What Every Woman Knows: Society By Gas Light
In their bedroom, Gregory becomes impatient and humiliates his wife about making a spectacle of herself in public:
- Gregory: I’ve tried so hard to keep it within these walls – in my own house. Now, because you would go out tonight, the whole of London knows it. If I could only get inside that brain of yours and understand what makes you do these crazy, twisted things.
- Paula: Gregory, are you trying to tell me I’m insane?
Gregory: It’s what I’m trying NOT to tell myself.
- Paula: But that’s what you think, isn’t it? That’s what you’ve been hinting and suggesting for months now, ever since…the day I lost your brooch. That’s when it all began. No, no, no, it began before that. The first day here when I found that letter. (Gregory stops and abruptly turns.)
- Gregory: What letter?
- Paula: That one I found among the music from that man…
- Gregory: Yes, you’re right. That’s when it began…I can see you still, standing there and saying, ‘Look. Look at this letter.’ And staring at nothing.
- Paula: What?
- Gregory: You had NOTHING in your hand.
- Paula: What?
The above is an excerpt from Gas Light (known in the US as Angel Street) by Patrick Hamilton. Gaslighting is an expression which has been coined after the play and film to refer to forms of psychological abuse in which information is manipulated and selectively omitted to favour the abuser, also it refers to situations where false information is presented with the intent of making victims doubt their own memory, perception, and sanity.
Gaslighting can take place in multiple forms, from simply from the overt lying and denial by an abuser that previous abusive incidents ever occurred, to the staging of bizarre events by the abuser with the intention to disorient the victim. This idea of manipulation and psychological dominance has to be acknowledged somewhere in the analysis of societies treatment of behaviour. Uncomfortable as it seems, we need to understand that our society does not always manifest the best ideals, that toxic relationships are quite possible and do manifest.
In medical situations, the clinician is in a position of power. Professor at University of Washington, forensic psychiatrist and suicidologist, Dr. Theodore Dorpat has studied many suicides. He has written the book ‘Gaslighting, the Double Whammy, Interrogation, and Other Methods of Covert Control in Psychotherapy and Psychoanalysis’ which examines how this power is sometimes unintentionally abused.
“While trying to embody a compassionate concern for patients, therapists use accepted techniques that can inadvertently lead to control, indoctrination, and therapeutic failure. Contrary to the stated tradition and values of psychotherapy, they subtly coerce patients rather than respect and genuinely help them. The more gross kinds of patient abuse, deliberate ones such as sexual and financial exploitation, are expressly forbidden by professional organizations. However, there are no regulations discouraging the more covert forms of manipulation, which are not even considered exploitative by many clinicians. In this book, noted psychiatrist Theo. L. Dorpat strongly disagrees.”
Where there exists a power differential, there exists a possibility of exploitation – as well as well intentioned folly. Here, we are interested in concentrating on the exploitation of power differentials. Knowing that these happen less often, but do happen, we are left with the chief question of how we recognize these situations when we encounter them ? We are familiar with the clear evidence for abusive relationships, but there is not such an abundance of writing and discussion on when this manifests in a situation where ‘society’ has invested its authority.
“While some individuals who use mind-control, indoctrination, or brainwashing methods are ‘compliance professionals’ working within institutional settings such as cults as well as in governmental, religious, military or business contexts, many others are intuitive or informal persuaders who regularly use rule of thumb home-remedy-type compliance tactics and heuristics for personal gain and control over others, especially their relatives, friends, and associates” [Page 181, Gaslighting, the Double Whammy, Interrogation, and Other Methods of Covert Control in Psychotherapy and Psychoanalysis].
In their paper published in The Lancet, Barton and Whithead examine ‘The Gas-Light Phenomenon’. Citing how a select committee of the House of Commons in 1763 concluded that some people were committed to asylums as a method of solving family and social problems, they raise the repeating of the concerns in times more contemporary (1959). They go on to describe two cases where there were definite ‘plots’ to remove an unwanted relative by sectioning in a mental hospital – one of them, an old lady admitted to based on induced incontinence [Lancet. 1969 Jun 21;1(7608):1258-60. The gas-light phenomenon. Barton R, Whitehead JA.].
The Select Committee of the House of Commons was chaired by Thomas Townshend, a long-standing Member of Parliament who represented Cambridge. The committee was organised in 1763 to study the problem of unlawful detention in private madhouses, and it focused on the Mrs Hawley case. She had been committed to the asylum solely on the word of her husband who had paid two guineas a month for her board. She was unable to leave the house or communicate with anybody outside it.
The inmates were treated as insane and apparently the agent who had taken them in stated that he had not committed a single insane person to the house in the past six years. On the basis of payment everyone was admitted however no physicians attended the inmates and no register was kept of their names. The committee stated this as a common situation noting a number of similar cases; thus they recommended that some form of legislative intervention was needed.
The Select Committee focused on two points:
- the manner of admitting people into houses
- and their treatment during confinement
A large part of their report was an examination of the issues raised by the (eventually successful) attempts of a Mr La Fortune to secure the release of a Mrs Hawley (confined in a Chelsea house 5.9.1762 to 4.10.1762) by writ of habeas corpus. They were specifically concerned with the extent to which madhouses were used to confine people who were not lunatics.
On this they examined Mr Turlington, proprietor of the house where Mrs Hawley was confined. He said he usually left house management and admission of patients to Mr King, his agent. His only instruction was a general rule to “admit all persons who were brought” and he added that although the house was intended for lunatics, other persons were admitted as lodgers.
There seems to have been no difference between the situation of a lunatic and a lodger. he considered a Mrs Smith “merely as a border”, but “it was not in her power to go out of the house if she would”. He “took her into confinement merely at the desire of her husband, who alleged that the neighbours were afraid she would set the house on fire”, and who paid six guineas a quarter for her maintenance. The house was simply for confinement “no physicians attend … no register of the persons is kept.”
The above is an excerpt from A Middlesex University resource provided by Andrew Roberts
According to the 2003 ‘Better Or Worse: A Longitudinal Study Of The Mental Health Of Adults In Great Britain’, carried out by the Office for National Statistics, women were more likely to have received treatment or used services of all types than men: 29% of women had received treatment or services compared with 17% of men. Younger men were less likely to have been in touch with primary or secondary care services or to have received a mental health treatment, whereas age was not a factor in women.
The 2010 NICE Guideline On The Treatment and Management of Depression in Adults’ reported that “prevalence rates for depression have consistently been found to be between 1.5 and 2.5 times higher in women than men and have also been fairly stable in the age range of 18 to 64 years (Waraich, P., Goldner, E. M., Somers, J. M., et al. (2004) Prevalence and incidence studies of mood disorders: a systematic review of the literature. Canadian Journal of Psychiatry, 49, 124–138.), although in the most recent UK survey cited above female preponderance was only marked for a depressive episode in those under 35 years whereas for mixed anxiety and depression it was across the age range.
The Psychiatric Morbidity among Adults living in Private Households (2000) study reports that prevalence rates were higher among women than men for all neurotic disorders except panic (7 cases per 1,000 for both men and women). The disparity between the rates for women and men was significant for phobias (22 and 13 cases per 1,000 respectively) and mixed anxiety and depressive disorder (108 and 68 cases per 1,000).
How do we start to contextualise these disparities in gender and mental health ? To what extent does structural sexism play a role in increasing diagnosis, and psychological ailment brought on by impoverishment of circumstance ? When glass ceilings and lower pay are clear indicators of social power differentials in modern times what questions do these raise in context with what manifests in the psychiatric structures ?
Thomas Sasz wrote the book The Myth of Mental Illness. He famously asked the question ‘Is there such a thing as mental illness?‘ arguing that there is not:
“In this chapter, I shall try to show that, today, the notion of mental illness is used chiefly to obscure and explain away problems in personal and social relationships; and that the notion of witchcraft had been used in the same way during the declining Middle Ages. We now deny moral, personal, political, and social controversies by pretending that they are psychiatric problems: in short, by playing the medical game.
During the witch hunts, people denied these controversies by pretending that they were theological problems: in short, by playing the religious game. The religious rules of life and their effects on man in the late Middle Ages thus not only illustrate the principles of rule-following behaviour, but also display the belief in witchcraft as a historical precursor of the modern belief in mental illness.”
(Page 182, ‘The Myth of Mental Illness; Foundations of a Theory of Personal Conduct’ by Thomas S. Sasz. MD, HarperCollins, ISBN 978-0-06-177122-4)
So if we lend this view credence to try to understand how the diagnosis of mental illness might ‘obscure and explain away problems in personal and social relationships’, how do we get at testing these ideas ? Do the labels of depression, anxiety, and phobia (and others) obscure the social problems that women are subject to ?? Sasz related the dynamics of psychiatry to that of witchcraft in the past:
“The Inquisition of the 16th Century sought to eradicate subversive influences from the Catholic Church by persecuting alleged witches, the supposition being that any anti-church influences would necessarily be instigated by ‘possession by the devil’. The ‘bible’ of the judges of the Church was a document written by two Dominican monks, Heinrich Kraemer and Jacob Sprenger, and entitled “The Witches Hammer” (Malleus Maleficarum).
It has been reported that upwards of 100,000 people, mostly women, were executed during the inquisition. A German physician, Johann Weyer, made extensive studies of the so-called witches brought to ‘Justice’ and proposed entirely different explanations for their behaviour than was supposed to be the case.
In a lengthy book he published in 1563, “Delusions of Witches” (De Praestigiis Daemonum) he exposed, not only the falseness of alleged witchcraft, but also examples of how the prosecutors of ‘witches’ sometimes hid their own indiscretions (especially sexual ones) under the guise of witch-hunting. Such an expose was necessarily a risky venture, in view of the pervasive power of the Church, but Weyer capitalized on the protection of his patron, Duke William of Julich, Berg and Cleves.”
(Page 69, ‘Documentary History of Psychiatry; A Source Book on Historical Principles’ by Charles E Goshen MD, Vision Press Limited, Copyright 1967 Philosophical Library New York)
What might statistics infer in these contexts of mental health ?
Radical Statistics (http://www.radstats.org.uk/) is a group of statisticians and others who share a common concern about the political assumptions implicit in the process of compiling and using statistics and the misuse of statistics and its techniques. In particular, they are concerned about the:
- mystifying use of technical language used to disguise social problems as technical problems;
- lack of control by the community over the aims of statistical investigations, the way these are conducted and the use of the information produced;
- power structures within which statistical workers are employed and which control their work and the uses to which it is put;
- fragmentation of statistical questions into separate specialist fields in ways that can obscure common problems.
VassarStats: Website for Statistical Computation