Borderline personality disorder, battered woman syndrome, emotionally unstable personality disorder — these are some of the labels used to pathologise and medicalise women, instead of addressing the trauma they may have experienced, and the causes of their trauma.
When women complain that they are being pathologised, medicalised, over-medicated, they are further labelled as “angry, opinionated, mouthy, aggressive, hysterical, mad, disordered, crazy, psycho, delusional, borderline, hormonal”.
Instead of being medicated, or pigeon-holed and dismissed, or labelled any of the above if they don’t meekly accept their diagnosis, women may need trauma-informed therapy. And the current system needs urgent restructuring, reforming, reframing.
Trauma-informed therapy can be anything from talking therapy to music and art to being outdoors in nature — unlike, say, cognitive behavioural therapy, there is no one-size-fits-all. Trauma-informed therapy works with the individual, adapting to meet their needs, and recognising that trauma response is as individual as the person experiencing it. In this case, women.
This is what chartered psychologist - with a PhD in forensic psychology - Jessica Taylor advocates in her new book,.
Dr Taylor is a 31-year-old working-class feminist who has been working directly with abused and traumatised women — those who have been trafficked, raped, assaulted, coerced — since she was 19.
She rejects the current model of often labelling and medicating as tools of further oppression of already oppressed women; her book, a lucid and wide-ranging challenge to the current model, demands radical change.
“Instead of addressing the enormous and complex traumas of women and girls subjected to male violence, there’s a strong culture of diagnosing them with mental disorders and encouraging them to take daily medication,” she writes.
“One of the most damaging impacts of this practice is the subsequent internalisation of self-blame and self-doubt for women and girls who are told that their trauma responses are not valid or relevant, instead they are mentally ill due to some form of ‘disorder’ or ‘imbalance’ or ‘faulty genes’.”
Speaking on Zoom, Dr Taylor is impassioned, super-articulate, direct and honest, compassionate and common-sensical.
“I didn’t see this coming,” she says, of her swerve away from conventional views on mental health.
“I was trained the same as everyone else — that people have mental health issues, that it’s in their brain, that there’s a chemical imbalance, it’s part of the illness framework — but this doesn’t make sense to me at all.
She says how being anti-pathologisation, trauma-informed and feminist “makes me a bit different”.
Dr Taylor’s influences include psychiatrist Thomas Szasz whose 1960 bookexamines how “convincing people in an oppressive capitalist society that they are mentally ill is a form of oppression and social control”.
She also cites psychiatrist Bessel van der Kolk, whose 2014 book, examines trauma and ways of addressing it beyond pathologisation and medication.
She has very little time for the DSM — the Diagnostic and Statistical Manual of Mental Disorders, known as the ‘bible of psychiatry’. Its contents, she says, “have always 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”.
Its list of mental disorders has grown from 128 in 1952, its year of inception, to 541 in its most recent edition in 2013, to include “caffeine withdrawal as a psychiatric disorder”, along with “disinhibited social engagement (children who approach new adults and chat to them with no caution)”, “grief disorder”, and “premenstrual mood changes in women”. Oh, and hoarding.
She looks at sexism, homophobia, and racism in psychiatry — “mental illness has always been used to marginalise, oppress, harm, control, and murder groups of people by those in authority” — and reminds us of the eye-watering range of ‘treatments’ through the ages, from trepanation and phrenology to tooth and organ extraction to insulin comas, lobotomies and electroconvulsive therapy, or ECT, which endures to this day.
She mentions, a book by child psychiatrist Sami Timimi, which argues that “compared to medicine, psychiatry has made virtually no progress in the last hundred years”.
Using anonymised case studies, Dr Taylor outlines how so often the behaviours of abused women and girls are not mental illnesses, but responses that are “rational, justified, explainable, normal, and natural”.
Trauma “does not cause personality disorders. It does not cause psychiatric issues. It does not cause criminality. It does not cause attachment disorders.”
From trafficked teenagers to Britney Spears, she argues that how mental health services treat traumatised girls and women “could be categorised as a form of gaslighting”.
We cannot end stigma of a system that relies on stigma, she says. The only way to really end it is “to focus more on humanistic, person-centred, non-pathologising approaches to supporting humans in distress”.
Also, it’s worth bearing in mind the long-term repercussions of mental health diagnoses for women. They tend to linger, which can, says Dr Taylor, lead to “doctors ignoring health issues;, universities rejecting applications; schools isolating them or referring them to special provisions; employers sacking them or discriminating against them; police forces and ambulance services flagging them as dangerous; criminal justice systems positioning them as liars and non-credible witnesses; social services assessing their capability to be good parents, and family court judges viewing them as a risk to their children, or lying about being abused”.
That’s a long list, yet women and girls remain convinced that diagnosis and medication are in their best interests.
Now we need to find solutions and stop women and girls being pathologised by the very services they seek for help.
—by Dr Jessica Taylor (Constable Books) £16.99
When Jessica Taylor, 31, was growing up on a council estate in Stoke on Trent, she didn’t realise that you could go to university in Britain. She thought you had to go to America for a university education, because she had only ever seen college life portrayed on TV. In her family, nobody finished secondary school.
In her teens, she was abused and raped, and had a child when she was 17. She reported her abuser to the police for physical, sexual, and psychological violence — she endured a miscarriage after being thrown down stairs, a dislocated shoulder, death threats, and constant fear for herself and her baby — but after 14 months of waiting for a trial date, the police came to her house in 2009 and said all charges had been dropped. So had bail conditions, which meant no protection from her abuser.
When the police came to tell her this, they gave her a leaflet on mental disorders and medication. An officer she had never met before told her that the police thought she was mentally ill, because of her persistent reporting of abuse, and that she might benefit from medication. She asked them to leave, and threw the leaflet about mental disorders and medication in the bin.
Instead, she processed five years of abuse by reading intensively about trauma and how it works, and accessing helplines and women’s services. She listened to music and journaled, trying to understand what had happened to her.
By 19, she had a second child, and was living in poverty. Keen to change her circumstances, she began her career by volunteering in a magistrates’ court, where she saw women and girls give evidence in domestic abuse trials. There she witnessed victim-blaming, character assassination, and the weaponisation of mental health diagnoses against these women and girls so regularly that she likened it to a script.
Taylor went on to work in rape centres, counselling services, child trafficking services, and victim services. She says she saw the same thing everywhere: victim-blaming and the pathologisation of female mental health. She completed a degree in psychology from the Open University, and in 2019 she received a PhD from the University of Birmingham in forensic psychology.
She turned her thesis, titled ‘Logically, I know I’m not to blame but I still feel to blame: exploring and measuring victim blaming and self-blame of women who have been subjected to sexual violence’ into a book,, which she self-published. After selling thousands of copies, it was picked up by the publishers Hachette. She received a lot of online hate.
When she was 27, lecturing and completing her doctorate, she reported harassment and bullying after receiving persistent emails from a man who disagreed with her feminism; he sought to get her kicked off her PhD course, suggesting she had an undiagnosed ‘personality disorder’.
Her workplace sent in a psychologist who attempted to reframe her as mentally ill. She made a formal complaint and was branded a conspiracy theorist. She dug in, presented 110 pages of evidence at a tribunal, and was awarded damages and a formal apology. “They picked the wrong woman,” she says.
In 2017, Dr Taylor founded VictimFocus, a company which offers resources and training to “challenge, change and influence” how victims of abuse are treated by professionals.
She now trains police and professionals, and has published widely — books, papers, and reflective journals both for victims of trauma and those who work with them. In 2019 she was awarded a fellowship of the Royal Society of Arts for her contribution to feminism and psychology.
In her personal life, she is “stupidly happy”. In May 2021 she married for the second time, this time to a woman. She lives with her wife Jaimi, and her two children, now 14 and 12. She is estranged from her family of origin — she is no longer invited to weddings and funerals — yet remains unimpeded, continuing her upward trajectory. Fierce and fearless.