Hysterical, Lesbian and Disobedient: The weird history of gendered psychiatry

Psychiatric treatment for women illustrates the importance of including cultural context in medical treatment

There are some views that will make all medical anthropologists grit their teeth. Nothing more so, perhaps, that western, science-based medicine has absolutely no association or vectored-influence with culture or society. Ha.

Ladies and gentlemen, I introduce to you, for your very own pleasure, the history of female psychiatric care in the flawlessly scientific, sensible and logical west.

Cruelty, voyeurism, ridicule and misogyny: not what you want from a doctor

Helen Beaumont is 28. She’s incredibly bright, working late into the night on mathematical equations and physics theories. Eccentric, yes. Unusual, certainly. But mad? Actually, this is enough for Helen to be forcibly sectioned under the all-male ‘science’ of psychiatric care in 1870.

Yes, ‘obsessive’ behaviour with ‘unnaturally male’ academic areas was considered a mental disorder. Why? Because, obviously, a woman’s healthy brain state is a soft interest in embroidery, having babies and making scrapbooks. Any keen interest (over education) in a serious subject showed unbalance. Even Emily Bronte was accused of being mentally ill for writing a dark book about abusive romances, instead of the usual scones and handsome clerks.

Similarly, if you weren’t interested in marriage, or, worst still, exhibited a disdain towards the idea, that was a sectioning offence too. Yes, if you showed a fear or dislike towards a husband and children, you were mentally unhinged. Clearly, your adversity to the warm bosom of a man and the delight of motherhood showed your unbalanced mentality.

Or, even worse, are you lesbian? Were you caught with a shopgirl at Regent’s Park? While not illegal, you could be expect to be labelled as insane and carted off to the asylum if your family wanted to limit the embarrassment of having a homosexual in the family. Obviously, as women cannot reproduce together, you must be unbalanced.

What every woman dreams of: an all male doctor team with chauvinistic views

Maybe you are unhappy or shut off in your isolated, drab existence, battling an alcoholic abusive husband and endless childbirth. Well, clearly you are suffering from a disorder! Women should, in a healthy normal state, look pretty and smile at all times. Instead of challenging conventions on a woman having to stay at home all day, unemployed and in a violent marriage, better that your frustrated husband gets you locked up for twenty years where you are less of a nuisance. You are the problem. Not the system.

Luna, Lunatic, and Lunacy. Women are, by nature, delicate and easily influenced by their cycles and natural instability. The word hysteria actually comes from the greek word for womb. Science.

Are you seeing a pattern?

Yes. Society, and your family, could get rid of difficult women who didn’t fit into their rigid rules by having them locked up as insane.

And having an all male -100%- researcher, clinician, pharmacist, diagnostic team only inflamed what men saw as ‘abnormality’ as opposed to what today we would acknowledge as normal psychiatric and behavioural traits. If I’ve never thought that a woman could be intelligent, independent and happily unmarried or gay, then I’m going to view these as fringe, dangerous abnormalities.

And the treatments were horrifying.

A lobotomy being performed on a female patient

You could be forced to take mercury (causes organ failure, muscle weakening, anxiety, memory problems, emotional instability, numbness and pain) to supposedly treat supposed venereal mental disorders. You would be overdosed on opium or early forms of methadone and mescaline to make it easier for staff to look after you. Later on, in the 1930s and 40s, you’d be forced to take hallucinogenic drugs that could often inflame traumatic, terrifying experiences and memories. Mentally ill women, and those considered mentally ill, were used as guinea pigs with very little consent or kindness.

Women were locked up in mass wards, some with hundreds of patients, of varying levels of disorder. They reported being attacked, screamed at or followed by dangerous inmates. You’d be locked in at night while people suffered epileptic attacks, anxiety disorders, night terrors and schizophrenic episodes all around you. How that was supposed to cure stress, anxiety and trauma is completely bizarre. The conditions were often filthy, with staff being abusive towards patients. Many vulnerable women were raped by senior officials or important visitors, many more beaten and assaulted by sadistic staff.

Sadly, many thousands of women died in asylums around the world, drug addicted, alone, frightened and unloved, some for things as small as being disobedient towards their husbands.

What am I getting at?

Science, particularly behavioural sciences such as psychiatry, psychology and behaviourism, does not exist outside the human world. What we believe to be normal, what we socialise as illness or a disorder, who we treat, for what purpose and of course, how society chooses to use our services all impact how treatment is delivered.

It is vital, essential, that we do not believe ourselves to be above human error, beyond cultural and social understandings, and separate from the complex, messy world of greed, bias and belief. Not only should we involve culture and society in our work, but we should actively analyse it to uncover our own faults. Ignoring it completely is just another confirmation bias.

If I tell you that 28 women have postnatal depression out of the 100 mothers on a ward, that is a statistic. That’s only a fifth of what is actually happening. A good scientist doesn’t ask what: they ask why, where, how, when, who.

Stop seeing science as a factual absolute. It isn’t.