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Notes to John
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Themes
Navigating Mother-Daughter Relationships
Content Warning: This section of the guide includes discussions of depression and anxiety.
Throughout Didion’s private diary entries on her sessions with Dr. MacKinnon, she attempts to heal her relationship with her daughter Quintana by confronting her personal history. The introductory section establishes Didion and Quintana’s relationship as the heart of Didion’s therapy, highlighting the fact that Quintana herself encouraged Didion to seek therapy at the request of her own psychiatrist:
Some of the subjects in the journal appear in Blue Nights, the last book Didion wrote, which was a meditation on her daughter’s life. Didion had started seeing MacKinnon because Quintana had told her own psychiatrist that her mother was depressed and should talk to someone. He felt that the mother/daughter relationship was at the core of Quintana’s problems, which he was not having much success resolving (v-vi).
In the subsequent entries, Didion openly discusses her concern for Quintana’s well-being, while Dr. MacKinnon interrogates her inherited modes of relating to her daughter. The object of the therapy is to understand why Didion and Quintana communicate the way they do, and how their relational patterns relate to both Didion’s and Quintana’s understandings of themselves.
Didion’s open and honest way of talking about Quintana during therapy reveals her deep and abiding love for her daughter. In particular, Didion’s anxiety over Quintana’s safety and health recurs throughout the diary entries. While Dr. MacKinnon encourages Didion not to minimize her fears, he does urge her to try to distinguish between love and worry, protection and control. He challenges her “to loosen [her] attachment to [Quintana]. Not the attachment that says you love her, but the attachment that says you need to run her life because she can’t run it herself” (59). Dr. MacKinnon’s advice speaks to Didion’s central inner conflict—balancing her need to fix her daughter’s problems with Quintana’s need to take care of herself. Over time, Dr. MacKinnon notes, this tendency of overprotective parents can become debilitating for the child. Dr. MacKinnon’s consistent encouragement for Didion to trust Quintana reinforces his belief that trust is at the heart of healthy mother-daughter relationships.
Didion's sessions with Dr. MacKinnon emphasize the tendency for familial relationships to fall into generational patterns. While neither Didion’s therapy nor her entries entirely resolve her challenges with Quintana, they both depict the active strides Didion makes toward understanding and healing their fraught dynamic. Didion doesn’t just agree to therapy to mollify Quintana but takes the sessions with Dr. MacKinnon seriously. She delves into her relationship with her own mother (despite her overt discomfort) to better understand why she relates to Quintana the way she does. Once Didion begins to make sense of her and her mom’s dynamic, she gains insight into her and her daughter’s dynamic.
Writing as a Means of Survival
Didion’s ongoing therapy sessions with Dr. MacKinnon emphasize the importance of writing to Didion’s identity and her life-long reliance on writing to stave off depression and anxiety. Didion admits to Dr. MacKinnon that she uses her writing to avoid or resolve particular internal concerns. For example, she says that all of the fiction she wrote during Quintana’s childhood “could be read as an attempt to work through separation from her before it happened” (42). She also notes that she uses it as a way to avoid confronting difficult emotions. Didion writes, “Working was what I did instead of engaging. Working, as you once pointed out, was the way I had found to not be there emotionally” (48). These reflections reveal her complex relationship to her work—both lifeline and crutch.
The complexity of Didion’s relationship to her work provides insight into the author’s private life. Writing was her means of escaping psychological pain—a habit of self-preservation that led to her literary success. In one session, Dr. MacKinnon comments specifically upon this dynamic and even lauds Didion’s ability to use writing as a stabilizing tool. He identifies working (or writing) as “an extremely effective anti-anxiety agent” that Didion has used “as such all [her] life” (69). However, Didion’s struggles with her writing reveal its limitations as a tool. Whenever Didion feels overcome by fear about Quintana’s safety or mental health, she feels detached from her work, complicating her dependence on it. Didion admits that despite her extensive writing about how to encourage Quintana’s independence, she still hasn’t been able to separate from Quintana in a healthy way. In the narrative present of her sessions, Didion often expresses her inability to write due to stress, worry, or emotional upheaval, which Dr. MacKinnon suggests is the result of her anxiety over Quintana’s well-being.
Dr. MacKinnon challenges Didion to be more open with Quintana about her distinct relationship to her work as a way of bringing both essential parts of her life and identity together to gain perspective on both. For example, Didion repeatedly wonders aloud why Quintana can’t ease her unrest via her photography the way Didion does with her writing. Dr. McKinnon emphasizes the ways that failing to connect with her daughter about her work—an essential part of herself—isolates her from Quintana, saying: “She sees you as some exalted supertalented being. She thinks you were born the way you are now, programmed from conception to succeed. I think you need to talk to her about […] everything that went into getting where you are” (56). This moment provides insight into Didion’s vulnerability—both as a person and as a writer. While Didion achieved literary success throughout her career, her writing wasn’t borne of raw confidence. It took hard work, repeated encounters with failure, and reliance on others for help.
Confronting Mental Health in a Therapeutic Setting
While Didion’s diary entries collected in Notes to John provide rare insight into the process of confronting depression and anxiety with a professional therapist, it also raises significant debate over the ethics of publishing private writings without the author’s consent. HIPAA laws or HIPPA-adjacent policies protect the privacy of those seeking professional treatment in a therapeutic context, so such in-depth accounting of psychiatric analysis isn’t readily available to the public. Some critics view the choice to publish Didion’s private notes on her sessions with Dr. MacKinnon as a violation of those protections, while others believe it offers an important example of how therapy can challenge those seeking treatment and affect change, improved psychological and emotional health, and increased understanding and empathy.
Didion’s therapy sessions with Dr. MacKinnon illustrate the ways confronting one’s mental health in a therapeutic setting can lead to self-revelation and healing. Throughout the sessions, Didion repeatedly admits that she has little interest in revisiting her childhood. When she tried writing her California book for the first time, for example, she couldn’t finish the project because it was too painful for her to recollect her upbringing. Across the arc of the narrative, Dr. MacKinnon gradually guides her to confront her past experiences and how they’ve impacted her life in the present, noting that she has “ to examine how far back in [her] life [she’s] been anticipating the worst. Because the farther back this pattern goes, the more likely it is that [Quintana has] been picking up on it for a very long time” (30).
Didion’s transcripts of significant moments from Dr. MacKinnon’s analysis highlight the ways his manner, tone, and posture complement his advice, leading her toward important revelations. He establishes trust with Didion allowing their sessions to be governed by good faith and shared goals. Her entries suggest that he uses a gentle tone as he urges Didion towards an internal challenge. He plays the role of the guide, ushering Didion into confrontation with her past as a form of healing and growth—exercises meant to help Didion understand her relationship with her daughter. Dr. MacKinnon helps Didion to see that while her past might feel frightening to revisit, it can grant clarity on her life and relationships in the present. As Didion works through the exercises and meditates on her past, she finds connections between the past and the present that allow her to move toward change.
Didion’s therapy sessions also challenge her to see herself in a new light. For years, Didion resisted “seeing a psychologist” because she saw it as “a constriction placed on [her]” and evidence that she “must need help” and “must be sick” (40). This viewpoint represents a common misconception of therapy, which Didion and Dr. MacKinnon’s sessions deconstruct. While Didion does indeed live with depression and anxiety, Dr. MacKinnon never treats her like an invalid. He doesn’t use a pedantic tone and Didion doesn’t assume a helpless position. Rather, Didion and Dr. MacKinnon communicate as confidantes. Their conversations present therapy as a mutual endeavor to help an individual find healthier ways of being. The subtext of Notes to John destigmatizes therapy and captures its transformative possibilities.
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