" I've got out at last," said I, " in spite of you and Jane? And I've pulled off most of the paper, so you can't put me back! "[1]
These are the last words that the protagonist of The Yellow Wallpaper utters as she gives in to the throes of madness. Charlotte Perkins Gilman’s 1891 short story narrates the tale of a wife who has been ordered a ‘rest cure’ by her husband for temporary nervous depression and a slight hysterical tendency.
The protagonist experiences what thousands of women have gone through over the centuries- punishment, confinement, and the pathologizing of the self, all due to the crime of being a woman.
Before psychiatric diagnosis, it was fairly simple to condemn a woman to doom. All you had to do was label her a witch! The first accusations of witchcraft came from male doctors who were afraid of being overshadowed by contemporary female healers.[2] An extensive array of behaviors could deem you harmful enough to be labeled a witch. Homosexuality, being ‘promiscuous’, not being married, or living independently of a man were all ‘sinful’. What stemmed from the insecurities of some doctors culminated in witch trials, and the targeted killings of 200,000 to 500,000 people in continental Europe.[3]
‘The trials have been seen as the embodiment of a hatred of women, organized and ritualized through patriarchal dictate, resulting in the torture and death of millions of women under the catch-all term ‘witch’: the ultimate in misogynistic annihilation’[4]
-Jane Ussher
As time went on, another more ‘sophisticated’ tool of social control was found to replace the witch-hunt. This was the psychiatric diagnosis. The same misogynistic words were shrouded in a new terminology to explain women’s behaviour.
‘Witches’ were now ‘Hysterics’.
Hippocrates coined the term Hysteria in the 5th Century BC[5] and said it was caused by a wandering uterus. The treatment? The holy trinity of Marriage, intercourse, and pregnancy.[6]
While the idea that a wandering womb caused hysteria slowly faded away, its relevance as a woman’s malady remained. In 1859 ‘Treatise on Hysteria’, youth, being a woman, low social class, and heightened promiscuity were deemed as causes of it.[7]
Hysteria diagnoses were also more often dished out to women active in the feminist movement in a classic witch-hunt fashion.[8]
Freud and Breuer’s Studies in hysteria[9] determined that Hysteria was caused by an excess of emotion- due to an active mind which had to sustain a sedentary life. While, in a way, their work was for-women in that they were more sympathetic and gave women a say in how they could be treated, yet it was disastrous in another crucial way. They suggested the ‘talking cure’ as an outlet for excitement through cathartic listening. However, when women told them about childhood sexual abuse incidents, Freud chose to view them as the fantasies of women and interpreted them through his view of the stages of sexuality. So, instead of drawing a relationship between abusive homes, trauma and mental illness, he saw it as an internal desire for incest.
'Hysteria' was listed in the Diagnostic and Statistical Manual of Mental Disorders-II[10] as 'hysterical personality (histrionic personality disorder)'; however, only the latter term was used from the DSM-III[11] forward, and this is still the case in the most recent DSM-5.[12]
People with the disorder are supposed to be ‘flirtatious, seductive, charming, manipulative, impulsive, and lively’, ‘vibrant, enchanting, overly seductive, or inappropriately sexual with most of the people they meet..’ and their ‘Physical appearance may be used to draw attention to oneself by wearing bright-coloured clothing or revealing garments’.
But the question that comes to mind is, isn’t this how women are expected to act? At least according to the standards of popular culture?
Gould[13] argues that the above disorder is not indeed a mental illness, but behavior resulting from a disordered culture- one that views women as inferior and as objects, and it is this culture that needs a change.
Borderline Personality Disorder (BPD) is another pathology that has carried on the infamous legacy of hysteria. The characteristics that define someone with BPD are ‘unstable mood’, ‘inappropriate, intense anger', a ‘lack of control’, unstable relationships, fears of abandonment, and suicidal thoughts or actions. Other more astounding criteria included ‘shopping sprees’, ‘casual sex’, ‘binge eating’ and ‘extreme sarcasm’.[14]
The above characteristics are a result of the constant infantilization of women that are in abundance in the history of psychiatry and psycho-analysis.
BPD also pathologizes ‘uncontrollable’ and ‘irrational’ anger and suggests that anger, in women is irrational.
This is contested on two counts, one- being that male anger is never seen as irrational, intense, or as inappropriate while female anger IS (75% of BPD patients are women).[15]
The other is that, by calling women’s anger irrational, it removes itself from the social context where women have plenty to be angry about in a patriarchal world especially when caste, class, race, etc., intersect.
When the two ‘Disorders’ above, psychology and society are viewed as a whole, we can see problematic behaviour in women is viewed as mental illnesses while that in men is viewed as delinquencies. The distinction in how they are framed might seem harmless at first, but it speaks loads about agency. A mentally ill person’s doings are deprived of any agency, a delinquent’s on the other hand is his own wrongdoing-actions committed with his own agency. Even in violating societal norms of gender, women have their agency snatched from them.[16]
Another observation might be that extreme conformation to femininity (shopping sprees, vibrant, enchanting personalities) and straying away from traditional femininity (casual sex, unstable mood, irrational anger) lead to the same conclusion- a psychiatric diagnosis.
“As madness itself is synonymous with femininity, those . . . who wholeheartedly embrace the gender role assigned to them, or those who reject it, are at high risk of being diagnosed as mad”[17]
Psychiatric and societal norms are also translated into how individuals and mental health professionals think. In 1972, a study[18] was conducted asking mental health professionals to describe the attributes of a 1. Mature, healthy, socially competent Adult, 2. Mature, healthy, socially competent Man, and 3. Mature, healthy, socially competent Woman.
While the answers for the first two questions were virtually the same, the description of the Woman was different- she was more excitable, concerned with her appearance, easily hurt, less independent, etc. To mental health professionals, a woman was less of an adult than a man was!
Coming to the Indian scenario, Indian psychoanalysis is heavily rooted in Hinduistic and Patriarchal ideologies.[19] Psychoanalysis was expected to ‘cure’ women suffering from ‘unresolved oedipal conflicts’ who could not adjust to their caste and marital status and who objected to the vermillion mark and discarded the sacred veil signifying her status as a married woman.[20] Idioms of distress expressed by lower caste women and other minorities were quick to labelled superstitious, or hysterical.[21]
When the theoretical foundations of the subject are intrinsically prejudiced, it comes as no surprise that mental health practitioners are bigoted too. From slut-shaming and telling a woman her depression was caused by her being unmarried,[22] to calling a person who opened up about their caste experiences disordered,[23] Indian mental-health practitioners have done it all.
For someone to reach out for help and be hit with the same discrimination that they have been hurt by can be a truly traumatizing experience. Women in top positions of the field, [24] more socio-psychological research with respect to mental health and gender as well as caste-discrimination and mandatory sensitivity training for all medical health practitioners would hopefully create a dent in the intolerant mindset that we see today. And hopefully, in the future, no woman will be labeled mad for being herself.
[1]Charlotte Perkins Gilman, The Yellow Wallpaper 10(Virago Press 1981). https://www.nlm.nih.gov/exhibition/theliteratureofprescription/exhibitionAssets/digitalDocs/The-Yellow-Wall-Paper.pdf
[2] Teri Kapsalis, Hysteria, Witches, and The Wandering Uterus: A Brief History, LITHUB (Jan. 18, 2022, 4:30 PM)
https://lithub.com/hysteria-witches-and-the-wandering-uterus-a-brief-history/#:~:text=%E2%80%9CThe%20Yellow%20Wallpaper%E2%80%9D%20was%20conceived,so%2Dcalled%20weaker%20nervous%20system.
[3]Ben-Yehuda, N,The European Witch Craze of the 14th to 17th Centuries: A Sociologist’s Perspective, 86(1)AJS 1, 1 (1980)http://www.jstor.org/stable/2778849.
[4]Jane M Ussher, Women's madness: misogyny or mental illness? 43(Amherst, University of Massachusetts Press 1992).
[5]Cecilia Tasca, Mariangela Rapetti, Mauro Giovanni Carta, and Bianca Fadda, Women And Hysteria In The History Of Mental Health,8 Clin Pract Epidemiol Ment Health110, (2012).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480686/
[6]Kapsalis, supra note 2.
[7]Briquet, P,Traitéclinique et thérapeutique de l’hystérie (J.-B. Baillière et Fils. 1859).
[8]Elaine Showalter, The Female Malady: Women, Madness and English Culture, 1830-1980(Penguin Books 1987).
[9]Breuer, J., & Freud, S, Studies On Hysteria(New York, Basic Books 1957).
[10]American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders Second Edition(2d ed. 1968).
[11]American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders Second Edition(3d ed. 1980).
[12]American Psychiatric Association, Diagnostic And Statistical Manual Of Mental Disorders Second Edition(5th ed. 2013).
[13]Gould, C, Why the histrionic personality disorder should not be in the DSM: A new taxonomic and moral analysis4(1) IJFAB, 26 (2011).
[14]American Psychiatric Association, supra note 11.
[15]Jemma Tosh, Psychology And Gender Dysphoria: Feminist And Transgender Perspectives 40(Routledge 2016).
[16]Joan Busfield, Men, Women And Madness106(Macmillan Press Ltd 1996).
[17]Ussher, supra note 4, at 167.
[18]Inge K. Broverman, Susan Raymond Vogel, Donald M Broverman, Frank E Clarkson &Paul S. Rosenkrantz, Sex‐Role Stereotypes: A Current Appraisal, 28(2)J.Curr. Soc. Issues. 59 (1972).
[19]Bhargavi V. Davar, Indian psychoanalysis, patriarchy and Hinduism, 6:2Anthropol. Med.173 (1999).
[20]Id.
[21]Id.
[22]Prateek Sharma, When bigotry invades mental healthcare: Women, sexual minorities are most vulnerable to harassment, Scroll.in (Jan. 20, 2022, 9:58 PM),
https://scroll.in/pulse/820412/when-bigotry-invades-mental-healthcare-women-sexual-minorities-are-most-vulnerable-to-harassment
[23] Meena Sawariya, Caste and Counselling Psychology in India: Dalit Perspectives in Theory and Practice, 2(1) J-CASTE 194(2021).
[24]Rebecca A. Clay, Women outnumber men in psychology, but not in the field's top echelons, 48(7) Monit. Psychol. 18(2017).
This article is authored by Surabhi KC, a student of Gujarat National Law University, Gandhinagar.
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