• Anna Putt

Women and Madness in the time of Britney Spears

From Woolf and Plath to Spears: an examination into the psychological treatment of women


In 1972, Phyllis Chesler’s book Women and Madness was first published in pursuit of uncovering the embedded sexism that was found in psychology at the time. The book has been edited numerous times since then to keep the information up to date, highlighting the continuous cultural relevance. Chesler explores different themes: asylums, the female career as a psychiatric patient, lesbianism, feminism, alongside Greek mythology, where she finds many origins to everyday sexism. The aim of this book is to break down the taboos and gender constructs that psychology, in both a professional environment and within the public sphere, is weighed down by.

When Women and Madness was first published, more than 90% of psychologists were men, but more significantly, there was a distinct lack of women in medical research as many did not include women in their studies. Men were seen to be the standard, leaving women to be considered “other” simply because their characteristics and symptoms sat outside of what the male “norm” was. Caroline Criado Perez also highlights this in her book Invisible Women, first published in 2019. She argues, similarly to Chesler, that we still see underrepresentation of women in medical research. For instance, in 2018, the British Journal of Pharmacology published a paper called “Gender differences in clinical registration trials: is there a real problem?”, in which the all male editorial team concluded that the problem simply wasn’t “real”. Women, in essence, have been treated as second class citizens throughout medical history. Dr. Inge K. Broverman, a notable female psychiatrist in the 1970s, challenged the outcasting of women in medicine by holding clinical trials with both men and women. Through these trials, Broverman discovered that there was a distinct double standard regarding mental health between the genders. Women were (wrongly) seen to be “more submissive, less independent, less adventurous, more easily influenced, less aggressive, less competitive, more excitable in minor crises, more easily hurt, more emotional, more conceited about appearance, less objective, and less interested in math and science” than men. Some of these states and descriptions sometimes share similarities with symptoms of mental illnesses.

As a result, women could be considered mad or neurotic, simply by being anything outside of what a man thought a woman should be. Different states exhibited by women were given no legitimate explanation, resulting in them being more easily and frequently diagnosed as mentally unstable. Men, on the other hand, had their anxieties and depression legitimised through the common acceptance of work-related stress and the pressures of providing for their family. This implicit emotional bias against women is a key contributing factor in the systemic devaluing of women in society, and it socialised women to devalue themselves on top of this. This is not to say that Chesler does not believe that some women do have mental health problems. Chesler distinguishes those who live with diagnosable mental health problems (for example, having more acute symptoms such as “experiencing certain transformations of self, or incorporating the meaning of certain heroines such as Joan of Arc...”), from those who are exhibiting typical emotional states.

Chesler frequently discusses the cases of Virginia Woolf and Sylvia Plath in her book. Both women were marred by challenging life experiences, such as sexual and domestic abuse, yet they were also seen to be irrational and mentally disturbed women on account of emotional instabilities. On account of Woolf and Plath exhibiting either sexual frigidity, or being in same-sex relationships, their “madness” was further legitimised. This resulted in both women being institutionalised several times, where they were most likely subjected to experimental treatments, isolation, sexual violence and medical neglect. Plath was famously treated with electroconvulsive therapy (ECT), and both had numerous suicide attempts before succeeding. It is clear to see how the treatment and hospital environments Plath and Woolf were subjected to could have done anything but support their mental health. It was certainly seen in society at the time (and often to this day) that there are “socially approved self-destructive behaviours”. In short, once a woman has started to display signs of neuroses, there is a common expectation that the woman will not get better, but instead will continue to decline. There is also a high chance that both Plath and Woolf’s multiple suicide attempts were not taken as seriously as a man’s might have been. Chesler highlights in the chapter ‘Asylums’ that men are statistically more likely to succeed in committing suicide the first time, while women are more likely to attempt suicide but fail to achieve the desired result. This led some psychiatrists at the time to believe that women often attempted suicide more for attention rather than anything else, and further shows that even in death, women were seen as less able than men.

Sadly, this taboo that Chesler identified in the 1970s is still attached to women in contemporary society, especially to those who appear anything outside of the social expectations or traditional constructs of how a woman should be. As Chesler points out, “men are generally allowed a greater range of acceptable behaviours than women are”. For instance, in Invisible Women, Perez draws upon the 2016 Clinton versus Trump US presidential race. In the run up to the election, Hillary Clinton was repeatedly referred to as “too ambitious” to be president. She was working too hard, displaying too much determination and enthusiasm and ultimately not being “ladylike” enough so she was dismissed by a large fraction of the general public and media. In one article from The Onion, the writer criticises Clinton, saying she is “bossy”, “extremely self-promoting”, that she “[should] just accept [her] place” and that “as a working woman, she should take those precious Sundays to spend some time with her family”. Whilst this language isn’t outright accusations of madness, the underlying sentiment of many Clinton sceptics during the presidential race was that she was acting outside of women’s socially acceptable behaviours and therefore was unfit to run for president. Donald Trump, on the other hand, took advantage of this greater range of acceptable behaviours through a nonchalant and sexually offensive attitude and pursued a seemingly lax political campaign, yet won.

Many could say we have come a long way in the discussion and understanding of gender differences in mental health considering this topic is more researched and understood than it was in the 1970s. However, in light of the backlash Clinton experienced during the electoral race and the recent case in the media surrounding Britney Spears’ conservatorship, the way in which women are viewed through the male gaze, particularly when in the public sphere, evidences the gendered link between women’s actions and emotions. Spears’ original “good girl” image played a key role in her route to fame from the young age of 17. She won the hearts of audiences of all ages by telling the world that her “virginity was important” to her, a stereotypical and traditional expectation that is placed upon young women. Her image was arguably the most important attribute to her fame, putting enormous pressure on her personal life. Any evidence of deviance would result in a media frenzy of her meltdowns or harrowing breakups dominating the news cycle. For instance, following her breakup with Justin Timberlake and her subsequent relationships with boyfriends that the public allegedly didn’t approve of, the world was fed regular images of her seemingly abusing drugs and alcohol. The press devised a self-destructive narrative, which fed much of the public's expectations that this was the path of a disgraced woman. By the time 2007 rolled around, Spears was in the midst of a divorce, had lost custody of kids, was in and out of rehab and the infamous head shaving incident occurred. In 2008 Spears was involuntarily hospitalised, the conservatorship was placed over her by her father, and the visitation of her two sons was suspended. The Britney Spears case is a complex, messy example of gendered politics and mental health issues being held up to scrutiny by the public. In Women and Madness (2005 edition), Chesler brings a very interesting study to light: in 2000, Elizabeth Klonoff, Hope Landrine and Robin Campbell published a paper that argued women sometimes displayed symptoms of depression and anxiety more than men because “women experienced a deleterious stressor that men do not: sexist treatment.” Clearly, the Britney Spears case reflects this study.

We can compare Spears’ situation to that of a male counterpart, for instance Michael Jackson. Jackson had numerous allegations of drug abuse and alcoholism, yet he was never removed from his children or had a conservatorship placed over him. This goes to show that Spears is another victim of daily sexism, whereby she must continue to prove her competency, financial acumen and sanity despite being held in a pressure cooker situation. Resembling something that could have been lifted out of a dystopian horror, she has even been stripped of the authority to get her IUD removed. Furthermore, when it comes to the medication Spears has been administered under her conservatorship, such as valium and lithium, both are drugs that have problematic impacts on women. As Perez points out in her chapter called ‘The Drugs Don’t Work’, valium has historically been aggressively marketed towards women for decades, for conditions ranging from anxiety to epilepsy. This also played a significant role in developing the popular idea that women were generally less emotionally stable than men and should be medicated. However, it was discovered in 2003 that valium had “never been tested in randomised clinical trials with female subjects.” Similarly, women notoriously react less well to lithium, often resulting in symptoms including depression and bipolar. In a paper titled “The History of Lithium Therapy”, Edward Shorter doesn’t mention the impact the drug has on women versus men during clinical trials, which suggests that the drug may never have been tested on women – the norm of medical trials, as we know, is men.

Britney Spears can be seen as a modern day example of how the Western patriarchal construct of female madness is used as a convenient tool to silence and control women. The example of Britney Spears also goes to show how women are still caught up in a trap of performance and voyeurism, of which the audience plays a key role. For Spears, the media circus that surrounds her every mistake is reminiscent of a Victorian freak show and is similar to the downfall that both Woolf and Plath experienced within the public eye. In the cases of Plath and Woolf, the socialised expectation that the woman will continue to decline can actually be seen as an expectation that a woman should decline once tainted with a reputation such as “madness”. For the most part, the conditions in nineteenth and twentieth century asylums often left women open to both physical and mental abuse. At times, a woman’s virtue was assumed to be tainted, earning her a reputation that, at the time, was considered worse than death. For many women in asylums during this period, suicide was often seen as the only option they had. The subject of the circus is not abnormal: instead, doesn’t the abnormality lie in the public who expect women to perform in a certain way, and then watch with enjoyment as these women crash and burn? Women such as Spears, Plath and Woolf have their madness propelled into the public sphere. The audience can gawp, laugh and pity in order to make a public spectacle of themselves to prove that they understand the consequence of women not performing in a certain way. However, women have a socially acceptable option to prevent them from falling into disgrace. Chesler refers to this in her final chapter as “the compassion trap”, where women are caring, charitable, supportive, selfless and subservient when in public. This women-led sympathy in the public sphere can lead men to expect a similar amount of sympathy and devotion in the home. If they don’t receive it, women are instantly painted as “nags and bitches, ungrateful and manipulative.” As women are so often pigeon-holed into caregivers, these boundaries can be misunderstood in a private environment. As a result, there is still a common perception of a woman’s character which has been built off the back of idealised stereotypes and the purveyor’s own fear and naivety, which fails to reflect a fair and comprehensive picture.

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  1. Women and Madness, by Phyllis Chesler, 2005

  2. Invisible Women: Exposing Data Bias in a World Designed for Men, by Caroline Ciado Perez,

  3. The Battle For Britney: Fans, Cash and Conservatorship, BBC, 2021

  4. Britney Spears’ Battle To Take Back Control Her Life and Fortune, The Guardian Today In Focus, 2021

  5. Like A Virgin: How Purity Culture Harmed Britney Spears & A Generation Of Pop Stars, Refinery 29, 2021

  6. How Psychiatry Promoted the Patriarchy, Ethan Moss, New Histories, 2020

  7. What Neuroscience Says About The Link Between Creativity And Madness, Eric Jaffe, Fast Company, 2013

  8. Canadian Institute of Health Research, The history of lithium therapy, Edward Shorter, 2013

  9. What Britney Spears has endured would not have happened to a male star, The Washington Post, Helaine Olen, 2021

  10. Response to lithium maintenance treatment in bipolar disorders: comparison of women and men, Pubmed.gov, 2001