NEXT TO NORMAL Revisited - Some Spoilers

[Wanna Be A Foster]

Posted: 4/11/09 at 7:23pm

I saw the final version of NEXT TO NORMAL, on Broadway, this afternoon, after having seen it at Second Stage a year ago.

Disclaimer: I am going to share some thoughts on what I saw today compared to what I saw a year ago. After reading my initial post, if people want to engage in a discussion, that would be wonderful. That is the purpose of this board. But if people want to begin to personally attack ME, I ask them to send me a private message, and do so in that form. I want to discuss a show currently playing on Broadway, on a Broadway message board. I would not like to be attacked personally or called names for my opinion on the musical being discussed. That is not the purpose of this message board.

So, onto the show. The reservations I had after seeing the Off-Broadway version pretty much remain, with one exception. I am glad that the song "Feeling Electric," a mad scientist type number demonstrating the main character as she undergoes electro-convulsive therapy, has been cut, as I found this to be the most offensive, stigmatizing number in the show. I'm thrilled that it's gone, and I give the creative team credit for getting rid of it. Sadly, too many other inaccuracies remain in this musical about a very serious human health issue, mental illness.

The entire second act of NEXT TO NORMAL is based around the fact that the main character, Diana, has lost her memory as a result of having undergone electro-convulsive therapy.

In reality, when a person undergoes ECT, an after effect can be some short term memory loss, but this show takes it over the bridge. NEVER does anyone who has undergone ECT forget their own home, their own family members' names, their LONG-TERM memory (their past). NEVER does ANY memory loss, let alone at this extent, last TWO WEEKS.

The authors of this show have taken a very serious subject matter and handled it carelessly. The main character has some unknown mental illness. From all of the possibilities NAMED throughout the show, it could be bipolar disorder, depression, or schizophrenia. But what the doctor and the family feel was the cause of this illness, a traumatic event in this character's life, it's almost too clear that what this character SHOULD have been diagnosed with is post-traumatic stress disorder. The entire storyline is based around this particular event and how it led to this illness. But not once is PTSD mentioned.

We see the character tell her doctor that she doesn't "feel anything" after having gone through series of medication regimens. He then lists her as "stable" into his notes recorder. The idea here is to give the impression that taking medication for mental illness makes you feel numb, a misconception today that prevents people who might think they are suffering from mental illness from seeking treatment. She proceeds to flush her prescriptions down the toilet.

We see her daughter steal prescriptions from her mother at one point, and carelessly taking HANDFULS of Risperdal, Xanax, and Valium (do the authors even know what these drugs do?) -- a regimen that in reality would send her to an emergency room -- but she just acts a little uneasy, then eventually stops them all at once, and is fine again at once.

I enjoyed the score last year, but this time it just comes off as derivative and lacking in any uniqueness.

Alice Ripley acts the HELL out of her role, that's for sure, but it's almost as if she doesn't even know what to do except for cry and cry and cry and shift her face into a different configuration every minute, probably because she hasn't been very well informed about what is going on with this woman (the audience certainly never finds out much).

The rest of the cast is just fine. They're all basically bystanders in what could have been a groundbreaking musical about mental illness, an issue that is prominent in U.S. society, but is handled with such an extreme lack of knowledge on the topics it swims through here. Offensive, inaccurate, and stigmatizing material about a monumentally serious human health issue.

And one last reminder: if you would like to discuss this show, please let's discuss the show. If you want to personally attack me or call me names, please do so by PM.

[Kad]

Posted: 4/11/09 at 7:51pm

"In reality, when a person undergoes ECT, an after effect can be some short term memory loss, but this show takes it over the bridge. NEVER does anyone who has undergone ECT forget their own home, their own family members' names, their LONG-TERM memory (their past). NEVER does ANY memory loss, let alone at this extent, last TWO WEEKS."


In regards to the ECT-induced memory loss- there have been documented cases of people losing a great deal of memory due to ECT, and in some cases never recovering it.

For example, here's a case of a psychiatric nurse who allegedly lost memory of 30 years of her life, including events such as the birth of her children as well as knowledge of all of her nursing skills, following her treatment with ECT:

http://www.peoplewho.org/documents/ctip.ectverdict.htm

Here's another article in which a former ECT recipient describes how the treatment was ineffective and harmful to memory, accompanied with an intriguing article describing a study (also included for your reading pleasure) conducted a prominent research at Columbia University that seemingly shows that ECT causes long-term cognitive side effects, including amnesia.


http://trouble.pwblogs.com/2006/12/22/funday-ect-study-shocks-ha-ha/


The fact is, this recent study (2007) indicates that ECT causes more harm than previously thought, despite its relatively high success rates. Obviously, true ECT horror stories that leave the patient without years of memory are in the minority. But they exist.

Sorry, I keep editing this as I think of new things to say.

Clearly there is a slight possibility of the events depicted in Next to Normal occurring due to ECT actually happening. From what I gather from what I've read, it's hardly impossible. Unlikely, but possible. Granted, my research is fairly limited and I do not know your own experience with ECT or this field of medicine. But in the interest of the show itself- is it not more dramatically interesting to depict an extremely unlikely outcome of ECT? Or any medical procedure? There are always medical "horror stories"- people remaining conscious under anesthesia and feeling every cut, malpractice, unforeseen consequences, etc. They make good drama. Clearly, Next to Normal would not be as interesting or compelling if Diana went in for ECT and came out like the majority of patients. But to say it's impossible seems a stretch.

Updated On: 4/11/09 at 07:51 PM

[Wanna Be A Foster]

Posted: 4/11/09 at 7:58pm

I stand corrected.

[Kad]

Posted: 4/11/09 at 8:08pm

I appreciate your civility.

I can't speak for the show's accuracy dealing with mental illness and medicine... that stands to be much more complex than finding some ECT studies. I am very much in the dark with those subjects, and hope people with more experience can detail how they feel Next to Normal deals with it. In regards of its dealing with mental illness, I have heard opinions from all across the spectrum, from people saying "It's like they get me" to "They have no ****ing idea". Perhaps that just indicates how slippery and innately personal the subject of mental illness is.

Updated On: 4/11/09 at 08:08 PM

[adamgreer]

Posted: 4/11/09 at 8:10pm

n reality, when a person undergoes ECT, an after effect can be some short term memory loss, but this show takes it over the bridge. NEVER does anyone who has undergone ECT forget their own home, their own family members' names, their LONG-TERM memory (their past). NEVER does ANY memory loss, let alone at this extent, last TWO WEEKS.


That's an awfully robust statement to make, considering that according to a recent study, "Four memory tests of personal or public events were administered before ECT, shortly after the fifth treatment, one week after completion of treatment, and about seven months later. The results indicated that ECT can initially disrupt recall of events that occurred many years previously, but recovery of these memories was virtually complete by seven months after treatment." (http://www.ncbi.nlm.nih.gov/pubmed/7458573)

Seeing as how the show ends two weeks after Diana comes home from the hospital, we don't really know if/when she gets the memories back. In just the bits we see in act 2, she does in fact recover many of them.

We see her daughter steal prescriptions from her mother at one point, and carelessly taking HANDFULS of Risperdal, Xanax, and Valium (do the authors even know what these drugs do?) -- a regimen that in reality would send her to an emergency room -- but she just acts a little uneasy, then eventually stops them all at once, and is fine again at once.

The only drug she takes is Xanax. She's flipping through the pills, looking for the one she wants.

We see the character tell her doctor that she doesn't "feel anything" after having gone through series of medication regimens. He then lists her as "stable" into his notes recorder. The idea here is to give the impression that taking medication for mental illness makes you feel numb, a misconception today that prevents people who might think they are suffering from mental illness from seeking treatment.

Nowhere in the text is her going off her meds considered a good thing. The show never condones such activities.

Potential Side Effects for Prozac:
Nausea, drowsiness, dizziness, anxiety, trouble sleeping, loss of appetite, weakness, tiredness, sweating, or yawning may occur. If any of these effects persist or worsen, tell your doctor promptly.

Potential Side Effects for Paxil:
Nausea, drowsiness, dizziness, trouble sleeping, loss of appetite, weakness, tiredness, dry mouth, sweating, yawning, or headache may occur. If any of these effects persist or worsen, tell your doctor promptly

Potential Side Effects for Xanax:
Drowsiness or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Potential Side Effects for Zoloft:
Nausea, dizziness, dry mouth, loss of appetite, increased sweating, drowsiness, diarrhea, upset stomach, or trouble sleeping may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly

I could certainly see where it would not be a stetch to call a number of those side effects above as "numbing."

it's almost as if she doesn't even know what to do except for cry and cry and cry and shift her face into a different configuration every minute, probably because she hasn't been very well informed about what is going on with this woman (the audience certainly never finds out much).

How much more information do you want? Her life story? It's a two hour musical, not a medical documentary on the Discovery Health.

But if people want to begin to personally attack ME, I ask them to send me a private message, and do so in that form. I want to discuss a show currently playing on Broadway, on a Broadway message board. I would not like to be attacked personally or called names for my opinion on the musical being discussed. That is not the purpose of this message board.

This sentiment is appreciated, but really, come on. You attack people on here all the time. It's ok for you to give it out, but not take it in? That's a huge double standard to set.



Updated On: 4/11/09 at 08:10 PM

[kidmanboy]

Posted: 4/11/09 at 8:14pm

I saw the show this afternoon, and disagree with your review. I hope that this is not considered an attack.

While the show does indeed discuss mental illness, to me the point of the show was more about tackling life's problems. In our society, we have a tendency to repress things that aren't considered "normal." Gays stay in the closet, family problems go undiscussed, mental illness is not spoken about. To me the message of this play has nothing to do with assessing psychological treatment, but instead assessing the situations that lead us to NEED psychological treatment.

That being said, psychological treatment is shown in the play, so the authors DO have a responsibility to treat it accurately. Perhaps the results of Diana's ECT are atypical, but they make a point of this in the show. Making a statement like NO ONE has EVER had that occur is, I think, very difficult to prove. Likewise, I don't think they glorify her daughter's use of her medication. Indeed, it shows her passing out and having hallucinations. As far as PTSD, I agree with your assessment, but think it's possible that could have been one of the issues Diana has been working on in treatment for the past 17 years. (Although the fact that it has taken that long to get to this point in her treatment is something that bothered my date to the show as well, and I understand that being a bit of a stretch)

I think the show's presentation of (and opinion of) psychopharmacology is an opinion. In the context of that moment in the show, it is Diana's opinion, and I think that it is fair to say that many in this country share her opinion, whether it be yours or not. I know many people who have taken antipsychotics and have stopped their use for the very same reason. These drugs work differently on every person, and that is something any medical profession would attest to, I'm sure.

Overall, I think the show successfully uses music to present characters confronting difficult situations in their lives. Each character has a distinct arc and learns something from the proceedings. I felt like I got to know them, understand what they were going through, and see them grow as they confronted the feelings they had been repressing for so long. During the reprise of I Am the One, both my wife and I turned into emotional messes. Remove the extreme circumstances of this particular situation, and I think you are getting to the heart of the universal emotions that anyone who deals with loss may feel.

My wife said to me after the show that it's hard to believe something that began as almost darkly comic as "feeling electric" has become something so deeply moving. And I agree with her wholeheartedly. Every change the creative team has made has been for the better, and the show has significantly improved since Second Stage, evening the tone and really getting into the heart of these characters.

[aliciag]

Posted: 4/11/09 at 8:14pm

I definitley understand where you're coming from in objecting to the way mental illness is treated and the degree to which the effects of ECT are seemingly too severe. Then again, it is a musical and there are many shows that would seem to blow things out of proportion for artistic effect. I don't know that that necessarily makes it right, as this is a very sensitive and important subject, but I think it kind of explains the writing in the musical. As far as I'm concerned, I don't necessarily go to a show expecting to see things played out exactly as they would in real life. I understand that no matter how realistic or educational it may be, the show is still a form of entertainment.

As has been discussed in other threads, one good thing about even presenting this subject matter in a musical is the increased awareness of it and getting more people to engage in conversation about it.

In the end though, everyone is entitled to their own opinion.

[changinandhow]

Posted: 4/11/09 at 8:47pm

From all of the possibilities NAMED throughout the show, it could be bipolar disorder, depression, or schizophrenia. But what the doctor and the family feel was the cause of this illness, a traumatic event in this character's life, it's almost too clear that what this character SHOULD have been diagnosed with is post-traumatic stress disorder.

They've tried to make it more clear that Diana always had something inherently 'off' even before the trauma - although what used to be obvious in a flashback is now reduced to one bit about her mother and being "high-spirited." Regardless, though, I believe Gabe's death is supposed to be looked at as a trigger of an illness that Diana was predisposed for due to her lineage, rather than a direct cause of her disorder.
Updated On: 4/11/09 at 08:47 PM

[steven22]

Posted: 4/11/09 at 9:52pm

are mermaids real? can lions talk?....?..come on....

[defyingravity11]

Posted: 4/11/09 at 10:36pm

In earlier versions of the show, it was obvious that she was mentally ill, or at least prone before giving birth. The narrative of N2N may not be representative of everyone's experience with mental illness, but I would hardly fault the production; I doubt any two people have had the same exact experience with any given mental illness.

[SporkGoddess]

Posted: 4/11/09 at 11:31pm

I haven't seen the show, but just from listening to the recording, I can tell that Diana can't be schizophrenic. She doesn't have flat affect, autistic interactions, anhedonia (well, aside from the kind caused by depression), any of the cognitive or verbal problems, etc. It's hard to describe, but you can tell if someone is schizophrenic beyond the psychosis. Diana acts bipolar, not schizophrenic. I could see major depression with psychotic features, but then there'd be no mania as described in "I Miss the Mountains." I could also see PTSD, definitely. But I think she was bipolar and predisposed to it genetically; then the trauma made the disorder manifest itself.

As for ECT: it is possible to have memory loss like that, but for the show to immediately jump to the worst case scenario strikes me as a little manipulative. But I've argued this before, so I know others disagree. Just saying how I feel.

Won't comment on anything else because I haven't seen the show. I love diagnosis, so wanted to chime in about that more than anything.

Updated On: 4/11/09 at 11:31 PM

[jake6970]

Posted: 4/11/09 at 11:38pm

I agree that the memory loss may be excessive, but it IS a musical and heightened drama is to be expected at some point. There are lots of examples of this is other musicals.

[Drunk Chita Rivera]

Posted: 4/11/09 at 11:40pm

"Alice Ripley acts the HELL out of her role, that's for sure, but it's almost as if she doesn't even know what to do except for cry and cry and cry and shift her face into a different configuration every minute, probably because she hasn't been very well informed about what is going on with this woman (the audience certainly never finds out much). "

Exactly. I couldn't figure out a way to say it. It seems all she does is cry. Thankfully her bad voice can pass for being sad and emotional. It seemed as if she was just as confused with the character as I was.

[jake6970]

Posted: 4/11/09 at 11:46pm

You can have opinions on Alice Ripley, but in what way do you feel that she was "confused" with the character? I'm honestly curious because no matter your opinions on her, her performance is at least consistent throughout the show.

[KingKong]

Posted: 4/11/09 at 11:49pm

Theatre is NOT reality. It is a heightened representation of reality.

We see the character tell her doctor that she doesn't "feel anything" after having gone through series of medication regimens. He then lists her as "stable" into his notes recorder. The idea here is to give the impression that taking medication for mental illness makes you feel numb, a misconception today that prevents people who might think they are suffering from mental illness from seeking treatment. She proceeds to flush her prescriptions down the toilet.

BS. The idea her is to give the impression that Dr. Fine is a ****ty doctor and that for Diana (like for some people in the real world), the medication makes her numb.

[Drunk Chita Rivera]

Posted: 4/12/09 at 12:00am

"You can have opinions on Alice Ripley, but in what way do you feel that she was "confused" with the character? I'm honestly curious because no matter your opinions on her, her performance is at least consistent throughout the show."

I think I mostly thought the character was just a little weird. I did not love the show and thought it was too depressing. I just thought the character was a little strange. I'm sorry, I don't know how to explain it, I just didn't like the show.

[SporkGoddess]

Posted: 4/12/09 at 12:00am

It doesn't really make him a bad doctor. The question is, what's worse, emotional numbness or bipolar symptoms.

And to go "Stable" after she tells him that is, just like the ECT thing, an exaggeration.

Updated On: 4/12/09 at 12:00 AM

[KingKong]

Posted: 4/12/09 at 12:02am

Yes, THAT IS THE QUESTION. And the answer is different for each person. and for Diana, the answer is emotional numbness.

[RentBoy86]

Posted: 4/12/09 at 12:13am

She seems confused with her character because she goes from absurdist comedy ("My husbands waiting in the car" with a deadpan to the audience) to melodramatic-obviously-staged swiping of the plates from the table ("You Don't Know"). And yeah, her voice is hard to listen to.

[KingKong]

Posted: 4/12/09 at 12:16am

[taylorPHENOMENON2]

Posted: 4/12/09 at 12:17am

Well, can I just say that was certainly the most fascinating Next to Normal review I have read.

[jake6970]

Posted: 4/12/09 at 12:17am

How is that confused with the character? Are people in real life displaying one emotion at all times? You do realize that during You Don't Know she is in a heated argument with her husband? It's not unrational to be upset. That's not confusion, that is a natural emotion that would come out of that situation.

[KingKong]

Posted: 4/12/09 at 12:21am

and during "My Psycho...." she's singing a song about how her visits to the doctor are like a secret romance.


People choose not to think, clearly.

[Craww]

Posted: 4/12/09 at 12:46am

The idea here is to give the impression that taking medication for mental illness makes you feel numb, a misconception today that prevents people who might think they are suffering from mental illness from seeking treatment.

Here is where you're wrong. I agree that the widespread perception of these medications as numbing is dangerous and unfortunate. However, one of the things that makes combating the stigma so difficult is that this is not necessarily a misconception. These medications are numbing for many people, and for many it's a very uneasy feeling to suffer. (If there's a misconception, it would just be people assuming that outcome is somehow inevitable.)

I had negative experiences with therapy and anti-depressants, but I still would recommend trying it to those who may be troubled. But I'm not going to lie and pretend it was the cure for me, just because I might scare them away from seeking treatment they may need.

The show doesn't suggest that Diana's experiences are common, and it certainly doesn't suggest that Diana's decisions are the correct ones to make. Wanting the show to only reflect responsible decisions and the standard outcome of these treatments is just asking to remove all the conflict. You remove the conflict, you remove the drama. Then there's no story to tell.

[SporkGoddess]

Posted: 4/12/09 at 12:50am

I dunno, I think the lives of people with mental illness are dramatic enough that they don't need to exaggerate treatment side effects to come up with good twists and turns.

Updated On: 4/12/09 at 12:50 AM