What purpose does “functioning” serve in our capitalist society? Why are we encouraged to pay for medications/therapy/etc. to make us “normal?”
To be in therapy is to signal to others that you are invested in yourself, your mental health, and improving your relationship with trauma. Being in therapy has become a colloquial shorthand for introspection and emotional depth, and in urban centers therapy has become as normalized as taking a yoga class or joining a writing group.
In the past couple years, there has been growing discourse on the limitations of therapy—whether it actually helps people or if it is part of the larger capitalist apparatus. And I concede there is space for both truths. Is the rising number of diagnoses actually helping people in crisis to understand themselves, or are new labels becoming social currency for an identity-saturated internet presence? If anyone has even cursorily spoken to me in the past year, I may have bombarded you with a discussion on dynamic nominalism. (Read: Why We’re Turning Psychiatric Labels into Identities, listen: Why is Everyone ‘Neurospicy’ Now? On the Individualisation of Neurodivergence Online)
To say this up front, I am always working through my own opinions on therapy, psychiatry, and mental health, especially as it pertains to gender (still holding onto the belief it’s net positive). This piece of writing exists in conversation with a piece I wrote in 2023 called Not A “Messy Woman,” We’re Just Trying Our Best: Memoirs by Women and an academic paper I wrote called “Technological Constructions of the Madwoman: An Anti-Sanist Critique of Cho Nam-Joo’s Kim Ji-young, Born 1982,” which I’ll mention later. First, I’ll go through some definitions/history, then the literature part (my favorite), and lastly the real world considerations. If you’ll allow me, let me give you all the disparate threads that have been floating in my brain so you can make sense of them with me.
First, some definitions
TW: Violence, sanism, mild self-harm
If you’ve never heard of “sanism,” that’s ok, I don’t think it’s a particularly prolific term outside of academia, though it’s something we’ve probably all observed. Essentially, sanism is the irrational discrimination against people based on actual or perceived mental illness or cognitive impairment. Think: nineteenth century women who were labeled as “hysteric” for ailments as simple as fainting or having a sex drive. Mad Studies is academia surrounding people who identify as “mad”—a term that people within the Mad Movement have reclaimed, similarly to how “queer” was reclaimed by LGBTQ+ communities. For many women within the Mad Movement, the issue of gender and the issue of madness and sanity cannot be separated as they are both forces that act upon their bodies and are embodied simultaneously.
This is where the theory gets kind of… confusing, so hear me out. Consider the “wandering womb,” an outdated diagnoses that claimed the uterus freely moved around women’s bodies causing them to be hysteric. According to the Royal College of Nursing in the UK, genecology is a Greek term literally meaning ‘the study of women’. And hysteria is derived from ‘hystera’ meaning womb. In the case of the “wandering womb,” male-dominated medicine of the time decided that wombs—completely foreign to their own bodies—were obviously the root cause of issues in women’s bodies. Wombs that had traveled throughout the body could cause suffocation or death, and the RCN goes further:
“Menstruation and pregnancy were thought to make women the weaker sex, both physically and mentally. By the late nineteenth century, it was deemed scientifically proven that women’s biology made them less rational than men, unfit to participate in many areas of public life.”
Female hysteria, then, was a medical diagnoses inherent to gender, and in extreme cases resulted in hysterectomies or women being sent away to insane asylums. The history of hysteria serves as an example of how men have historically used psychotherapy and medical diagnoses to control both women’s bodies and minds.
Ok now the literature part, my favorite!!
Anyone who has talked to me about Korean Literature knows that I decided to do a Masters in literature because of three authors: Cho Nam-Joo, Han Kang, and Choi Jin-Young. While not intentionally, though perhaps reflective of my interests and experiences, they are all Korean women who write extensively about being women.
The first novel I read by Han Kang, The Vegetarian, has remarkably similar themes to Kim Ji-young, Born 1982 by Cho Nam-Joo. Both center women who are institutionalized by their husbands after having “psychotic” outbursts. Deemed “mentally unstable,” both women are committed to psychiatric hospitals and subjected to various (mis)diagnoses and observation by male doctors. In The Vegetarian, Yeong-Hye gives up eating meat after a violent dream. At a family gathering, she is held down by her husband and her brother and forced to eat pork, after which she breaks free and cuts her arms. She is then hospitalized and in turn sent away to a psychiatric ward. While there, her sister visits her and finds that she has tried to forgo her human body completely and become a non-violent plant. In Born 1982, the titular Ji-young begins to show signs of psychosis after leaving her job to care for her newborn daughter. She starts to embody the voices of women in her life—from the stubborn tone of her mother to the candid expressions of her late college friend, and even sucking her thumb like her infant daughter. Her husband, unsure of how to respond, has her sent to a psychiatrist, and what follows is an unspectacular account of Ji-young’s life from a young girl to a mother.
What is remarkable to me about these two novels is how psychotherapy is a tool used to uphold patriarchal violence against women. In the aforementioned essay I wrote for my Master’s degree, “Technological Constructions of the Madwoman,” I considered an anti-sanist critique of Born 1982, because I thought too many people were taking Ji-young’s diagnosis of mental illness at face-value, not questioning both the validity and social constructions of her “madness.” A literary reviewer in The Guardian reviewed Born 1982 and said, “[Ji-young’s] derangement is the only way out of the cramped paradox of gender-based roles.” Which… can I just say that “derangement” is a particularly unkind word used against people in crisis.
Reviewers often wrote about Ji-young’s “descent into madness” as her only route of rebellion, and stopped there—they did not question: 1. Who was narrating the story and thus was controlling the perspective, 2. how her psychiatric diagnoses is influenced by Ji-young’s gender as a woman, and 3. How the “Madwoman” trope does not exist in a literary vacuum and has real world implications.
Metaphorizing madness in literature as an expression of gendered rebellion is seen by some within the Mad Movement as a reduction of the lived experiences of women struggling with mental illness. For Ji-young and Young-Hye, being institutionalized limited their pathways to empowerment by relegating them as “other,” as “unwell,” as “not of right mind.” What I mean by that is that their only way out (read: functioning, healthy) is to rely on the men who have diagnosed them for not subscribing to neo-Confucian ideology that dictates Korean women’s expressions of their bodies, sexuality, and morality. Remember, the wandering womb.
Yeong-Hye is alternatively responding to the violence enacted on and by her body (on her body by the men in her life, and by her body by eating meat) by trying to rid herself of her corporeal form, the site of violence. In an interview with The White Review, Han Kang said while she was writing The Vegetarian, “I was harboring questions about human violence and the (im)possibility of innocence. Yeong-Hye’s extreme attempt to turn her back on violence by casting off her own human body… lies a deep despair and doubt of humanity.” What strikes me about this quote is how human violence is tied to Yeong-Hye’s gendered body. As long as we are human, can we ever be free from violence? Both as perpetrated and perpetrator?
Though rooted in the Korean context and held within the literary sphere, I’ve been thinking a lot about how psychotherapy is being normalized these days, to the point where diagnoses are somewhat expected of any behavior that deviates from the norm. (Here, I challenge—who controls what is considered “normal?” What purpose does “normal” or “functioning” serve in our capitalist society? Why are we encouraged to pay for medications/therapy/etc. to make us “normal?”) We should think about the social constructions of mental illness in our own communities, the larger mechanisms at play, and how psychotherapy can be a (dis)empowering tool.
Ok now the real world considerations
I’ve never had a particularly negative or positive view of therapy, and have only tried regularly seeing a therapist once in my life. The first time I was ever sent to counseling was as a teenager. I was pulled out of first period Spanish and told that I had written some “concerning” things in a short story for English class. As I was sitting in the dimly lit office of the middle school guidance counselor, she told me the check-in was just protocol, to ensure that I had a friends to talk to if I was ever feeling bad about myself. She had me list them. Though she was kind, I left her office feeling punished and humiliated, though I assured her that everything was fine and they had nothing to worry about.
Some women within the Mad Movement identify themselves as survivors of involuntary psychiatric subjugation, in that they are told they aren’t normal and need to be “fixed” for not conforming to societal standards of gender etc. Using this framework, we can think about the possibilities of psychiatry as a tool of sanist oppression. Consider a hypothetical: a highly qualified male doctor who has never had experience being a woman—is he equipped to synthesize a woman patient’s experience concisely into a singular diagnoses? Born 1982 argues in the Korean context, a resounding no. But perhaps he has treated hundreds of women and is trained to recognize patterns. Though historic signs from the time of Female Hysteria also rouses some suspicion. But perhaps gender—itself a social construct—doesn’t have a noteworthy impact on the firm science that dictates neural pathways. Though research suggests that gender roles do have an impact on “precipitation or perpetuation of mental health crises” (Vigoud et. al 2016).
Perhaps we can consider my earlier questions: Who controls what is considered “normal?” And what purpose does “normal” serve in our capitalist society? While I can see the value in therapy as a method for unpacking trauma and deconstructing unhealthy coping mechanisms on the individual level, I have a suspicion that “talking through our problems” doesn’t necessarily equate to taking action. And with the downward spiral our political climate and environmental climate is taking, perhaps it’s very human of us to be responding with dread, anxiety, and depression. Therapy has become America’s band-aid solution to social inequity in that we are told therapy will help us solve our own problems—by encouraging us to look inward, instead of outward to our community.
But as I alluded to before, I am still holding onto the belief that therapy can be a net positive if used well. I believe there is some value in having a person dedicated to your externalized reflections, who can pull you out of cyclical thinking. Counseling can be a critical resource for women escaping a cycle of violence and perhaps the simple fact of knowing you have someone in your corner is healing enough—I’ve seen it happen in my own work in the domestic violence space. While therapy won’t save us, perhaps we can build upon it by making holistic choices with our community in mind.
Only Naengmyeon 
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