By Hannah Ahmed
Throughout the twentieth century we see the emergence of psychiatry as a branch of medicine and care. While a huge amount of progress has been made within the discipline with confronting biases within psychological theory and the implications this has on treatment, its foundations remain problematic. Linked to early ideas about biology and influenced by social gender norms, psychiatry developed as an inherently misogynistic practice. Whilst in recent years these biases have been confronted and attempts have been made to prevent any discrimination, we cannot ignore the harmful implications of these biases in the past.
The proliferation of women’s and feminist history in the 1970s-90s has brought to light the issues within psychiatry and psychological theory that pathologizes femininity therefore inevitably promoting the patriarchy. Nancy Tomes highlights the social construction of disease and how psychiatry was used a mode of social control. Late 19th and early 20th century scientific research and explanations ignored differences between men and women due to the lack of female participants in medical research. Western language is embedded in binaries and we tend to apply these to our understanding of pretty much everything. In this case the main binaries that are used in psychiatry are reason and madness, male and female, mind and body. When the male body and behaviour is considered the norm for all people, female differences are labelled abnormal, negative or weak. These concepts are seen throughout 20th century psychiatry.
When it comes to explaining women’s mental illness the language used implies the reasons for illness are trivial compared to men. Women’s disorders are suggested to be emotional and without legitimate reason. When it comes to men, explanations for anxiety and depression revolve around work-related stress and having to provide for their families, whereas for women, reasons go unexplained. Instead they are presented as being overly-emotional, irritating and provocative. In the 70s and 80s benzodiazepines were developed and were essentially prescribed for all mental problems to get women to put up with their unhappiness, rather than actually taking the time to solve their issues individually.
In the 1940s, Freudian ideas were used to justify domestic femininity and to keep women in these roles ambition or career goals was perceived as a rejection of femininity and therefore a mental illness. This constructed the idea that women could be a threat to the stability of society where the men have the authority, thus demonstrating how psychiatry could be used to diagnose or treat women for reasons of social control. These ideas a presented in drug adverts such as the one below; depicting a woman imprisoned by domestic items. The tagline ‘you can’t set her free’ demonstrated the fixed nature of gender roles, suggesting that women have to come to terms with their domestic role and if they can’t or don’t want to they can be cured with medication.
It is important to note that advertisements for anti-psychotic drugs were not published to the general public but just to doctors and people within the medical profession. This does raise the question of whether doctors were influenced by these adverts in their diagnoses and treatment. When we look at prescription trends we can see that women are consistently prescribed medication more than men. In Jayasree Kalathil’s study on Drug advertisements he found SSRI prescriptions to women outnumbered men 3:1, Miltown and minor tranquilisers were prescribed to middle-class white women more than any other group, for instance Valium was prescribe to women 7:1 compared to men. The irony is that drugs were meant to remove gender bias from treating and explaining mental illness. Drugs were meant to represent a step towards neurological and chemical explanations and treatments, yet because of the way they were administered to women they became gendered.
Patriarchal ideals are embedded in the foundations of psychiatry, however acknowledging and raising awareness of the harm this can have helps confront problematic aspects of the discipline. Thanks to feminist psychiatry, women are given more agency to avoid the power imbalance of a doctor-patient relationship that can be exploited and result in abuses of power. This demonstrates why we need feminist perspectives, to confront these issues and make changes to ensure women are not subject to injustices.
Jonathan M, Metzl ‘“Mother’s Little Helper”: The Crisis of Psychoanalysis and the Miltown Resolution’ Gender & History 15.2 (2003)
Jonathan M. Metzl & Joni Angel ‘Assessing the impact of SSRI antidepressants on popular notions of women’s depressive illness’ Social Science and Medicine 58 (2004): 577-584
Jayasree Kalathil, ‘Ideological Reproduction of Gender and Normality in Psychiatric Drug Advertisements’ in Bhargavi V. Davar and T. K. Sundari Ravindran (eds) Gendering Mental Health: Knowledges, Identities, and Institutions Oxford University Press (2015)
Nancy Tomes ‘Feminist Histories of Psychiatry’ in Mark Micale and Roy Porter (eds) Discovering the History of Psychiatry (London, 1994)
Serax advertisement, 1967. JAMA: The Journal of the American Medical Association, Vol. 200, No. 8, pp. 206-207