In this op-ed, Caralena Peterson draws parallels between the sexist ideas that contributed to women’s historical institutionalization, and those surrounding Britney Spears’s behavior.

In her new memoir The Woman in Me, readers are given new insight into the life of Britney Spears – a superstar with a long and (unfairly) very public history of mental health struggles. As a fan, it can be difficult to tell what is real and what is fabricated about our favorite celebrities, and that’s particularly true when it comes to Spears. Before the release of her own first-hand account, it was hard to know the truth.

By Spears’s own telling of events, her truth wasn’t necessarily the same as that of her conservators. In her book, Spears claims she was treated as unsound and the so-called proof was her normal range of emotions: “If I became flustered, it was taken as evidence that I wasn’t improving,” she writes. “If I got upset and asserted myself, I was out of control and crazy.”

She further reflects: “It reminded me of what I’d always heard about the way they tested to see if someone was a witch in the olden days. They’d throw the woman into a pond. If she floated, she was a witch and would be killed. If she sank, she was innocent and, oh well, she was dead either way, but I guess they figured it was still good to know what kind of woman she had been.”

In the summer of 2021, the #FreeBritney movement was full blown in its efforts to release the pop icon from her 13-year conservatorship, under which she was largely under the legal control of her father, Jamie Spears, among a few others.

At the time, I was working on a research project for my Masters program concentrated on the historic reporting of 17th-to-20th century women being institutionalized against their will and without informed consent. The more I read, the more parallels I saw between my studies of what were commonly called “madhouses” and Spears’s experience. The circumstances are certainly different, but many of the attitudes pathologizing women’s emotions seem similar.

After learning Spears’s own account of her conservatorship and the control she says her conservators were given over nearly every aspect of her life, it seems that the gendered ideas that landed many women in madhouses in the past have been repackaged. Spears may not have been sent away like the women before her (though she has said she was forced into a mental health facility), but her experience appears to echo the sexism historically employed to dampen women who defy societal expectations.

Historically, “Private madhouses” popped up around London during the 16th and 17th centuries and continued to spread throughout Europe and North America in the form of overcrowded public institutions. With no legal requirements initially regulating these establishments, abuses were abundant. Even into the 20th century, patients might be imprisoned, medicated, lobotomized, or given electro-convulsive and shock treatments – often against their will.

These practices disproportionately impacted women. Research has found that women were more often lobotomized than men, a procedure that, in some cases, was thought to make them fall in line with gendered expectations. While men once outnumbered women in state mental hospitals, women tended to be more often institutionalized in private madhouses, and by the 19th century, women were overtaking men in institutional settings across the board. And according to the Centre for the History of Medicine, women were “admitted to private asylums on slender evidence, notably those who contravened expectations concerning their modesty, conduct, duties or behavior or those who would not bend to their husbands’ will.” Historically, reasons for women’s institutionalization were all over the board, including “anger, cursing, aggressiveness, sexual love of women, increased sexuality in general, and refusal to perform domestic and emotional-compassionate services,” according to feminist psychotherapist Phyllis Chesler.

In her book Women and Madness, Chesler details the overlooked past of “madhouses” often occupied by perfectly sound wives and daughters that were “psychiatrically imprisoned… as a way of punishing them for being too uppity.” Madhouses, Chesler argues, were once seen as “a comparatively inexpensive way of ridding themselves of bothersome wives.” In 1861, Susan B. Anthony and Elizabeth Cady Stanton wrote: “Could the dark secrets of the insane asylums be brought to light… we would be shocked to know the countless number of rebellious wives, sisters, and daughters that are thus annually sacrificed to false customs and conventionalisms, and barbarous laws made by men for women.”

Despite being sent for “treatment,” these women were often mistreated. In her famous piece of investigative journalism “10 Days in a Madhouse,” Nellie Bly describes the deplorable conditions within these institutions (she feigned mental illness to gain entry). Once free, she reflected: “I regret that I could not have brought with me some of the unfortunate women who lived and suffered with me, and who, I am convinced, are just as sane as I was and am now myself.” She decried the treatment of the women in such facilities as the true reason for their degrading physical and mental health, proclaiming: “What, excepting torture, would produce insanity quicker than this treatment?”

The practice of sending women to madhouses purportedly faded out toward the end of the 19th century as most industrialized nations began developing systems of regulation for treating the mentally-ill. But as I flip through the crisp pages of The Woman in Me, the parallels between Spears’s experience and the gendered expectations and ideas that led to woman being committed more than 200 years ago seem to linger. Spears was largely placed under the control of the man in her life — her father — after she was declared “incompetent” in 2008.

Spears’s father has said the family pushed for a conservatorship to repair her mental health and rebuild her finances, but Spears maintains in her memoir that her father’s reasons for establishing the conservatorship were mainly to take control of her assets. (Her father has refuted that characterization, and has denied any wrongdoing. After he was suspended as her conservator in 2021, Jamie Spears issued a statement through his lawyer, according to Variety, saying he acted in his daughter’s best interest and remained silent about “all the false, speculative, and unsubstantiated attacks on him.”) She acknowledges she had been “bad” and doing a lot of partying leading up to the conservatorship, but she didn’t feel she had done anything that “justified upending [her] entire life.”

Still, the legal arrangement was made on her behalf after what many at the time saw as a downward spiral. Spears was portrayed in the press as out of control; paparazzi shots showed her looking disheveled, articles implied she was a bad mother, and tabloid after tabloid recounted her alleged bad behavior. It largely came to a head when, in 2007, Spears was photographed smashing a paparazzo’s car with an umbrella, the same day she had shaved off all her hair. What wasn’t much noted at the time was that Spears was mourning the death of her aunt, the demise of her marriage, and fighting for custody of her children — all while paparazzi followed her every move.

We won’t ever know every detail of what happened behind closed doors, nor can we truly know someone’s intent. But in her memoir, Spears repeats that her actions, while less than ideal, weren’t indicative of person who lacked the mental capacity to control her own life. Instead, she writes that she was subject to sexist ideas of how she should act. Spears urges readers to “think of how many male artists gambled all their money away” and “how many had substance abuse or mental health issues,” yet “no one tried to take away their control over their body and money,” as had been the case for her. Spears laments unfair gender dynamics imposed by this status quo in her memoir, noting, “Other people, and by other people I mean men, were afforded that freedom [to rebel]. Male rockers were rolling in late to award shows and we thought it made them cooler. Male pop stars were sleeping with lots of women and that was awesome.”

Chesler theorizes why men are typically allowed a broader range of acceptable behaviors than their female counterparts: “It can be argued that psychiatric hospitalization or labeling relates to what society considers unacceptable behaviors. Thus, since women are allowed fewer total behaviors and are more strictly confined to their role-sphere than men are, women… will commit more behaviors that are seen as ill or unacceptable.” Their challenges to the status quo seem more threatening, thus receiving more immediate pushback.

Luckily, times and attitudes are changing – although scenarios like Spears’s show us they are not changing quickly enough. Psychologists and psychiatrists like Judith Lewis Herman continue to center feminist theory more fully in their methods and models. And, therapists largely do not declare women mentally ill for expressing strong emotions that don’t fit into conventional expectations of the feminine role, nor do they pathologize women who desire full time careers or express homosexual desire or refuse to marry or commit adultery or want divorces or use birth control or have children out of wedlock or have abortions in the ways they sometimes were in the past.

This history is not as far in the past as one might like to believe, but I like to believe all this is in the rearview mirror. With more and more women entering the fields of psychology and psychiatry, and advances in the ways women are treated and respected, change is occurring. Instead of writing off women’s anxiety and depression as hysteria or the inability to adapt to their proper womanly role, feminist-founded therapy pays more attention to the traumas of everyday women. It makes sure to “bear witness to a crime” and to “affirm a position of solidarity with the victim,” in the words of Chesler.

We as a society are unlearning the protocol of “diagnostically pathologizing” women for what are totally normal responses to trauma and oppression. Spears and all women alike deserve this kind of care, a kind of care with no place for the misogyny so often carried by labels like “crazy” and “unhinged.” Her story is one that draws attention to the need for feminist frameworks to be utilized in the treatment of women and their trauma.