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(WOMENSENEWS)-- In the 1970s and '80s, feminists from a range of academic disciplines began to tackle the issue of women's mental health in earnest, often going back to the 18th and 19th centuries to trace the formation of attitudes towards gender and psychological disorder. These critics noted the disproportionately high numbers of women traditionally treated for mental illness; highlighted the fact that psychiatry was an overwhelmingly male-dominated profession; attempted to identify the distinctive social and cultural pressures that might cause women to seek treatment; and pointed to a long-standing cultural association between femininity and madness.
One of the key books to emerge from this wave of feminist scholarship was Elaine Showalter's "The Female Malady: Women, Madness and English Culture, 1830–1980," published in 1985. Showalter is a literary critic, but her analysis extended way beyond the usual parameters of her academic discipline to take in areas as diverse as social history, the development of psychiatry and the visual arts. Here's how Showalter summarized her findings:
"Madness is a female malady because it is experienced by more women than men . . . But how should we interpret this statistical fact? There have always been those who argued that women's high rate of mental disorder is a product of their social situation, both their confining roles as daughters, wives and mothers and their mistreatment by a male-dominated and possibly misogynistic profession . . . By far the more prevalent view, however, sees an equation between femininity and insanity that goes beyond statistical evidence or the social condition of women . . . women, within our dualistic systems of language and representation, are typically situated on the side of irrationality, silence, nature and body, while men are situated on the side of reason, discourse, culture and mind . . . . [Feminist philosophers, literary critics, and social theorists] have analyzed and illuminated a cultural tradition that represents "women" as madness, and that uses images of the female body . . . to stand for irrationality in general."
Were one to discuss the issue with a typical 19th-century medical man, he would probably explain that it was hardly surprising women suffer more psychological problems than men: they are fundamentally unstable. It's not their fault, mind you: thanks largely to the peculiarities of the sexual and reproductive systems, women are prey to huge and unsettling emotional volatility. "Madness," for women, is always close at hand.
Showalter argued that this identification of madness as inherently female only truly took root at the end of the 18th century. It was then that "the appealing madwoman gradually displaced the repulsive madman, both as the prototype of the confined lunatic and as a cultural icon." And the plentiful representations of female insanity in art, literature and opera "operated as ways of controlling and mastering feminine difference itself."
This cultural linking of femininity and psychological disorder had its corollary in real-life care of the mentally ill. Prior to the mid-19th century, men made up the majority of asylum inmates. There then began a sizeable shift in the opposite direction. Charles Dickens, visiting St Luke's Hospital in 1851, noted:
"The experience of this asylum did not differ, I found, from that of similar establishments, in proving that insanity is more prevalent among women than among men. Of the 18,759 inmates St Luke's Hospital has received in the century of its existence, 11,162 have been women."
And at the same time as the asylums were filling with women, the treatment and control of those psychiatric patients became increasingly dominated by men.
Ah, but that was the Victorian age, you might be thinking; those attitudes have long since disappeared, haven't they? In 1985 Showalter was far from convinced that the link between women and madness had weakened, nor indeed that women and men were being treated equally in the mental health system:
"In modern literature and art, the schizophrenic woman stands for the alienation and fragmentation of the age. In medical psychiatry . . . women appear to be the prime subjects of shock treatment, psychosurgery and psychotropic drugs."
More than 25 years later, many feminist critics argue that even now nothing much has changed. In her recent book "The Madness of Women," the health psychologist Jane Ussher writes:
"Women outnumber men in diagnoses of madness, from the 'hysteria' of the 18th and 19th centuries, to 'neurotic' and mood disorders in the 20th and 21st. Women are also more likely to receive psychiatric 'treatment', ranging from hospitalization in an asylum, accompanied by restraint, electro-convulsive therapy and psychosurgery, to psychological therapy and psychotropic drug treatments today. Why is this so? Some would say that women are more mad than men, with psychiatric treatment a beneficent force that sets out to cure the disordered female mind. I proffer an alternative explanation – that women are subject to misdiagnosis and mistreatment by experts whose own pecuniary interests can be questioned, as can their use (or abuse) of power."
Ussher doesn't dispute the fact that a great many women suffer psychological and emotional distress. But she argues that this unhappiness is more accurately interpreted as a "reasonable response" to "restricted and repressive" lives than as a sign of illness.
Reprinted from "The Stressed Sex: Uncovering the Truth About Men, Women, and Mental Health" by Daniel Freeman and Jason Freeman with permission from Oxford University Press, Inc. Copyright © Daniel Freeman and Jason Freeman 2013.
Daniel Freeman is a professor of clinical psychology, and a Medical Research Council Senior Clinical Fellow, in the department of psychiatry at Oxford University, and a Fellow of University College, Oxford. He is also an honorary consultant clinical psychologist in Oxford Health NHS Foundation Trust. Details of his clinical research group at Oxford can be seen here. Jason Freeman was educated at Cambridge and Sussex universities in England. He spent several years working in publishing and is now a freelance writer and editor. He lives in Sheffield, though not because it provides him with a handy excuse for missing Watford home games.
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