Study Guide

Perfect Madness

By Ellen Hopkins


I've lived with the pretense/of perfection for seventeen/years. Give my room a cursory/inspection, you'd think I have OCD. (1.7)

Cara's joking, but she knows there's a difference between having a mental illness and just appearing to have one. The story of Cara's life is looking like one kind of person but actually being another.

I never would have expected/Conner to attempt the coward's way/out, though. Some consider suicide/an act of honor. I seriously don't agree. (1.15)

Cara's version of honorable is to stick it out, not check out. She's the lone twin left behind to deal with their parents—whom, we might add, seem to need therapy way more than their kids do.

When people ask/How he's doing now, I have/no idea what to say except for,/"Better." I don't know if that's/true, or what goes on in a place/like Aspen Springs, not that any-/one knows he's there, thank God. (1.56-57)

Cara feels she has to hide the fact that Conner's in a psychiatric hospital, and she doesn't correspond with or visit him. There's still a lot of stigma around mental illness, and even someone with whom you shared a womb can feel unsure about what to do or say.

Did/a switch flip inside your brain? If it did/I think what flipped it was that little boy/who suddenly grew tired of being scared. (6.83-84)

Conner's mental health was slowly eroding due to the pressure to be perfect. While the attempt may have been impulsive, Kendra sees many years of desperation led up to it.

Maybe I'm two people./God, maybe I'm many./Does that make me a freak?/Do I belong in Aspen Springs,/finger-painting scenes from/my childhood, right along with/my messed-up brother? (13.6-8)

News flash: Feeling like you're lots of people trapped in one person's body is totally normal, especially if you're a teenager.

No wonder/Conner flipped./It's in the genetics./Both of his parents are freaks. (21.21)

Cara's dad doesn't think Conner's improving enough, given the amount of money he's spending to keep Conner in Aspen Springs. Cara understands why Conner wouldn't want to come home. People in a mental hospital are less insane than their parents.

"I knew he was/messing around with his teacher./If I would have told, maybe… he…" (33.41)

Cara's dealing with classic survivor guilt here—she thinks that by telling someone Conner was sleeping with his teacher, she could have stopped him from shooting himself. Sometimes it's easier to feel guilty than to accept that there was nothing you could have done.

Conner Sykes, loose in/the head? Yep, that makes/sense. But even if it's true,/why should I give a s***?/I guess I don't/Unless it means Cara shares/whatever craziness gene/he's carrying. (35.10-11)

The world according to Sean: Craziness is genetic, and the same genes that make you crazy make you gay. Can someone please give this guy some biology lessons?

He says I'm/borderline schizo and that/he won't supply me anymore./At least, not for a while. (47.19)

Sean's pretty misinformed about mental illness, but describing his hallucinations as "borderline schizo" is accurate. There really is such a thing as steroid psychosis, which mimics the symptoms of schizophrenia.

We hug, as we're supposed to do./I watch her go, leaning on her mother,/wonder if she'll be around next year, or/if she might wind up starved, in a coffin. (57.9)

Conner is the character in Perfect who dies by suicide, but Kendra's the one with the deadliest disease. Anorexia has the highest mortality rate of any mental illness.