Photo: Netflix

For the inmates at Litchfield Prison, the psychiatric ward is considered a fate worse than solitary confinement. “Once you go to psych, you get lost in psych,” warns Suzanne “Crazy Eyes” Warren to new inmate Piper Chapman in the first season of Orange Is the New Black. The Netflix show’s beloved characters are clearly not offered adequate psychiatric treatment, which is a shame, because some of them could really use some therapy. With season two set to debut tomorrow, Vulture called up psychiatrist Dr. Paul Puri for another installment of our ongoing series Armchair Analyst. After issuing an important disclaimer (“Like always, we’re making these guesswork diagnoses with very limited information. And these are all context-dependent behaviors. Like, would these people be behaving this way if they weren’t in a prison?”), Dr. Puri evaluated Piper for signs of narcissism, parsed Pennsatucky’s violent tendencies, and assessed what makes Crazy Eyes so crazy.

Is Piper a textbook narcissist?

Maybe in the mildest possible form. She has some definite aspects of it, and also what I’ll call externalization of blame, meaning she had a lot of trouble seeing what she was doing wrong with other people. But those are not necessarily leading to the degree that we would diagnose any kind of personality disorder. She’s presented as a very sheltered character, and things that could be viewed as narcissism, in this case, might be more of a class issue.

What kind of crazy is Suzanne, a.k.a. Crazy Eyes? She’s very childlike in some ways.

It’s tough to read without knowing a whole lot more about her background. Since she has white parents, the presumption is that she’s adopted. At what age, we don’t know. But some children who are adopted come in after having a lot of jumps in the foster system or having been in an abuse situation. And so they learn to not ever trust, and one of the ways that they do that is that they form very inappropriate attachments to strangers and never get close, because they learn that if they get close enough, then they’re going to get hurt. So it’s possible that Suzanne has something a little bit akin to an adult version of reactive attachment disorder, which is represented by devoting yourself to people who are complete strangers, and then when actual intimacy comes up, completely pushing them away and fleeing.

She also has what are commonly classified as borderline traits: unstable relationships in general, mood instability, impulsivity. Reactive attachment is not mutually exclusive from that. And many children in these systems, they end up acting out when they’re in situations that they don’t like; they get impulsive, the behavior escalates to the point of, say, peeing on the floor or hitting themselves, and they end up getting thrown into hospitals. The impulsive episodes that result in her getting hospitalized when she gets frustrated, her frustration is way out of proportion to the actual event that takes place, her relationships are unstable, and she has an overdeveloped attachment to other people.

Is Mendez, a.k.a. Pornstache, a sadist?

They’ve represented him in the antisocial personality disorder kind of spectrum. He’s an extreme representation of the machismo male psyche, so to speak: He’s shut down, he’s aggressive and violent. I think that’s reflective of a lot of what we teach men to cultivate in our society, which is, to a degree, a level of satisfaction through sadism. In its most extreme versions, that could be seen in someone who’s antisocial, particularly if he doesn’t have a conscience over it. We never really see a conscience in Mendez. The only redeeming thing we ever see is when he says he’s in love with Daya, the first person who showed him any kind of caring or tenderness. And he fell in love immediately, which just shows a relatively young man in terms of his relationship experience.

Why doesn’t Norma talk?

Selective mutism could mean I.Q. issues. It could be a history of abuse — it being specific to how she doesn’t feel safe not speaking up, therefore being silent is not taking a chance that she’d get hurt. I could make up probably a dozen different possibilities, but we don’t know what she went in for.

Nicky often refers to her “mommy issues.” Are they really worse for her than the other ladies at Litchfield?

Neglect is often talked about as being worse than abuse in child development and pathology circles. With abuse, there can still be signs of affection, and even through negative punishment for things, children can still learn to develop a relationship with another person. With neglect, there is a complete absence of signals, and so children don’t necessarily learn how to communicate or bond well with others, so they might explore other ways. Since Nicky has a particularly neglectful or absent mother, she might be looking for relationships in other ways, and would probably explore anything she could, including extremes, to do that. She may amplify some coping strategies that might work a little bit, so this often happens with kids who act out: When they’re not getting any good attention, they may act with bad things in order to get any attention. And when somebody acclimates to the level of acting out they’re doing, the kids may raise the stakes more to to the point where they’re eventually getting attention again and on a long-term scale, that can really get out of control. So whether you combine this with her lack of a mother figure and her trying to develop other female relationships dysfunctionally, or functionally, such as with Red — many kids will try to form a reparative relationship with somebody else that can replace a parent figure.

Is Pennsatucky a psychopath?

Let me speak a little bit about meth use. Meth is basically an inhaled form of amphetamines, and those can be very stimulating, they can make people do things that are impulsive, they can drive psychotic tendencies such as having hallucinations and paranoia. When someone’s coming off of meth, those things won’t necessarily have resolved or improved. And there’s some research that supports that brain effects like these can last for up to two or three years after stopping the drug. So whether that is really represented here or not is less clear.

A psychopath goes off the most extreme form of antisocial personality disorder, where people actually get pleasure out of hurting animals or people. They have no conscience, but it’s more extreme than the con-man form, where they really get pleasure out of violence or torture. I don’t know that we really know that [about Pennsatucky]. She has a history of violence, but it’s what we call affective violence — she’s emotionally charged up, she’s pissed off. She’s more revenge-minded than a predator who targets people because they’re weak.

As for believing she’s God’s messenger, it makes sense as somebody who’s never had any purpose in her life. It’s given her a sense of status, and that can be, for lack of a better term, intoxicating to some people. It fits with her character just based on that. I wouldn’t go so far as to say it’s delusional, though someone might go that far.