I chose to read this book firstly as an aspiring psychology student, but also with an interest in history and learning more about the sociology of womanhood (as a somewhat juvenile, but genuine, feminist). This book manages to combine all three topics cohesively in an informative and pragmatic way. It is a bit of a dry read as it focuses mainly on intellect and there isn’t much sensationalism or mythical storytelling to it (which, as a spiritualistic Irish woman; I am partial to) compared to alternative books in this genre. ’Women who run with the wolves’ by Clarissa Pinkola Estes is the first that comes to mind if you are looking for something more spiritual or holistic than scientific. However, this book does still serve my initial expectations and is valuable reading material for budding psychology enthusiasts who wish to learn more about historical theories and relate them to the current status and role of psychology in society.
To start, I feel the introduction of the book very clearly sets the tone and style of the upcoming chapters. If you find it a bit drab and factual, then the introductory chapter establishes this for the reader. As per my introduction, educational reading isn’t always going to be riveting and exciting, so I took this opportunity to realign my expectations a bit and appreciate the depth in which the writer actually studied and researched for this book. Her aim is clearly education, rather than speculation, fabrication or (as so many feminist books have) expressing strongly biased or personal opinions. This book is a well-written, scientific-based read. A female writer explains, objectively, the maltreatment of women in psychiatry for their femininity, based on the prognosis of subjectivity, which makes them ‘crazy’. Showalter narrates from the beginning that ‘madness is the price women artists have had to pay for the exercise of their creativity in a male-dominated culture’. This book is in one sense a historical artefact of female psychiatry and she doesn’t fail to mention those whose names serve as a reminder. ‘ In the annals of feminist literary history, Virginia Woolf, Anne Sexton and Sylvia Plath have become our sisters and our saints’. As a fellow female writer, her subtle and gracious solidarity towards the voices of those before her is a sweet snippet to be found amongst the informative text.
‘Domesticating Insanity’ was definitely my favourite chapter. It describes how women of any class or position could classify as clinically insane. We learn just how much women were reprimanded and controlled for behaviour that was considered socially unacceptable, how their ‘hysteria’ was often a rebellious response to the confinements of society on their gender. As Showalter defines it, this female insanity was a psychological aversion to ‘resist the social definitions that confine them to the doll’s house of bourgeois femininity’. As society technologically and corporately progressed (there are a lot of other progressions I could mention here like consumerism and vanity), it is clear that over time humanity has suffered psychologically, but it is difficult to determine where it all went wrong and how to remedy it. It becomes clear, however, that England played a paternal role in domesticating insanity, as ‘both natives and foreigners agreed that as the richest and the most advanced society, England necessarily had the highest incidence of insanity.’ Medical practitioners understood this at the time and, as quoted by Dr. Andrew Halliday, ‘madness was a disease of the highly civilised and industrialised; “We seldom meet with insanity among the savage tribes of men... Among the slaves in the West Indies it very rarely occurs... and the wilds of Ireland are almost free from this complaint.’ This should have prompted a lot more social considerations in psychiatry.
As reflected by Dr. Halliday, the advancement and progression of the external structures of society has wrecked havoc on the internal structures of our psyche. From a social psychology perspective, this makes you consider how the pressures of society and economy have inhibited our ability to create happiness and how humanity was never supposed to live in such a fast-paced, competitive environment. However (as a proud Irish woman), my attention drew to the factual basis of England’s profound influence on culture globally, how the power and greed of the very ‘masculine’ English appetite created a generational wound for years to come in the psychological effects of its industrialisation, but also its entire colonisation of rural Ireland. The English both destroyed and transformed Ireland in a psychologically traumatic way-but also socially through its pastimes, values, and norms. English, in a sense, groomed the Irish to behave and think like them-but that’s part of a historical story for a different day. But I think it made clear in these chapters that England, with all its prestige and ambition, also promoted the unravelling of social psychology.
Another point worth mentioning is that those who failed to keep up with the ever-increasing demands of society were, and still are, more susceptible and vulnerable to psychological issues. Whether this is negligent of the individual or of the government to which the individual conforms to is another question of social policy that we can consider after reading this book. But what struck me as interesting, and likely accurate in many cases, is that the writer outlines the possibility that society could have considered insanity as an economic choice for the poor and homeless. As a statistical consequence, ‘Between 1844 and 1890, the number of pauper lunatics in public asylums quadrupled’. It is, of course, extremely unfortunate that anyone (past or present) would feel it necessary for their survival to feign insanity (and morally it is questionable too), but from a historical or scientific standpoint, it creates inconsistencies. The credibility and authenticity of the documented diagnoses in these asylums are not truly reliable because of the many variables, misdiagnosis and sexism prevalent in psychiatry. Although the female psyche is the focus in this book, it is hard not to reflect on the correlation between poverty and insanity, even more so the higher incidence of poverty-stricken women in these asylums as they fell into two minorities of class and sex.
This made me think of how this statistical situation in asylums could mirror in other sectors of community segregation. It must also occur in correctional facilities (although probably not as rampant in modern days) where inmates like these asylums patients seek refuge, shelter, sustenance, and maybe even structure and routine by convicting themselves. Poverty and homelessness can make even the most grim institutions seem domestic and hospitable. However, the factual credibility of a convict’s crimes, whether intentional or not, is easier to prove-the detection of mental insanity and hysteria is difficult to define. Hence, the historical records of insanity and asylum patients are definitely very inaccurate, even more so than that of criminal incarnation. Regardless, an issue of poverty and lack of education correlate the two. This just shows how flawed our socio-economic systems are to this day, that the lack of support and resources for lower-class citizens can hinder the progression and accuracy of psychology as a science and a treatment. Poverty and psychiatry have more reasons for being linked than just this, but it is the most simplified correlation that we can first detect.
Poverty in society also affected the practice of psychiatry in more subconscious causes of insanity. The repressive attitudes of classism only served to ostracise mentally precarious people to rehabilitation, because often poverty was so socially unacceptable that it genuinely did create breeding grounds for insanity. Especially since in the asylums, the aim was to promote certain ideals for standards of living. It is certainly a counterproductive approach to inclusion, integration and ‘curing of mental illness’ when we are giving a portraiture of normality. The writer describes how, when reformers created ‘moral’ and ‘normal’ structures of class in the asylums, ‘they defined their facades of sanity as well’. Although this approach is obviously flawed, we can also appreciate how it may have held some value to patients who craved normality as promoted by the status quo and potentially for acceptance and recognition from society. However, the writer also makes another point which I think is comparable for analysis in the psychiatric attempt to ‘domesticate’ insanity. She points out that these asylums typically used the nuclear family model when treating patients, perhaps to replicate the experience of childhood to comfort patients through feelings of maternal/ paternal care. This argument can also face challenges, as it appropriates society, suggesting that any deviation from the nuclear family is disruptive and psychologically harmful. But personally, from a humanistic and biological perspective, I actually approve of this system, one that could potentially promote inner child healing and address the psychological effects of traumatic formative years in patients.
Earlier I mentioned how poverty played a significant role in contributing to the number of asylum patients, but really this book is trying to tell us that above all factors and considerations, most of these patients were women. ‘The rise of the Victorian Madwoman’ makes it profoundly clear to us - even the header itself suggests that women were quite literally driven insane. As the writer explains-‘In a society that not only perceived women as childlike, irrational and sexually unstable but also rendered them legally powerless and economically marginal, it is not surprising that they should have formed the greater part of the residual categories of deviance’. A gen-z would say that women were gaslighted into believing they were crazy, and we very much still are! Although our current society has developed in its attitudes, the way in which women are judged based on their sexuality has just evolved. Its demand and pressures imposed upon women are still very prevalent, but now they are more subtle and subconscious. Social media has heightened the ideals of femininity, and marketing, consumerism and corporatism still undermine women sexually and mentally. This book just highlights how sexism developed from one perspective-a psychological one.
However, we have liberties and choices that Victorian women could not have considered for themselves-we can access education. The Female Malady illustrates how the patriarchal systems almost set women up for mental illness through the restrictions imposed on their livelihood-‘Since their education provided them with so little of the self-discipline and inner resources psychiatrists deemed essential for the individual’s struggle against moral insanity, women were seen as poor mental risks’. Sexism is easy to understand generally, so one doesn’t need to refer to this book. However, it is easy to forget that historically, the segregation and degradation of a woman and her mental capacity have been connected to her body. Showalter reminds us that Victorian psychiatric care for women was based on the belief that the ‘instability of the female nervous and reproductive systems made women more vulnerable to derangement than men’. This meant that before a woman even attempted to put herself out there in the world, she was scientifically deemed inferior. We are reminded that their supposed psychological inferiority ‘was used as a reason to keep women out of the professions, to deny them political rights, and to keep them under male control in the family and the state.’ I think that piece of information really summarises how the Victorian woman rose to madness.
Much of this book refers to the biology of women and as modern readers we have a healthier understanding of the relationship between our hormones, menstrual cycles and the psychological phenomenons we feel that differentiate our mental experience to that of an assigned male at birth. Sometimes, it even feels empowering to bleed, especially when we can better track our cycle and appreciate the catharsis of menstruation. But in ‘Managing Women’s Minds’ we are informed that even Victorians understood the connection between a women’s cycle and her mind, except it was considered an issue where ‘the regulation of women’s cycles in Victorian psychiatry often seems like an effort to postpone or extirpate female sexuality’. This wasn’t just mythology but a medical theory, as quoted by a practitioner-‘Dr. Edward Tilt argued that menstruation was so disruptive to female brains that it should not be hastened but rather be retarded as long as possible’. The trans-generational effect and relevancy of this opinion can be accounted for today. My sexual education was devoid of any compassion and emotional consideration for the transitory experience of menstruation. It was taboo, shameful, embarrassing. Many girls hid their signs of puberty or prayed to delay the onset. It seems females have been conditioned for centuries to see menstruation as something problematic. Women of the past, and even still in the present, are not educated enough academically or socially about female anatomy and sexual pleasure. Our organs are often diminished to a monthly nuisance, a plague on our sanity, or a vessel for the duties of motherhood.
Womanhood and the connection between our psyche and body have long been wounded. In Victorian times where young girls were encouraged to ‘eliminate meat from the diets’ only reminds me of the widespread disordered eating, fad diets and body image issues that plague girlhood and womanhood today. We have been sold advice both socially and medically where the contradictions are endless, the limitations and rules ever-changing. This also applies to the fashion industry and the beauty standards we are upheld to but also scrutinised upon. It didn’t occur to me fully, until reading this book, how much a woman’s mentality is judged based upon appearance (or maybe I did) but was shocked to see it mentioned scientifically. This book narrates how it all started in these asylums where ‘female sanity was often judged according to their compliance with middle-class standards of fashion’. In Hanwell Asylum, the psychiatrist would commend and compliment women for their neatly groomed hair-almost as if an affirmation of external conformity was a sign of psychiatric improvement. It seems valuing a woman for her beauty goes so far as to clinically assess and treat her mental illness through the same means.
In lliterature, culture and the media a ‘mad woman’ has always been portrayed as unkept, but is it not half crazy in itself to expect women (or those who are unwilling) to spend hours of time grooming and styling themselves, especially if it wastes time that could be spent on more empowering and stimulating tasks of the heart, mind and soul? As the Victorian doctors contradict themselves in their prognosis of the many lunatic ladies they’ve taken into care, we also learn that ‘too much attention to dress and appearance was a sign of madness as well’. This also has relevancy to the current psychological state of women and their relationship with their appearances, self esteem and self-worth-the mental health effects are obvious. It isn’t surprising that this issue dates back to Victorian times. Women are already at their most vulnerable in psychiatric care, only to be degraded and reduced even more to the frivolity of their outward appearance, cuts to the core of feminism and the ‘crazy’ feminist who shaves their head or refuses to shave their armpits. The irony of all of this lies because they were supposedly inpatients for the ‘insanity’ of their brains, only to be treated for the socially constructed perception of insanity perceived in their appearance. Madness!
In ‘Nervous Women’, the writer revisits a lot of themes discussed previously, but talks more intimately about the experiences women had in their everyday lives and how social structures failed to support or value them beyond their maternal or matrimonial roles. The most extreme action taken in an attempt to subdue, control and marginalise women was, of course, the lobotomy. The reason that it was mainly women who were lobotomised seems quite obvious to the reader, but we are reminded that practitioners recommended these procedures because psychosurgeons considered that ‘the operation is potentially more effective with women because it is easier for them to assume or resume the role of a housewife’. It is heartbreaking to consider the women who were forced into this, or even worse, the women who entrusted themselves into the care of psychiatry in a hope of elevating their nervousness. Whilst some women truly put all their faith in their doctors (some still do), even Victorian women developed a scepticism and resistance to this male authority, as included from Alice James diary-‘I suppose one has a greater sense of intellectual degradation after an interview with a doctor than from any human experience’. Once again, the writer brings the point of view back to the modern-day reader, so many women will relate to this experience of feeling misunderstood, dismissed or reduced to a prescription or prognosis when sitting in a practitioner’s patient chair.
In the final chapter of ‘Women, Madness, and the Family’ we start to see some of the breakthroughs that began to circulate in psychiatry, mainly through the mention of Ronald David Laing. His understanding was that we would not progress in science, but especially practice because ‘the mad things said and done by the schizophrenic will remain a closed book if one does not understand their existential context’. This summarises the use of empathy and emotional intelligence to develop a wider scope of understanding and eventually statistical patterns to apply in treatment of patients. It is obvious throughout the book that the patient, the mental illness and the lunatic were reduced to their symptoms before their life experiences were ever truly considered. I now know what book I will add to my psychology reading list-‘The Divided Self’ is clearly a must read for people like myself, who wish to learn more about the history and development of theories and practice of psychology. Even the preface of Laing’s book sounds promising; its ‘basic principle is to make madness and the process of going mad, comprehensible’. Overall, I really did think The Female Malady was a valuable read on my quest for information about psychiatry, however it is definitely more historical than scientific, so I would keep this in mind for any assignments or specified reading recommendations.