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This article is from the Essays on the
topic of Women and Disability.
14 Psychiatrized Women
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York University, 4700 Keele Street, North York, Ontario M3J 1P3
Notes for Feminist Theorists on the Lives of Psychiatrized Women
by Lilith Finkler
If the women's movement is to adequately reflect our
perspectives, the lives of psychiatrized women must be central
to, rather than at the margins of, feminist discourse.
Part 1
When I was originally approached to present on this panel, I
understood that all the other participants would be psychiatric
survivors. I discovered only inadvertently, two days before this
conference began, that the title, composition, and direction of
this session had been changed! While I welcome the new roster of
participants, a more wide ranging phenomenon needs to be
addressed.
One of the speakers was informed that self-identified
psychiatric survivors would be speaking strictly experientially.
As the theoretical analyst, she would speak last. Who assumed
that those who live a particular oppression are unable to
theorize its existence? Are women unable to engage in feminist
theory? Should lesbians not analyze heterosexism? Or is it that
psychiatrized women, in particular, are inadequately prepared for
the intellectual rigour of an academic milieu?
When presenting at an academic conference, an unspoken
requirement exists to identify one's credentials, one's previous
publications and current status in the academic world. I suggest
that presenters identify their connection to the group they
purport to study. Do they belong to the group in question? Are
they active members of a community that may stand in opposition
to the group they study? Anthropologists studying First Nations
people is a good example of this phenomenon.
The politics of appropriation are such that a privileged few
manage to determine subjects of study and gain recognition as
"experts" on a community outside their own. This process becomes
particularly insidious when so-called "progressive" individuals
claim to be allies of an oppressed group and in so doing,
constantly speak on their behalf. This disempowers the people
directly affected by a particular experience, since they have
less "credibility" and less access to privilege.
These relations of power revealed themselves at this conference
when a non-identified survivor was asked to lend her "objective
voice" to the survivor experience. Once again, psychiatrized
women were being defined by the authoritative articulations of
others.
These same dynamics are evident within the context of the so-
called "therapeutic relationship" where an admission of suicidal
feelings can lead to involuntary committal in a psychiatric ward.
Psychiatrists, social workers, and feminist therapists are unsafe
for women with psychiatric histories.1 Yet, not
surprisingly, it is precisely these professionals that claim an
understanding of our experiences! It is utterly enraging!
Part 2
This article articulates the realities of psychiatrized women
from a survivor perspective. Psychiatry is a "woman's" issue
because women comprise 40 per cent of those admitted to
provincial psychiatric institutions (Ministry of Health). Class
stratified health care delivery in Ontario determines that poor
women and women of colour are more likely to see a psychiatrist
since their services are free. White middle-class women can often
afford the exorbitant fees charged by so-called "feminist
therapists" and avoid some of the more blatant abuses.
While we refer to ourselves as "psychiatric survivors" or "ex-
psychiatric inmates," we who mourned our freedom and who heard
the sharp clang of locked doors are commonly referred to as
"mentally ill." This term connotes a biological reality designed
to reinforce the medical model. An "illness" is a physiological
problem. Cancer, brain tumours, epilepsy are "illnesses." There
are x-rays and blood tests which confirm or deny their
existence. Some argue that "schizophrenia" is also biologically
based, claiming that an insufficient amount of dopamine in the
brain results in "mental instability."
Biology has been used to justify the oppression of many peoples.
Doctors once theorized that women had floating wombs which moved
up to their abdomens. This resulted in "hysteria." Black people
were characterized as having a smaller brain circumference which
limited their intellectual abilities. People with developmental
disabilities were warehoused in large institutions in rural areas
in order to prevent the "contagion of feeblemindedness." It is
not surprising that individuals whose behaviour does not adhere
to social norms receive a biological explanation for the basis of
their oppression. There is no such thing as "mental illness."
Rather, there exists psychological stress and intense emotional
suffering caused by one's social and political
location.
Psychiatry, as a form of social control, reinforces the
marginalization of various oppressed groups. One has only to
peruse versions of the Diagnostic,and Statistical Manual
commonly known as "DSM-III-R" to view the extent to which women,
persons of various colours, and persons with different
disabilities have been labelled. Refugees, often survivors of
torture in their countries of origin, allegedly suffer from
"post-traumatic stress disorder." There is no analysis of the
racism and ethnocentrism that many refugees face upon arrival
into Canada, nor the ways in which the refugee determination
process itself contributes to the psychological stress facing
exiled peoples.
Native people who drink excessively are labelled as having
"psychoactive substance use disorders." The DSM-III-R does note
that "There is a higher incidence of inhalant use among minority
youth living in depressed areas," but neglects to explain why.
Psychiatrists, typically content to focus on the individual,
rarely acknowledge the impact of residential schools, the
systematic removal of Native children from their families and
their placement into white adoptive homes. Broken treaties, the
mass sterilization of Native women, the outlawing of spiritual
practices all remain invisible in the medical understanding of
human behaviour.
Enslaved blacks in the last century who wished to escape their
owners were labelled as suffering from "drapetomania." During the
late 1950s, white psychiatrists suggested that blacks
engaged in the civil rights movement were more prone to "mental
illness" as the process of desegregation was "anxiety-producing"
and led to ambiguities in their social status. Diagnostic
practices and psychiatric labelling processes effectively
reinforce white supremacy as well as patriarchal power
structures.
Therefore, I oppose the introduction of "battered women's
syndrome" as a legal defence. Women battered by their husbands
are not suffering from a psychiatric malady, but rather from a
prevalent expression of patriarchal power. Using psychiatric
terminology to defend a woman in court reinforces the medical
model, and the oppression of many other peoples.
Unfortunately, many feminist theoreticians conceive of "woman" as
a female individual who is non-disabled. The dangers inherent in
the labelling process are trivialized or ignored altogether.
If the women's movement is to adequately reflect our
perspective, the lives of psychiatrized women must be central to,
rather than at the margins of, feminist discourse. Activists
demanding an end to "violence against women" refer specifically
to wife assault, rape, and incest. Some engage in research
exploring sexual abuse of female survivors of the psychiatric
system. However, the presumed universality of the definition of
"violence against women" ignores the brutality of the hospital
setting. Four point restraints, chlorpromazine, and electroshock
are all patriarchal weapons.
Feminist definitions of "violence" must also incorporate the day
to day realities of psychiatrized women. Many women with
psychiatric histories reside in boarding homes. They live two or
three to a room without a lock on their doors. Less fortunate
individuals live on the street, staying in hotels or hostels for
short periods of time. These women are vulnerable not only to
their male partners but to the systemic violence of the state.
The lives of psychiatrized women must also be considered when
feminist theory is being formulated. As Jenny Morris says, the
invisibility of women with disabilities is particularly evident
when contemplating the politics of caring. Since women are
conditioned to nurture, and inevitably assume responsibility for
those persons with disabilities in their families, feminists
ideologues argue, persons with psychiatric disabilities should be
institutionalized to liberate the individual female of her unpaid
and unrecognized labour.2 This intellectual paradigm does not
construct "woman" as anything other than emotionally
independent. What if the person being cared for is also female?
What if there are no other means to provide for her on-going
care? Does the loss of control that the psychiatrized woman
experiences when institutionalized merit the financial gains that
the care giver enjoys when she is relieved of her duties? Who
decides? Is not the right to control one's own body a
feminist demand as much as equal pay for work of equal value? Why
are feminist demands considered appropriate for only some women?
Who should care for women who experience extreme emotional
and/or psychological stress? An institutional setting does not
relieve the pain. It exacerbates an already difficult situation.
Forced drugging and electroshock, traditional treatments of
choice, also cause physical disabilities. Forty per cent of
individuals who receive neuroleptic drugs as a long term form
of"treatment" develop tardive dyskinesia (qtd in Breggen, 74),
which consists of involuntary muscle movements, drooling, etc.
According to many survivors, electroshock results in both short
and long term memory loss.
Part 3
The literature of feminists in general does not consider women
with psychiatric histories as part of their theoretical
paradigm. Moreover, it is rare to discover a thoughtful approach
to our lives in the body of knowledge referred to as feminist
jurisprudence. Organizations such as Legal Education Action Fund
(LEAF) and the Advocacy Resource Centre for the Handicapped
(ARCH) focus on charter litigation. Most litigation affecting
women with psychiatric histories occurs not in the courts but at
administrative tribunals. These tribunals act as formal
interpreters of statutory laws pertaining to particular pieces of
legislation.
The Social Assistance Review Board (SARB), for example, makes
decisions with regards to the General Welfare Act and the Family
Benefits Act. The Psychiatric Review Boards make decisions
regarding the Mental Health Act. Individual women, currently
incarcerated in a psychiatric ward, are unlikely to employ
charter litigation to secure their release. The process is
lengthy, expensive, and provides no guarantee of freedom.
This is not to completely decry the use of the charter, but
rather to challenge the notion of its centrality as a vehicle for
legal social change. For example, Section Fourteen of the General
Welfare Act and Section Ten of the Family Benefits Act provide
for the appointment of a trustee, should a social
assistance recipient be deemed incompetent to manage their own
financial affairs. Unlike the statutory provisions under the
Mental Health Act, which require an examination by a medical
practitioner and the right of appeal, the decision to appoint a
trustee is made by a worker without right of appeal. One could
use the charter to challenge this statute. However, in my own
experience before SARB, cases of this nature are settled on an
individual basis in order to avoid precisely this situation.
If the courts are to provide a forum for the assertion of our
rights, psychiatrized women themselves must determine the
directions of such efforts. It is all too dangerous for legal
practitioners to identify a case with "good facts" and proceed
without the guidance of those affected.
I, myself, was guilty of this. When I began working at the legal
clinic, I assumed that my clients would all require
representation at review board hearings. I prepared students for
such situations. To my surprise, a significant minority
requested admission to the psychiatric wards I had once wished to
escape! To poor women, hungry and homeless, a warm bed and three
meals a day were a welcome change from the dreariness of the
street. As a result of my experiences, I now prepare
students to negotiate with psychiatrists as well as argue cases
against them.
Clearly, psychiatric survivors are no more homogeneous than any
other grouping. Our views of the world, our perspective on law,
are affected by our location. As psychiatric survivors, our
understanding of what constitutes a "survivor" must be expanded
to include women who remain in the back wards of provincial
hospitals, those on psychiatric drugs, and those women attached
to the electrodes of a shock machine. If the woman remains alive
despite those forces acting against her, she is a survivor. As
feminist activists and academics, we must re-examine our notions
of the universal female. The word "woman" must mean all of us; we
must recreate both the theory and practice of feminism so that it
incorporates the images and interests of all of us.
This article was originally presented at the panel on
psychiatrized women at the CRIAW conference in November 1992.
Lilith Finkler survived a variety of psychiatric institutions
during her childhood and adolescence. She is an anti-psychiatry
activist committed to alternative methods of emotional and
psychological healing. She is also a member of West End
Survivors in Toronto, a group which is organizing Psychiatric
Survivors Pride Day on September 18, 1993.
1 The author contacted approximately 25 feminist therapists. Each
one insisted that if a client was a "danger to self or others"
they would consider involuntary committal to a
psychiatric institution.
2 See for example, the discussion of the institutionalization of
women in the book, Review of the Situation of Women in Canada,
National Action Committee on the Status of Women, 1993.
References
Breggen, Peter, M.D. Toxic Psychiatry. New York: St. Martin's
Press, 1991.
Ministry of Health, Report of the Provincial Psychiatric
Hospitals Systems Division, 1991.
Morris, Jenny. Pride Against Prejudice; Transforming Attitudes
Towards Disability. London: Women's Press, 1991.
Sunnybrook
Sculpture and text by Persimmon Blackbridge
I got the interview at Sunnybrook because I put on my
application that I had worked at a child guidance clinic in
Ontario.
(Actually, I had been a patient there, but I knew the jargon and
I knew the routines, so what the hell.)
I went there dressed for success, in brand new panty hose,
borrowed shoes, and a dress with nice long sleeves that covered
the scars on my arms. I was interviewed by Dr. Carlson, the head
psychiatrist. I think he wanted to hire someone quickly and get
back to his important work. It was a short interview.
"I understand you've worked with teenagers with learning
disabilities," he said.
"Yes," I said.
"So you must be used to dealing with some pretty anti-social
behaviour," he said.
"Yes," I said.
"But you've never worked with retarded people. Well. That's
unfortunate. But you do know behavior mod?"
(I know behavior mod.)
"Oh, yes," I said.
"Good. Very good. Well then. I feel I must tell you: the girl we
hired last month for this position quit. One of the residents bit
her. Quite badly."
He looked at me. I didn't flinch, and the job was mine.
I liked Ward D. There were lots of friendly people there--
Shirley, Pat, Geneva... In fact everyone there liked me except
for Mary. Mary liked to sit by herself and look out the window.
She didn't like people bugging her.
But I had to bug her or I'd get fired for not doing my job. Dr.
Carlson got me a book on American Sign Language and told me to
teach Mary to sign.
I had a few days to study my book, and then I went to meet Mary.
Nurse Thompson, the head nurse on Ward D, took me over to where
Mary was staring out the window. Mary glared at her for a
second, and then looked away.
"You do know behavior mod?" Nurse Thompson asked.
"Oh, yes," I said.
"Well behavior mod is a little tricky with kids like Mary. And
not just because she can't speak or hear. The form of negative
conditioning we like at Sunnybrook is withdrawing attention."
"Of course," I said.
"On Ward B, that means a few hours in the side room, which is
your basic solitary confinement."
"Right."
"Here on Ward D, we put them on a chair in the hallway and
everyone ignores them for awhile. It's humane, it's effective.
Except with kids like Mary who are so anti-social they'd just as
soon be ignored." Nurse Thompson laughed and shook her head. "In
cases like Mary's, we use good old positive reinforcement. It's
really just as effective."
(It didn't matter that no one else on Ward D knew how to sign. It
didn't matter that I didn't know how to sign. I could learn from
the book and teach Mary. Then she would have a way to
communicate, in case anyone who did know sign happened to drop by
the ward.)
I was at Sunnybrook for a couple of weeks before I started on
Ward B. But when I reported in to the office on my first day,
Nurse Jones told me Janey was locked in the side room.
"She'll be there for another hour or two. You might as well take
a break."
I sat in the staff room. No one else was there. I didn't feel
like reading old magazines, or writing my weekly report.
I went back out to the dayroom. It was nothing like the dayroom
on Ward D. Ward B had a bare concrete floor and no TV, no
pictures on the wall, no curtains over the barred windows.
But there were lots of people and they were all shouting except
for the ones who were sitting in corners with their eyes closed.
There was an orderly sweeping up broken glass. He nodded to me
and kept on working.
I went back down the hall, past door after locked door. One door
had a window in it, with bars and safety glass. Inside, I could
see a woman in a strait jacket.
(I knew it was a strait jacket, even though I had never seen one
before.)
The room was small and square, with a tiny high window that
didn't let in much light. The woman was singing.
(It had to be the sideroom and it had to be Janey.)
I stood there for a minute and then I unlocked the door. It
locked behind me, automatically, like all the doors in
Sunnybrook.
When she saw me, Janey started to scream, kind of a high quiet
scream through clenched teeth. An anxiety scream.
(I could understand her being anxious. I was feeling a little
anxious too, and I had keys and no strait jacket.)
I backed into the corner by the door, and we stood on our
opposite sides watching each other. After a while she stopped
screaming.
One of the best places in Sunnybrook was the staff washroom in
the basement of the administration building. No one ever used it,
not even the maintenance staff.
If you had keys you could go in there and close the door and know
that no one would ever come in, or even knock on the door. I used
to go down to that washroom for my breaks or even my lunch hour.
I would just sit there, doing nothing, thinking nothing.
(Or maybe I would cry.)
The only sign I ever saw that anyone else ever went there was
when I found a book on the back of the toilet. It was called
Honeymoon for Nurse Holly.
At first I ignored it, but when it was still there after a few
days, I started reading it. It was a little bit boring, but also
kind of soothing. Like you knew just what was going to happen,
and you didn't really care.
(The story was about this woman Holly, who graduates from
nursing school and comes to work in a big hospital. Right away,
she starts having trouble with this handsome but arrogant
doctor.)
"Jesus, Persimmon, it makes me so mad!" my girlfriend said,
typing furiously on my weekly report.
(The reason she called me Persimmon was because it was my other
name, the name my friends called me. No one but shrinks and
landlords and people at work called me Diane.)
(She could type and talk at the same time. It was impressive.)
"Mary doesn't belong in that place!"
"None of them do," I said.
"Well yeah, but Stuart and Janey...it sounds like they really are
seriously brain damaged. You know? And Mary isn't."
They shouldn't be in that place, I thought to myself. After a few
minutes, I said it out loud.
"Yeah, but what's the alternative?" my girlfriend asked. "Do you
really think they could get along in the outside world?"
(I had already considered this problem. It was the main
unworkable element that had forced me to abandon my kidnapping
scheme.)
I was silent for a long time and then finally I said, "Things
could be different. Like big things. It's possible."
"Yeah," my girlfriend said. "Don't hold your breath."
Janey, your arms are scar on scar. Tooth marks track you layer on
layer year on year. I've seen you tear your skin to blood and
skin is strong. How can someone bite that hard? I guess you use
what you can get. I use a razor.
I was finished for the day, walking across the grounds and down
to the main gate, like every day, the long walk down to the gate,
clutching my keys.
I had a key to the main gate. I could get out. I could leave
whenever I wanted to. I wasn't an inmate.
Dr. Carson told me I was doing a good job. At our last meeting he
said the nursing staff was pleased with my work. He said he liked
my reports. He acted like it was really true.
Maybe I was doing a good job. I considered that possibility as I
walked down to the gate. Maybe they'd keep me on, even after the
government took away their one to one counsellor money. It could
be real, like a career, and not just one more in a long series of
short jobs.
I could take night school classes, even. My girlfriend could help
me type papers, and I could learn how to write things with
footnotes.
And look up things in the library.
And read serious books.
And memorize things for tests.
(You can do it. Come on. Everyone has trouble at first.
Just try. Just try harder. You're not trying. You're lazy.
You're selfish. You're irresponsible. Just try. Try harder.
You're not trying.)
Or maybe I wouldn't take a class. Maybe it would be ok if I just
kept faking it. They seemed to like the way I was faking it, so
far.
There was a security guard near the gate. If he asked me what I
was doing, I'd tell him I was a staff person going home. I'd show
him my keys. I'd quote Shakespeare: Out, out, damned spot. See, I
know Shakespeare, I'm on staff, I can prove it.
The guard nodded to me as I unlocked the gate.
"Good night," I said, with my best Nurse Holly smile, and made my
escape.
Sunnybrook is not written from the perspective of a good-
intentioned social worker. It is written from the perspective of
a woman with learning disabilities (myself) who fakes her way
into a job at an "institution for the mentally handicapped "
Sunnybrook isn't about a sympathetic staff person who disagrees
with the hurtful things that she is required to do to inmates--
it's about a person who is required to do the same hurtful
things that were done to her, in order to keep a job that could
be her ticket out of the minimum wage ghetto.
Persimmon Blackbridge has worked as a part-time housecleaner and
a part-time artist for the last fifteen years.
Sunny brook was recently exhibited in the Charles H. Scott
Gallery at the Emily Carr College of Art and Design in
Vancouver, B.C.
Artwork used within the sculpture by: Shani Mootoo, Jo Cook, Deb
Bryant and Susan Stewart
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