Gender, Culture, and Madness Exam 1

Epistemology/epistemological frames

• The study of how we know what we know. Epistemological frames are the lenses (religious, medical, cultural) that we use to interpret unusual experiences. 

• Different frames decide whether someone is labeled as divinely inspired, possessed, or mentally ill, showing that madness is culturally and historically constructed and highlights that making meaning of these experiences can be central to living with madness.. For example, Celeste interpreted her dissociative episodes through multiple frames: psychiatric (trauma), neurological (epilepsy), and religious (God/Devil).

Heriot-Maitland

• Heriot-Maitland argues that mystical and psychotic experiences share features, but whether they are distressing depends on how they are appraised.

• Challenges rigid boundaries between madness and mysticism, highlighting how social interpretation and cultural meaning shape experiences of self. This is important in understanding whether madness is simply a matter of classification or if there is something else that exists outside of our labeling of it. 

Mystical experience/mysticism

• Altered states of consciousness involving direct contact with ultimate reality and awareness of divine power far greater than the self. Mysticism refers to the structured practices aimed at achieving such states and was often seen as something desired.

• In medieval Europe, mysticism disproportionally affected women, with many female mystics engaged in fasting, self-denial, or ecstatic visions. This gave them religious authority, but also made them vulnerable to being labeled as hysterics or mad, showing how extraordinary states can be seen as life-enchanting or pathological depending on cultural and historical interpretation. 

Psychotic experience (in contrast to mystical)

• Psychotic experiences involve delusions, hallucinations, or disorganized thought/behavior, usually considered symptoms of mental illness. Unlike mysticism, these experiences were feared and out of a person’s control. 

• Comparing psychosis with mysticism shows how similar phenomena can be pathologized or sanctified based on cultural or institutional context, 

Experiences of oneness

• A state in which personal boundaries and constructs dissolve, leading to a sense of unity with everything.

• Women mystics often described oneness through metaphors of union with Christ. These experiences gave them a spiritual voice but also invited suspicion that their bodies and sexuality made them vulnerable to Satan or delusion, showing how personal and cultural interpretation decides whether these experiences are life-enriching or terrifying. 

Appraisals of oneness

• The way individuals and societies interpret experiences of unity. 

• Appraisals determine the outcome, whether these were positive or stigmatized. Women’s appraisals were scrutinized a they could elevate them to sainthood or condemn them as heretics.

Anxious Bliss

• Celeste, a Mexican nun, experienced ecstatic dissociative states that she and others interpreted through multiple lenses (trauma, neurology, God).

• This shows the ambiguity of labeling experiences as madness or mysticism and how making meaning of these experiences becomes central to a person’s wellbeing and acceptance. 

Madness and moral philosophy

• Madness was judged through a moral lens and seen as an imbalance between good and evil reflected in outward behavior. 

• This showed how cultural values tied madness to morality, family honor, community responsibility, and gender expectations rather than to biology alone. 

3 key developments regarding madness

• 1. The concept of the mind, 2. focus on the brain, 3. the asylum as a specialized institution. 

• Marks the shifts from religious/supernatural explanations to scientific and medical frameworks for madness, shaping psychiatry’s authority.

Humanistic perspectives on madness (vs. earlier understandings)

• Emerging in the Enlightenment, these views emphasized empathy, rational engagement, and the possibility of moral improvement for the mad and the community's responsibility to foster this.

• Replaced punitive or religious responses with attempts at humane treatment, linking psychiatry to broader cultural ideals of progress. 

Pinel and Tuke

• Reformers who pioneered moral treatment in asylums. Pinel in France and the Tukes in England. They criticized the previous reliance on drugs and confinement and used moral treatment.

• Their work exemplified a cultural turn toward seeing the mad as rational beings who could be rehabilitated, reflecting Enlightenment humanism.

Moral therapy

• A therapeutic approach focused on kindness, structured routines, and treating patients as reasoning individuals, instead of relying on confinement or harsh cures. 

• Illustrates how treatment methods reflect changing social values as this reflected humanistic and Enlightenment changes. 

Madness as moral failing

• During the Renaissance, people began to view madness as more of a moral weakness, weak will, indulgence, or uncontrolled passions. It was not just something to contain, but something that could potentially be “cured.”

• This shift positioned the rehabilitation of the mad as a metaphor for the moral and social rehabilitation of humanity itself. It reflects how cultural optimism about human perfectibility tied ideas of madness to broader themes of morality, gender, and the progress of civilization

Sexuality and moral imbalance

• By the 18th-19th centuries, madness was frequently linked to uncontrolled sexuality or disruptions in gender roles. 

• Demonstrated how psychiatry pathologized non-normative sexual and gender expression. 

Victorian Era (general dates, key themes)

• The reign of Queen Victoria (1837-1901) was marked by industrialization, colonial expansion, scientific progress, and strict gender roles. 

• The era’s cultural anxieties about gender, sexuality, and social change shaped psychiatric categories like nervous breakdown and hysteria.

Kraepelin

• Kraepelin was a psychiatrist who developed a disease model of psychiatry.

• His work medicalized madness as a disorder of the mind rather than of morality, laying the groundwork for modern diagnostic psychiatry. 

Nerves

• A 19th-century concept linking mental illness to the nervous system. Thought to be depleted by stress, overwork, or reproductive cycles. 

• This framed madness as biological yet gendered, since women’s fragile nerves were tied to menstruation, childbirth, and domestic roles.

Nervous breakdown

• A medical term used in the Victorian period for collapse under stress, involving exhaustion, fatigue, and psychological distress. Fashionable among the upper class

• Reflected cultural pressures of industrialization and gender roles, often legitimizing upper-class women’s withdrawal from duties.

Gender and nerve force

• Belief that each person had a finite supply of “nerve energy,” with women thought especially vulnerable to depletion through education, menstruation, or sexual exertion.

• Reinforced restrictive gender norms by discouraging women from intellectual or professional pursuits

Nerve sympathy

• The idea that disruptions in the womb or reproductive organs could cause nervous symptoms (e.g., hysteria) through “sympathetic” effects on the brain.

• Linked female physiology to madness, legitimizing medical interventions into women’s bodies to control behavior.

Hysteria

• A diagnosis for women with symptoms like seizures, paralysis, or emotional instability, historically tied to the womb.

• How psychiatry medicalized women’s resistance or distress, framing it as pathology tied to gender and sexuality. A term still used today to delegitimize women’s concerns. 

Freud

• Austrian Neurologist (1856-1939) who was a psychoanalyst, a theory and therapy emphasizing unconscious drives, sexuality, and childhood development.

• His ideas connected madness to human development and sexual repression, reshapring cultural and gendered understandings of mental illness.

Psychoanalysis

• A theory and method of treating unconscious conflicts through talk therapy, dream analysis, and interpretation of symptoms. Controversial for being reductionist, essentialist, and misogynistic.

• Central to 20th century psychiatry. Framed madness not as random but as a result of universal development and sexual struggles.

Theories are tools to think with

• Psychoanalytic theories are cultural products shaped by their social, historical, and personal contexts

• Reminds us to see theories as interpretive frameworks, not objective truths, showing how cultural and knowledge co-produce madness.

How/why was the Victorian era primed for psychoanalysis?

• The era’s emphasis on sexuality, morality, medical expertise, and the dangers of unregulated desire set the stage for Freud’s theories

• Demonstrates how psychoanalysis emerged as both a product of and a response to Victorian anxieties about gender, sexuality, and social order. 

4 key elements of Freudian psychoanalytic theory

• 1. Structure of the psyche (id, ego, superego), 2. Psychic processes (defense mechanisms like repression), 3. Understandings of psychosexual development (childhood stages), 4. The importance of social structure

• Systemic framework tying madness to universal human drives and cultural regulation

  Id / Ego/ Superego

Freud's model of how the psyche is constituted.  The Id is the "animalistic" drives, the superego is the "should/should not" voice, and the ego is the part of the self that mediates the two and is our conscious sense of self.  This is relevant to the class because it illustrates core psychoanalytic concepts and was central to Freud's theories of proper gender development.  Specifically, women were thought to have a weaker superego because they did not experience castration anxiety, thereby making them less suited to activities like management or politics.

Sublimation

• Redirecting unacceptable drives into socially acceptable activities

• A cultural process that turns potentially pathological impulses into productive contributions

Repression barrier/repression

• A defense mechanism that pushes unacceptable thoughts or desires into the unconscious.

• Key to Freud’s explanation of both mental illness and everyday behavior, showing how cultural taboos shape the psyche.

Unconscious

• The part of the mind containing repressed desires, memories, and instincts, outside of conscious awareness.

• Places madness within normal human functioning. Everyone has an unconscious, but a breakdown happens when repression fails.

Psychosexual development

• Freud proposed that all humans go through a series of developmental stages, each named for the bodily region through which the child primarily experiences his or her world. Oral —> anal —> phallic —> latency —? genital stages shaping personality and sexuality

• Links madness to unresolved conflicts in childhood, tying individual to cultural norms.

Bodily contours of the Ego

• Freud thought children learn to experience their world through their bodies and the ways in which their bodies are responded (and responsive) to by others around them

• Grounded psychological development in gendered, embodied interactions, influencing feminist critiques of Freud.

Oedipus complex for boys

• Boys desire their mother, and they see their father as a rival. Castration anxiety leads to identification with their father and superego development. If unresolved, boys may fail to internalize masculinity.

• Shows how deviations from masculinity and socially acceptable outlets were linked to madness

Castration anxiety

• Fear that father will punish a boy’s desire for his mother by castrating him

• Central to Freud’s account of how boys renounce forbidden desire and develop morality.

Oedipus complex for girls

• Girls first desire their mother, then shift their desire to father due to “penis envy.” If unresolved, they may retain phallic orientation (leading to hysteria, frigidity, or homosexuality).

• Expemplifies Freud’s gendered theory, shaping how women’s mental illness was pathologized

Penis envy

• Freud’s claim that girls experience lack and resentment at not having a penis, shaping their desire for men/children.

• Controversial concept reflecting how psychoanalysis pathologized femininity within patriarchal norms and domesticity.

Ontogeny recapitulates phylogeny

• Idea that individual development mirrors human evolutionary history.

• Supported Freud’s view that both individuals and societies “progress” through stages, tying psychology to colonial and evolutionary thought

Hysteria

• Hysteria is seen as result of repressed sexual desires and psychic conflict, often manifesting as physical symptoms

• Reframed hysteria as a psychological disorder rooted in unconscious processes, rather than purely biological or moral failings.

Colonialism

• The political, economic, and cultural domination of one territory and people by another, often justified as a “civilizing mission.”

• Shaped how madness was defined and treated in colonized contexts, intertwining psychiatry with racism and imperial power

Hobbes vs. Rousseau on the question of human nature

• Rosseau believed that human nature is essentially good but is corrupted by society and institutions. Hobbes believed that human nature is essentially evil and violent and needs control

• These frameworks influenced colonial portrayals of “savages” as either noble but childlike or brutish and dangerous, justifying governance.

Social Darwinism

• The application of ‘survival' of the fittest’ to human societies, ranking some groups as more evolved than others

• Justified colonial hierarchies and framed mental differences as evidence of evolutionary inferiority. 

Psychic unity of humankind

• All humans have same cognitive/intellectual personalities that are developed differently across societies.

• Supported the idea that ‘primitives’ were like Europeans but less developed, legitimizing colonial paternalism

Cognitive relativity

• The idea that different groups have fundamentally different psychic constitutions

• Used to argue that colonized people could never fully progress to European civilization 

Unilinear evolution

• The theory that all societies pass through the same evolutionary stages (savagery —> barbarism —> civilization)

• Used to argue that colonized people could never fully progress to European civilization, reinforcing racialized boundaries of madness

Multilinear evolution

• Diverse trajectories of technological and social evolution in different regions of the world. Ecologically shaped paths.

• Challenged unilinear models of “progress” used to justify colonial hierarchies, highlighting cultural relativism but also suggesting that not all societies were destined to reach the same outcomes. However, while it challenged unilinear “progress” models, it was not always beneficial for colonized people because it could still frame them as fundamentally different, outside of “civilization,” and thus not worth investing resources in for development

Kraepelin

• Applied his psychiatric disease model cross-culturally, studying mental illness among Indonesians.

• Claimed similar disorders existed everywhere but were shaped by culture, blending “psychic unity” with colonial hierarchies.

Culture-bound syndromes

• Locally specific forms of distress framed within cultural meaning systems. Examples: Amok (Malaysia), Koro (Asia), Latah (Malaysia/Indonesia), Pibloktoq (Arctic hysteria), Brain Fog (West Africa).

• Challenge universal psychiatric categories by showing how culture shapes symptoms and diagnoses.

Frantz Fanon

• Psychiatrist and revolutionary (1925–1961) who analyzed colonialism’s psychological effects in works like The Wretched of the Earth.

• Showed how racism and colonial violence produce madness, linking individual pathology to political oppression.

Post-colonial theory

• Addresses the legacy of colonial rule and the struggle for political and cultural independence of peoples formerly subjugated in colonial empires

• Reveals how psychiatry and psychology were implicated in colonial domination and remain shaped by those legacies.

Decolonialization

• Reveals how psychiatry and psychology were implicated in colonial domination and remain shaped by those legacies.

• Frames madness as inseparable from histories of oppression, highlighting the need to rethink psychiatric categories in postcolonial contexts.

Clark University lectures, 1909

• Freud and Jung’s lectures in the U.S. that introduced psychoanalysis to American audiences.

• Marked the start of psychoanalysis shaping U.S. ideas about family, gender, and mental health

“Traditional” American families

• The mid-20th-century ideal of the white, heterosexual, middle-class nuclear family.

• Constructed as the cultural “gold standard” of mental and social health, even though it excluded most families.

Profamily policies post-WW II

• Government and cultural initiatives promoting domesticity, marriage, and childbearing in the 1950s.

• Reinforced the nuclear family as central to national security and prosperity, shaping gender roles.

Changes in trends from previous 100 years

• Postwar trends saw earlier marriage, higher fertility, and lower divorce compared to prewar decades.

• Showed how the “traditional family” was a new invention, not a timeless structure.

New specialization of the family

• Families were expected to focus on emotional nurturance, childrearing, and producing “modern personalities.”

• Linked family life to mental health, making mothers especially responsible for children’s psychological outcomes.

 Moral domesticity and personal service (for women)

• Expectation that women found fulfillment in serving husbands and children through homemaking.

• Recast women’s unpaid labor as a moral duty, aligning femininity with self-sacrifice.

Family man

• Men in the 1950s were expected to root themselves in home and family, becoming "family men."  This was part of the re-entrenchment of "traditional" gender roles following WWII. 

• This illustrates that understandings of "proper" gender development and roles are not fixed but are linked to broader social, cultural, economic, and political phenomena.  As a result, understandings about pathology linked to gender norms are culturally and historically variable.

Child-centered family

• The postwar model where children’s happiness and development became the family’s central purpose.

• Reinforced mothers’ role as caregivers while framing family stability as key to national health.

How is gender tied to progress/modernization?

• The belief that clearly defined gender roles (domestic women, working men) signaled modernity and social stability.

• Made conformity to gender roles a patriotic duty in the Cold War era

Domesticity and class

• Middle-class families embraced domestic ideals more than working-class families, who often required women’s wages.

• Showed how gender norms were stratified by class and economic realities.

Going steady

• Postwar dating practice of exclusive relationships before marriage.

• Reflected shifting sexual norms, where women were tasked with controlling premarital intimacy and releasing them in marriage. Men were free of the burden as it was natural for them to be sexually aggressive.

Double bind for women

• Women were labeled “unnatural” if they rejected motherhood, but “neurotic” or “castrating” if they overinvested in it.

• Demonstrates how contradictory gender expectations were pathologized as mental illness.

The Feminine Mystique

• Betty Friedan’s 1963 book describing women’s dissatisfaction with domestic life as “the problem with no name.”

• Exposed the psychological costs of enforced domesticity and helped launch second-wave feminism.

Premarital pelvic exam

• Medical practice of introducing women to penetration before marriage, framed as preparing for a “healthy” wedding night.

• Medicalized women’s sexuality and reinforced the compliant, passive vagina as feminine ideal.

“Right kind of sex”

• Cultural emphasis on vaginal intercourse leading to vaginal orgasm as the only “healthy” form of sex.

• : Pathologized women who did not conform (e.g., labeled as “frigid”) and tied sexual health to national stability.

Importance of the wedding night for future family health

• Belief that sexual adjustment during the wedding night determined long-term family stability.

• Made female sexual compliance central to the health of the family and, by extension, the nation.

The awakened vagina

• Idea that husbands “awakened” women’s vaginas through marital intercourse.

• Reinforced passive femininity and male responsibility for women’s sexual fulfillment. Sexual assertiveness could cause fears of castration for men, thus disrupting their appropriate sexual identification and performance, showing the patriarchal nature of sex.

Frigidity

• Diagnosis for women who failed to transfer orgasm from clitoris to vagina.

• Pathologized female sexual autonomy, casting women as psychologically “maladjusted” if they resisted norms.

The compliant vagina

• Medical/cultural ideal of a vagina that passively and receptively adapts to heterosexual penetration.

• Embodied gendered expectations of passivity and sexual conformity.

G-girls

• Women working government jobs after WWII. Believed that with so many women in the workplace, there was a risk of them being swayed by communist influence, as well as single women seducing men into communism.

• Showed how gender and masculinity were linked with national security, showing the patriarchal gender norms ingrained in society. 

Femmocracy

• A right-wing term to disparage women in the workplace, and the fear that women’s growing presence in the workplace and public life threatened male authority and social stability.

• This framed female empowerment as dangerous and unpatriotic, reinforcing rigid domestic ideals for women.

Red scare/second red scare

• Periods of anti-communist hysteria in the US, especially late 1940s-50s. This period was characterized by suspicion, blacklisting, and loyalty tests.

• Family structure, sexuality, and gender conformity became tied to patriotism. Deviance was linked with communist sympathies.

Lavender scare

• The concern about men in the office’s masculinity. Led to a fear that there were secret homosexuals, which means that they are either already communists or could be blackmailed by communists, causing the Senate to start investigating to route these out.

• Shows how sexuality was politicized and linked to masculinity and patriotism, and therefore seen as a national security threat.

McCarthyism

• Senator Joseph McCarthy led a campaign of accusations against alleged communists in government. 

• Tied masculinity, gender, class, and sexuality to loyalty. McCarthy’s downfall also reflected anxieties about male dependence and homosexuality. 

Stereotypes of male bureaucrats and male homosexuals (how do they overlap?)

• Both were stereotyped as soft and lacking masculine toughness and were thus untrustworthy.

• Reinforced the idea that masculinity equated loyalty and patriotism, while deviation equaled danger to the nation. 

Unfeminine Communist women (in right-wing imaginary)

• Women who stepped outside the traditional domestic roles were seen as unfeminine and therefore a suspect of communist sympathies. Portrayed women from communist countries such as Russia as ‘manly’.

• Domestic femininity was tied to American values, and women who rejected that model were framed as political threats.

Mood changes vs. mood disorders

• Mood changes are temporary emotional shifts, while mood disorders (like depression) are persistent, clinically significant disturbances in mood. 

• The novel illustrated the blurred line between everyday sadness and diagnosable illness, showing how cultural context shapes whether distress is medicalized.

Major Depressive Episode vs. Major Depressive Disorder

• A Major Depressive Episode is a period (≥2 weeks) of depressed mood or loss of interest plus other symptoms. Major Depressive Disorder involves recurring episodes meeting those criteria.

• Esther’s struggles invite the question of when distress becomes pathology, echoing the stigma around mental illness.

SIGECAPS + mood

• Sleep, Interests, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicide + Depressed mood

• A clinical checklist as opposed to the more subjective portrayal in the Bell Jar, showing how psychiatric systems categorize experiences of suffering.

Sylvia Plath (dates of birth/death, circumstances of death, importance in relation to the class)

• American poet and novelist (1932-1963) who died by suicide at the age of 30.

• Her work highlights the gendered pressures of women’s mental health in the mid-20th century in America. 

The Bell Jar

• Sylvia Plath’s semi-autobiographical novel about Esther Greenwood’s descent into depression and psychiatric treatment. 

• Reveals how madness, gender, and social expectations (domesticity, career, and sexuality) intertwine. 

Esther Greenwood

• The novel’s main protagonist who is a young woman in the mid-20th century whose descent into depression and psychiatric treatment reflects personal struggles and societal constraints.

• Embodies the tension between individuality and cultural norms of domesticity, showing how gender expectations shape mental illness narratives.

Doreen

• Esther’s rebellious, nonconforming friend in New York. Esther often looked down on her for being too free, as she represented someone whom Esther wasn’t

• Doreen was often over sexualized and is an example of a woman who, in Esther’s eyes and society, took her sexual instincts too far. She represents the concept of a woman being a wife or just for fun, representing what was viewed as the former. 

Buddy Willard

• Esther’s boyfriend who embodied conventional masculinity and domestic expectations. 

• He symbolizes the pressures of conforming to heterosexual marriage and gender roles that Esther resists. His betrayal is a representation of masculinity’s self-centered and patriarchal views as well as the nuclear family. 

Marco

• A violent, misogynistic man who assaults Esther

• Illustrates the dangers women face under patriarchal power and how sexuality, violence. and madness are linked.

Dodo Conway

• A neighbor with many children, embodying the ideal of maternal domesticity. 

• Serves as a foil to Ester’s rejection of domestic roles, highlighting cultural pressure towards motherhood as ‘normal’.

Dr. Gordon

• Esther’s first psychiatrist, who represents detached, ineffective, and patriarchal psychiatry. Instead of addressing her psychiatry, he quickly resorts to the tools of institutional psychiatry of the 1950s, ECT.

• Shows how institutional psychiatry medicalized and silenced women’s suffering, failing to recognize the lived realities of women’s suffering. 

Joan

• An acquaintance of Esther, whom she later meets again as a fellow patient. Joan mirrors aspects of Esther’s struggles and later dies by suicide.

• Joan, like Esther, is an unconventional woman; however, unlike Esther, she embraced her mental illness and was more secure in herself. Her story shows the issue of mental illness for women and the varied outcomes of women navigating it.

Dr. Nolan

• Esther’s female psychiatrist, who provides compassionate and supportive care and whom Esther trusts as a woman.

• She represents a more humane, gender aware approach to treatment, contrasting with Dr. Gordan.

Irwin

• A man with whom Esther has a sexual encounter that results in hemorrhaging.

• Ties Esther’s exploration of sexuality as she is assertive in the situation to bodily danger. This shows how sexual expectations for women and gendered double standards impact women’s mental health.

Bell jar (as a motif)

• Symbol for Esther’s suffocating mental state, being trapped, cut off from the world, and unable to breathe freely.

• Encapsulates the idea that madness is both an individual experience and a product of social and cultural conditions as Esther struggles with her desires and cultural expectations of domesticity.