Misogyny in the Mental Health System: by the survivors themselves

By Dolly Sen

This book holds survivor accounts of misogyny in the mental health system and asks if the mental health system is intrinsically sexist and damaging to women. With psychiatry's dubious history of labelling insubordinate Victorian women, right up to modern times where the labels have changed but not the

• Language: English
• Publisher: Cuckoo's Nest Books
• Release date: Oct 2, 2023
• ISBN: 9781739358914

Dolly Sen

My arts practices crosses writing, performance, film and visual art. My work is seen as subversive, humorous and radical. I am interested in debate and social experiment around themes of madness, sanity, the other, and acceptable behaviours, from an unusual and unconventional position of power. I am interested in this because I have been labelled mad, although I think my challenging of inequality and vicious systems of the 'normal' world makes perfect sense. I am interested in society's perception of mental health and madness - whether people think 'it's all in the head' and not a response to social and political issues. Madness is partly political.

Book preview

MISOGYNY IN THE

MENTAL HEALTH SYSTEM

By the survivors themselves

FOREWORD BY DR JAY WATTS

COMPLIED BY DOLLY SEN

EDITED BY DEBRA SHULKES

First published 2024

All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher.

The authors have asserted their right to be identified as the authors of this work in accordance with the Copyright, Designs and Patents Act 1988

British Library Cataloguing in Publication data: a catalogue record for this book is available from the British Library.

© Debra Shulkes and Dolly Sen

COVER DESIGN: Caroline Cardus

ISBN 978-1-7393589-0-7

Ebook ISBN 978-1-7393589-1-4

WWW.CUCKOONESTBOOKS.CO.UK

Funded by

Dedicated the memory of the most wonderful, beautiful, kind and glorious Debra Shulkes (1975-2022)

CONTENTS

Foreword by Dr Jay Watts

Introduction by Dolly Sen

PSYCHIATRY’S IMPACT ON WOMEN’S LIVES

1. Dolly Sen

Psychiatry Doesn’t Love The Abused               29                                               

2. Kate Rose

Being a Woman in The Mental Health System        35

3. Amanda McDowell

Hospital Photos 40

4. Robyn Timoclea

Borderlines Of Blame: A Narrative of Rape And Retraumatisation In Psychiatric Services 52

5. Katie Suzanne

Taking Back My Story 71

6. Jennifer Reese

Prone 80

7. Carina Edwards

Would You Rather? 90

8. Greta Gillett

Swimming in Reeds 107

TURNED AWAY WHEN IN DISTRESS

9. Catie Silvestre

An Unwell Feeling 120

10.      Lottie McCartney So Smiley 128

11.      Ally Mcginn Does the NHS have ‘Narcissistic Personality Disorder’?                       143

YOUNG WOMEN AND THE SYSTEM

12.      Alexandra Pullen Dreams in Bars 158

13.      MWB             Tick Tock Tick Tock 174

14.      Elspeth Wilson   Is Revenge the Opposite of Forgiveness? 187

15.      Sophie Manton Borderline Trauma 198

WORKING CLASS WOMEN AND THE MENTAL HEALTH SYSTEM

16.      Wendy Young Haridan 210

17.      Bryony Ball Charities & Support Services are Part of the Problem 218

CLOSING POEM

Dorothy Gould      Not a ‘Proper’ Woman       228

CONTRIBUTORS

BIRDSONG TEAM

THANKS AND ACKNOWLEDGMENTS

GLOSSARY

INDEX

FOREWORD – Dr Jay Watts

Misogyny and mental health is an intersection that psychiatry has managed to all but ignore despite fourth-wave feminism’s phenomenal recent impact on society. In contributing to, reading, and lobbying for this book, we refuse psychiatry’s attempts to escape misogynistic accusations unaltered. As the crashing waves of feminist backlash break around us, Misogyny in the Mental Health System serve as a life raft, giving us something collective to hold onto.

We also benefit from the trust that so many of us have in the much-loved Dolly and Debra. Trust that has been forged from decades of brilliant, bold and bloody-minded activism which I, and I am sure many of the contributors, fangirl. This allows us, readers, to hear voices otherwise unsafe to speak, many of whom have had to write under pen names. What a gift, albeit one that may make us want to shout in rage at various points, the moments of light a rainbow enticing us to do better.

Misogyny, to remind us, is the hatred of women and those assigned females at birth (AFAB). It restricts our motion, policing how we can think, feel, and act. Misogyny achieves this by trying to shuffle us into a series of norms. These norms rely on a template, that template generally being of White, middle-class, able-bodied, neurotypical femininity. Should we - by birth, choice, disability, or difference - default from this template, then we are at greater risk of violence that undermines our autonomy. Our financial and physical freedom. Our right to speak.  Our psychic equilibrium. Our bodily agency.

If we comply with misogyny’s insistences, we are more likely to succeed in life in the very limited outcomes that neoliberalism sees as important. Get a good job. Have a steady income. A stable relationship. Manage these goals – enshrined, of course, in the psychiatric outcomes that treatment is directed towards – and we get praise. A stranger’s smile. Escape from precarity. A platform to speak. These tend to make us feel good though they can also alienate us from our desire.

Fail to comply, though, whether by choice or because we have no option, and we find ourselves at greater risk of physical, sexual, and ideological punishment for refusing to play the game. A game that is not ours but theirs. A game that demands a fundamental alienation from our queerness, our neurodivergence, our ‘race’, our marginalisation in every sense of the word that we cannot pay. Or else we can pay briefly before the cost becomes so overwhelming that we kick off, self-injure, cling, collapse, dissociate, or get lost in altered states of reality. Because how else are we to resist our occupation? How else are we to try to escape the patriarchal grip and the outbreaks of violence done to us under its tyranny?

Once upon a time, I might have used an invitation to speak of misogyny to tell one story, one meta-narrative where psychiatric diagnosis was the ogre trampling over our distress. But listen to survivors for long enough - with and from the belly - and it becomes apparent that one story doesn’t speak for us. One story never can. And so, to the eruption of alternative narratives that refuse the drumbeat of misogynistic insistence we have in this glorious, agonising, infuriating, heartbreaking, inspiring collection. To plurality because, just as no one description can ever capture all women, so ideas of illness can save or scar us.

The scarring is especially clear in the devastating testimonials we hear of women and AFAB people who have been diagnosed with Borderline Personality Disorder. BPD is a diagnosis that nosologically enshrines misogyny, gaslighting neurodivergence, trauma and queerness in a character assassination that reinforces every toxic message we’ve been told. It rewrites stimming as attention-seeking.; self-injury as manipulative, gender fluidity as identity disturbance, and abusive relatives as ‘carers’ noble for putting up with us.

Whenever we get rewritten, we get erased, which is why our collective writing is so very important, often reassembling a narrative that has been stolen from us by those in power, whether that be people in our private life or professionals. This rubbing out of our agency is accompanied, as so many of the writers bravely and brilliantly show us, by dehumanisation and violence, from face-down restraint and depots to symbolic-death-by-ward-round or being seen as an interchangeable ‘anorexic’.

As important as the registering of these psychiatric abuses is – and note the dilution of their violence in the more benign new term ‘iatrogenic harm’ - so too is a new normal of statutory neglect. We read this in so many forms in Misogyny in the Mental Health System. To give a few examples, we read of the years spent languishing on wait lists. The class lottery in who gets trauma therapy. The foreclosure of how psychiatric drugs can affect our capacity to have kids. The omission of PMDD and contraception as factors affecting AFAB mental health. The erasure of what psychiatric diagnosis does to maternal rights in and out of family courts.

None of these experiences can be understood outside their intersectional location, hostile environments in society working in tandem to produce a perfect fortress of despair for many of the contributors across the three books in this series. Accordingly, Misogyny in the Mental Health System demands that we fight against racism, especially and also classism, ableism, homophobia, transphobia and tens of other discriminations as much as psychiatric oppression, using our personal to galvanise our politics when we have the spoons. Material reality – money to live and a kind benefits system, safe streets, decent housing – is central to what we fight for. Like many of the motifs in Misogyny in the Mental Health System, it differentially affects racialised women and AFAB folk and the Disabled community, an inequity worsened by austerity measures and the pandemic.

Stories matter too. Stories can squeeze and suffocate us.  But they also help us survive if we can claw our way to a space where we can write them, sing them, photograph them, dance them, at which point they become something different.

In the most difficult moments of my life, it has often been survivor stories that have kept me going, especially the work of Survivors Speak Out and Mad Pride. When I am mad, I cannot bear language, its persistent use against me returning like an avalanche ready to envelop and entomb me. Few things can help me in this state, sliding into mutism and eventually catatonia, even kind words little daggers piercing my skin. The professional texts I have quite literally been indoctrinated into have never captured this kind of experience. Have never, truth be told, come near to the type of I-have-to-rip-my-insides-out-pain we survivors so often know. But survivor works like those I have just mentioned. Those in a very rare lineage of unsanitised survivor testimonials this book now joins? The remembrance of them and what they evoke serves as a far island of hope, of community, of possible attempts to write something other.

I hope these stories do something similar for you if you need that right now.

Or, if you are reading this as someone without blood in the game, that you lobby for this book and the rare lineage of survivor stories it falls within to have centre place in the bookshelves, libraries and reading lists of professional institutions and training.

Place us where we belong in our most unapologetic form.

Remember misogyny before mental health services suture up this rare moment of possible change.

DR JAY WATTS – Consultant Clinical Psychologist, Psychotherapist, Activist & Writer

INTRODUCTION BY DOLLY SEN

Some quotes from authors in this book

I cannot quite express what it feels like to have my own story taken away and replaced by something that just was not me or my experience but was masked as fact, only that it kept me feeling unwell for a long time.

[I am] grateful for my life, but also resentful that my life so far wasn’t really mine at all. Just always one cage to the next. I feel as if, all this time, people have been helping me to live within a cage, but what I really want is help to smash it, to get out of it.

I will never voluntarily enter hospital again as a patient as I will never feel safe inside one. And yet, once a week, I volunteer as an art therapist teacher on an acute female ward.                                                     

So now I am writing my story, whispering it quietly with an assumed name because I was silenced for so long. But the quietest whisper is still a voice; it may not be loud but it has no less worth for that. This is me. I am slowly standing up for the curled-up child they turned me into and saying ‘enough’

This necessary book is part of a project funded by Unlimited, an arts commissioning body that supports, funds and promotes new work by disabled artists for UK and international audiences, and the Wellcome Collection which explores and challenges the narrative in existing mental health archives and libraries, and goes some way to ease the trauma of mental health system survivors having to fight for the truth.

The idea for this project has been floating around in my brain for years, ever since I helped Anna Sexton do her PhD around the mental health archives at the Wellcome Trust, and saw how little of the voice of the people who go through mental distress is in the archives, how the human being is lost, silenced, demonised by the professional voice.

Why should the people who’ve never visited a land be that country’s prime historians? How can we tell our true stories when our words are seen as sickness? Most mental health archives and libraries, as they stand, have observable data of inobservable worlds. Having mental health lived experience filtered by mental health professionals, is like lions representing bird song in roars.

Apart from the lack of authentic voices, the representation of mental health in patient notes does not give a person the essence of their life or their right to beauty.  I remember reading my mental health notes and not recognising the person they were describing. Do you know I do not have copyright of these notes, these words that are about me, that judge me ugly and cannot tell the truth about me? I cannot correct them either, because addressing any misrepresentations in patient notes could be deemed a sign of my sickness, it can never be deemed a sign of the sickness of the system. The horrible thing about it is we have to accept these ugly words and diagnoses and stay silent to ensure we get our benefits and other help. The ugly words seep through the whole system even affecting our physical healthcare. I realise the system cannot save me despite the few decent people in it.

Meanwhile the hidden song from the perspective of the individual has been lost or was never valued in the first place. This is particularly true for groups discriminated against in society and who have also been the subject of institutionalised discrimination from psychiatry.

Psychiatry is not a mechanism that relieves mental distress, it polices what is socially sanctioned behaviour, and one of the things it can give the people that go through its system is a deep sense of shame that they were disgusting enough to be different or sensitive to trauma or the brutalisation of their situation in life.

Historically many identities have been judged as problematic, or labelled mad. For instance, women were diagnosed with ‘hysteria’, when they stepped away from their ‘feminine’ roles. Black slaves were pathologized for wanting to escape and given the label of ‘drapetomania’. Gay people were given shock treatments and nausea-inducing medication to ‘cure’ them of their homosexuality.

Psychiatry has caused great pain to generations of people, and there are not many places they can say this without being punished for it. I applied to Unlimited with the hope I could deliver three books of survivor voices relating to those marginalised lives under the name of Cuckoo’s Nest Books.  Whether you are a woman, a racialised person, or an LGBTQIA+ person in our society and mental health system, you feel like you don’t belong and are not permitted to tell your truth. We also decided to pay our writers to acknowledge their labour. Survivors are often asked to give up their stories to professionals, charities and others for free. I know when I have turned down unpaid work, some professionals have thought I was being ‘difficult’ because of my ‘madness’. This has to stop. Survivors need to be paid for any work they do.

Luckily, with the help of my ever-lovely producer Caroline Cardus, we got the funding to deliver three performances and three books on the subjects of misogyny, LGBTQIA+ Phobia, and racism in the mental health system.

This book is one place people can talk of how misogyny affected their mental health and their time in the mental health services.  Apparently, there are some who don’t think misogyny is an issue in the world or in psychiatry.

I am writing this introduction during the strange painful days after the US Supreme Court overturning of Roe v Wade, meaning that abortion will now be illegal in many states in America. This also coincides with the global cost of living crisis, which means, apart from there being no baby formula on supermarket shelves, any person who is already struggling financially and gets pregnant, where it wasn’t their choice to do so, is promised poverty,