68A/N: Long, unedited ramble about the story, my interpretations of things, themes, symbols, and hints that are dropped throughout. I really just jotted this off very quickly after a cursory look at the chapters, so I'm bound to have missed things and it's likely there are typos galore. As I re-read, I will edit for mistakes I find. EDITED 4/9/19
Here is the promised supplemental information for the story. Enjoy!
Overall, the "big" ideas for this story are: exploring what it means to be sane (how do we know what is real, and what isn't?), how the mind will protect itself from trauma (and how the mind is shaped by it), how capable is a young woman of consenting to a relationship with an older man (fantasizing is one thing, but the reality is quite another—and when the man has been an authority figure in her life and had a hand in shaping her, is the choice ever really hers?), and the responsibilities of parenthood.
I think most people picked up on Dr. Prevarant's name being a clue. It translates into "liar" or "conman." Either he really is Jareth in disguise and his name is a nod to that, or Sarah's mind recognizes Brooksong is a hallucination and the little bit of intact reason she has is trying to warn her. I liked the name because it was close enough to an English word, "prevaricate", to make it obvious to a reader what this doctor is all about.
There is a lot of description of things being bright/white/blinding throughout the story, as well as descriptions of things being dim/dark. At some points, things become so bright that they are hard to look at for Sarah. The push and pull between the dark and the light is representative of the struggles of mental illness, the light being sanity/wellness and the dark being the delusions. The chapter titles for ch 12 and 13 are literal references to this: ch 12 "Between Cocktails and Chess" refers to the "cocktail" of medicines used for floridly psychotic patients (to subdue and hopefully rapidly induce stability or "sanity") and the "chess" game Sarah thinks of herself as playing with the doctor (or the disguised Goblin King), which is testament to her "insanity" (that she even believes in something as fanciful as a Goblin King, and that she's his equal and can play his game. Even believing such a "game" exists could be construed as paranoia). Ch 13 "Between Kingdoms and Clans" is a more obscure reference, but the names of all the kingdoms are foreign words that translate into "sanity" or "clarity" and the names of all the clans translate into "insanity" or "obscurity." Sarah is physically trapped between the light and the dark/sanity and insanity by virtue of her location, the Goblin Realm, which is bordered to the south by the coastal kingdoms (sanity/clarity) and to the north by the mountain clans (insanity/obscurity/mystery).
The other recurring theme is "red and blue and gold and green." I think that becomes fairly obvious by the end—Toby's baby quilt, the one a little body (maybe his, maybe a changeling's) was found wrapped in. It's a blue quilt with gold and green whales on it, but it becomes soaked through with red blood. That Sarah sees those colors in both the hospital and the Goblin Realm is meant to highlight her feelings of guilt that never quite leave her even when if she's in the deepest of her delusions (I say "if" because even I'm not sure if the time Sarah spends underground is a delusion or if it's real).
My idea was that Jeremy was such a big part of this struggle of Sarah's—she has a crush, or an attraction, or a dark desire, or an obsession involving him (how much came from her side and how much from his is left obscure). Whatever exactly happened between them (and whether Jeremy was really Jeremy or Jareth in disguise when it did) is left up to the reader to decide. But, Toby happened, so there was definitely something improper. The two worlds we see have a portion of the Jeremy character to them. Dr. Prevarant is the authority figure/father-figure/practical side of Jeremy and Jareth is the dangerous/romantic/cruel side of him. I think this fits in with the source material, because we see the Jeremy character plastered all over Sarah's mirror and the statue of the Goblin King before she goes into the Labyrinth. Her mind has obviously blended those two together to create her nemesis as she runs the maze.
Chapter by chapter notes:
Ch 1 Comedy, Tragedy, Normalcy
Sarah in Brooksong obviously remembers her time in the Labyrinth and believes it to be reality, even though she's in a bright, white, clean setting (which suggests reality/sanity). Sarah in the Goblin King's palace feels guilt, alluding to the fact that she lives in splendor as a reward for something she did that was cruel or wrong. Also, she stares into a vanity mirror (which comes up throughout the story, leading back to her vanity in her bedroom at her father's house) and it the mirror turns black (which suggests insanity/mystery).
Ch 2 The Fox in the Pen
The title refers to the unease Sarah feels about being trapped in this locked up place with her adversary (so there's no escape). There's also a mention of military time, where one o'clock is referred to as thirteen hundred or written 13:00, which is a nod to the 13 hour clock from the movie (obvious, I know). Sarah also talks about the key-card that the doctor wears, one of those badges common in hospital settings where waving the badge over a lock pad will unlock a door. He holds the key to her escape. A skeleton key or universal key is a theme that gets repeated later (when one of the gifts Sarah receives from a visiting dignitary is a key that can unlock any door, and her thoughts about it in the Labyrinth chapter are exactly the same as they are here, when she thinks: The power to come and go as you please. What must that be like? ). Escape and freedom seem to be things on Sarah's mind a lot.
This chapter also introduces the visual of the calendar with pictures of a tropical paradise representing the month of July. That comes up a few times as well. I had a thought that July was either when Toby was born or when "Toby" died (or, maybe when he was conceived). Beyond just the pretty picture, the month of July has some sort of significance for Sarah, or she wouldn't dwell on it so much.
Ch 3 The Thirteen Steps
The references to the red portions of Sarah's dress/jewels (the ruby choker) are just meant to evoke blood. Sarah has blood on her hands and when the 'Goblin King' is feeling cruel, he likes to remind her of it. The reason I put his name in quotes is because it's really Sarah's choice to feel these things (as he likes to tell her throughout). The reason his behavior alternates between doting and cruel is because he reflects whatever Sarah is feeling at the moment. When she's unsure, he may shower her with compliments. When she feels guilty, he may punish her. He practically admits this later when he tells her he's only as scary as she makes him. That can come off as something a gaslighting, controlling abuser might say (and if he is a reflection of a part of Jeremy, then a gaslighting, controlling abuser might be exactly what he is), but it can also be taken quite literally. Sarah's psyche is what creates Jareth, day to day, moods and all.
Ch 4 L'Enfant
This chapter introduces the idea that something happened involving a baby. Sarah's reaction to the baby that visits Brooksong is more understandable after finding out about Toby at the end of the story. But I think she also is screaming because she sees a loving mother behaving in a motherly capacity with her child. Sarah feels cheated out of that, both because her mother abandoned her, and because she doesn't have her own baby in her arms to show her love. Sarah also recognizes her own guilt a bit more in this chapter, referring to the "real monster that lives inside of her."
Ch 5 The Noble Savage
The title refers to Ludo, of course, but also to the whole idea of the "noble savage"—which can be Jareth as well. Not that he's the traditional idea of "savage" but it just refers to the fact that you can't reasonably apply the idea of our modern/Western morality to someone who is not: modern, human, western, or even Earthly! So, we see Jareth making a romantic overture to Sarah (and get hints of Sarah's own desires) and while it would be easy to say, "Ew, she's not an adult and that makes him a predator", it's hard to apply that standard to someone who may simply be a manifestation of a teen girl's own desires, but even if he's more solid than that, he's from a land of magic and fairies, not her world. Also, the room is very dark/dim and there's a mirror again, and it only shows her some things, not everything she's trying to see.
Ch 6 The Stairs of Dr. Penrose
The title refers to two things: the doctor with the Escher tattoo who predated Dr. Prevarant at Brooksong (the character named 'Dr. Penrose' in the story), but also the actual device of creating the infinity stairs upon which some of these Escher drawings are based. They are called "Penrose Stairs" after their creator, and I just wanted to nod to that for anyone who geeks out on that kind of stuff like I do. Also, Sarah has a memory of Dr. Penrose telling her that fantasizing is an immature coping mechanism and it's fruitless. One way to take this story is that almost all of it (save the St. Mary's scenes) is a complete fantasy, taking place only in Sarah's head, so she obviously doesn't take Dr. Penrose's advice! Of course, there are several other ways to take it as well (it's all real, it's partly real, it's all a dream which is different than a fantasy, etc). Luke is introduced here. Later, we learn Luke is a real person from Sarah's past. So, either her mind is creating these different worlds and populating them with things and people familiar to Sarah, or she's dreaming, or it's all a big coincidence.
Ch 7 The Gold Standard
This chapter is mostly for comedic relief, but there's a good bit of blinding brightness happening, as well as evidence that Sarah yearns for both Toby and Jareth (Jeremy?) based off whose face appears in her locket. It also introduces Lord Draimen, the large, imposing, midnight-black wolf who Sarah fears a little. So, even when things are easy and light, there's still something sinister lurking to make Sarah uncomfortable.
Ch 8 Forevermore
Here, thanks to Mandy (the OCD patient with borderline personality disorder), we learn that Sarah isn't just in Brooksong because of her mental status. She did something *bad*. There's also a question of Sarah's feelings for Dr. Prevarant (Jareth? Jeremy?) but also his feelings for her. Of course, it's all from Sarah's point of view, but she wonders if when she brushes past him/touches him, that was by his design. Is there a hint he may have inappropriate feelings for her developing (or, is he allowing his feelings to show in some small way?) or is this all a product her Sarah's delusions?
Ch 9 Fever Dream
Sarah's perspective shifts a lot in this chapter. In the beginning of the story, Jareth seems almost like a jailer, torturing her in small ways. Here, she rethinks his behaviors and comes to regard them in a positive light. It's hard to know if it's because she's maturing and stops seeing things from a childish perspective, or if she's developing Stockholm Syndrome. There's a small callback to a previous hospital chapter here. At one point, Sarah talks about how Luke would follow her footsteps as if he was afraid the floors might give way under him if he didn't (Sarah understands the impulse, thinking about how it would metaphorically be nice to not have to walk on shifting sand). Here, in this chapter, she talks about how one small misstep in the Labyrinth could lead to disaster. There's a lot of small ideas like this that are mirrored in each reality of Sarah's, which is meant to show either that they are products of one consciousness OR that parallel worlds will still have common threads.
Ch 10 Gone with the Wind
When Sarah sings "With or Without You" she isn't trying to be a pain in the butt (like she is with her other song suggestions), she just likes the song. And, the song reflects a sentiment she feels about Jareth (she obviously has an attraction/desire for him, but she's set up as his adversary in this world).
Ch 11 The Prisoner of Zenda
Oh, how I love this old Technicolor movie! With James Mason as the villain… I loved the book as well, but I digress…
Red and Blue and Gold and Green make an appearance here. We also see that basically everyone but Sarah understands the implication of her impending birthday. Jareth had tried to warn her at their interrupted breakfast, but things got really busy and they haven't had time for that discussion at this point. This chapter also ends with the exact same line as the last chapter, once again tying the two worlds together. "Let the games begin."
Ch 12 Between Cocktails and Chess
This has already been discussed a bit. Here, "chess" is the game Sarah refers to at the end of the last hospital chapter. Of course, it's not literal chess, but the idea of using strategy to outmaneuver her adversary (Dr. Prevarant/Jareth). The doctor refers to Sarah using her words as a weapon, cautioning her that she can "lacerate" people with them. This echoes something Sarah remembers Jareth saying to her in the Labyrinth.
In this chapter we also see how Sarah's awareness/recognition of what Dr. Prevarant is trying to accomplish can be viewed simply as the side effects of her different medication regimens (that happens throughout the hospital chapters). It makes it easy to dismiss her anger—'she's not really mad, it's just her meds.' But, is it? She also looks at everything that's happening and likens it to a chess game, only realizing at the end that he's been two steps ahead of her the whole time. And that might be true. Or, it might be how her paranoid mind justifies that she isn't getting her way (something that happens with delusional people—their mind takes bits of reality and uses those bits as evidence to justify their disordered thinking).
Ch 13 Between Kingdoms and Clans
This has also been discussed a bit (the kingdoms and clans representing wellness/sanity and disordered thinking (madness)/obscurity). The gift of the chessboard from Clan Norost is a nod to the "chess" Sarah was playing with Dr. Prevarant in the last chapter (and "Norost" itself literally translates to "madness"). And, here is the nod to the idea of "freedom" and a desire to have dominion over one's own life I referred to earlier (when Sarah covets the doctor's badge for it's ability to open all the locked doors): The kingdom of Lucidesa has gifted them with a silver key, rumored to open any lock (The power to come and go as you please, Sarah thinks. What must that be like?) It's important the gift of the key comes from a kingdom rather than a clan.
There's also this in the chapter: The brilliance of the banquet hall has mesmerized her, the whole thing luminous and twinkling, even her own gown. She hadn't seen it in the dim light of her chamber, but here, exposed to the blaze of a thousand candles, ten thousand, she realizes that the fabric is somehow reflective. It becomes incandescent and she feels as though she exists in the very center of a star (and her, the iron ash at its core; the pinpoint of darkness within the explosion of searing radiance). So, again, there's all this light that dazzles her, but despite that, she still feels as though she is dark (the iron ash at the center of a star). She's still unwell/insane/having dark thoughts even when surrounded by so much light/clarity.
Archduke Valo—his name translates to "light." Tamsos Neviltis—his name translates to "darkness despair." Okay, yes, I was hitting that particular nail with a sledgehammer, but the idea just tickled me.
At the end of the chapter, Sarah actually voices the words "my love" to Jareth. She is moving further away from her initial opinion of him. Or, she's growing more open about her true feelings (which perhaps scared her too much to be open about initially).
Ch 14—The Dragon and the Knight
Here there's more red and blue and gold and green. Then, Luke makes Sarah a gift—a box with her initial topped by a crown. So, there's recognition in this world that Sarah is royalty in another world. But, when she thinks of herself, she doesn't think of being a princess or queen, she thinks of being a dragon (the villain, or the monster). The gift is a set of cardboard nesting boxing, decorated to look like jeweled boxes. This echoes one of the gifts Sarah received from a visiting dignitary in the Labyrinth, a set of jewel encrusted boxes, one inside the other. The biggest nesting box, the one with the Crowned "S" is noted to have the "S" made of plastic rubies. Sarah herself thinks in this chapter that the "S" reminds her of a snake (which is more reference to Sarah as a "monster" or the "bad thing") and the rubies are meant to evoke blood (once again pointing out that Sarah has blood on her hands).
Ch 15—The Tyrant and the Peacemaker
The title refers to Sarah and Jareth, and in this instance, she is the tyrant (making demands of the clans and kingdoms, forcing their hand with a drunken royal proclamation) and Jareth is the peacemaker, smoothing things over for her. This is also the chapter where Jareth explains that he is exactly as terrifying as she wishes him to be. Then there a reference to some of the named characters that are visiting, including the Vice Admiral of Klarhet (another reference to light/clarity/sanity). In this chapter, we learn Sarah kissed Jareth (while under the influence, which, incidentally, mirrors how her behavior changes while on various psychotropic meds. This is also echoed in the final chapters, when we see glimpses of Sarah and Jeremy's interactions while she is drunk on champagne).
Ch 16—Pennyroyal Tea
This chapter references a Nirvana song about a substance rumored to be an abortifacient, which has meaning for a previously pregnant teenager, especially in light of the fact that the chapter opens with Sarah being exhorted to talk about "the baby." Not only that, but this chapter holds the faint hint of Sarah's prior pregnancy (she has a memory of crying in the doctor's office with Karen. We see that memory laid out at the end of the story when Sarah's pediatrician tells them she's pregnant and Sarah cries while Karen demands to know who the father is). Dr. Prevarant also makes a note about Sarah "prevaricating" in this chapter (that sly dog). Sarah calls the doctor "Jareth" in this chapter an accuses him of "preying on young girls." That might give some insight into at least part of Sarah's belief about what happened with Jeremy (or it may simply be her "oh, poor me!" attitude about how Jareth treated her in the Labyrinth).
Ch 17—The Lesson of Opium
I took this title from a quote by Andre Malraux, "Opium only teaches one thing, which is that aside from physical suffering, there is nothing real."
There is a nightmare of what happened to Toby, coupled with some red/blue/gold/green, and then again, Sarah wonders if she is the thing from which others need protection. Jareth assures her she isn't and vows to "eat the liver" of anyone who says otherwise. This could be Jareth loving Sarah for who she is and brooking no ill will toward her, or it could be Sarah's mind trying to protect her from the reality of what she's done.
Ch 18—Fairy Tales
Sarah experiences SSRI withdrawals and the onset of psychosis because she no longer has meds in her system (alternatively, it could be viewed that she finally sees what is real—Jareth/Goblins—now that the meds are out of her system. It depends on which reality you are buying off on…) Jareth tells her that nothing about Brooksong has to do with "magic" (so, either it's reality—one of them, anyway—or it's all in her head. If you trust Jareth here…)
There is more of Sarah accusing herself of being "bad" and having the "bad thing" inside of her, but of course, she decides that means the meds she is taking and then takes pains to get them out of her system. Her meds are also the colors which keep recurring—red, blue, gold and green. That could be coincidental, or evidence that Brooksong is indeed a delusion/dream rather than reality. Sarah also sees a glow behind the doctor's head (which could be a med withdrawal effect) and she thinks it makes him look like a saint with a light halo. She thinks this a few times throughout the story—Jareth/Dr. Prevarant as a "saint."
Ch 19—Lullabies
Sarah and Jareth talk about the choice she must make. She sees it as choosing between sustaining the Labyrinth or returning to her family. They had previously talked about this choice when Sarah learns she has to either agree to marry Jareth or be expelled from the realm by her 18th birthday. This choice between one world or another can also be looked at as a choice to accept her delusions as reality and give up all attempts to regain her sanity (and return to her 'real' life) or continue struggling to return to wellness despite the fact that will mean facing some potentially awful things she's done (again, that's one interpretation. There are others).
A false alarm references the baby in this chapter (or, at least Sarah thinks that's what she hears) so now we have guilt about the baby crowding into her waking time, not just her dreams. At the end of the chapter, Jareth, who has become softer throughout the story, reminds us that he is no tame thing (could be a metaphor for Sarah's descent into darkness/insanity. She can give up her guilt and just live in this delusion, but while that has an appeal, it's not without dangers).
Ch 20—The Difference Between Pashmina and Tweed
We get more concrete hints about the relationship between Sarah and Jeremy here. Sarah reveals Toby's name comes from one of Jeremy's characters (and why would Sarah, a teenaged half-sister, get any say in what Karen's child was named?) There's some indication of Sarah's admiration for Jeremy here, and also a hint that no one was paying close enough attention to Sarah at the time to know what she was really up to (that she had a 'relationship' with Jeremy). There are vague hints here that Sarah is Toby's mother and Dr. Prevarant knows (either because he's part of her consciousness, which knows it all, or because he has read her journal). Sarah is ranting about Karen using her as a "babysitter" and wanting her to do things for Toby which Sarah thinks is unfair. The doctor comments on it, making it seem as though he doesn't find these things unreasonable (because Sarah's not just a babysitter, she's Toby's mother, and should want to do these things for him).
Sarah also feels the tweed of the doctor's pants (the second incidence of very minor yet somewhat inappropriate touching between them in this chapter) and thinks how different it feels than the cashmere of Jeremy's suits (this is supposed to cause the reader to wonder how Sarah knows what Jeremy's clothes felt like).
When Sarah talks about "wishing the baby away" she means in the way the movie shows, wishing the Goblin King would take him, but the doctor obviously thinks it's a way for her to avoid taking responsibility for killing Toby.
Ch 21—How Silk and Sackcloth are the Same
Jareth is attentive but in an almost predatory way here. I imagine how it sort of tantalizes and worries Sarah would be akin to some of her feelings about receiving the attentions of Jeremy. Sarah wants to take it a bit slower, and Jareth becomes almost threatening over the idea. Here, Sarah stands her ground despite her fear. How would "real world" Sarah have fared against similar pressures from Jeremy? Of course, later in the story, we see that Jareth had legitimate reasons for wanting Sarah to give into him sooner rather than later—unless that's just a way to justify controlling behavior, claiming it's for her own good… (more exploration of the idea of the issues with "relationships" between partners with significant age differences).
The title refers to the fact that though Sarah is dressed in finery, it's no different than being in mourning dress when it comes to her experiences while wearing the clothes. Or, the idea that a wedding dress might as well be made of sackcloth when you are being forced to wed.
The chapter ends with more dwelling on how she is the "bad thing" in the story (that can be taken literally—she's a murderer who committed infanticide, but can also be a young, impressionable girl being manipulated to think poorly of herself by someone with an interest in controlling her).
Ch 22—The Tragedy of Anna Karenina
This is the most direct Sarah has been about her feelings about Toby. She says Anna should have given up her son to keep her love. She also realizes she could easily sit in Dr. Prevarant's lap and it makes her think of "another man, and another lap," more reference to Jeremy. Later in the chapter, she references the fact that Jeremy wasn't "with" her mother anymore ('not really'—meaning, probably, in appearance only, but his heart belonged to another). We also get a glimpse of Sarah's perception of Jeremy's feelings about Toby. We're left with the impression that Jeremy rejected Sarah over the pregnancy (or at least she felt he did—which might explain even more the resentment she felt toward Toby. Of course, if their relationship is problematic anyway, and Sarah might have been upset by Toby simply because of his resemblance to his father).
She's been irritated by how calm and "in character" the doctor has been throughout the story and in this chapter, she is so bothered by it, she says it "lacerates" her, which echoes some previous mentions, though in those, it was Sarah who was doing the lacerating.
And then we find out Sarah is in St. Mary's (and why). Or, at least she dreams she's there…
Ch 23—The Madness of Ophelia
There are many interpretations about what led to Ophelia's madness, but one is that it's because she was rejected by the man she loved…
Small glimpses of Sarah's dreams help fill in the blanks a bit about what happened with her and Jeremy (courtship vs grooming, flirtation vs abuse) and even some hints as to what is wrong with Sarah now (post-partum psychosis has led to some high profile infanticide cases).
There is also discussion of a "blood oath" in this chapter, which isn't too far from a "blood sacrifice." I had this vague idea while writing this that one possible explanation for the whole Labyrinth adventure could be that you had to make a blood sacrifice to gain entrance, and that's what Sarah did by killing Toby (her mind invents the "kidnap" plot to protect herself from the idea of her own depravity) but that felt a little too dark, so I ended up with the notion that Toby is of Jareth's blood and that was her ticket to the Underground (still kind of dark). Still, at this point, Sarah wavers between the (mistaken?) realization that she killed her son (she doesn't know about the changeling yet) and the idea that he's her brother and she had to leave him behind in the real world to come here. But when Jareth finds her toward the end of the chapter, she's raving madly (like Ophelia) while trying to dig Toby up in Jareth's garden (suffering from a delusion that he's buried there). And she starts to call Jareth "Jeremy" before she corrects herself.
At the end, she wakes up in a nightmarish "reality"—St. Mary's. This could actually be the reality, or it could be a terrible manifestation of her mind being torn in two as Jareth has warned.
Ch 24—Eventide
This is the most "real" reality we've seen thus far, and so the name of the chapter is a little ironic since it invokes darkness (insanity). But maybe that's because it lays out the reasons for Sarah's descent into madness (if you buy that version of events).
I also had Karen become "Irene" as a nod to the two accepted names for her in the fandom.
We also get to see that although Sarah's father and stepmother were the more responsible of her parent-figures, in a way, they used her, too. There doesn't seem to be discussion of Sarah's wishes surrounding her child, just the adults telling her what is best for them all (and possibly considering their own interests above hers, without much thought of what it would be like for Sarah to pretend her child was her brother, or to be confronted with the issue of her relationship with Jeremy—not that Robert and Karen knew about that relationship consciously).
There are hints that Sarah was devolving into psychosis during her pregnancy and after, but the symptoms were dismissed as her being a "hormonal teenager" and being a dreamer who wanted to spend time in her fantasy books (rather than recognizing that she was losing touch with reality and considered the fantasy a reality). This is another way Sarah was failed by those who should have taken care of her. Even her friends wrote her off.
Ch 25—The Dawn of Days
The title should indicate sanity/enlightenment but it's an ironic title because though Sarah does gain a sort of clarity by the end, she's doing it by allowing herself to accept the madness as the truth (so, this fantasy realm is not her reality, or, you could look at it like her giving in completely to the mental illness, with no more intention to struggle against it. This is her choice).
This chapter changes settings/scenes without any explanation. Sarah's thoughts jump from one world to the next, memories are mixed with dreams, and it's a bit hard to follow. This is meant to mimic the way disordered thinking flows in mental illness. It makes perfect sense to the person afflicted with it (the same way a very changeable dream will make sense to the dreamer as she is dreaming), even though to an impartial observer, it will seem like nonsense.
Earlier in the story, despite some occasionally sinister undertones, the Goblin Realm has seemed to make the most sense for Sarah. She's been her sanest here. But now, we see that slips. She loses track of time, seems to have trouble remembering things (Jareth has been gone a month and it catches her off guard when she learns it), and her nightmares have increased. This is either because Sarah really is insane and her dream of this world is being affected by it, or Jareth was right and her mind is being affected by the fact that she has taken an oath but not fulfilled its requirements yet. Or, it could be that she is just being slowly driven insane in this world as her actions in the other world (regarding Jeremy, Toby, etc) are coming to the surface.
There are clearer memories about her interactions with Jeremy (he at least plied her with alcohol when she was far too young to have it, and touched her in a suggestive way, if nothing else). Her behavior seems to suggest this wasn't unwelcome on her part (I don't mean to suggest that makes what he did acceptable, this isn't an examination of what's moral for an adult to engage in with a teenage girl, just the way such a girl might view those events).
In her dream of the party with Jeremy, the voices of Sir Didymus and Vergess Trindlebark (likely arguing by her sick bed as she lay asleep) pull her away from that memory and toward Dr. Prevarant's office. Of course, Dr. Prevarant is revealed to definitively be Jareth here (and you can believe that as much as you believe any dream-revelation equates to the truth), and Jareth is reading her journal (we know the journal refers to the baby and giving up her dreams for him from discussions she had with her doctor earlier in the story). Jareth states that the entire thing is about him. Sarah denies it, because she wrote much of it about Jeremy, but if Jareth is just a manifestation of part of Jeremy's personality, then what he says is true. And if Jareth is actually a real entity (the Goblin King) who masqueraded as Jeremy because he thought that was something Sarah wanted (as he later claims), it's still true.
Next, Jareth, Dr. Prevarant, and Jeremy are all blended together, as first Sarah speaks to one, then the other seems to take over, and then the memory is of the third. That's meant to show that they really are all parts of the same person, at least in Sarah's mind. If that's true, then you are left with two choices at this point: either Sarah's mind fractured Jeremy into three so she could compartmentalize and deal with what happened between them more easily, or what Jareth says later is true: He was disguised as Dr. Prevarant (maybe in some sort of dream world while her mind was dealing with the consequences of her blood oath) and Jeremy all in a bid to give Sarah her desires.
Conveniently, Jareth introduces the idea that Sarah is not as selfish and cold as her mother, that Sarah's sins were justified (as mercy). He also shows her that she has put herself in St. Mary's as a punishment for her misplaced guilt, and if she makes the choice to leave, she can. And she does. He then shows her that the garden graveyard is where she lays all her perceived sins and mourns over the innocence she's lost (rather than it being a literal graveyard where her murdered child is buried, as she has assumed). Jareth may be right, or this may be a way for Sarah's subconscious to absolve her of her sins. He suggests the baby Sarah killed was a changeling, an old, dying fairy that had taken Toby's place and needed to be put out of its misery.
In her weakened state, Sarah is pretty easy to convince that this is the case, and Toby is alive, and all will be well if she'll just complete the requirements of her oath. And all that might very well be true. Or, Sarah finally "choosing" Jareth and Toby may be just the last step of her giving in to her mental illness and deciding to live out her life in her delusions, because they are more pleasant than the truth.
At the end, Jareth looks into the crystal to see someone who looks like Sarah with "wrong" eyes restrained at St. Mary's. This could simply be one of Sarah's nightmares (which will likely continue until she marries Jareth and throws that blood-oath monkey off her back) or it's a reflection of the truth (Sarah really is in St. Mary's, and the Goblin Realm is her dream—this has been the question since the beginning, which world is real?) or Sarah has been rescued from St. Mary's by Jareth, and he has left a changeling in her place.
The choice is yours, really. I am not even 100% sure which story I believe. When I'm feeling more practical, I think Sarah is dreaming Brooksong and the Labyrinth while she's heavily medicated at St. Mary's as one of the criminally insane who murdered her own child. When I'm feeling more whimsical, I think all the hospital stuff is a nightmare due to her mind being torn by the unfulfilled oath, and her reality is her life with Jareth, and she's destined to marry Jareth and be the Goblin Queen and raise Toby and his soon-to-be brothers and sisters in the palace. I think you can also consider both stories reality, like alternate universes, where in one, Sarah is a mental patient, and in another, she's a queen. Or, the entire thing until the very end could be a great, complex dream, induced by Jareth who has kept her prisoner in his realm after she initially ran the labyrinth, trying to convince her to stay since she declared he had no power over her.
I'm happy to answer any further questions!
