The Abused Mind: Feminist Theory, Psychiatric Disability, and

Trauma
Nicki, Andrea.

Hypatia, Volume 16, Number 4, Fall 2001, pp. 80-104 (Article)

Published by Indiana University Press

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The Abused Mind: Feminist Theory,
Psychiatric Disability, and Trauma
ANDREA NICKI

I show how much psychiatric disability is informed by trauma, marginalization,

sexist norms, social inequalities, concepts of irrationality and normalcy, oppositional
mind-body dualism, and mainstream moral values. Drawing on feminist discussion
of physical disability, I present a feminist theory of psychiatric disability that serves to
liberate not only those who are psychiatrically disabled but also the mind and moral
consciousness restricted in their ranges of rational possibilities.

Much psychiatric disability is closely linked to trauma. Many people who

suffer from mental illnesses that force them to seek help are survivors of child-
hood abuse. “50–60 percent of psychiatric inpatients and 40–60 percent of
outpatients report childhood histories of physical or sexual abuse or both”
(Herman 1992, 122). Freud in 1896 publicly affirmed his discovery that hysteria
in women was caused by childhood sexual trauma (Herman 1992, 122). In a
report entitled The Aetiology of Hysteria, Freud states, “I therefore put forward
the thesis that at the bottom of every case of hysteria there are one or more
occurrences of premature sexual experience” (1962, 13). Freud, infamously,
later repudiated the hypothesis of trauma as the origin of hysteria, because
of its unseemly social implications which attacked proletariat and respectable
bourgeois families alike, claiming that his patients’ accounts of childhood
sexual abuse were pure fabrications. For feminists this subsequent betrayal
of women may be seen as engulfing the whole enterprise of diagnosis and
treatment of mental illness in smog (the smoke contributed by Freud’s cigar),
casting it as suspect and confused in thought.
In this paper I am concerned with mental illnesses related not only to
trauma and abuse but also, more generally, to prejudice, discrimination, sexist

Hypatia vol. 16, no. 4 (Fall 2001) © by Andrea Nicki

 Andrea Nicki 81

socialization, social inequalities, marginalization, or poverty. The latter promote

toxic social environments in which mental illness thrives. I hold to Thomas
Szasz’s view of mental illness as involving “difficulties in social adaption” (1975,
54), but not in opposition to the common view of mental illness as biochemi-
cal disorder, analogous to physical illness. Mental illnesses have biochemical
and biophysical aspects that may be improved or worsened by pharmaceutical
interventions. For instance, symptoms of clinical depression can include slow
thought-processes, negative affect, lack of appetite, or fatigue. These symptoms
can be reduced or overcome by psychiatric medications, but this accomplish-
ment by pharmaceutics alone does not establish an underlying biological cause
of the illness. Similarly, certain treatments may improve or worsen a physical
illness like cancer, but this does not mean the underlying cause of cancer is
biological. For people who live next to toxic waste dumping sites and develop
cancer, the primary cause of their disease is certainly not in their genes or
biological makeup.
That many instances of mental illness are not best understood as having
primarily genetic or biological causes in no way means that these illnesses are
not real or genuine. Mental illnesses, like physical illnesses, involve difficulties
in social adaption that, without proper accommodation, sources of support, and
aid, can be seriously disabling. Just as anyone can become severely physically
ill and disabled, so also can anyone fall severely mentally ill and disabled, with
illness of both types exacerbated in those with unequal access to health care,
social resources, and support. Susan Wendell argues that social structures based
on able-bodiness, which do not integrate people with physical illnesses, serve to
disable them (1992, 69). Similarly, social structures based on able-mindedness,
which marginalize people with mental illnesses, and assume that they can
simply “snap out” of their conditions, are also disabling.
The case of psychiatric disability is complex because a variety of beliefs
inform a social understanding of mental illness and thus attitudes toward those
who are mentally ill: that mentally ill people are irrational and dominated
by emotion; that emotion lacks directive, cognitive content and is inferior to
calm reason; and that negative behavioral or ideational components of mental
illness can be easily suppressed or overcome. Also, norms of mental health are
different for men and women. For instance, a woman who displays aggression
and ambition, and is not feminine, risks being labelled “mentally ill” or, if
genuinely mentally ill, having her illness seen purely in terms of her transgres-
sion against her gender. Cultural concepts of irrationality and sexist norms
of mental health marginalize people with mental illnesses in attacking their
personhood. In attacking the personhood of those who are simply nonconform-
ist they contribute to the development of mental health problems in such
people. Further, in attacking the personhood of those with mental illnesses to
which low self-esteem is central, they promote their mental illnesses.
82 Hypatia

I argue that cultural and social analysis of mental illness is important

since cultural and social factors contribute to the development and prevalence
of much mental illness in members of disadvantaged groups. However, in
considering how such factors inform many instances of mental illness, I stress
that it is important not to reduce these instances to their cultural and social
components. This reduction feeds into a mentality that blames mentally ill
people for their illnesses.
A mentality that blames sufferers for their health problems has been well
documented in the case of physical illness (Overall 1998; Wendell 1996). I
discuss how feminist theories of physical disability are illuminating for the case
of psychiatric disability, which has received much less attention in feminist
work on disability. Wendell writes, “We need a theory of disability for the
liberation of both disabled and able-bodied people since the theory of disability
is also the theory of the oppression of the body by a society and its culture”
(1996, 78). Similarly, I argue that we need a theory of disability for the liberation
of both psychiatrically disabled and able-minded people. Whereas society’s
rejection of physically disabled people is based on cultural insistence on the
control of the body, society’s rejection of psychiatrically disabled people stems
from cultural insistence on the control of the mind.
Society devalues and despises extreme mental states that are beaten down,
fettered by this rejection: intense dissatisfaction or frustration becomes clinical
depression; mania or profound enthusiasm becomes manic-depressive illness.
I present a liberatory theory of psychiatric disability that validates diverse
mental states. It acknowledges the thought and behavior of people broken
by personal and social harms as rational responses to various facets of oppres-
sion. For instance, trauma-related disorder is a rational response of a mind
subjected to intense psychological stress in the same way that cancer is a body’s
meaningful and intelligible response to a toxic physical environment, to severe
physical stress. Just as we need to discard a paradigm of humanity as young
and healthy against which physically disabled people will be seen as lacking
(Wendell 1992, 66), we need to overcome a paradigm of humanity as mentally
healthy so that those with mental illnesses will not be judged deficient. Further,
since a lack of social acceptance or self-acceptance directly promotes mental
illness related to low self-esteem, we need to reject a paradigm of humanity as
rigidly self-controlled, moderate, dispassionate, pleasant, and conformist, with
strict adherence to norms of one’s gender. In effect, we need to challenge the
values inherent in this paradigm, the belief that only certain human traits and
dispositions are praiseworthy.
Wendell argues that people with physical disabilities desire some transcend-
ence of the body, of negative bodily states and limitations (1996, 166). People
with psychiatric disabilities also seek some transcendence of the mind, of nega-
tive mental states and limitations. In cases of trauma-related mental illnesses in
 Andrea Nicki 83

which depression is common, I argue that symptom-management and recovery

may require the realization of values outside mainstream morality. In order to
overcome depression and attain more pleasant states of mind, survivors may
need to experience and transcend other unpleasant states, such as anger or
cold indifference. Feminist theory of disability is inclusive toward those with
traumatic disorders by recognizing the moral merit of some alternate values. I
present a feminist theory of psychiatric disability that serves to liberate not only
those who are psychiatrically disabled but also the mind and moral conscious-
ness restricted in their ranges of rational possibilities. I explore several topics:
feminist theory and the social construction of mental illness; mental illness and
“craziness”; biopsychiatry, and marginalized people and mental states; feminist
theory, mind-body dualism, and coping with disability; and traumatic disorders
and feminist ethics.

Feminist Theory and the

Social Construction of Mental Illness

Feminists (Chesler 1972; Millet 1990) and others (Szasz 1975) have extensively
discussed the use of the construct of mental illness as a means of social control.
Certainly, many specific constructions or “discoveries” of mental illness have
served to support the status quo and to enforce the oppression of various social
groups based on gender, class, race, sexual orientation, or ability.1 Only recently,
in 1973, did homosexuality get removed from the Diagnostic and Statistical
Manual of Mental Disorders (the official register of psychopathologies) as a
real mental illness (Horrocks 1998, 15). The use of the term “mental illness” to
denounce deviant behavior and to problematize women and other oppressed
groups is at odds with the term’s use to validate medically certain instances of
difficulties in social adaption as aspects of legitimate illnesses. While criticizing
the former use is very important, such an endeavour, by partially invalidating
the concept itself, throws into question the legitimacy of the latter use. In order
for mental illnesses to be conceived as real illnesses and those afflicted to be
treated appropriately, mental illnesses must not be seen purely in terms of their
cultural and social components.
Phillis Chesler, in her classic book Women and Madness (1972), maintains
that mental illness in women is essentially and literally “an expression of female
powerlessness and an unsuccessful attempt to overcome this state” (1972, 16).
Confinement in a mental institution is a penalty for “being female, as well as for
daring or desiring not to be” (Chesler 1972, 16). Women become mentally ill
as they realize to an extreme degree feminine norms of dependency, vulner-
ability, and helplessness in order to escape constraining traditional female
roles. For instance, in the mental illness of depression, women become ultra-
feminine—childlike, dependent, and helpless—seeking the help of an authori-
84 Hypatia

tative, knowledgeable expert to guide and watch over them (Chesler 1972,
50). Discussing the cases of the female artists Ellen West, Zelda Fitzgerald, and
Sylvia Plath, whose intellectual creativity made them feel intensely alienated
in traditional female roles, she maintains that they became depressed in order
to be released from maternal and domestic duties (1972, 15). Their mental
illnesses were both protests against barriers confronting them and willful self-
entrapments within these barriers.
Similarly, Susan Bordo in her discussion of anorexia nervosa emphasizes
the role of cultural norms, values, and ideals in accounting for the upsurgence
and increasing incidence of the disorder, and for its predominance in women.2
While Bordo maintains that anorexia nervosa is a real illness, “a debilitating
affliction” (1993, 147), she argues that it constitutes a protest against the confin-
ing traditional female roles of self-abnegating mother and wife (1993, 156).
Women who suffer from anorexia nervosa become ultra-female by pursuing the
feminine ideal of excessive thinness, but in carrying this pursuit to an extreme,
they reject their female bodies, refashioning them into young boyish ones,
not capable of menstruation or motherhood (Bordo 1993, 160). In obsessively
and rigidly monitoring their food intake and dominating their bodies, they
realize masculine ideals of aggressiveness, self-control, strength, and conquest.
However, in their physical and emotional exhaustion they are reduced to
feminine infantilism and dependency (Bordo 1993, 160). By directing all their
energies into the ideal of extreme thinness—obsessively exercising and count-
ing calories—anorexic women have nothing left for intellectual, moral, or
social development and achievement (Bordo 1993, 160).
Bordo’s work was a response to a relative absence of cultural or social analysis
in research on anorexia nervosa (Bordo 1993, 140), and contributed, alongside
work by such authors as Hilde Bruch (1981) and Kim Chernin (1981), to a
better appreciation of the role of cultural and social factors in the disorder. But
while a social constructionist approach to mental illness is illuminating, the
view that mental illness in women is a self-contradictory protest against and
conformity to “the devalued female role” (Chesler 1972, 56) may be used to
undermine mental illness as a legitimate illness and disability. Those educated
in the role of social and cultural factors in the disorder may, when faced with
a woman suffering from anorexia, not view her condition as a debilitating
illness, perhaps unsympathetically attributing to her an extremely conformist
mentality or an irrational rebelliousness.
Similarly, if depression is understood in women as the enactment of a “female
role ritual” (Chesler 1972, 50), clinically depressed women might receive the
same kind of critical gaze as might be given to anorexic women. Chesler writes:
“Conditioned female behavior is more comfortable with, is defined by, psychic
and emotional self-destruction. . . . Female suicide attempts are not so much
realistic ‘calls for help’ or hostile inconveniencing of others as they are the
 Andrea Nicki 85

assigned baring of the powerless throat, signals of ritual readiness for self-
sacrifice” (1972, 49). These ideas are interesting and insightful regarding the
implication of feminine norms of self-destruction in promoting and sustaining
mental illness in women. However, they may be used to express “ritual readi-
ness” to blame the suffering victim of illness. Such readiness has been well-
documented in cases of physical illness, with sufferers receiving unwelcome,
reductionist explanations about the psychological or behavioral causes of their
conditions (Overall 1998, 157; Wendell 1996, 97, 106). For instance, people
with physical illness may be told that an unhealthy lifestyle or unresolved
psychological issues caused their illness (Wendell 1996, 97).
The potential for victim-blaming in the case of mental illness can be seen
more clearly in the employment of metaphors of travel and place to illuminate
the phenomenology of mental illness, as when Chesler claims that women
attempt to escape confining female roles by “going crazy” (1972, 14). This
expression carries the implication that their conditions are actively and will-
fully self-imposed. On this view, women escape from one female domestic role
only to enter into another, more lethal female role of self-sacrifice. Women take
a journey into a nightmare state that often includes institutionalization in a
mental hospital, referred to by Kate Millett as a “loony-bin trip” (in the title of
her 1990 book by that name). The conception of mental illness as involving
a “trip” informs and reinforces the practice of institutionalizing those with
mental illness: mental illness is a place where one goes. One goes down into
its hell, brought there by one’s own feminine inferiority, resignation, and
helplessness—punished for femaleness—just as in Judeo-Christian religions
one is condemned to hell for evilness: “Contemporary women carry themselves
headlong down . . . to the underworld” (Chesler 1972, 22). Similarly, John
Bentley Mays, who suffered from clinical depression, refers in a metaphoric vein
to depression’s “black dogs” (1995). Also, Julia Kristeva emphasizes depression’s
“black sun” (in the title of her 1992 book by that name).
While all these authors are emphatically opposed to romanticizing mad-
ness, such metaphorical ways of describing mental illness preserve its morbidly
romantic mystique. One would not say that someone who has acquired a
physical or cognitive disability has “gone ill,” as if her illness were a place to
which she has journeyed. A hard existentialist would insist that a condition
of mental illness is much more voluntarily maintained than one of physical
illness, pointing to negative factors or events in one’s life that one could have
responded to more cheerfully or stoically (Sartre 1947). But at issue here is
the extent to which mental attitudes and emotional responses and the life
experiences related to them are in one’s control and can be freely chosen.
Notably, while Chesler maintains that mental illness in women is an expres-
sion of self-destructive female behavior, she also claims that this behavior is
conditioned, or determined by social norms (1972, 49). On her view, women
86 Hypatia

are conditioned to be depressed, full of self-doubt and guilt, in the same way
that they are conditioned to diet, attract male attention, or find husbands.
However, although feminine norms of self-destruction contribute to mental
illness in women, their mental illnesses are not merely realizations of these
norms—women being “simply unhappy and self-destructive in typically (and
approved) female ways” (Chesler 1972, xxii).
Chesler does concede that a minority of women who have psychiatric
“careers,” or who undergo continual psychiatric treatment, experience “genuine
states of madness” (1972, xxii). However, it is not clear, in Chesler’s account,
what a woman must suffer or suffer from in order to be considered genuinely
mentally ill. Given that self-destructive behavior is debilitating, the woman
who engages in it is obviously disabled by it. Whether one argues that she is
willfully mentally ill as a result of female conditioning that she does not resist
or is mentally ill because of factors somehow more beyond her control, mental
illness is not something she desires or finds desirable. Women who commit
suicide are not simply “tragically . . . outwitting or rejecting their ‘feminine’
role” (Chesler 1972, 49). Rather, they are judging that their lives with mental
illnesses and the social sources of these illnesses are not worth living. None-
theless, the misuse of the term “mental illness” applied to those who are
mentally healthy deserves further exploration so that this misuse can be clearly
distinguished from the term’s proper use. In the next section I will investigate
the relation between the two uses and whether the term’s misuse has any
bearing or impact on those who are genuinely mentally ill.

Mental Illness and “Craziness”

Notably, social revolutionaries throughout the world have often been the first
to be labelled “mentally ill” and forcibly locked up in asylums or, as in Stalinist
Russia, in state mental hospital prisons. Perhaps because of the association of
mental illness with political fanaticism, the term has come to denote extremity,
intense passion, or a lack of accessible meaning. This seems especially true
when seen as synonymous with the term “craziness.” Like the label “mentally
ill,” the label “crazy” is also used as a tool to control people who are simply
nonconformist and not genuinely mentally ill.
A person called “crazy” is judged to be irrational, off the chariot of reason,
her speech and behavior thought offensively aimless or stupid: thus the phrase
“crazy as a loon” applied to wandering vagrants talking to themselves. A person
may also be termed “crazy” when believed to be dominated by wild feeling,
caused by emotion taking the reins, as in the case of those called “crazy radicals.”
The insult of “craziness” feeds on and expresses various beliefs: that strong
or intense emotion is devoid of meaningful, directive cognitive content; that
people with mental illness are irrational; that they are cognitively impaired;
 Andrea Nicki 87

and that they are frightening. The label of “craziness” directed at people who are
simply nonconformist or who challenge the status quo, without serious inquiry
into their mental health, derives its power from prejudiced views of those
genuinely suffering from mental illness as irrational, disordered, cognitively
impaired, and frightening.
For instance, Marilyn Frye describes an exchange she had with an angered
black woman in a discussion on white privilege: “One Black woman criticized
us very angrily for ever thinking we could achieve our goals by working only
with white women. . . . She seemed to be enraged by our making decisions,
by our acting, by our doing anything. . . .What she was saying didn’t seem to
make any sense. She seemed crazy to me. . . . I backed off. To get my balance, I
reached for what I knew when I was not frightened” (1983, 111–12). The black
woman’s anger and unfamiliar assertions frighten Frye and lead her to initially
judge her “crazy”: because the other is dominated by emotion, her speech seems
to lack sense, and she provokes fear; Frye concludes she is “crazy.” People suf-
fering from mental illness may be irrational, disordered, cognitively impaired,
or frightening, but no more so than those not suffering from mental illness. In
the case of irrationality, it depends on how irrationality is being defined and
what frames of reference or value systems are being invoked; as Frye writes,
after she reconsiders her initial response, “I have been thought crazy by others
too righteous, too timid and too defended to grasp the enormity of our differ-
ence and the significance of their offenses” (1983, 112). Further, while mental
illnesses in which depression is present involve a diminished capacity to think
or concentrate, many persisting factors in mentally healthy people’s lives can
cause cognitive impairment, such as self-centeredness or arrogance, where one
has difficulty distinguishing between where one’s self ends and another person
begins, between one’s own interests and those of others.3 Finally, in the case of
women who are mentally ill, given that, as Chesler argues, the feminine norm
of self-destructiveness informs women’s mental illnesses, they most often only
pose a threat to themselves (Herman 1992, 109). Many women with trauma-
related disorders frequently injure themselves (Herman 1992, 109). Such self-
inflicted injury might be thought of as irrational, or senseless. However, from
the perspective of those engaging in it, it is a method of self-preservation that
substitutes physical pain for unbearable emotional pain and produces a sense
of calm (Herman 1992, 109).
The derogatory label of “craziness” serves to silence communication of dif-
ferences in ideas or intensity of emotion. Calling someone “crazy” keeps that
person and her differences away, but it also reinforces the belief that “crazy” or
mentally ill people are less than fully human and not deserving of respect. It
was because her initial view of the black woman as crazy expressed a lack of
respect for her opinion that Frye reconsidered it.
Calling someone “crazy” throws at her the same kind of verbal abuse as
88 Hypatia

calling her a “mental retard” or “stupid cow.” 4 The latter terminology draws on
and serves to reinforce the oppression of cognitively challenged persons, who
are thought to be less than fully human, and of animals, who are thought to be
subhuman. One might argue that while some uses of these terms are explicitly
meant to reduce or criticize another, other uses are more “fun-loving,” as when
one calls another “crazy” jokingly for having done something silly or foolish or
“piggish” for sexual promiscuity or abundant food consumption. But even these
“fun-loving” uses are problematic, like the term “bitch” used in a light-hearted
way between friends.
Here I am not advocating a total policing of all language, putting the tongue
in chains, but rather simply pointing out that uses of language that derive their
meanings from systems of oppression cannot be divided into good and bad
uses, as if a bucket lowered into the same polluted well could obtain clean
water. Perhaps a term like “bitch” used between women to secure bonds of
female friendship could serve as an antidote to help destroy a patriarchal well
of significance. The same may be said for the term “crazy” between mentally
ill women. But that would only be to claim that uses of language that express
and reinforce oppression can be used for other, good or bad ends—to enliven
or diminish. While a woman is laughingly calling her friend a “bitch” she is
also telling her she is more animal than human, only that she could use and
is using her animal nature to her admirable advantage. Similarly, in the case
of the use of the term “crazy” by a woman suffering from a mental illness to
refer good-heartedly to a kindred sufferer, the woman is saying that she finds
the other’s “otherness” delightful, where others typically find it offensive (as
in: “Those people in the state mental hospital are really sick,” a woman says,
her voice dripping in disgust). She is affirming that her friend is other, only
that this is acceptable, even praiseworthy in her eyes.5
The use of the term “crazy,” whether intended good-humoredly or not, with
its various pejorative connotations, serves to sustain mental illness in sufferers
by enforcing their marginalization. Further, the application of the term to,
on the one hand, people who are mentally ill and, on the other, people who
are simply nonconformist or who challenge the status quo, and who are not
actually mentally ill, also serves to promote mental illness in those afflicted by
reinforcing their “otherness” through association.

Biopsychiatry, Marginalized People, and Mental States

The marginalization of mentally ill people and nonconformist people occurs

alongside the marginalization of another group, that of “mad, starving artists.”
This group has been subject to much biopsychiatric mystification which has
served to obscure the connection between marginalization and much mental
illness.
 Andrea Nicki 89

Biopsychiatrist Kay Redfield Jamison argues, referring to numerous studies,

that there is a strong correlation between mental illness and artistic tempera-
ment. She focuses particularly on manic-depressive illness. Presenting charts
of family histories characterized by generations of members with the illness or
significant aspects of it, she argues that manic-depressive illness is “indisputably
genetic” (1993, 16). Those committed to biopsychiatry, such as Jamison, insist
on a genetic and biophysical determinacy of mental illness perhaps as a way to
gain acceptance for it as a legitimate illness no less serious than cancer, with a
potentially fatal outcome.6 Without drug therapy, Jamison claims, a condition
of manic-depressive illness will inevitably worsen, with an increased risk of
suicide (1993, 16).
One can sympathize with a sense of frustration behind Jamison’s insistence
on a pure, unalloyed genetic and biophysical basis of mental illness in general
in a culture where mental illness has become a flippantly used catchphrase:
“I’m mentally ill. You’re mentally ill. We’re all mentally ill. People aren’t sick;
society is.” However, notably, after listing many prominent writers, artists, and
composers with probable, undiagnosed major depression, manic-depression, or
cyclothymia (mild manic-depression), Jamison admits in a footnote, “Many
of [these] had other major problems as well, such as medical illnesses. . . ,
alcoholism or drug addiction . . . or exceptionally difficult life circumstances”
(1993, 268).7 Their mental illnesses were surrounded by other problems in social
living. These problems, one could argue, unavoidably influenced their illnesses.
Thus Jamison’s reduction of their illnesses to their genetic, biochemical, and
biophysical components is not convincing.
The manic-depressive illness of poets is related not only to their social
marginalization but also to the marginalization of mental states associated with
mania. One problem with arguing for the recognition of an illness like manic-
depression as a genuine illness and disability is that mental states central to
the condition can be socially advantageous. But their very extraordinariness
makes these also social liabilities. For instance, in the manic phase of manic-
depressive illness, there is a rapid increase in goal-directed activity (socially, at
work, or at school) and an increase in the production of ideas, with high self-
esteem and enthusiasm (Jamison 1993, 262). However, all planes must land,
and because a person experiencing mania does not want to come down she
will experience landing as crashing. She crashes down into a world that has
outlawed natural states of intense exhilaration and exaltation, preferring that
these states be induced and controlled through artificially engineered products
that are dangerous and illegal. It is a world that has outlawed manic thinking,
or “divergent thinking” (Jamison 1993, 106), which often precedes or informs
such pleasure—thinking which spins off into a variety of different directions
and is not content with a box at the end of a question, as if there is only one
conclusion or answer. It is a world that does not recognize the beauty of colors,
90 Hypatia

often keenly appreciated in mania, where those fashioning beautiful tableaux

of color cannot earn a living doing so and have to pay to rent places where
others can come to enjoy them. It is a world where abilities heightened in
mania—fluency of thought, verbal fluency, and ideational fluency, or the abil-
ity to rapidly produce relevant, original, or innovative ideas—do not cause
appreciation or admiration in others but, rather, distress, fear, or anger. Running
a mile a minute is seen as commendable; talking a mile a minute is not.
Kate Millett, who was diagnosed with manic-depression, refers to the social
rejection of mania: “Depression—that is what we all hate. We the afflicted.
Whereas the relatives and shrinks, . . . they rather welcome it: you are quiet
and you suffer. . . . For we could enjoy mania if we were permitted to by others
around us so distressed by it, if the thing were so arranged that manics were
safe to be manic awhile without reproach or contradiction, the thwarting and
harassment on every side that finally exasperates them so that they lose their
tempers and are cross, offensive, defensive, antagonistic—all they are accused
of being” (1990, 72). Wendell argues that fear of “the other” is at bottom a
fear of oneself, of one’s own vulnerability or susceptibility to the object of one’s
response (1992, 73). As Millet exclaims: “How crazy craziness makes everyone,
how irrationally afraid. The madness hidden in each of us . . . The more I fear
my own insanity the more I must punish yours” (1990, 68).
People who exhibit the extraordinary traits found in mania are berated
for them, treated as children and punished, force-fed medicine “for their own
good”: “Accusing me of mania, my elder sister’s voice has an odd manic quality.
‘Are you taking your medicine?’ A low controlled mania, the kind of control
in furious questions addressed to children, such as ‘Will you get down from
there?’ . . . [A friend’s] hand approaches my mouth so fast I hardly see it; she is
forcing the pill between my lips, her other hand reaching to hold my chin, as
one forces a child to take pills, even a dog” (Millett 1990, 32–58). Women who
are manic are particularly vulnerable to others’ abuse since, as Chesler claims,
women are conditioned to be filled with self-doubt and insecurity rather than to
have the opposite, inflated self-esteem or grandiose enthusiasm—traits that are
seen as normal and encouraged in men. Women who are denounced for their
mania are rejected for their “unwomanly” abilities or behavior, a denunciation
that they may internalize: “You should shut up because you talked too much
before, you should close down all your capacities because you were boastful
and extravagant about them before” (Millett 1990, 72). Conventional feminine
behavior involves quietness, self-effacement, and cautiousness that does not
give rise to manic, risky involvement in pleasurable activities like sexual affairs
or financial investments, activities that are condoned, even applauded, in men.
Women who display mania are doubly deviant, defying norms of femininity
and challenging an Aristotelian paradigm of humanity as self-controlled and
moderate, occupying a mean between extremes. Women who exhibit levels
 Andrea Nicki 91

of self-confidence and initiation that would be seen as normal or average in

men risk being labelled “mentally ill.” Further, they might apply this label to
themselves, judging themselves mentally ill for self-praises or brilliant ideas,
especially insights into women’s oppression (as in: A woman talks passionately
and tirelessly about radically feminist critiques of culture and wonders if she is
“crazy.”). As a result of this denigration, imposed by others or self, women might
become mentally ill. Persistent insecurity and self-doubt develops into clinical
depression, just as genuine mania, through others’ incessant beratement, turns
into manic-depressive illness.
In the absence of any cultural or social analysis, we risk applying the category
of “mental illness” to people who are simply nonconformist, thereby promoting
more mental illness. Unless attention is given to the cultural or social aspects
of genuine mental illnesses, we risk giving these illnesses overly personalized
explanations—“bad genes,” faulty biochemistry, and so on—and viewing them
as purely personal problems, in no way social. This is not to deny that there are
cases of mental illness that have primarily a biochemical or physical cause. For
instance, Wendell sometimes suffers from severe depression caused by chronic
fatigue immune dysfunction syndrome (1996, 174), and people may be afflicted
with mental illness as a result of brain injury or damage. But the reason that
members of oppressed groups form a high percentage of mentally ill people is no
mystery. Mental illness is found predominately among such groups as women,
homosexuals, the poor, unemployed, or homeless, the physically disabled, the
racially marginalized, or the elderly.8 In societies with rampant prejudice and dis-
crimination, social inequalities, violence against women and children, unequal
access to health care, low-paying jobs, unsafe working conditions, technologi-
cal domination, chemically compromised natural environments, waste, greed,
egoism, and so on, members of oppressed groups will be more likely to become
chronically or perpetually physically and/or psychiatrically disabled, with their
minds overwhelmed with the negative realities in their lives.

Feminist Theory, Mind-Body Dualism,

and Coping with Disability

Understanding the role of social and cultural factors in physical and psychiatric
disability includes understanding the contribution of mind-body hierarchical
dualism to social and environmental problems. According to this dualism,
mind and body are seen as oppositional and the mind is valued over and against
the devalued body (Warren 1998). The devaluation of the body includes the
devaluation of entities associated with it, such as emotion, women, nature
(Warren 1998). However, in a society based on mind-body dualism and other
hierarchical dualistic conceptions, such as able-bodied/disabled and able-
minded/disabled, people with physical and mental disabilities are forced to
92 Hypatia

conceive of their struggles to some extent according to a norm of value-

hierarchical thinking. Coping with disability requires learning to work with
rather than against a negative body or mind. In this section and the next
one, I show that because of various sources of oppression and social pressures,
an oppositional relationship between self and body or self and mind can be
difficult to transcend.
Wendell discusses the feminist preoccupations with challenging mind-body
dualism, which has fundamentally structured patriarchal theories throughout
the ages, and with affirming the value of the body and bodily experience (1996,
165–69). She argues that feminist theorists need to take into account struggles
that people who are physically disabled have with their bodies as sources of
pain and frustration. The body can be confused and confusing, providing
information that is false and misleading, as in the case of chronic pain which
is meaningless and does not, as with acute pain, signify immediate danger
(Wendell 1996, 173). For people who experience their bodies as intractably
negative, the ideal of bodily transcendence has appeal (Wendell 1996, 166).
Feminists’ celebration of the female body has been accompanied by celebra-
tion of the female mind which patriarchal theorists denigrated when they cast
women as other, body and mind, more body than mind. However, in the case of
people with psychiatric disabilities, some transcendence of the mind is desired.
Just as the body can be deceptive and misleading, so also can the mind. For
people with psychiatric illnesses the mind is sometimes experienced as other,
as untrustworthy and disordered, and certain thoughts, ideas, and negative or
morbid beliefs need to be transcended.9 For instance, a person suffering from
clinical depression is plagued by negative judgements regarding her own worth
or abilities which are not accurate but which if not overcome may lead her to
abandon or sabotage important projects. Some women have ceased to trust
their minds because they have been subject to gender-based violence—because
they have been experienced as so infuriatingly “other”—just as a woman might
become physically disabled after a male lover beats her. In this case they
might be tortured by ideas of self-blame that make them believe that they are
unworthy of respectful treatment or that resistance is futile. Negative thinking
might extend far and wide. Everything is caught up in it; there is no help,
comfort, or sanctuary perceived in anything or anyone; everywhere seems
horribly unsafe.
The kind of transcendence that Wendell favors toward the negative body
involves a sensitive attunement to it, learning to adjust to its differences and
changes. Wendell gives an example of such attunement when she claims that
if her body tells her she must rest, she curtails her activities, explaining that
ignoring her body’s need to rest could result in a worsening of her condition
(Wendell 1996, 173). Similarly, sensitive attunement to a disabled mind would
also mean working with its differences and changes. This could mean, in the
 Andrea Nicki 93

case of those with traumatic memory syndrome, that they should not push for
the recollection of memories if recollecting is causing too much distress and
intensifying their symptoms, producing nightmares and intrusive flashbacks
throughout the day. Further, such sensitive attunement could also mean avoid-
ing situations or people that might trigger traumatic memories when survivors
are feeling emotionally drained from other sources of stress. Survivors could
monitor their responses and feelings toward others so that they do not become
entangled in relationships where they will be exploited and their recovery
threatened.
But just as the state of one’s body or one’s mind is not under one’s complete
control, likewise sensitive attunement to a negative body or mind is not always
possible, nor can one always respond appropriately. Particularly overburdened
and overstressed people, such as women with multiple roles—self-abnegating
mother and wife and full-time worker outside the home—may not have the
time or the necessary supports that would allow them to pay attention to their
bodily and psychological needs and respond accordingly. Notably, Christine
Overall relays how people regarded her illness of viral arthritis mistakenly as
the result of intense and constant exertion to hold her place in academia (1998,
157). However, she remarks significantly in a footnote that such great exertion
was necessary because of the prevalence of sexism in academia, specifically,
the belief that women are less able to hold positions, and the higher standards
for women’s performance (1998, 157). As Wendell states, people who look for
purely internal causes of someone’s illness have a myopic view of the sufferer
and her condition, wondering only what she must have done to get herself in
that state (1992, 72). Heavy children on a mother’s back could very well wear
her down physically and/or psychologically. While, as Wendell claims, “health
and vigour” are not “moral virtues” (1992, 72), these can be better obtained
the more socially privileged one is (just as financial generosity and liberality
are easier for the wealthy to achieve).

“Normalcy,” Psychiatric Disability, and the Workplace

Social arrangements which do not accommodate people with disabilities inten-

sify their disabilities. In this section I show that modifying the social environ-
ment of the workplace, and the norms of behavior and personal interaction
that structure it, can serve to liberate people with disabilities (Wendell 1992,
69). Toward this end of liberation, it is important to challenge a paradigm of
humanity as invulnerable, happy, and carefree. Cultural pressure on people
with depression-centered mental illnesses to be cheerful and to completely
deny their illnesses promotes in them an unhealthy oppositional relationship
with their negative minds. In implying that people who suffer from clinical
depression really suffer from negative personality traits, such pressure also
94 Hypatia

supports their low self-esteem. I stress that sound understanding of psychiatric

disabilities is important in making changes in the workplace that support those
who are psychiatrically disabled.
Wendell discusses how Western society is structured on the assumption that
everyone is physically healthy and strong, that everyone can work smoothly
and efficiently at the same rate, managing with the same number and length
of breaks (1992, 69). Overall emphasizes specifically how the environment
of academia can be both physically and socially inhospitable to people with
physical disabilities (1998, 151–60). Overall talks about how she was, as a
temporarily physically disabled person, subject to “pressure to pass for normal”
(1998, 155). Some faculty and students continued to make demands on her
with full knowledge of her weakened condition as though she were not really
or seriously impaired (1998, 156).10 In the case of people with psychiatric dis-
abilities, the obstacles in the social environment are in some ways similar but
in others different. Overall relays Lois Keith’s (1996) point that the pressure
to pass as normal brings with it a requirement that one appear cheerfully
pleasant at all times, and not at all affected by pain (Overall 1998, 166). This
is a requirement imposed on the abled and disabled alike. There is a cultural
insistence on cheerfulness; we are always supposed to appear as though life
were happy and carefree (Ariès 1974). While, as Overall states, underlying the
insistence on cheerfulness in disabled people is the fear that they are needy
and demanding (1998, 168), a cultural insistence on cheerfulness in everyone
expresses the fear that everyone is needy and demanding. This is the fear
of one’s own vulnerability which the “othering” of disabled people expresses
(Wendell 1992, 74). The cultural demand of cheerfulness is also supported by
the requirement of social conformity and acceptance of the status quo.
Overall claims that the pressure to seem happy at all times affects the
psychological harmony of disabled people (1998, 167), forcing them to deny
feelings of discomfort and pain and so reject their disabilities as true parts of
themselves. The pressure on the disabled to be cheerful is particularly intense
for people afflicted with mental illnesses to which depression is central, since for
them the pressure to be cheerful requires a full-fledged denial of their disorders.
People suffering from a physical disability can explain their lack of cheerfulness
by reference to physical pain or weakness. They may encounter many people
who find this explanation inadequate, who tell them that they simply do not
want to get better or that they have not tried all possible treatments, perhaps
from a lack of effort (Overall 1998, 157; Wendell 1996, 97). People suffering
from a psychiatric disorder, on the other hand, may receive no sympathy or
concern whatsoever, or only concern from those who have suffered from the
condition themselves, or who had a friend or relative so afflicted.11
Those who have no familiarity with the world of psychiatric disability may
not only be dismissive of explanations of psychiatric illness, not seeing it as
 Andrea Nicki 95

real illness, but outright hostile toward these explanations, seeing an afflicted
person as emotionally immature, self-centred and self-indulgent (focusing too
much on her own problems), attention-seeking, or morally or spiritually weak
(not able to cope with life). Of course a mentally ill person could be all these
things, but such traits do not in themselves inform or reveal mental illness.
There is no inherent correlation between these features and mental illness. A
person who tells others she is suffering from a mental illness such as depression
may be told, like a person suffering from a physical illness, that it is “all in her
mind.” Her condition and symptoms are perceived as imaginary, as if she were
not really depressed but just thinks she is. Or her condition is thought to be
self-imposed, as though she were willfully depressed (perhaps with the view
that she is conforming too strongly to a female role of self-destruction and
helplessness). But in the case of a person suffering from a mental illness, the
claim that her illness is “all in her mind” would be in one sense correct. Her
condition is fundamentally constituted in her mind, in negative thoughts about
herself, about her worth and value, about her life and future, possibly about
others and their lives, or about the world in general as hopelessly evil. These
thoughts are like the eyes of storms of sad or angry emotion by which others
may feel resentfully engulfed. Insisting that a person suffering from clinical
depression be cheerful, they demand that she not only hide her illness—her
tearful or raging negativity—but that she immediately overcome it in order for
them to continue to respect her as a person. If a person cannot control her
mind—that which allegedly distinguishes persons from animals—the assump-
tion is that she must be mentally defective and so not deserving of full human
respect.12
People suffering from clinical depression risk becoming more depressed
because of the hostile and confused attitudes of others regarding their illnesses.
Those who insist that people suffering from depression be cheerful ignore the
reality that depression, for those afflicted, is an undesirable state of unwelcome
thoughts and doubts that fill every corner of the mind—the thought of death
the worst intruder. If those afflicted could so easily overcome their conditions,
they would.
Notably, Millett concludes her book by displaying a speed of thought, a
wonderful flight of ideas—a denigrated state of manic consciousness which she
reclaims and champions: “We do not lose our minds, even ‘mad’ we are neither
insane nor sick. Reason gives way to fantasy—both are mental activities, both
productive. The mind goes on working, speaking a different language, making
its own perceptions, designs, symmetrical or asymmetrical; it works. . . . Why
not hear voices? So what?” (1990, 315). In this passage Millet is directing her
arguments against, specifically, the cultural treatment of people diagnosed with
mental illnesses as criminals to be treated with forced hospitalization, drugging,
electroshock, or other “savage methods” (1990, 314). However, as Millet claims
96 Hypatia

earlier in her text, whereas mania is desirable (except for mania in an irritable
form, which can be highly unpleasant), severe depression is not. Further, the
poet Anne Sexton (a survivor of childhood sexual abuse), who heard voices
telling her to kill herself, experienced these hallucinations as invasive and
coercive, as her mind working against her, speaking a language that was hostile
to her and that she could not silence (Middlebrook 1991, 16). There is a certain
fantastical soar to Millett’s claims that forgets about mental illness as a response
to oppressive life circumstances, about a mind fettered by trauma, cruelty,
neglect, prejudice, or discrimination. Millett writes, “If we go mad—so what?
We would come back again if not chased away, exiled, isolated, confined”
(1990, 314). Certainly, there is much that is wrong with aggressive approaches
and medical treatments concerning mental illness.13 But mentally ill people
are disabled by their illnesses and have difficulty functioning from day to day,
with adverse effects on various aspects of their lives.
Better understanding of psychiatric disability has great social and economic
importance. If others perceive a mental illness in a co-worker simply, and
unsympathetically, as a personality problem, the latter may be fired, not re-hired,
or not promoted. While understanding of psychiatric disability is important for
good communication in the workplace, and for the avoidance of misunderstand-
ings, a person suffering from a psychiatric disability might keep her condition a
secret for fear that others might be unsupportive about its background causes.
Some common psychiatric disorders such as “borderline personality disorder”
or “multiple personality disorder” are strongly linked to histories of childhood
sexual abuse (Herman 1992, 97). Because of the strength of this link, some
psychiatrists have proposed a new diagnosis for survivors of childhood abuse
called “complex post-traumatic stress disorder” (Herman 1992, 120). For the
psychiatrically educated, disclosures of these traumatic disorders can amount
to disclosures of abuse. Thus, in making their diagnoses public, the afflicted
risk putting themselves in the very vulnerable position of having possibly two
stigmatized identities, that of “disabled” and that of “abused child of ‘bad
blood’” (shameful parents and “defective genes,” as in, “Her own family abused
her”).
Making the work/social environment more hospitable to people with psychi-
atric disabilities would involve challenging a lot of prejudices and conventional
ways of thinking that blame victims and judge individuals in terms of family
backgrounds, including, of course, class and racial backgrounds (as in, “She
must be lying about the abuse; her parents are highly respected people”). It
would also require a greater place for the personal so that disabled people could
openly discuss and explain their conditions and limitations.
 Andrea Nicki 97

Trauma-Related Disorders and Feminist Ethics

In the case of people with trauma-related disorders, discussing their conditions

could involve explaining behavior and decisions related to their recovery that
express values outside of mainstream moral thought. People with traumatic
disorders may need to realize alternate moral values for their recovery. In this
section I argue that feminist ethical theory can be inclusive toward people with
psychiatric disabilities linked to abuse by affirming a wide range of moral pos-
sibilities, and not simply ones that express love, compassion, and interdepen-
dence.
Wendy Donner criticizes Karen Warren’s ethic of care for, in cherishing
an ideal of interdependence, essentially marginalizing people with difficulties
related to histories of abuse (Donner 1997, 385–88). She explores the case of
Elly Danica, a woman who wrote an autobiography (1988) about her experi-
ences of incest and emotional abuse, her sense of entrapment in marriage
and childcare, her subsequent departure from her husband and child, and her
solitary existence. As Donner argues, Danica achieves a better life only by
realizing selfishness as a moral value and severing all ties with others: “I have
no energy to bring anyone with me. No energy for relationships, not even with
a cat or a goldfish. . . . Soul dwelling: found. Self: found. Heart: found. Life:
found. Hope, once lost: found. . . . The mind, Free. Freedom. Bestowed from
within. Self . . . I am” (Danica 1988, 91–95). Only by caring for and loving
herself in separation from others can Danica be able to properly love others
(Donner 1997, 338). According to Donner, Warren’s account recognizes as
moral values only pleasant dispositions like compassion, kindness, empathy,
and sensitivity. However, as other care ethicists argue, in a sexist culture where
women’s self-sacrifice through caring is wrongly extolled as a moral virtue,
women’s selfishness through not caring can be morally good (Fisher and Tronto
1990, 35). Women should value their own well-being rather than abusive
relationships sustained by a love that excuses those who severely harm them
(Tronto 1987, 660). For survivors of violence, like Danica, realizing unpleasant
dispositions such as anger, callousness, insensitivity, and indifference as moral
values is necessary for their recovery and moral development—for them to be
capable of compassion and love. It is simply not realistic to maintain that one
can move from a very low level of self-devaluation, from feelings of worthless-
ness and self-hatred, to a level of free-flowing love and compassion for others,
where one generously and warmly supports others’ lives. Other, intermediate
steps, which are marked by unpleasant dispositions, are needed to get to a
higher moral level.
The outward expression of hostility is particularly important in people
with clinical depression. As theorists, such as Freud, have traditionally argued,
clinical depression is hostility turned inward. Hostility that could or should be
98 Hypatia

directed outward in response to abuse and injustices is turned against the self.
Marilyn Frye claims that anger “implies a claim to domain,” a claim that
one’s projects, activities, and interests are worthy of respect (1983, 87). In the
case of women suffering from traumatic disorders as a result of chronic abuse
from battering partners, achieving unpleasant dispositions such as anger and
callousness toward their abusers may be necessary for their survival and moral
growth. As Claudia Card claims, a woman who ends an abusive relationship
“may be growing ethically in overcoming a sexist training to put others’ needs
consistently ahead of her own” (1996, 88). To forcefully escape an abusive
relationship, a woman may need aggressive tools, which include the emotion
of anger. Several feminists (Card 1996, 88; Cuomo 1999, 272) have referred to
the inevitability of “dirty hands” in moral endeavour, where one is not purely
an oppressed but also an oppressor. Sometimes the best one can do is to choose
the least harmful option and, after acting, to leave the situation with slimy
feelings of regret for having to cause harm at all (Card 1996, 88). However,
sometimes one can only become “cleaner”—morally better—by dirtying one-
self, as when one rubs sticky hands through dirt to get them clean. Dirtying
oneself may be seen as part of the project of “getting cleaner,” more able to freely
express compassion and love. A feminist ethical account that does not mar-
ginalize people with certain psychiatric disabilities should not underestimate
or undervalue the ideals of autonomy and independence. Feminist ethicists
have been critical of traditional Kantian ideals of autonomy and independence,
arguing that these lie outside female identity, which is based on ideals of
connectedness and interdependence (Wendell 1996, 144). Wendell upholds
these critiques as expressing sensitivity toward those who are unable to achieve
ideals of autonomy and independence because they need a great amount of
help from others (1996, 145). On her view, alternate ideals of connectedness
and interdependence value the lives of the disabled in valuing the relationships
of dependency and interdependency so central to them (Wendell 1996, 145).
However, as Donner argues, accounts that emphasize connectedness must be
careful not to ignore the lives of severely abused women for whom a strong
sense of disconnectedness, of being separate and apart, is necessary in their
struggles to manage, overcome, or survive their mental illnesses (1997, 385).
For people like Danica, from severely abusive families, connectedness is a great
source of despair and self-hatred (Donner 1997, 385).
Further, while the ideal of autonomy may present an unrealistic demand
for people with disabilities in general, who need a great amount of help from
others, this ideal may be acutely demanding for people with multiple personality
disorder. Such people may not be able to achieve a unified personality and
continue to rely on different personality fragments or modalities to express
different emotions and behavior. Moreover, in addition to undervaluing the
lives of people with multiple personality disorder, the ideal of autonomy could
 Andrea Nicki 99

serve to undervalue the lives of people suffering from manic-depression who do

not have a tightly unified self which they can regulate and control. People with
widely varying moods, thoughts, ideas, or feelings, whose inner lives contract,
expand, or fly across personal boundaries, will have their lives devalued for
coursing and receding like waves.14 Thus, while feminist theory of psychiatric
disability should not neglect the moral value of selfishness expressed in the
ideals of autonomy and independence, it should be aware of the limitations of
these ideals to cast value on the lives of psychiatrically disabled people.
Finally, linked to the ideal of autonomy is the ideal of detached rational-
ity. Kantian philosophers maintain that moral agents have self-respect and
are reasonable, acting according to principles mutually agreed upon by other
reasonable agents. These claims marginalize people with trauma-related psy-
chiatric disabilities who have fragile self-respect and who, because they have
mental illnesses, are necessarily cast as unreasonable, as explored earlier. In
her essay “Moral Failure,” Cheshire Calhoun presents a Kantian conception
of moral agency. She claims that there are four basic commitments, including
the principle of character, involved in attempting to engage in moral action:
“a being with moral character . . . will cultivate and express the virtues” (1999,
84). She argues that with “sufficient bad luck, our moral lives can fail because
they are characterized by abnormally frequent unintelligibility to others” (1999,
84). In stressing the predominant social and moral understandings, which
regard moral revolutionaries, those who challenge so-called just social systems,
as perverse, Calhoun concludes that the lives of moral revolutionaries will be
partially “moral failures” (1999, 97). Wendell maintains that in societies that
regard certain human ideals as very important, those who cannot achieve these
ideals will feel inadequate (1996, 145). Calhoun’s conclusion can only diminish
the self-esteem of moral revolutionaries, just as her belief that the cultivation
and expression of traditional virtues is necessary for moral character can only
fail to cast value on the moral achievements of people, such as traumatized
women, who may need to realize alternate moral values for their survival.15

No Fine Madness, Only Mind

In ethical discourse (and philosophical discourse in general) there needs to be

less talk of failures to realize ideals of rationality and autonomy and human
paradigms of normalcy and intelligibility. Rather, there should be more empha-
sis on the achievements both of those challenging oppressive social systems who
are typically seen as “crazy radicals” and of those with abuse-related psychiatric
disabilities who have been told far too many times through actions, words,
or silence that they are worthless. Abuse-related disorders are complex, with
psychological and behavioral components that others find bizarre and incom-
prehensible. Survivors of childhood abuse are frequently misunderstood in the
100 Hypatia

mental health system, accused of manipulation or malingering (Herman 1992,

123). Typically they receive many different diagnoses before being understood
as having a complex post-traumatic syndrome (Herman 1992, 123). The failures
that one should speak of are failures in others to open the windows of their
own closed worlds of intelligibility and dare to venture into other worlds of
meaning. Calhoun asks, “Would we think it tragic that a life devoted to
doing the right thing was incomprehensible to others or vilified as perverse,
irrational, or immoral?” (1999, 97). This question she answers affirmatively. I
prefer this question rephrased as, “Would we think it tragic that others could
not appreciate the moral excellence of a life and vilified it as perverse, irrational,
or immoral?” To this question I respond affirmatively. Similarly, it is important
that others try to appreciate the difficulties and struggles of those with abuse-
related disorders instead of seeing them as irrational and seeing necessary
selfishness during their recovery as a sign of moral inferiority or moral damage16
rather than as a sign of blossoming self-respect. It is tragic that the predominant
meaningful worlds cannot appreciate the meaningful worlds of those with
psychiatric disabilities and accept them, thereby lessening their suffering.
Feminist theory of physical disability focuses on society’s oppression of the
body, of the alternate bodily states found in the physically disabled (Wendell
1992, 78). Similarly, feminist theory of psychiatric disability concerns the
oppression of the mind by a society that rejects and despises the alternate
mental states found in the psychiatrically disabled. The history of Western
thought has not truly been about the glorification of the mind. True apprecia-
tion will come when there is no more oppressive talk of some mental island
called “madness” to which one in illness goes, no more morbid romanticization
of offshoots of oppression and abuse—of “mad starving artists”—or scientific
mystification of fettered minds. Let there be no more beliefs that partition the
complex wheel of the mind or that enforce the isolation of those suffering from
oppression and mental illness.

Notes

I would like to thank Le Centre D’Artisanal des Femmes, a non-profit women’s arts
and crafts organization for underemployed and disabled women in Montreal, where
I worked as an instructor in the summer of 2000. The women I met shared with me
their experiences with abuse, mental illness, and psychiatric treatment. The central
arguments of this paper grew in conversation with artists Andrée Blackburn and
Giovanna Parenté. I would also like to thank the three anonymous reviewers of Hypatia
who provided very constructive feedback on a much earlier version of this paper.
1. See Paula Caplan (1995) for a fascinating discussion on the formal processes
used by the psychiatric establishment to determine legitimate categories of mental
 Andrea Nicki 101

illness. She argues that judgments regarding proposals of categories of mental illness are
sometimes fraught with biases and assumptions that support the status quo.
2. Ninety percent of anorexics are women (Bordo 1993, 140). In 1973, when a
suicidal Ellen West stopped eating, anorexia nervosa was relatively rare (Bordo 1993,
140). In 1984, however, roughly “one in every 200–250 young women between thirteen
and twenty-two suffer[ed] from this disorder” (Bordo 1993, 140).
3. See Frye (1983) for a discussion of the cognitive impairment involved in an
arrogant perception of others.
4. See Joan Dunayer (1995) for a discussion on sexist, speciesist language.
5. Similarly, Claudia Card, in discussing the strongly negative meanings of “les-
bian” in heterosexist society, writes, “It is absurd to think that you can change the
meaning of something just by intending a different meaning when you use it yourself
or with your friends” (1996, 150).
6. Notably, Wendell writes that people with unrecognized physical illness may
be “socially isolated with it by being labeled mentally ill” (1992, 78). Psychological or
psychiatric explanations of serious physical illnesses serve to invalidate these illnesses
partially because mental illnesses are not seen as real illnesses.
7. It is not surprising that female poets, for instance, would be especially prone
to mental illness or that their mental illness would be sustained through their work,
notwithstanding their social marginalization. As Germaine Greer (1995) argues, the
female norm of self-destructiveness is exemplified in criteria for “the great female
poet.” On Greer’s account, the most celebrated female poets of the twentieth century
are women who killed themselves and who documented the course of their self-
destructiveness through their creations (Greer 1995, 390). Plath’s blazing final poems
about dying and self-contempt (for example, “Lady Lazurus,” “Daddy”) and her poem
entitled “Edge” about self-completion, which records her final acts before her suicide
(for instance, of leaving her children with bottles of milk) are literally scripts for her
self-destruction.
8. For instance, 50 percent or more of the institutionalized (neglected or abused)
elderly suffer from a mental illness (Smyer 1995, 164). Regarding rates of mental illness
found in homosexuals, Joan Callahan relays that “roughly 30 percent of gay teenagers
report attempting suicide, and roughly 40 percent of all attempted teen suicides are
connected to real or perceived homosexual orientation” (1999, 263).
9. Inasmuch as perceptions, ideas, and evaluations are informed by and inform
emotional states like despair, rage, and hatred, which partially constitute some psychi-
atric illnesses, people suffering from these will desire some transcendence of emotion,
which patriarchal theorists have devalued with the body. This view does not affirm
a rigid mind-body dualism, as it recognizes the cognitive content of emotion and the
emotional affect of cognition.
10. I do think, however, that the pressure that non-disabled persons impose on
disabled persons to pass as normal does sometimes stem from a fully aware, shameful
sense of the true nature of their behavior; yet they believe that this behavior, though
unfair and unreasonable, is unavoidable. For instance, a teaching assistant who is taking
a prolonged length of time to mark essays, albeit for a good reason, might compromise
the health of the course, because students need feedback on their work for upcoming
assignments and the professor needs an assessment of student comprehension before
102 Hypatia

making any course adjustments. This case illustrates that a teaching assistant’s difficulty
in passing as normal may disturb an academic balance that is fragile because of a
strong general insistence that everyone be continually normal when this insistence is
unreasonable. By not taking into account the potential of a compromised capacity to
function, this insistence jeopardizes the health of the academic environment.
11. This, of course, is not an argument that those with psychiatric disabilities are
worse off than those with physical disabilities, or that the former deserve more concern
than the latter. Here I am simply exploring differences in social attitudes toward those
with psychiatric disabilities versus those with physical disabilities.
12. Notably, in the French language one might say of a mentally ill woman, “Elle a
l’air bête.” While figuratively this expression means she seems “crazy,” literally it means
that she seems like an animal, “bête” translating as “animal.” Further, the expression
“crazy as a loon” also reinforces both the oppression of animals and that of people who
are mentally ill, in invoking a negative image of an animal to insult a person who is
(or judged to be) mentally ill.
13. For a critique of modern pharmaceutical interventions in mental illness, see
Breggin (1994).
14. A patchwork quilt is called a “crazy quilt” because of its multiple, disparate
elements.
15. Calhoun’s view of moral failure involves the notion that expressions of self-
respect in members of subordinate groups may be misunderstood by others as displays
of arrogance, as when they condemn members of dominant groups or express moral
outrage concerning injustices (1999, 86). Her conception of a moral revolutionary
does not include an individual who might in her struggle toward moral perfection
realize as virtues what are usually considered vices. In my account, on the other hand,
interpretations of selfishness, and not appropriate pride, in members of subordinate
groups may in some cases be correct, and this selfishness may be morally good, because
it furthers moral growth.
16. In The Unnatural Lottery Claudia Card argues that oppression damages victims,
making certain virtues difficult for them to achieve (1996). On her view, traditional
vices are justifiable for self-defense, but this justification does not make them virtues
(1996, 53). She writes: “Those who tell just the right lies to the right people on the
right occasions may have a useful and needed skill. But it does not promote human
good, even if it is needed for survival under oppressive conditions” (1996, 53). However,
such behavior promotes the human good of the survivor.

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