Please Note: The following article refers to sexual violence, domestic violence, trauma, self-harm, and rape.
In the early 2000s, a popular Youtube video titled Hot Crazy Matrix A Man’s Guide to Women garnered millions of views worldwide. I first encountered this video in grade school, finding that the boys in my classes were drawn to the simplicity and conciseness of the concepts. The video delineates between an acceptable woman and one deemed ‘crazy.’
The more attractive the woman, the higher the likelihood of being “crazy.” In this way, women are labelled and categorized depending on their potential benefits to men. If a woman is “too crazy,” she is bound to create relationship problems. However, such relationship problems are primarily a man’s problem, his headache to bear. Men are, thus, reinforced as the “caretakers and keepers” of women and their level of ‘craziness.’ So what does it mean to be a woman who is “crazy”?
Normalization of ‘Crazy’ Women
Women such as Britney Spears are assumed to be damaged, ill, and ultimately crazy. In 2008, Spears shocked the world by shaving her head and going on an unfortunately all-too-public bender. Despite patterns of domestic and relationship abuses, Spears was deemed ‘crazy’ for succumbing to stress during her meltdown. All too often for women is that a rational, logical reaction to prolonged abuse, anxiety, and trauma is intentionally pathologized.
Pathologizing refers to the medicalization and medication of actions, coping mechanisms, and reactions. The process of medicalizing women’s rational emotions is not a new phenomenon. It predates what we know now as “mental health” or “mental illness.” For instance, in the mid to late 1800s, women were placed in asylums for being too tired, assertive, interested in politics, and not interested in sex. In this way, women were successfully deemed “insane” and “crazy” for failing to submit to female gender stereotypes and norms.
What About “Mental Health?”
Increasingly as women speak out against physical, sexual, and emotional abuse, they are met with a diagnosis and a prescription. Borderline personality disorder, battered woman syndrome, and emotionally unstable personality disorder are only a few examples of syndromes and disorders designed to medicalize women’s responses to abuse and trauma. Unfortunately, what emerges from a medical system that treats abused women as “mentally ill” is pharmaceutical companies’ increased pharmaceutical profits and female submission.
While women have concerns about antidepressants, birth control, and other pills designed to control them, little attention is given to such matters. Moreover, women who share their trauma and experiences of abuse with a medical practitioner are more likely to receive a prescription for a “mental illness.” Notably, Dr. Taylor, a UK-based psychologist who explores the issue in her book Sexy but Psycho, notes that girls under 18 receive the highest chemical restraints of all age groups and genders.
Racialized Women and Sexual Minorities
Antipsychotic drugs, sedatives, and tranquillizers are utilized to restrain women and enforce a medical submission practice. In this way, the medical model of “mental illness” and, in turn, “mental health” are tools of oppression against women and sexual minorities. As recently as 1973, homosexuality was classified as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Later, the DSM used terms such as “sexual orientation disturbance” to label possible symptoms of a mental illness.
Moreover, racialized women and sexual minorities are more likely to be diagnosed with a “mental illness,” alluding to racially motivated stereotypes. Assumptions, for instance, that Black women are “angry, mouthy, and bitchy” attempt to reduce the emotions of Black women. Further, little attention is paid to the daily stressors impacting racialized women and sexual minorities. Passive and explicit racism, xenophobia, homophobia, and other forms of oppression and discrimination are neglected in the medical model of “mental illness.”
Consequently, a medical model of “mental illness” perpetuates the victim-blaming of women and girls. Over the last decade, “mental health” has been caused by imbalances of fluids in the body and brain. Such explanations are standard and delivered in speech-like efficiency by practitioners. Take a moment and ask yourself, what tests did you complete for your physician to reach such a conclusion?
Well, Here Are Some Pills!
For one moment – imagine you are going to see your doctor because you have been feeling uneasy, depressed, anxious, and overwhelmingly ashamed. At many points in my life, I sought medical help for such symptoms. Time after time, I encountered the same response: Well, you have a chemical imbalance in your brain that needs to be corrected with [insert drug of choice], which will allow you to stabilize before seeing a therapist or psychiatrist.”
At this point, I explicitly asked the doctor which test I completed for them to conclude I have a chronic chemical imbalance in my brain, requiring a lifelong dependency on antidepressants or other forms of psychiatric medication. What shocked me was that my question was a symptom. As I asked the doctor this question, her eyes glazed over, and she began typing on her keyboard. While I cannot imagine the words typed, it is no surprise that a patient who seems resistant to diagnosis is, in fact, even more mentally ill than she was previously.
Gatekeeping Counselling and Trauma-Informed Services
Of all the problematic statements made by medical practitioners, the one that stood out to me the most was that medication was a requirement to access therapists and other trauma-informed services. Despite sharing trauma and violence experiences with a medical practitioner, there is little a doctor can do to provide social and emotional support. However, is it ethical to require someone to remain medicated to receive trauma-informed support?
Factors such as low self-esteem, being sexually promiscuous, being perceived as frigid, or being too outspoken often section off women and sexual minorities into particular “mental disorders.” For instance, being sexually promiscuous may be perceived by a medical practitioner as acting impulsively, leading to the assumption of Borderline Personality Disorder. Likewise, even being perceived as frigid could lead a doctor to think you are reluctant to make connections with others, leading to a diagnosis of Avoidant Personality Disorder.
Psychiatric diagnosis has become the gatekeeper of therapeutic services. Many practitioners are told that the best thing you can do for the girl is to get her the diagnoses she ‘needs’ so they can access funding, support or services. Such ethically ambiguous collaborations are commonplace in psychiatry and mainly impact women and sexual minorities.
Not only does a diagnosis of “mental illness” follow you for the rest of your life, but it remains an essential variable for assessing allegations of sexual assault and rape. For instance, if you report a sexual assault or rape and successfully file a case against the perpetrator, a diagnosis of “mental illness” can impact the defendant’s case. In this way, women are victim-blamed and shoe-horned into a medicalized assumption of their mental capacities.
Well, She Should Have Acted Right
She asked for it. She was flirting. She was drinking. She was wearing a revealing dress. She was too confident. She walked home alone. She stayed in that relationship. She was naïve. She didn’t report soon enough. She didn’t fight back. She wanted it. She lied about it. She comes from a bad area. She was vulnerable. She should have known. She should have seen it coming. She should have protected herself.
– Dr. Jessica Taylor, in Why Women are Blaming for Everything
The medical model of psychiatry and “mental health” come full circle and fall in-line with the Hot Crazy Matrix. Although the terms illness and health are used today, they allude to the same vision of ‘crazy’ that labels and categorizes women. Ultimately, the onus is on women to act right and behave as they should, irrespective of their circumstances, class, race, ethnicity, gender, and sexuality.
Such critiques of modern “mental health” narratives are often reduced to speculation or woman-fueled discontent with the current system. Irrespective of the origins of these narratives, there is no situation in which silencing the valid concerns of women is appropriate. Therefore, arguments against a medical model of psychiatry are necessary to instil trauma-informed approaches to mental wellbeing.
Trauma-informed refers to a focus on the social and environmental implications of an individual, instead of assuming a chronic chemical imbalance in the brain and prescribing medication. A trauma-informed approach primarily concerns a strengths-based, non-pathologizing, and non-victim-blaming approach based on the social model of mental wellbeing. In this way, the experiences of violence, trauma, and abuses perpetrated against women and sexual minorities are the catalysts of poor coping mechanisms and trauma responses.
For instance, a woman may self-harm due to repeated inflictions of sexual and physical violence. In such cases, there is no chronic chemical imbalance in the brain that suddenly appeared, instead, the experience is a trauma-response in which the woman feels calmer when self-inflicting abuses have already been inflicted on her previously. This is just one example of why an individual would self-harm. It is important to note that every individual will have a different answer, different reasons, and different sensations when self-harming.
Are You Even A Doctor?
Although this article references many different streams of the medical profession and the medicalization of mental differences, I am not a doctor or psychologist. However, I would like to make one final remark on the variability of mental difference and its impacts on women and sexual minorities.
Picture this: You have a broken leg – what happens when you go to the doctor? When receiving care for a broken leg, anywhere you go worldwide, you will be treated in the same way. Every doctor will know how to treat a broken leg and act accordingly.
Now, picture this: You’re feeling down, constantly, and are experiencing fatigue and a lack of interest in hobbies and activities you previously enjoyed – what happens when you go to a doctor? A million responses could fill this response. For example, suppose you go to India and present with depression. In that case, you will be treated differently than you would be in the UK, Canada, Ghana, Nigeria, Zambia, and Haiti – the list continues.
Little consideration is given to the variability of “mental health” and how different cultures treat the supposed “chemical imbalances” assumed by Western doctors. I challenge you to think differently about the modern wave of “mental health” acceptance and ask yourself, is the “mental health” movement normalizing mental difference, or the medicalization of mental difference? Having such conversations can broaden your understanding of psychiatry and the reasons why you or someone you know are being diagnosed with “mental illness.”
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