The Feminist Times
Impact Of Patriarchy On The Mental Health Of Women In India
Mental health can roughly be conceptualised as an individual’s inner experiences linked to their interpersonal group experiences that entail cognitive experiences (thinking processes), affective experiences (feelings and moods) and relational experiences (the way in which people interact with their environment). Lately, the concept of mental health has got broadened with the increasing recognition and inclusion of the importance of external forces such as interpersonal relationships, social and economic factors and organizational and physical environments on mental health. We can all assuredly agree on the fact that women across the globe are overtaxed and undervalued. Their subordination in a male dominated society makes it gruelling for them to cope with all the tacit social, physical or mental demands made upon them. It is an indisputable fact that women are more vulnerable than men to violence, all forms of exploitation, be it economic, social, sexual or emotional, as well as to poverty, malnutrition, chronic diseases exacerbated by early pregnancy and forced motherhood, and thus to worse mental health issues into the bargain. Furthermore, men’s self-seeking and insouciant attitude towards them only adds insult to injury.
Early psychological theories of sex differences entailed prescriptive traditional sex roles that could be used to control female behaviour. As a result of this, women were viewed as maternal and domestic. Additionally, hygiene manuals described a cause-and-effect relationship between female sexual “transgression” and their bad health thus buttressing the connection between women’s social role and their health status. Other regressive psychological theories emphasized the equivalence of “insanity” with “femininity” as a result of which the concept of “hysterical woman” was born. The culturally ascertained patterns of behaviour of women led to situational anxieties which were unfortunately normalised in the name of gender stereotypes and gender norms. As Plath rightly said, “as a woman you are dammed anyway; if you are normal you are mad by implication and if you are abnormal you are mad by definition.”
The stresses imposed on women deteriorate their mental well-being. There is enough epidemiologic evidence to highlight the link between women’s powerlessness and alienation and their mental health issues. These issues mostly appear in adulthood but their source can often be traced back to early childhood. The girl child grows up to closely observe, hence, internalise the somewhat fixed gender roles and identities around her and processes information based on gender-typed knowledge. The cognitive theory of gender schema given by Sandra Bam explains these processes. This theory can be used to explain the subconscious obsession of a lot of girls’ parents and eventually girls themselves with how they look or how much they weigh, for example. This paves the way for self esteem and body image issues in girls at an early age that predispose them to more weighty, deep-rooted issues and mental disorders in future. Another example is girls passively or directly observing violence towards their mothers at home which could result in them internalising their mothers’ agony because of which they will find it difficult to cope with similar unpleasant situations in future. Additionally, mothers that are victims of domestic violence are unable to care for their children properly. Often, they transmit their own feelings of low self-esteem, helplessness, and inadequacy to their children.
While childhood is characterized by subconscious internalisation of societal expectations, explicit demands for the emotional availability of women start to get evident during adolescence. Since girls are already at a relatively vulnerable stage in their lives because of the sexual, emotional and physical changes brought about by puberty, their mental well-being further gets compromised. Mobility and autonomy of girls during puberty wanes due to increasing restrictions on clothes, appearance, conduct, speech and interaction with the opposite sex. In some Indian cultures, girls are even isolated in a separate room for a certain number of days when they are menstruating and are hence “untouchable” during this period. As a consequence of this, girls often see themselves as impure and dirty. This practice, in some extreme cases could lead to generalized anxiety disorder, psychological isolation, depression and social anxiety in future.
A typical Indian household imposes “womanly” expectations on the young girls of the house, an example of which is the implantation of the importance of learning how to run a household, cook and sew in the minds of girls from an early age. Most times, girls actually do end up inheriting their mother's domestic chores and adopt conventional gender roles because this is the only option available to them. After marriage, husband and in-laws control her life. In certain communities, girls are taught to walk with a downward gaze. Consequently, the girls enter a state of “learned helplessness” wherein girls may accept and remain passive in negative situations despite their clear ability to change them. This happens when they are repeatedly subjected to aversive stimulus to an extent that they stop thinking about escaping it. As a result of these negative expectations, other consequences may accompany the inability or unwillingness to act, including helplessness, low self-esteem, chronic failure, sadness, and physical illness.
Women also face violence at the hands of their husbands, fathers, brothers, and uncles in their homes. The abuse is generally overlooked by social custom and considered a part and parcel of marital life. It may also include rape and sexual abuse. Psychological violence includes verbal abuse, harassment, confinement, and deprivation of physical, financial, and personal resources. All types of abuse and violence can lead to mental health issues, but when it is perpetrated by someone from the family, the consequences cage the victim with problems that become extremely hard to battle. Such issues, which mostly go unresolved because they happen within the family setting, are followed by mental disorders like Post Traumatic Stress Disorder (PTSD), and feelings of excessive shame, guilt and episodes of anger. It may also contribute to the development of dysfunctional behaviour, depression, anxiety, eating disorders, somatization disorders, etc. Discrimination and neglect can result in lowered self-expectations, negative attitude towards self, lack of initiatives, and so on. Many a times on probing further, the symptoms can be conceptualized as exaggerations or stereotyping of female gender roles and sex-typed behaviours. It is also documented that girls tend to somatize and dissociate more owing to their status in authoritarian patriarchal society. Women are often not able to escape abusive interpersonal relationships and the first question people ask when they hear about a case is “why didn’t she just leave?” even when she had the financial resources and external support to leave. This is where learned helplessness comes in. The repeated cycles of trauma make them habituated of it as a result of which it is mentally impossible for them to break free from the shackles of abusive marriages.
Based on my own experiences and observations, whenever girls tend to open up to their family about their inability to cope mentally due to whatever reasons, expressing the need to seek professional help, parents often brush it off on the pretext that “this is what girls do.” Thus, combusting into tears, inability to control emotions, feeling overwhelmed, getting short of breath, which are all symptoms of anxiety disorders would be accounted as the usual “tantrums” girls throw. Sometimes, women learn to extinguish their symptoms as a coping mechanism which could also result in high-functioning anxiety.
Although policies have been introduced in India recognizing the importance of mental health, but they did not bring about a paradigm shift in how mental health is viewed in the Indian society. For instance, the Mental Healthcare Act was introduced in 2017 that aimed to provide mental healthcare services for persons with mental illness and ensure these persons have the right to live a life with dignity by not being discriminated against or harassed. However, since Savarna Hindu men centrism is ubiquitous in the Indian society, it is important to introduce a new policy reform with an intersectional approach that acknowledges the fact that women, the queer community and other economic and caste-based minorities have it worse and hence need more attention under the policy framework. Incorporating group therapy sessions that include having liberating discussions on patriarchy and sexism in general and having women personally relate these societal phenomena to their own life based on their past experiences can facilitate the promotion of gender sensitive mental healthcare services in India. It has been found that as the awareness about mental health is increasing, the demand for a feminist approach to therapy is also shooting up. This kind of therapy also entails gay affirmative therapy which is principled on being non-judgemental and validates the choices that people make which may be beyond what's considered ‘normal’. In many ways, this therapy is centred around the client and has a narrative based nature. It is important to note that feminist therapy should not solely pertain providing therapy to well off cisgender heterosexual upper caste Hindu women but universally to women taking into account the existence of societal oppression in India. The Mental Health Act does condemn discrimination of people seeking help on the basis of gender, caste, sexual orientation and so on but the real stumbling block is the lack of the monitoring, failures in execution that overlaps with the genuine lack of mental health professionals in India.
Thus, women's mental health cannot be addressed in isolation to social and economic issues. A woman's health must incorporate both mental and physical health across the life cycle and should get beyond the narrow perspective of reproductive and maternal health, which is often the focus of most health policies in India.
- Gurman Kaur Chawla