In the nineteenth century, distressed women were “hysterical.” In the twentieth, instead of Freudian analysis, “distressed” women got the majority of treatments like lobotomy and electroconvulsive therapy, or shock. (For the latter, they still do). Clinicians learned about women’s "penis envy" and "innate passivity" as late as the 1960s, according to psychiatric historian Phyllis Chesler. A woman running for office still invokes that deadly combination of female hormones and nuclear codes.

And then there’s Britney Spears.

At a June hearing, Spears detailed the abuses that have come with her conservatorship. She told the court she's been forced to perform and packed off for refusing a dance move; she cannot remove her IUD; the money she earns from those performances and dance moves pays those who control her.

The conservatorship started in 2008, managed by Spears’ father and a lawyer, Andrew Wallet. In 2007 Spears earned headlines like "Mad" and "Broken" when she shaved her head in a beauty salon and used an umbrella to bash a photographer’s car. The following year Spears refused to turn her two sons over to estranged husband Kevin Federline. Police came and after a standoff, she was loaded into an ambulance and placed on an involuntary hold. Sources reported that Spears was bipolar.

I have been in Spears’ place, without the IUD and the money. I had no conservatorship, but I’ve also had no control. In the early 1970s, dismay over shock treatment and its coercive use and effects like memory loss led to nationwide hearings. In 1975 California finally put strict legal controls on its use. Still, I received it in 1972, at the developing-brain age of 15. In one hospitalization I had, a doctor discussed his sexual desire for a teenage patient in group therapy. Shock in that hospital was used half for therapy, half as threat.

I am also bipolar. But at the time, I was far less worried about my mood-swingy mind than about what could be done to my body.

It’s unsurprising to me that these stories about Spears have been so widely reported with so little discussion of their basic assumptions. Britney went mad. She "broke" with reality. But irrationality and emotionality are the province of women. And normative behavior is set by the dominant culture. Witness the case of "drapetomania," Dr. Samuel Cartwright’s 1851 “mental illness” that consisted of being a Black enslaved person who wished to be free.

What is rational? Lisa Bortolotti, a philosopher of psychiatry, argues that all human beliefs exist on a spectrum of rationality, with many if not most of them at least somewhat irrational. She’s far from alone in this re-visioning. Bortolotti gives the example of a young man who feels persecuted, whose belief helps him make sense of a lifetime of poor treatment. People may be distressed, or not, by thoughts and behavior, but looked at closely, they have context. Context can fix their place on that wide spectrum of the rational and challenge how they’re used against patients.

For women, our context is often absent or interpreted with bias. It’s hard to jump to potentially damaging treatments like shock and lobotomy if you think your patient’s history makes sense of their choices. For years, many articles about Spears used "successful, functioning Britney" — her albums, her Las Vegas show — as examples of the success of her conservatorship. To use a relevant metaphor, this is the proverbial trial of the witch: if she floats in the water, she’s a witch. If she sinks, she isn’t—but she still drowns.

In the Spears documentary "Breaking Point," hairstylist Esther Tognozzi reports that on the night of the head-shave, one of Spears’ own bodyguards opened the blinds for the paparazzi. Britney told a tattoo artist she was tired of people touching her hair. Finding betrayal and unwanted touching disturbing makes sense.

As to the standoff, the escalation of distress when police answer calls like Spears’ is real and rightly coming to the fore. The Mental Health Justice Act introduced into the House this year creates grants to allow such first responders to be mental health teams. For a woman who had just lost custody, the arrival of police must have been terrifying. I wonder where Spears would be if this law had been on the books in 2008.

I will tell you one final thing. I ran away from the psychiatric hospital where a young girl was sexually targeted and I had shock. I begged on the street, senselessly, for cash to go somewhere, though I knew I had nowhere else to go. A very kind nurse found me and drove me back with a minimum of attention.

This act of running was, without my preceding paragraphs, irrational. A sensible person could easily take it as evidence they should have held me longer. But my action was meaningful. In some sense I freed myself. And it’s time for Spears to do so, to stop dancing to somebody else’s tune.

Susanne Paola Antonetta’s newest book is "The Terrible Unlikelihood of Our Being Here." Awards for her writing include a New York Times Notable Book, an American Book Award, a Library Journal Best Science book of the year, and others. Her essays and poems have appeared in The New York Times, The Washington Post, The UK Independent, Orion, The New Republic and many anthologies and featured on CNN.

Published on Jul 30, 2021