Her-say: Women’s Mental Health

Women and girls have repeatedly been told that their normal responses and coping mechanisms to abuse and trauma are abnormal and disordered. Trauma responses are pathologised by the medical model and women are diagnosed with mental illnesses. Between 1450 and 1750 up to 100,000 women were murdered during witch-hunts throughout the British Isles and Europe; these women were often, ill, disabled, non-conforming, opinionated, intelligent and/or were suffering from abuse and trauma. Misogynistic modern-day witch hunts continue throughout the world in India, Papua New Guinea, Amazonia, and Africa. The same women in the 19th and 20th centuries were hysteric; hysteria is a Greek word meaning womb or uterus. Originally hysteria was a medical condition named the wandering womb syndrome and there was a belief that the uterus could move around the body causing mental health issues. The female disease appeared in the Diagnostic and Statistical Manual of Mental Disorders (DSM) II in 1968. In 1896, Sigmund Freud presented his paper The Aetiology of Hysteria and concluded that child sexual abuse was the cause of his client’s distress and therefore their diagnosis of hysteria. This was met with disapproval and Freud abandoned his theory and developed the Oedipus Complex which theorised that instead of children being abused they were experiencing an abuse fantasy. This reinforced the idea that mental illness is random without cause and a collective collusive silence which perpetuated child sexual abuse. Society's response to child sexual abuse is failing because policies are rooted in mythological and historical theories resulting from Freud. In the 20th and 21st century the hysterical woman is now described as borderline. Hysteria was removed from the DSM-III and Borderline Personality Disorder (BPD) added. The diagnostic criteria for hysteria in DSM-II and BPD in DSM-V are similar and in 2019 women and girls were 7 times more likely than men to be diagnosed with BPD, even in similar presentation. Despite The National Institute for Health and Care Excellence's guidelines stating that children under 18 should not be diagnosed with personality disorders BPD is usually first diagnosed in adolescence. The symptoms of BPD echo disorganised and insecure attachment and it is common in girls in locked after care services and girls who have disclosed abuse. From witch hunts to hysteria to BPD, women have been silenced, pathologised and medicated for centuries.

References

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AMERICAN PSYCHIATRIC ASSOCIATION., 1980. Diagnostic and Statistical Manual of Mental Disorders (online). 3rd ed. Washington, USA: American Psychiatric Association.

AMERICAN PSYCHIATRIC ASSOCIATION., 2013. Diagnostic and Statistical Manual of Mental Disorders (online). 5th ed. Washington, USA: American Psychiatric Association.

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HORSLEY, R. J and HORSLEY, R. A., 1987. On the Trail of the “Witches:” Wise Women, Midwives and the European Witch Hunts. Women in German Yearbook (online). 3, pp. 1-28.

PLATFORM., 2022. Briefing on Boderline Personality Disorder and the Labelling of Survivors of Abuse and Violence.

SHARP, C., VENTA, A., VANWOERDEN, S., SCHRAMM, A., HA, C; NEWLIN, E., REDDY, R and FONAGY, P., 2016. First Empirical Evaluation of the Link between Attachment, Social Cognition and Borderline Features in Adolescents. Comprehensive Psychiatry (online). 64, pp. 4–11.

SPRING, C., 2016. Recovery is my Best Revenge: My Experience of Trauma, Abuse and Dissociative Identity Disorder. Buxton, UK: Carolyn Spring Publishing.

TAYLOR, J., 2020. Why Woman are Blamed for Everything: Exposing the Culture of Victim-Blaming. London, UK: Constable.

TYRER, P., 2014. The Likely Classification of Borderline Personality Disorder in Adolescents in ICD-11 (online). In: SHARP, C and TACKETT, J, eds. Handbook of Borderline Personality Disorder in Children and Adolescents. New York, USA: Springer. pp. 451-457.