Book Review : Mental Illness Among Women Probed

The Female Malady by Elaine Showalter (Pantheon Books: $19.95)

After gracefully acknowledging her debt to professional colleagues who have previously written on this provocative theme, Showalter both broadens and narrows the field. Though her hourglass approach owes a great deal to Chesler’s 1972 book, “Women and Madness,” Showalter not only turns her attention beyond America to England, but also extends the fictional metaphors used by Gilbert and Guber in their close examination of Victorian images in “The Madwoman in the Attic.” Limiting herself to the years between 1830 and 1980, Showalter investigates biography, letters, and the fine and lively arts as well as actual case histories, creating a concise history of psychiatry from a feminist standpoint.

The author has marshaled an impressive body of evidence to show that madness was generally regarded as a female malady throughout the 19th Century. Only after World War I produced about 80,000 cases of male hysteria were physicians forced to recognize that men were equally vulnerable to mental breakdown, a discovery with less effect upon modern psychological therapy than might have been expected. Though the majority of these casualties were nowhere near exploding shells at the time of their collapse, the misnomer “shellshock” persisted, partly because it implied an external cause, while “hysteria” referred explicitly to the womb.

Still clinging to cherished notions of gender differences, psychiatrists were reluctant to confront the fact that symptoms of the condition were essentially the same for men and women. Though that war and subsequent ones shock entrenched beliefs about mental illness, Showalter chillingly demonstrates the astonishing durability of the idea that women are more liable to mental disorders than men, a theory apparently reinforced by statistics. Like her feminist predecessors, she finds women’s high rate of mental illness partly traceable to “confining roles as daughters, wives and mothers, and their mistreatment by male-dominated and possibly misogynistic professions,” but she attaches considerably more weight to a “dualistic system of language and representation,” equaling women with “irrationality, science, nature and body,” while men are assumed to monopolize “reason, discourse, culture and mind.”

Showalter is convinced these lingering divisions have become a self-fulfilling prophecy, a vicious cycle in which identical behavior may be defined as “mad” when exhibited by women, “sane” when demonstrated by men. Though the author seldom draws upon politics for her illustrations, even more persuasive arguments for her point of view can be found in recent history, which abounds with examples of male megalomaniacs elevated to positions of authority while women with milder symptoms were incarcerated, drugged, and lobotomized.

Avoiding the obvious, Showalter has assembled an extraordinary bill of particulars from the annals of art, literature and psychiatry. She cites the tradition of physicians illustrating their case studies exclusively with drawings and photographs of female patients; supporting her case with scores of references to the preponderance of madwomen as characters in novels, plays, operas and films; pernicious stereotypes reinforcing the notion that insanity is the exclusive province of women. A detailed section shows how the actual architectural plans of asylums and the treatment offered to inmates was explicitly designed to infantalize women and reduce them to helpless dependency in the name of mercy.

A Curious Reversal

Though images of madness were traditionally male until the middle of the 18th Century, Showalter finds “the appealing madwoman thereafter displacing the repulsive madman both as a prototype of the confined lunatic and a cultural icon,” a curious reversal that did, however, have a faintly brighter side. When shocking revelations were published showing the brutal treatment of women in madhouses, public sympathy forced radical--if not always beneficial--changes. In the Victorian era, the “correlation between madness and the wrongs of women became one of the chief fictional conventions of the age,” quickly adopted by novelists who romanticized the fate of a troublesome wife, daughter or ward unjustly committed or locked up in secret with a cruel keeper; the phenomenon investigated by Gilbert and Guber.

Carefully reasoned and thoroughly documented, “The Female Malady” is most compelling when concentrating upon the development of psychiatry as a new field of inquiry at the same time that women were beginning to challenge the most profound beliefs about their destiny and their sphere. The author provides succinct portraits of psychiatry’s revolutionaries and rebels, who in turn influenced the social philosophers of their times. The ironic and often tragic conflicts caused when these parallel movements collided are the soul of Showalter’s book, giving it a value far beyond the limits suggested by her stated “feminist perspective.”