Written by Jessica Taylor
In a new book, psychologist Dr Jessica Taylor argues that our eagerness to diagnosis women with psychiatric disorders is a symptom of the patriarchy.
I don’t know about you, but each time I scroll through social media, it feels like I see a new advert for a T-shirt, mug or phone case emblazoned with the words ‘Cute but psycho’. Just the other day, I saw a crop top that simply had the word ‘Borderline’ spelt out in a sexy, lipstick font across the chest. Often, it’s women who lightheartedly buy these items, who laugh along when a friend calls them crazy. And so, my question is this: why are we fetishising women as psychotic, deranged, mad? Why do the lyrics of hit songs yell out ‘Oh, she’s sweet but a psycho’?
Today, millions of women and girls in the UK are living with mental health issues, disorders and syndromes. Women and girls are seven times more likely to be diagnosed with borderline personality disorder than men and boys and being female positively correlates with every single psychiatric diagnosis. We are more likely to be diagnosed with depression, anxiety and somatic disorders, panic disorder, phobias, suicide ideation and attempts, postpartum depression and psychosis, eating disorders and PTSD.
At the same time, we are regularly told that our emotions and thoughts are irrational, unstable, hysterical, dangerous, delusional, psychotic, manic, and most of all, abnormal – by everyone from GPs to ex-boyfriends.
I know this from both personal and professional experience. I’m a chartered psychologist who has been working with women and girls for over 10 years. In recent years, I’ve come to specialise in the ways women and girls are blamed for having normal responses to trauma – and then gaslit into believing they’re mentally ill because of it. I’ve worked in charities, courtrooms, rape centres, police forces, children’s services and mental health. No matter where I was or what I was doing, the pattern of women and girls as young as 10 disclosing abuse, trauma and violence and then being sent to a mental health team or a psychiatrist was impossible to ignore. I had to do something.
But to understand why women are in this situation, we have to first look at the origins of psychiatry itself – and the closer you look, the more its links to racism, misogyny, homophobia, classism and capitalism become apparent.
Its roots stretch as far back as the witch trials between the 14th and 17th centuries, when unruly women were branded as ‘evil’ and ‘hysterical’ in one steady swoop – and literally killed for it. This period saw a genocide of 600,000-1,000,000 women and girls who didn’t do as they were told. You were at risk of being accused of witchcraft if you were too intelligent, too opinionated, too knowledgeable, knew too much about your biology or your menstruation, read too many books, questioned politics and religious elders, didn’t want to marry men, or couldn’t have children. Midwives were thought to be witches because they understood how to help women conceive and give birth.
And so when the witch trials ended in 1735, a new method of containing and controlling women and girls was born – asylums. The Quakers (Protestant Christian church) moved from accusing women and girls of being satanic to mentally ill, with their suggested, ‘humane’ cure being time in an asylum and converting to Christianity. Within a few decades, the first ‘lunatic asylum’ was opened by The Quakers and the next century saw thousands more religious ‘lunatic’ asylums spring up all over Europe, USA and UK.
Women were diagnosed with ‘hysteria’; a made-up illness only diagnosed in females. Hysteria (also called ‘Wandering Womb Syndrome’) was diagnosed in women who didn’t conform in some way. The theory at that time was that female mental illness was caused by a displaced womb floating up to the brain and attacking it, making them insane. Amazingly, women were still being diagnosed with this until the 1960s.
Inside these asylums were women who didn’t conform, asked too many questions, and didn’t behave in a socially acceptable way – they were different in some way, or were from marginalised and oppressed minorities. This continued for centuries and is the foundation of modern psychiatry.
Throughout the 19th and early 20th century, educated men and community leaders who claimed to be doctors and ‘physicians’, would observe, medicate, experiment on and torture women and girls in these asylums under the guise of ‘medical research’. They were subjected to treatments and interventions that sound like they are fresh out of an 18-rated horror movie. They were injected with malaria. They were spun around until they passed out. They were made to ingest toxic lead. They were injected with insulin until they were in fatal diabetic comas. They were forced to have their wombs extracted and their brains lobotomised. They were shocked with electrical currents sent through their brain until they had brain damage and concussions. They were given dangerous levels of lithium that injured or killed them.
None of this was as long ago as we often imagine, either – these treatments were all used in the last 120 years. Some of them are used to this day. I still encounter women and teenage girls being given lithium, receiving electroshock therapy, being medicated with strong tranquillisers and painkillers they may not need. I still meet women and girls who have found themselves sectioned and labelled mentally ill after disclosing childhood abuse, rape, domestic abuse or other traumas. I am still working on cases where women and girls are being discredited and humiliated in the courtroom when they have been raped or abused. Defence barristers love to suggest that she is mentally ill or delusional.
You can see, then, why I’m concerned by the increase in women and girls receiving psychiatric diagnoses. While the mental health movement seeks to destigmatise the process of diagnosis, this is not possible while we are pathologising women for having normal reactions to events in their lives – be it anger, sadness or heartache. Stigmatising women as different or irrational or too emotional or abnormal in some way has always been the point of psychiatric diagnosis. And so, to ‘end mental health stigma’, we must also end the constant labelling of women and girls as mentally ill; as ‘cute but psycho’. We need urgent reform.
I am suggesting an alternative. We need to move away from the now widely debunked theory that mental illness is caused by brain chemical imbalances again and deepen our understanding of our mental distress and trauma.
One alternative, and the one I prefer to use in my work with women and girls, is the trauma-informed approach. Instead of treating a woman as mentally ill or disordered, I work with her to understand what’s been done to her, what’s upsetting or scaring her and what can be done to solve them or support her. It’s a simple, humanistic approach. We don’t seek to medicate or sedate. We don’t section or refer to mental health wards. We simply listen, work together and validate women and girls in their times of crisis and distress. In my 12 years of work in this field, I’ve never suggested that a single one of the women I treat is mentally ill, and yet I’ve had incredible success in supporting them through their traumas.
Isn’t it time that we stopped doling out labels to millions of women and girls who are distressed and traumatised? Isn’t it time we stopped asking ‘what’s wrong with you?’ And started asking, ‘What happened? What was done to you? How can I help?’
Sexy But Psycho: How the Patriarchy Uses Women’s Trauma Against Them by Dr Jessica Taylor is published by Little, Brown, £16.99
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