Book Review

Women and Madness
by Phyllis Chesler
published by Four Walls Eight Windows
ISBN 1568580967
Review by Anitra Freeman
Originally published in Real Change

Women and Madness has been reprinted three times, had sold two-and-a-half million copies by 1997, and carries as much impact today as when it was first published in 1972.

As a woman whose life has been strongly affected by bipolar disorder, I was grabbed by the title. As a feminist, and as a "mental health consumer" whose entire family has both benefited and suffered from the medical and psychiatric professions, I was interested in what a long-time feminist who is also a psychologist had to say about the subject.

I ended with mixed feelings, because Chesler seems to be sending mixed messages in her book, arguing at least three theories of "women and madness" that to some extent contradict each other.

First is the argument that "madness" among women is extremely over-diagnosed. Chesler observes that women who exhibit traditionally "male" traits like independence, self-assertiveness, and dominance are often diagnosed as mentally ill — paranoid, schizophrenic, manic, etc. Women whose behavior is more typically "feminine" — passive, underachieving, and retiring — are diagnosed as depressed or compulsive. And medical illness is often misdiagnosed as mental illness, especially in women, poor people, gays, and people of color.

I am well aware of this over-diagnosis and mis-diagnosis. If you have doubts about it, please read this book — Chesler documents cases thoroughly. Some of the most powerful portions of her book are the testimonies of women themselves.
A second argument is that women (and poor people, gays, and people of color) who are in real suffering from either medical or mental illness are less likely to get adequate and appropriate treatment. They are less likely, even, to get understanding and support from family, friends, or employers and co-workers. Again, this is well documented and gets no argument from me.

The point at which I begin arguing with Chesler is when she categorizes all mental illness, including depression and schizophrenia, as normal human response to abuse and stress — an understandable reaction to an oppressive patriarchy that can only be cured by social change.

Hey, I’m all for social change, and I believe a healthier society would make everything easier, including getting over pneumonia. But you’re still going to need antibiotics for pneumonia, and people who suffer many mental illnesses will still benefit from medication.

I agree with Chesler that if you are in an intolerable situation that is driving you nuts the cure is not Prozac; the cure is to get out of the situation. But if your own body chemistry is sabotaging you, the right medication can be the only thing that makes it possible to change your situation. And even after the change, you can benefit from therapeutic counseling.

Chesler’s psychological prescription for the future is for women to become passionate about their own survival and self-development, not focusing all that passion on others. Let me make that image more concrete.

For 45 years, my life was disrupted in cycles by bipolar disorder. I would either be going a mile a minute or be dead in the water. I drove everyone around me nuts. They all accused me of being deliberately aggravating. I felt increasingly guilty for all the misery I caused, but will power alone changed nothing.

I was finally told that it was not my fault — I had an illness that could be treated medically. I dropped the guilt, no longer felt I had to defend myself, and began living as if I had a right to "my own survival and self-development." I became passionately persistent about getting the right treatment, not accepting mis-treatment from anyone, including doctors and psychiatrists. It will still take many years of counseling to learn to live on level ground instead of on a roller coaster.

Chesler’s prescription works. But please, if medication is what works for you, don’t let anyone, including Phyllis Chesler, tell you to take a political demonstration instead.
Storm the barricades after you take your meds. It’s more effective that way.

Phyllis Chesler has also written Letters to a Young Feminist and Woman’s Inhumanity to Woman.

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