I follow Dr. Jessica Taylor on social media - I find her content incredibly powerful, insightful and challenging, but above all, courageous. I can't remember where I first came across her, it was either in a book or a friend recommended her content and I started following her on social media. She recently posted on Instagram mentioning her book 'Sexy But Psycho' in relation to the assisted dying bill which was being debated in Parliament - highlighting the risks to women in the mental health services. Personally, I support the assisted dying bill for the terminally ill but the risk of legalising ethanasia to mental health patients has always concerned me, so I was eager to read this book - and I'm so glad I did.
The book was an incredibly harrowing read, with a lot of content explicitly detailing women's experiences of the most horrific abuse - it's not for the faint hearted. I've experienced my unfair share of sexual violence and psychological abuse, but nothing in comparisson to some of the cases Dr. Jessica Taylor provides in this book. Her explanation of the pathologisation of abused women by a Patriarchal and oppressive institutions really resonated with me, as I could relate to much of her explanations through my personal experiences of the NHS mental health services. She explains how abused women are given labels and medicated to control them, rather than recognising and acknowledging their trauma - when this "treatment" doesn't work they are often deemed "hysterical" or "trouble-makers" and dismissed and ridiculed, or given higher doses of medication which isn't working or harmful treatments, such as ECT - and not given the trauma-informed care they actually need. She describes the commonly prescribed (because its cheap to deliver) 6 week course of CBT as "gaslighting" women and girls who have experienced trauma into thinking that the problem is how they think about things rather than acknowledging the fact that they have been abused. This chimes exactly with my experience; CBT had no benefit to me, and I was deemed to be "hyper sensitive" to SSRI drugs (after trying many different kinds at higher and higher doses), none of them seemed to be working - it took me 7 years to figure out that my "symptoms" were actually coping strategies and the problem wasn't a "chemical imbalance" in my brain, but psychological abuse and sexual violence - for which the NHS was not going to treat me. At which point I left the services and worked on recovering, by myself - through changing my living situation and reading trauma-informed psychology and psychiatry books.
The book relates heavily to my interest in systems of oppression and psychological manipualtion and abuse which I wrote about in my research paper. A lot of the content makes me angry, especially the "hot-crazy matrix and the way women's physical health illness is dismissed as "attention-seeking". Nearly every woman I know has an experience of being gaslit and dismissed by medical professionals and it is something which has significantly affected me in the last year.
Something for me to think about (because I do it), is labelling abusers and oppressors with terms such as 'sociopath' or 'narcissist' which Dr Jessica Taylor describes as an "own goal" - because it takes away accountability for their actions. I think the work of psychogists such as Dr Ramani Durvasula who educates about naracissistic abuse patterns of behaviour is incredibly valuable to help victims understand, escape and recover from it - but I can also see how the label itself may be unhelpful.
Key Quotes
‘It is now commonplace for women and girls who report rape, abuse, distress, or trauma of some sort to be quickly diagnosed with a range of psychiatric disorders, medicated and then discredited.’ (page xvi)
‘In 1952, the ‘bible of psychiatry’ was first published – the DSM… The DSM is, and always has been decided by an elite group of middle-class white male psychiatrists who sit around a table and decide what is normal and what is abnormal. That is pretty much the entire process in one sentence.’ (page 4)
‘The DSM editions have always contained problematic and ridiculous psychiatric disorders which stereotyped and pathologised groups in our societies – including Black people, gay people, women and people with disabilities.’ (page 6)
‘Instead of talking about symptoms and illnesses, we talk about trauma responses and coping mechanisms. Every behaviour, thought, or feeling after distress and trauma can be put into these two categories: they are either a response to what happened, or a way of coping with what happened – and sometimes they are both. It doesn’t matter if it is nightmares, binge eating, perfectionism, self-harm, flashbacks, head-aches, hearing voices or becoming withdrawn for many years – a truly trauma-informed approach can explain and explore these experiences as either trauma responses or coping mechanisms. They are never categorised as mental disorders, illnesses or syndromes.’ (page 14)
‘Psychiatry relies on the framing of normal trauma responses as abnormal or disordered thinking and behaviour. Trauma-informed approaches consider that our ‘symptoms’ and ‘signs’ are completely normal responses to distress and trauma, rather than medicalising or pathologizing them.’ (page 16)
‘Being frightened, angry, upset, confused, irritable, tired, frustrated or struggling with negative impacts of all of these stressors – for months, years or entire lifetimes – do not justify a label of a mental disorder. They are all proportionate responses to a very difficult way to live as a woman or girl in a patriarchy.’ (page 17)
‘From a trauma-informed perspective, I would argue that when we are subjected to traumatic experiences those memories will stay with us for the rest of our lives. I often explain to professionals, students, and women who write to me that they should never expect themselves to go back to being the person they were before that trauma. This isn’t because they are going to be mentally ill or disordered for the rest of their lives, but because every experience they have shapes them and changes them.’ (page 23)
‘Despite there being absolutely no evidence that teenage girls are addicted to sexual risk taking due to brain chemical imbalances, many social workers have been taught that this is the reason that teenage girls cannot see the risks they are taking. Of course, teenage girls, who are being raped and exploited are not the ones taking the risks, and neuromyths are therefore contributing to significant victim blaming of girls who have been raped and abused.’ (page 26)
‘Dr Samuel Cartwright was the man who developed the psychiatric disorder ‘drapetomania’, meaning a mental illness, which caused enslaved Black people to want to escape from slave owners, plantations and oppressors.’ (page 36)
‘By the eighteenth century, one of the most common psychiatric diagnoses used to control, imprison, and violate women was that of hysteria.’ (page 39)
‘The history of homosexuality as a mental illness is predominantly concerned with the persecution of white gay men, many of whom were diagnosed as ‘sexually deviant’ or ‘mentally disordered’ and according to Carr & Spandler (2019) were either criminalised under sodomy laws (if they were working class), or sent for psychiatric treatment (reserved for the missle- and upper-class men).’ (page 42)
‘The possibility of a woman not needing or wanting a man, and instead loving or desiring women was (and has been) so unthinkable, that where the church argued that it was evidence of demonic possession and witchcraft, modern medicine argued that it must mean that the thinking and behaviour of the woman is disordered, damaged and corrupted.’ (page 44)
‘Statistically, many girls will be sexually abused in childhood by men and boys in their lives – but this does not mean that the abuse is a causal factor in their sexual orientation. If it was, and being subjected to male violence caused women and girls to change sexuality, the majority of the female population would be lesbian or bisexual.’ (page 49)
‘Simply put, girls under eighteen in NHS mental health facilities are being chemically restrained using forced injections around seven times more than boys under eighteen are… When the majority of all attacks on NHS staff are committed by men, and the majority of violent crime is committed by men, why are teenage girls being chemically restrained more than once per week using forced injections and tranquilisers, but the same NHS data shows that men and bpys are being physically restrained and placed in seclusion or isolation rooms to calm down?’ (page 63)
‘Statistically, being subjected to domestic abuse during pregnancy is more common than any other pregnancy complication or health issue (UCSF, 2021). Simply put, you are more likely to be beaten and abused whilst pregnant than to have medical issues or complications arising from your own body or the baby.’ (page 79)
‘There is a strong survivor movement online, made up of men and women who talk about their experiences of psychiatric harm and abuse. I have noticed the way authoritative psychiatrists mock, laugh at, and bully them on Twitter – without seeming to care that we can all see them doing it. Throughout 2020 and 2021, I’ve watched several male psychiatrists with thousands of followers quote tweet and reply to survivors of psychiatric abuse ad harm, to tell them that they are delusional, obsessed, psychotic, anti—science and anti-expert.’ (page 118)
‘Despite there being thousands of disclosures of religious, ritual and satanic abuse, leading academics have brushed them off as mere fantasies of women and girls for decades.’ (page 121)
‘Alongside dangerous and harmful psychiatric treatments and pathologisation during life-threatening violence and abuse, the dismissal of health concerns is yet another way that women’s and girl’s lives are put at risk by the belief that women are hysterical, emotional, exaggerators and attention seekers.’ (page 150)
‘doctors such as Edward Clarke wrote in 1870 that women should avoid education as the brain would take up too much blood flow in thinking and learning, which should be being used in their menstruation (Strange, 2000).’ (page 157)
‘Every teenage pregnancy under the age of sixteen is technically illegal, and yet, nothing was done to tackle the number of men and boys who were having sex with girls who couldn’t consent. This is particularly poignant when we consider that there are around four to five times more teenage mums than teenage dads, which suggests that the majority of teenage girls becoming pregnant were being abused by adult men, who rarely appear in the narrative.’ (page 174)
‘In their original study, Vercellini et al. (2013) used two female and two male participants to rate the attractiveness of women with different forms of endometriosis… Additionally, researchers such as Hammerli et al. (2018) conducted in-depth qualitative research into the experiences of men who felt their sex lives were impacted by their female partner having endometriosis – and inevitably reported that men felt they were not getting enough sex. Whilst vital research into endometriosis receives little to no resource or funding, here were funded academics writing about how sexy women are with a painful disease, and whether men were getting enough sex from women who were struggling with chronic pain from endometriosis. The mind boggles.’ (pages 178-179)
‘It is clear that women are being failed – and ultimately, psychiatry has a lot to answer for. Women are routinely told that they are overreacting, exaggerating or lying about their ain or symptoms – and are often told that they have health anxiety.’ (page 184)
‘CBT was being used to victim blame and gaslight women and girls who had been raped. Instead of validating their trauma as real, they were being prescribed six sessions of CBT to change the way they thought, felt and behaved in response to their trauma.’ (page 201)
‘In my field of expertise, women and girls had not been given voices about their experiences of being blamed and blaming themselves for sexual violence, as the field had over-relied on quantitative studies and decades0old theories which positioned women and girls as passive sponges that would absorb any belief that anyone gave them. This resulted in oversimplified, misogynistic and unhelpful approaches to victim blaming and self-blame of women and girls’ (page 218)
The "hot-crazy matrix"
‘Mentally sound women will have rules, boundaries – and can therefore be perceived as stable but boring. Mentally ill women might have no rules, no boundaries ad might be ‘psycho’ enough to do whatever a man wants them to do… The basic theory is that men want a woman who is hot (and naturally crazy), but not so disordered that you can’t date or marry her. As you can see in the diagram, millions of people who have viewed this are led to believe that the majority of women are so mentally unstable that they are confined to the ‘no go zone’. These women are psychotic, but not hot enough to justify having sex with, Basically, if she is crazy but hot, this is okay, but if she is crazy and unattractive, she holds no value to men… the y-axis of the scale which measures ‘crazy’. Begins at 4, whereas the x-axis which measures ‘hot’ begins at zero. This is commonly explained to mean that there is no such thing as a sane woman’ (page 234-236)
‘I have seen more and more feminist writers which seeks to position violent offenders, abusers and misogynists as having personality disorders, being ‘narcissistic’, ‘psychopaths’ or ‘sociopaths’. This is an own goal. We must not engage in any kind of psychiatric diagnosis of the oppressors. They are not mentally ill, they are making an active choice to harm women and girls.’ (page 311)
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