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Women’s Madness: Misogyny or Mental Illness? by Jane M. Ussher, Harvester
Wheatsheaf, pp 341, £12.95

Why should more women than men be ‘mad’? Many women are responding to
what are, literally, maddening circumstances, and to label their distress
or anger as mental illness is to describe their behaviour as pathological,
control and silence them: the madwoman’s ramblings may be safely dismissed.

Jane Ussher, a lecturer in psychology at the University of Sussex, believes
women are poorly served by the swelling ranks of competing experts in ‘the
marketplace of madness’, and that the whole rhetoric of madness is highly
questionable. It is useless to treat a woman for agoraphobia when the real
problem is a marriage she cannot or will not leave.

Ussher’s style is lucid, compelling, empathic and personal, with the
minimum sprinkling of academic psychobabble. She opens with a harrowing
tale of her mother’s madness, or rather, her excruciating unhappiness, and
her own realisation that psychological training offered neither explanations
nor solutions.

She is not the first to highlight the misogyny of psychiatry, nor to
view its strictures within a wider frame of abuse and control of women.
What makes the book dramatic is the direct lineage she draws between past
cruelties, present barbarisms and therapeutic abuse, set within a social
framework where mysogyny is deeply ingrained.

‘Madness has become the heir to witchcraft,’ she says. From suttee (Indian
widow-burning) to electroconvulsive therapy, chastity belts to tranquillisers,
fear and hatred of women are depressingly wide-ranging across time and geography,
‘a misogynistic jigsaw which is horrific in its magnitude and extent’.

Men are ‘mad’ too, but more often act, or are labelled as, bad. Statistics
on female depression and mental illness parallel those on masculine crime,
violence and imprisonment. ECT, insulin shock and lobotomy are all practised
more often on women. Ussher cites a note on ECT that ‘its disabling effects
are deemed less problematic in women’.

Tellingly, little girls are less ‘mad’ than little boys. ‘It is evidently
only in post-adolescence that women become notably mad,’ Ussher points out.
It is then only particular women who are at increased risk – the married,
mothers and those without paid employment.

On the subject of marriage she is fierce and unequivocal: it is tyranny
– at best, a cruel deception and at worst, a cross between prostitution
and slavery. ‘The married relationship acts to make women subservient and
mad’. Yet since legalised marriage is on the decline but mental illness
is not, the problem is presumably wider than the legal contract per se.

The crucial questions of why misogyny is so prevalent, and why women
en masse put up with it so placidly, are scope for another book. But one
question she leaves hanging deserves more attention, especially as she implies
that men know they are on to a good thing and will not change unless forced.
Why do women often act as instigators in enforcing submission on their daughters,
whether in insisting on footbinding or clitoridectomy or promoting corsets
and virginal purity?

Ussher seems despairing of change coming from women. ‘What does a woman
do when she realises her father/husband/boss is a prime mover in her misery?
Leave him? Change him? Most women . . . cannot simply leave the luxury of
the consulting room and change their worlds’. She accepts that they do not
have the range of options open to white, middle class, self-supporting feminists,
but tacitly ignores their option at least to offer their daughters an alternative
range of responses, and the experts’ option to suggest that they can.

Of course to do so would be to accept their own lives as futile, and
to come face to face with the hatred and the con tricks that underpin women’s
lives. If this is too painful, it exposes the ultimate flaw of both therapy
and academic debate.

There are no simple answers, but Ussher’s crisply pessimistic analysis
of the past and present is not matched by clarity and optimism for the future,
without which the book ultimately raises another profound question. ‘Is
it better to be cognisant and in pain, or senseless and serene?’ she asks
– the same dilemma as physical or pharmaceutical salves for depression which
may help women to live less painfully on their barbed pedestals.

Against this background it becomes surprising that women are not ‘madder’
than they are, in many senses. So what help is there for women in distress?
Even feminist therapy may merely increase women’s awareness and sensitivity
to their misery and powerlessness and, as Ussher’s own story demonstrates,
such knowledge makes little practical difference.

The implication that the dualism of misogyny and submission have become
self-sustaining makes the book ultimately depressing – at least, for women.
It is men who should read Women’s Madness: Misogyny or Mental Illness?,
and it is part of misogyny that most will dismiss it for its title alone.

Sheena Meredith is a science writer specialising in health, psychology
and social issues.