Mangold's first two films, HEAVY and COPLAND, were both about main characters leading lives of quiet desperation; the pizza chef in HEAVY unable to express himself, and the partly sheriff in COPLAND who must learn to assume his responsibility with that position. Susanna fits in with those two characters, and Mangold does just as good a job with her, except for some melodramatic scenes near the end. There are some major themes going on here, like whether Susanna is really crazy, just spoiled, or conditioned to think something is wrong with her, the nature of what "crazy" is in the 60's, and of course being a woman at the time, but Mangold avoids making big statements for the most part, instead concentrating on Susanna's growth into being a little more sure of herself.

As has been said before, Ryder brings a lot to the table, not just being a talented actress, but life research, having spent time in a hospital due to exhaustion(this is why she pulled out of GODFATHER PART III as well). And instead of going for obvious drama, she too just makes Susanna's recovery a gradual and detailed journey, except for those melodramatic scenes. The first third, which seems to be influence by SLAUGHTERHOUSE FIVE, flashes back and forth through time, as if showing Susanna feeling lost and fragmented. The rest of the movie is more linear, but Ryder doesn't make it boring.

Some people have dismissed this as a chick ONE FLEW OVER THE CUCKOO'S NEST, which is the usual knee-jerk response whenever a mostly female cast tackles what is normally done with a mostly male cast. In truth, they're very different movies, primarily because in CUCKOO, we're meant to see the hospital staff, represented by Nurse Ratched, as evil, trying to break down the patients rather than build them up. Here, on the other hand, while we're meant to see the system's shortcomings(in addition to what I said before, the different meanings of "promiscuous" when applied to men and women), the hospital staff is generally seen as trying to do the best they can. The patients may make fun of the doctors(well-played by Jeffrey Tambor and Vanessa Redgrave) and occasionally challenge the nurses(head nurse Whoopi Goldberg gives her best performance in a long time), but there's no real hatred here, except maybe from Lisa.

Angelina Jolie certainly has a flashy role with Lisa, the resident sociopath, but makes her seem real, until the movie betrays her at the end. When she's pushing people's buttons, she's actually quite sly about it, which is a lot more multi-dimensional than some have made it out to be. The rest of the cast playing patients is also good(it was a little heartbreaking seeing Elisabeth Moss playing a burn victim, especially when they show a picture of her as a young girl, where she looks like she did in IMAGINARY CRIMES). But it's Ryder who is the main reason for seeing this fine movie.