way I can,” but the film’s final line—“Good night, and happy birthday”—implies that the filmic Wright acknowledges Beth’s autonomy as a whole identity as the novel’s Wright does not for the heiress. By depicting reintegration as a literal break—“Suddenly I had a violent impulse to smash them, to destroy them”—Haas transcodes the final personality violently and through one of the personality’s intentional destruction of the others, such that Beth’s permanent appearance becomes a triumph of personal will. But simultaneously, the film emphasizes the inherent sociality of mental health; Beth’s disintegration results from childhood trauma and manifests as unhealthy social attachments, only to be resolved at a birthday party, a communal celebration of life.

“The human creature at odds with its environment,” Wright contends in The Bird’s Nest, “must change either its own protective coloration, or the shape of the world in which it lives” (Jackson 255). Jackson lambasts midcentury therapeutic models of wellness and performative intimacies by chronicling the patriarchal logics underscoring women’s mental health care as inevitably failing. Elizabeth, that “creature at odds with her environment,” therefore embodies postwar anxieties about an “all-too-powerful woman with contradictory selves that could not coexist in a healthy, ‘normal’ woman” (Caminero-Santangelo 53). A Bird’s Nest, then, both narratively performs Freudian psychoanalytic logics and rebukes them. But where Jackson critiques, Haas reinforces; Lizzie transcodes Jackson’s ironic critiques of postwar anxieties about the role of sexuality and domesticity to women’s mental health care as a stylized reinscription of those anxieties with a triumphant conclusion. If the psychiatrist’s task, according to Prince, is “to determine which personality was comportable with abnormality and which with normality, and so find the real self,” then Lizzie finds this supposed real self as the personality most suited to a normative social performance (241). Although Haas’s film is often lost in conversations about cinematic representations of mental health in the wake of The Three Faces of Eve, Lizzie’s visualization of the dis- and re-integration of a socially unbalanced woman renders the film foundational within the canon of psychiatric cinema. A historically contextual reading of Lizzie specifically as an adaptation of Jackson’s literary preoccupations with gender, isolation, wellness, and domesticity opens space for broader consideration of how widespread fears about non-normativity and gendered performative brinksmanship wrote the scripts for women’s mental health care in the therapeutic age.

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