Women and Madness – exploring women’s firsthand literary accounts and asking how the social context of gender impacts on the diagnosis of mental illness.
In this essay I discuss three pieces of writing by women, reflecting on their experiences of medical treatment. Dating from 1898 to 1999 they explore the concepts and realities of women diagnosed with mental illness. I will mostly focus on the content of the pieces although discuss the imagery and metaphor that is repeated in all.
The first piece “The yellow wallpaper” by Charlotte Perkins Gilman is a work of semi autobiographical fiction, the other pieces “Thorazine shuffle” by Allie Light and “The Looney Bin trap” by Kate Millet are autobiographical accounts of episodes of care. I will discuss themes that reoccur through all pieces and contrast the differences experiences to build a picture of mental health care for women throughout these times.
The yellow wall paper
Written in 1892 by Charlotte Perkins Gilman, “one of the most commanding feminists of her time” (Hedges 1973 :119) at a time it was rare for women to address sexual politics, Gilman makes the link between gender, insanity and patriarchy. Gilman was a prominent activist and writer on social reform including “Women and economics” (1898) – an analysis of the situation of women and a theoretical treatise that argued that women were “subjugated by men, that motherhood should not preclude a women from working outside the home” (Gilman 1898).
The yellow wallpaper is a short story written in epistolary style as a series of first person journal entries. The journal describes the narrator’s experience of isolation during a period of “rest cure” (Oppenheim 1991) for a “temporary nervous depression – a slight hysterical tendency” (Gilman : 33).
Hysteria from the Greek hysteron for uterus, was a female condition defined as relating to femininity and female sexuality – a once common mental diagnosis of the 19th century it is no longer used as a diagnostic category (Micale 1993). “Like all things feminine (hysteria) seemed elusive and enigmatic to a patriarchal medical profession and was resistant to male rationality” (Showalter 2007). A Neurologist and progressive thinker of the 19th century, Horatio Bryan Donkin, linked the complaint not just to females’ physicality but to her “social conditions”. Donkin also noted a high propensity for hysteria among unconventional women, namely writers and artist (Showalter :145.) In this period doctors linked female ambition to mental illness warning that “pursuits of new opportunities (in work and fulfilment) would lead to sickness, sterility and race suicide (Showalter :121).
The tale describes the narrators gradual decent to madness. A feminist stance can and should be read into the novel considering the author; the themes of restriction and confinement echo the experiences of women of this time. Throughout the tale the narrator acts as prisoner, but a prisoner of her husband’s patriarchy not her own madness. Her husband forbids her to exercise her imagination in any way (Gilman: 34, 35, 36). She rebels and, deprived of any other stimulation turns imagination on to neutral objects in an attempt to ignore her increasing frustrations (Gilman: 34). Her preoccupation with the paper begins at first with dislike of the pattern, building to her seeing the pattern as bars with a creeping skulking female figure behind (Gilman: 40). Her negativity colours all she describes, “I never saw a worse paper in all my life… (its sprawling pattern) committing every artistic sin”. The idea of sin is pertinent, as is her description of the papers colour as “repellent, unclean yellow” a “sickly sulphur” (Gilman:35). These themes of illness, un-cleanliness and unnaturalness echo ideas of blame and questions of morality with pervaded the culture at this time. She reflects John makes her angry (Gilman: 34), and attributes this to her condition. She speaks of the effort it takes to dress or entertain, she blames herself saying she wishes she could help John (to make her better). She reflects John doesn’t know how much she suffers, simply that he knows there is “no reason and that this satisfies him” (Gilman:35).
Our narrator is intelligent and educated, she knows a “little of design” (Gilman:39). Frustrated by her lack of intellectual stimulation (Gilman :36), she is excited by the paper – watching it gives her something to look forward to. John says she is getting better despite the paper (Gilman: 42) she doesn’t tell him she feels it’s because of the paper (Gilman: 43) for she fears he will take this away from it. This seems to suggest that life outside the room is equally if not more dull than it is now inside with her preoccupation. The more the wallpaper occupies her, the more reality retreats. Her dissociation begins as she starts to hide her true feelings from the real world.
Gilman was sent home after a month of rest treatment with instruction “never touch a pen, brush or pencil as long as you live” (Knight: 323). We see this element to the cure in John’s insistence that she doesn’t write. We see also the prevailing theory of the time in Jennie “…a perfect and enthusiastic housekeeper, and hopes for no better profession…she thinks it is the writing which makes me sick!” (Gilman: 37).
The idea of writing as therapy the narrator offers “I think only if I was well enough to write a little it would relieve the press of ideas and rest me” (Gilman: 36) opposes prevailing medical belief that linked female ambition to mental illness (Showalter :121).
At this time psychiatrists were concerned with a moral cure for hysteria. Victorian Psychiatrist Henry Maudsley said “there is sex in mind as distinctly as there is sex in body”. The pervading thought at this time was that Mental illness would come if women tried to defy their “nature” and try to act as equal to men in society rather than as companions. Dr Edward C. Mann wrote in a medical journal in 1980 “The mental condition of women with hysteria is somewhat peculiar. The patient, when the hysterical feelings come upon her, does not feel disposed to make the slightest effort to resist them, and yields to her emotions, whatever they may be…she cares nothing for her duties and seemingly takes pleasure in exaggerating all her slight discomforts and annoyances, and be her suspicious exacting and unreasonable behaviour makes life generally uncomfortable to those about her.”(Shannonhouse: XIII).
Through illness the narrator is absolved of her obligations but as punishment or moral reminder of her duties she is placed in the nursery. Here, with little other stimulation, she becomes fixated on the wallpaper beginning with dislike for its appearance, moving from identifying secret meaning it its pattern to being excited by its hidden world. Considering Gilman’s feminist ideals, her experiences of mental illness and her understanding of the cause of this, as well as her experience of receiving the “rest cure” we can read the creeping woman (Gilman:40) in the paper as allegory for woman’s place in society. The bars she sees in the paper (Gilman: 42) being representative of the constraints of society and marriage (Gilman 1935:5)
The narrators husband John – also her physician – treats her not as his wife but as patient and as child; we see this in his language to her “blessed little goose” (Gilman: 36) “What is it little girl…Bless her little heart!…she shall be as sick as she pleases!” (Gilman: 37). Of all the rooms in the house it is the former nursery she is confined to despite her protests. The narrator speaks early on status of their marriage, immediately seeking to place this in context of social norm “John laughs at me of course, but one expects that in marriage” (Gilman :32). The narrator suggests that John as physician is the reason she does not make a quick recovery (Gilman: 33). In this way both author and narrator demonstrate insight to female mental illness and to the role that both patriarchy and medicine play. Today a prominent part of the treatment of the mentally ill is socialisation and integration with daily activities not isolation.
Gilman shows us the separation of the narrators’ consciousness in her secret journal as the story moves gradually towards climax, from the first mention of the wall paper until it builds to consume her thoughts and writing. Through her sickness the narrator is relinquished of her own parental and marital responsibilities. “Mary is so good with the baby. Such a dear baby! And yet I cannot be with him, it makes me so nervous.”(Gilman:35). The narrator struggles to not creep and to maintain her independence and autonomy, however the weight of guilt she experiences at neglecting her moral obligations as “he said I was letting it get the better of me and that nothing was worse for a nervous patient than to give way to such fancies” (Gilman: 35) coupled with the punishment of isolation slowly drives her mad. Gilman herself accredited her illness to marriage and motherhood (Gilman 1935).
We can read the narrators madness as a choice, she chooses madness over returning to her obligation but in this choice we can hear Gilman’s critique of women’s’ options at this time -Madness or compliance. In her autobiography Gilman says she sent a copy to Weir Mitchell, who chose not to comment she later learned however that he had revised his treatment (Gilman 1935).
Written in 1999 Light reflects on her treatment in a mental institution 1963, she says “I was twenty seven when I began having the blues, not feeling in control of my life. I needed help with my children. I was afraid I didn’t know how to be a mother”. The theme of motherhood, and expected role are echoed here from the previous piece as is the authors fixations with descriptions of light “the particular slant of the light…the quality of late afternoon light…refracted on walls” (Light: 168) we can compare this to the narrator in The Yellow Wallpaper preoccupations with light “you can only see it in certain lights” (Gilman: 38) “when the cross light fades and the low sun shines directly” (Gilman: 39). “I watch for that first long, straight ray” (Gilman: 42). Also, her desire to set her belongings on fire (Light: 168) is again echoed in yellow wallpaper “I thought seriously of burning the house” (Gilman: 44).
Light like Gilman, tells how in illness her morality is called into question. She describes how her first meeting with her male psychiatrist involves her naked in a gown on a bed and him asking her questions of a sexual nature “do you like kissing your husband’s penis?” (:169) She reflects there was no right answer to this question, both called her nature into repute, either “frigid or a whore” (Light: 169). She describes her embarrassment and her shame. Here we see that a woman questioning her place in patriarchal systems is still a consideration in diagnosing female mental illness.
Within the ward itself Light describes a war, between the depressives and the manic patients “two battling armies” (169). She describes the sphere of influence within the Hospital as feudal system; the choice of language paints a vivid picture. “Langley Porter was a serfdom. Doctors came as trainees and we became their property…even as these potentates profited from the shambles of our lives we trusted them” (171). The language shows the divide between practitioner and patient and the authority of the former. “Potentates profited” – the power relationship is reinforced by the alliteration and the choice of words; Potentates – people with power and authority -who don’t simple make a living but profit from their patients. The word serfdom creates an image of the hospital as farm with patients as dumb animals to be worked and sold.
“I was given to Dr. Schwartz” (171), again the passivity is shown in the language, given to not assign to. The author uses the language of child or victim, a supplicant powerless to affect change. “if I behaved myself I could sleep at home”.(171) “Our contract began with the removal of clothes”(171). The use of “contract” suggests a business transaction; the passivity of the statement seems to reflect a blunting of emotion in the face of the oppressive environment.
The imagery has a sexualised overtone. “I had entered a kindergarten of managed play…the physical therapist pressed upon us the need to practice looking beautiful” again the merging of ideas of childlike helplessness and adult sexuality. “With our uncombed hair and unfocused vision, we sleep walked the corridors with books on our heads to improve out posture”. The idea that this is a legitimate treatment feels preposterous in light of modern treatment.
Themes of gender, responsibility and obligation of the earlier piece are echoed here. Even in chaos the obligation to be thought beautiful and to work towards this goal. “There is no way a patient, using her own words, can logically convince a doctor that she knows something about her person. He has to see for himself and then, if the patient doesn’t die, she might have won her point.” The helplessness is overwhelming. The author says “patient” but her use of “her own words…her point” add to the argument that it is woman as patient, female as supplicant to male – the social norm in a patriarchal society which psychiatry still was at this time. “He said I would feel better if I looked at him… I obeyed Dr Schwartz. I wanted to be a good girl…so I would do whatever that entailed…I often told Dr Schwartz that I needed something in my life…Something of my own…I wanted to go to school…his reply was “if you can’t stay home and look after your children, then get a job. Don’t waste everyone’s time by going to college”. Experienced 64 years after the writing of Yellow Wallpaper the idea as female as equal and deserving of education and experience is still seen as dismissible.
The loony-bin trip
In Millet’s account her first description a treatment and of oppression comes from a woman “tonight big nurse found me out…her instinct grabbed for me…and found the pill still in my cheek. I could confront or swallow. I decided to confront” (Millet :98). Hers is the most recent account of admission and her opponent female, perhaps this is what leads her to confront her treatment openly, unlike her counterparts. Her opposition is no good however, she is medicated. Here again we see women as powerless “Ann’s husband put her here, Mary’s in-laws, Margaret’s own mother” (100) although this time other women are complaisant in this forced incarceration and treatment. A female nurse “…who treat us as defective children…more like convicted felons” (99) administers medication. Millet talks of “being in the hard lock of Dr.Strong forever” (103).
The patriarchy she feels suppresses her is religious “You are in the hands of the church you ran away from…despite the presence of state it is Rome that has you prisoner…you little American freedom fighter business quite over, women’s lib and other notions crunched like cellophane” ( 103). “Joan of Arc, a heretic. Every night I will be tortured thus…they will inoculate me with this horror…our great sad room of waking women, each a prisoner of her mind and body.” (104).
Millet born 1934 is an American feminist writer and activist. Best known for her 1970 book “Sexual Politics”, she won a trial to prove her sanity and changed the state of Minnesota commitment law (Time 1970). Although in this age, 1970 women fight against their oppression “After a certain time many victims collapse and agree to be crazy; they surrender.” (Millet: 100). This new treatment environment is as toxic as the rest cure Millet describes it as “an irrational deprivation of every human need” asking if the cure for madness is fear and if the fear of being a captive might motivate recovery (101).
Sleep is a reoccurring theme of all three pieces. Gilman’s physician wants the protagonist to get more of it, Light describes how “I was put to sleep” (Light:169) Millet recounts “I won’t need anything to sleep. No, really. No. And the needle jabs your rear like an insult and the white stupor comes over”(Millet :102).
Both light and Millet describe how “a mental patient was not allowed to refuse medication. We were warned to take it orally or it will be injected” (Light: 172). This theme of women as defective or broken, for arguing with oppression and wanting different experiences from their lives reoccurs though all three accounts. Hard to fathom treatments with illogical cures acting to reprogram women to “behave” by fear and boredom appears in all, As the ideas of childlike powerlessness and of being property are also repeated.“there have always been those who argue women’s high rate of mental disorder is a product of their social situations, their confining roles as daughters, wives and mothers and their mistreatment by a male dominated and possibly misogynistic psychiatric profession” (Showalter:3).
Depression and anxiety are twice as prevalent in women as in men (Busfield 1996) and inequalities of gender create dependence and powerlessness in women. Because relationships between patients and staff reflect those in society the work force is often blind to inequality (DH 2002) and this is clearly highlighted in the suffocating treatment all three women experience. “There are differences in the family and social context of women’s and men’s lives…mental health care must be responsive to these differences” (Jacqui Smith, minister of mental health; department of health 2002).
Light tells us she comes from a line of depressives, passed down through the female line and again reiterates the connections between motherhood and depression. Light reflects on the history of depression on the female side of her family “My grandmother gave birth to nine children…her despair at perpetual pregnancy was contagious…My mother was a small girl when her mother tried to hang herself from the kitchen rafters. Pregnant again”.
Her mother’s favourite bed time story was about a little girl afraid of being stolen from her bed, the mother promises the girl will be safe but the girl is still stolen. The learned helplessness in their situations is passed down with each generation. The author reflects that all the stories her mother told her were about the consequences of looking, Blue beards wife looks it the locked room and seals her fate to join the dead wives there. Psyche looks at her lover after being bidden to love in the dark and loses him to death. In reality they are all about the consequences of defying patriarchal dictate.
Gilman , writing at a time when it was uncommon for women to have a voice, as an active feminist who divorced she still had to adhere to the confines of her society, her story then is a cautionary tale against women’s madness, its roots and its treatments.
In all accounts relatives exist as diminished characters over powered by the protagonists madness, this overpowering seems to be a release from the pressures and constraints all three women feel in their lives.
Busfield,J., 1996 Men, Women and Madness – Understanding Gender and mental disorder. London :Macmillian Press Ltd
Chesler, P., 1997. (3rd ed) Women and madness. New York: Fall Walls Eight Windows
Department of health (2002) Womens mental health : into the mainstream accessed at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4075487.pdf On 31/3/11
Hedges. E,R., 1973 Afterword. The Yellow Wallpaper. New York: The Feminist Press
Knight, D,D,. 1994 The Diaries of Charlotte Perkins Gilman. Charlottesville: University Press of Virginia
Light, A., 1999 “Thorazine Shuffle” in Shannonhouse, R,.ed. (2000) Out of her Mind: Women Writing on Madness: New York: The Modern Library
Micale, M.S., 1993 On the “Disappearance” of hysteria: A Study in the Clinical Deconstruction of Diagnosis .The history of Science Society. ISIS. 84:496-526
Millet, K., 1990 The Loony-Bin Trip in Shannonhouse, R,.ed. (2000) Out of her Mind: Women Writing on Madness: New York: The Modern Library
Oppenheim, J,. 1991 Shattered Nerves: Doctors, Patients and Depression in Victorian England. Oxford: Oxford University Press
Perkins Gilman, C., 1891 The Yellow Wallpaper.in Shannonhouse, R,.ed. (2000) Out of her Mind: Women Writing on Madness: New York: The Modern Library
Perkins Gilman, C., 1898 Women and economics. New York: Cosmobooks
Perkins Gilman, C.,1935 The Living of Charlotte Perkins Gilman: An Autobiography. (3rd Ed) London: The University of Wisconsin Press
Shannonhouse. R. (ed) ,2000 Out of her Mind : women writing on madness. New York: The Modern Library.
Showalter, E., 2007 The Female Malady- Women, Madness and English Culture 1830- 1980. London: Virago Press
Time magazine, 1970 The liberation of Kate Millet. Accessed on 31.3.11 @ http://www.time.com/time/magazine/article/0,9171,876784-1,00.html
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