• Kate Fitzgerald

The ‘wounded woman’ in fiction has always been a troublesome concept. From the glamorisation of nineteenth-century asylum inmates to the belittling of the contemporary memoirist, the ‘woman who cried pain’ is viewed as either enticing and prophetic or narcissistic and dishonest. For the female writer with a mental disorder, the implication that she should not write of her suffering for fear of cliché is overtly damaging. In ‘A grand unified theory of female pain’, Leslie Jamison discusses the importance of the creative expression of pain, and questions whether it is possible to do so while eluding stigma. I will build on Jamison’s considerations by establishing a fictocritical dialogue between writer and critic, suggesting an avoidance of diagnostic discourse and the shifting of narrative focus towards characterisation that encourages resilience, yet refuses to apologise for or suppress pain.

Keywords: Creative writing — fictocriticism — women and mental disorder — female pain — stigma


Every morning I woke in dread, waiting for the day nurse to go on her rounds and announce from the list of names in her hand whether I was for shock treatment, the new and fashionable means of quieting people and of making them realise that orders are to be obeyed and floors to be polished without anyone protesting and faces are made to be fixed into smiles and weeping is a crime. (Frame 2008 [1961]: 8)

In the first half of the twentieth century, female writers began discussing a new type of moral management. ECT (electroconvulsive therapy) was described by Janet Frame in Faces in the water as a tool for forcing emotional repression. She tells of medical professionals who used all the familiar maxims to imply that a mental disorder is easily controllable by such methods, in some cases implying that the women’s symptoms were merely the product of bad behaviour (Oikkonen 2004). We hear these maxims aimed at children, we heard them when we were children, equating emotional honesty with weakness.

Snap out of it, behave yourself, that’s unladylike behaviour. Big girls don’t cry.

The sane/insane dichotomy contains several paradoxes; namely that, according to Venla Oikkonen, mad female bodies are seen as not ‘proper’ bodies and yet are emphatically bodily. ‘Mad women are seen as lacking depth and yet as having potentially rebellious minds’ (2004: 7). Depending on who you ask, a mental disorder is either nothing or everything. Either a big narcissistic fabrication or a prophetic revelation.


I tell this story all the time:

When I first began to show signs of psychological distress at the age of eighteen my doctor, who had been my general practitioner since I was a small child, said, ‘You enjoyed drama classes at school, right? Then why don’t you just pretend you’re happy?’

Later, I wished I had asked her if she would have had said the same thing had I come in with a broken arm, a nicely severed tendon, a six-inch gash in my arm from operating dangerous machinery. The kind of injury that makes someone take a sharp intake of breath through the teeth and buy you flowers. I prefer to buy my own flowers, but I still need to know there are people out there who would make a comparable gesture.

I visited a psychologist. ‘You don’t look ill,’ he noted, looking me up and down. And up and down again.

I went to a psychiatrist to be diagnosed. ‘Well, among many other things, you certainly have histrionic personality disorder.’

Now, when I write, I am apprehensive that the reader will look for hyperbole in my words.

It is more acceptable to bleed than to weep. But, as Hippocrates said, ‘It is more important to know what person the disease has than what disease the person has’ (in Hustvedt 2016: 111). No two people experience mental disorder the same way. It is erratic, contradictory, maddening. To have true empathy for the neurodivergent is to recognise one is not defined by one’s symptoms; that the DSM’s1 definitions are not immutable.

It is an asset to be resilient. It is also an asset to admit, when the pain is too much, that you cannot manage. To ask for help, to desire empathy — attention — is a natural response to pain. It is concerning, then, that those who express hurt, who openly weep, who admit to needing, invite their own maxims.

You’re a hypochondriac, a coward, a lot of people have it much worse, everybody has problems, stop playing the victim.

They roll off the tongue; I even relay them to myself in more inventive and damning intonations, fitting for a writer; the inner critic with the ability to make a condition terminal. Girls are expected to be more emotionally unguarded than boys but are still derided for showing ‘too much’ emotion. This stigma creates an environment of discomfort, placing responsibility on the neurotypical to do some emotional labour, to empathise. The woman who weeps is a mess no one wants to clean up.

In her essay ‘A grand unified theory of female pain’, Leslie Jamison says:

A cry for attention is positioned as the ultimate crime, clutching or trivial — as if ‘attention’ were inherently a selfish thing to want. But isn’t wanting attention one of the most fundamental traits of being human — and isn’t granting it one of the most important gifts one can ever give? (2014: 191)

To desire attention is to desire assistance, consolation, relief. The idea that this is shameful, that pain should be concealed, reinforces stigma that harms both women and men. Shame encourages emotional suppression. Studies have found that complaints from women regarding pain are less likely to be taken seriously. Since women are generally more forthcoming with complaints of ill health, their sincerity is more frequently questioned (see Hoffmann 2001).

When not being disparaged, female pain has been romanticised for centuries. In 1815, author George Dyer wrote a piece called Written in Bedlam: On seeing a beautiful young female maniac, in which he effuses over the ‘gentle bosom’ and ‘angel face’ of a young woman. Her mental disorder, along with a perceived frailty and vulnerability, made her a desirable sexual object (in Showalter 1987). Pre-Raphaelite artist John Everett Millais painted Hamlet’s Ophelia floating on her back in the river, looking remarkably beautiful for a victim of drowning. If I were a painter, I would paint the young woman after she was pulled from the water, perhaps after a few days, purple and grey and bloated like Francis Bacon’s portraits of Henrietta Moraes. To send a reminder: this hurts.

Patients of Freud and Jung are lauded by some scholars as rebellious heroes, subversive idols, their suffering disregarded as though mental disorder were a subversive, deliberate state. French feminists, champions of l'écriture feminine, assumed hysteria to be ‘the historical label applied to female protest and revolution’ (Showalter 1987: 5). One of Freud’s most famous case studies in hysteria, Ida Bauer, or ‘Dora’, is held up by Hélène Cixous in The Laugh of the Medusa as a form of subversive idol. Her inability to speak was read as a protest against Freud’s phallocentric methods. ‘Dora’ was given the burden of being the very spirit of modern feminism:

who, with a single word of the body, have inscribed the vertiginous immensity of a history which is sprung like an arrow from the whole history of men and from biblio-capitalist society, are the women, the supplicants of yesterday, who come as forebears of the new women, after whom no intersubjective relation will ever be the same. (1976: 886)

‘Dora’ may not have been a passive patient; she may have objected; but it remains that she was suffering. Suffering is forgotten when a higher purpose is sought for ailments we do not understand. We turn to fantasy for solace.

From the shell of the wounded woman, genre fiction creates a monster, a seer, a champion. In Naomi Alderman’s novel The power, girls affected by trauma suddenly find they have the ability to shoot lightning from their hands and punish their oppressors. Marvel character Jessica Jones channels her anger via super strength and the ability to metabolise alcohol at a faster rate than most humans, making addiction appealing. A power fantasy has the ability to pull the wounded woman from the sick bed and onto a dais. If perpetuating these discourses assists in the healing process it is worthwhile — I have felt empowered by narratives in which a woman is able to channel her pain into something transformative. Still, creative practitioners need to be aware of how myth feeds stigma and how writing pain is not simply a matter of reiterating these formulas. Ophelia dies repeatedly from one generation to the next, as a teenager tacks a JW Waterhouse print to her wall, takes a photographic homage in her bathtub and uploads it to her Tumblr blog. She wants to communicate her pain by reclaiming that beauty and seizing control.

Elizabeth Wurtzel notes in her memoir, Prozac Nation, that if there is no discernible release from pain, it should at least serve a purpose (1994). But there is no purpose. The reality is that you end up having to listen to hollow reverberations of this review of Wurtzel’s memoir from the New York Times that begins:

Instead of prescribing Prozac to depressive patients, doctors might now want to try something else first: give them a copy of Prozac Nation and say, ‘Read this; if you don't watch out, you could end up sounding like her’. (Tucker 1994)

Wurtzel’s detractors could not abide the fact that the author’s experience of psychological pain is often selfish, difficult, obnoxious. Appropriate behaviour is not always displayed, unwanted emotions instigate difficult conversations no one wants to have. You have a meltdown; everyone is mad with you. You spend your life apologising rather than receiving the care you require.

Maria Caminero-Santangelo (1998) argues that the ‘madwoman’ is mythologised to the extent that the power and subversion of acting up, rebelling, outside of structural sexism is only an illusion. Women with debilitating mental disorders are rarely ever heard, and many are not as fortunate as Elizabeth Wurtzel in being able to communicate their symptoms sufficiently to their doctors, let alone expound the hard truths of neurodivergency to a broader audience.

In fictional exemplars, any victory the ‘madwoman’ achieves is fleeting. Edna Pontellier in Kate Chopin’s The awakening leaves her husband and children in pursuit of a room of (her) own and a passionate affair, but ends up walking into the sea. Toni Morrison’s Sula lives a life free from social convention yet is demonised by her community and mythologised as the source of all their problems. Elizabeth Richmond’s multiple personalities seem to have completely disappeared thanks to her over-bearing therapist, who seems to have infiltrated her life (and rendered her ostensibly mute) by the end of The bird’s nest by Shirley Jackson. These wounded women all end up othered, alienated or dead.

Alberta, the narrator of my novel-in-progress, Laura Lives on Cloud Nine, observes the isolating nature of her disorder. She sees that people are in awe of a certain ‘type of crazy’, specifically that belonging to her best friend, Laura, who seems to have enviable amounts of confidence and charisma. This leads Alberta to dismiss Laura’s severe psychological symptoms, to assume her friend could not possibly be suffering as much. A battle between external and internal stigma is fought amid a cloud of paradox and self-sabotage. Alberta is a character that is semi-autobiographical. Many of her observations about her illness reflect my own. I still feel the desire to ridicule myself in order to fit in.

Can my self-deprecation be used as a defence?

Leslie Jamison argues that the contemporary woman is discouraged from displaying hurt. We feel the need to apologise for our emotions lest we are labelled melodramatic or hysterical. We avoid creating art in response to pain for fear of becoming a cliché of the ‘broken woman’.

Jamison (2014) coined the term ‘post-wounded woman’ to describe not only the way female pain is stigmatised by outside forces, but also how these forces have become pervasive. One must conceal one’s pain for fear of being dismissed, judged and ridiculed. The post-wounded woman adopts a hardened façade that evades emotional discourse. Jamison believes that the trope of the wounded or broken woman has been so reviled that many female writers have reacted against it, attempting to find ways to brush off or conceal their pain by buying into the very stigmas that seek to oppress them.


This is the only time I will ever tell this story:

I decided to walk away from my best friend. For good. The idea formed in my mind, far too late, when he sat in the corner of my bedroom, a sobbing, shaking, drunken wreck. A mutual friend suggested that perhaps he needed to ‘talk to someone’. He grimaced and gurned in fury as if he was trying to keep everything that had ever troubled him from rising and exploding. He lifted a shaking finger and pointed it at me. ‘No. I’m nothing like her. I’m not insane like her.’

Too many irrational meltdowns over the years, too much of a burden. Just too much. All the stupid, illogical things I said. The scapegoat for everything wrong with his life.

I have nightmares where tormentors from the past resurface to chastise and violate me. I’ve seen my dog cut in half by an unforeseen guillotine, had graphic alien miscarriages, pulled parasites from my skin. You probably think this is all hyperbole. If you ask him, he will swear I made it all up.

The hills step off into whiteness.
People or stars
Regard me sadly, I disappoint them. (Plath 2001 [1965]: 5)

In her poem, ‘Sheep in Fog’, Sylvia Plath describes the sensation of being under constant derisive observation: inhabiting a cold void where a multitude of voices tell you over and over that you are an inconvenience; you are letting everyone down. If only you could recover, join the realm of the sane, these elusive spectators would finally reward you with their affection and approval.

The uglier the emotion, the less palatable. The main criticism of my own writing has been that it is ‘too much’ — too many tears, too much vomit, too much menstruation. Make your narrator less of a weirdo. In the past, many of my male peers have been fixated on states of melancholia, the old romantic word for depression, the kind that turns your protagonist into a Byronic anti-hero, ponderous, productive and brilliant: a Roth, a Bukowski, a Burroughs. Lots of cigarettes and whisky and no good, lousy dames.

In my undergraduate years, I was told it was best to write like Hemingway. Less is more, be aloof not uncouth. I felt pressure to write ‘like a man’ — if I was going to use lived experience I assumed it must be hidden, so that no one could recognise the grotesque elements of me. The grimy parts of the I. I thought it would be self-indulgent to write of my own suffering. What resulted was female characters who were idealised versions of myself. Destructive women who resembled the male anti-hero while still being physically desirable. Exuding an innate sexuality that glamourised self-destruction.

Photos of Ophelia in a bathtub – Crazy but not, like, too crazy. I was writing the post-wounded woman.

Post-wounded women know that postures of pain play into limited and outmoded conceptions of womanhood. Their hurt has a new native language spoken in several dialects: sarcastic, jaded, opaque; cool and clever. They guard against those moments when melodrama or self-pity might split their careful seams of intellect, expose the shame of self-absorption without self-awareness. I know these dialects because I have spoken them; I know these post-wounded narrators because I have written them. I wonder now: What shame are they sculpted from? (Jamison 2014)

My shame-fuelled dialects were sculpted from male mentors who still cannot say they entirely approve of my subject matter. My early work camouflaged the parts of my disorder that were too ugly: I had heard the disgust voiced by those around me at the thought of suffering in a similar fashion. It’s the disapproving responses from the academy and in the workplace; the need for silence.  

Don’t let on or you won’t get far.

A decade ago, as a tutor in a tertiary creative writing course, I was encouraged to supress the passions of my students. The department had laid a set of unofficial ‘rules’ for students to consider that included a set of topics on which they should avoid writing. The most contested being to ‘not write a memoir of personal trauma’. These stories were seen as belonging to the realm of personal diaries, or confidential therapy sessions with a licensed professional.

This ‘recommendation’ was established because past students had reacted badly to negative feedback on their writing. These students had allegedly felt that their pain was being critiqued rather than their work. For many writers, personal pain is their work. Instructors rightly do not desire conflict and should have procedures in place to avoid compromising situations — for themselves and for their students. Yet the concept of emotion should not cause such apprehension. In any academic discipline, if a student has a quarrel with their instructor, there is always a chance that someone will be negatively affected. It is ultimately limiting to tell a student of the creative arts they shouldn’t write in their chosen style. This concern is not limited to the academy. The writer Nancy Mairs said, ‘I don’t think any man has ever suggested I give up writing. It’s just that a lot of them want me to write something else’ (1994: 22).

Write like them. Write like Hemingway. See the way in that doco about Bukowski, see, see how he kicks his wife off the couch? Mad bastard. Ha. ha.

I am ashamed. At the kind of men I once saw as role models.

Mairs adds:

Let the masters of the written word cling to their bodiless principles. Let them pronounce what is interesting and what is not, what is a poem and what is not, what merits their grudging praise and what does not … I want to give her the courage to say the next hard thing, without fear of ridicule or expulsion if she strays across the borders of good taste, good sense, or good judgement demarcated by a tradition she had no part in forming. I want her to do the same thing for me (1994: 24).

It was up to me to discover female writers who spoke the same language. Who had been published regardless of the ‘airing of dirty laundry’. It took me almost a decade to realise what texts I should have been engaging with. What I should have been writing all along. The next step was to find a way to write about my own mental disorder while minimising the chance my work would be read from a diagnostic perspective.

Psychoanalysis plays a large role in cultural criticism. Students are still asked to employ Freudian theory in a variety of arts programs. Kate Zambreno discussed the responses of some of her creative writing students to characters in literature who display identifiable symptoms of mental disorder. These students attempted to diagnose a character based on a combination of textual clues and their own preconceived notions, gleaned from books and films.

There is a readerly and critical desire to understand the damage in order to understand the narrative. As though you can’t be burned by the fire without knowing the cause. Zambreno tells an anecdote:

Someone I once met told me that in graduate school she went through The Awakening and highlighted every instance of what she saw as clinical depression. Then wrote an essay on it. Charlotte Perkins Gilman struggled with depression so the story (The Yellow Wallpaper) must be her diary. When you reduce an author or character’s torment to a diagnostic category you are not allowing her the existential alienation of a novelist-hero, but the narcissism of a heroine. (2012: 259)

Rather than affording the female anti-hero the complexities of her male counterparts, armchair diagnoses reinforce the literary stereotype of the ‘woman who cried pain’. The awakening and The yellow wallpaper are not written around a distinct diagnosis — Victorian notions of hysteria and similarly ‘feminine’ maladies are alluded to — yet readers are still tempted to highlight symptoms, and conduct analyses, regardless of their own expertise or experience.

While diagnoses are clearly a useful and important means of treatment, it’s not always useful when these findings are presented in creative writing — both fiction and nonfiction. In her memoir Girl, interrupted (2000) Susanna Kaysen quotes extensively from the DSM definition of Borderline Personality Disorder in order to make sense of her stay in a mental institution. While Kaysen successfully engages in a dialogue with this definition, her approach detracts from any significant introspection and makes it harder for the reader to discern any nuance. The concept of creative, non-diagnostic writing is not so limiting as to dispel the use of diagnostic terms. However, they should be used sparingly, with the centre of the narrative being grounded in the personal, rather than the clinical.

Writing about personal pain allows for significant detail that can be lost in other forms of communication. It demands to be heard because it gives the individual, and only the individual, a platform. This is where the writer is at an advantage. When she faces stigma in real life, she can easily be silenced, misunderstood. She can’t hold someone down and force them to listen; the written word is the closest she can get to forcing another to hear her story. In reading her work, the audience is choosing to engage.

Some of the most successful non-diagnostic works of fiction view mental disorder from the perspective of the neurotypical. To show stigma in action highlights how damaging certain behaviours can be. Han Kang’s The vegetarian (2015) is told from the perspective of the family of a woman named Yeong-hye. At the beginning of the novel her husband is infuriated when she stops eating meat, a serious taboo in South Korea. When Yeong-hye is hospitalised after a suicide attempt that took place at a family gathering, her husband reacts with mortification and resentment. He stands by her bed, as though benevolence is the most hideous of chores, observing:

the only people left in the general ward aside from my wife and me were a schoolgirl with a ruptured intestine, and her parents. They kept on darting sideways glances at me while I stood at my wife’s bedside, and I could see perfectly that they were whispering together. But any minute now this long Sunday would be over and Monday would begin. Which meant I would no longer have to look at this woman. (2015: 44)

According to this man, the teenage girl with a tangible physical affliction is the more ‘legitimate’ patient. He imagines this girl and her mother judging the self-inflicted cuts on Yeong-hye’s wrists, her slowly changing body an intolerable malady. She has become repulsive, a galling inconvenience to her husband. Young and bleeding is much more acceptable than old and sad.

Mental disorders do not merely distort the mind; the entire body is affected. In her essay ‘On being ill’ [1947] Virginia Woolf identified a need for diseases of the mind to be directly associated with the toll they take on the body. She also noted that, at the time of writing, little was said in literary fiction of the relationship between mind and body. Woolf suggested that the impermeable workings of the tormented mind seemed somehow more palatable, more romantic to the poet and the philosopher than the exhausted, mutilated, aching body.

In The vegetarian, it is the details of the relationship between Yeong-hye’s mind and her body that highlight the singular experience of her pain. As the novel progresses, Yeong-hye develops a fascination with plants, and allows her artist brother-in-law — despite his exploitative yearnings — to paint vivid flowers on her skin. Later she is institutionalised and spends much of her time silent, doing handstands, trying to become a tree. Yeong-hye desires a complete bodily metamorphosis that would transcend her suffering; or, at least, make the pain somehow bearable.

I began writing Laura Lives on Cloud Nine from the point of view of multiple narrators to provide a balanced view of the protagonist’s disorder. I had been conditioned over the years to believe that the first-person confessional style was somehow juvenile and self-indulgent. Chris Kraus writes in her exegetical memoir, I love Dick:

whenever I tried writing in the 1st person it sounded like some other person, or else the tritest most neurotic parts of myself that I wanted so badly to get beyond. Now I can’t stop writing in the first person, it feels like it’s the last chance I’ll ever have to figure some of this stuff out. (2016: 122)

The phrase ‘figuring this stuff out’ is key. As soon as I changed the point of view of my novel to that solely of the character based upon myself (Alberta), the text became less affected. I wrote in the first person, not to solve my problems, but to seek a broader understanding of them. To eliminate shame. I wanted to write about what Alberta thought of herself, conscious that doing anything else would be employing the same silencing methods that have been enacted upon women for centuries.

It is possible to write of personal pain with critical and creative acumen. It is frowned upon perhaps, ‘(Because) emotion’s just so terrifying the world refuses to believe that it can be pursued as discipline, as form’ (Krause 2016: 180). The first person confessional style is not written without restraint, without discipline. We’re all just far too scared of the I. As Anne Sexton said, ‘creative people must not avoid the pain that they get dealt … hurt must be examined like the plague’ (in Jamison 1996: 117).


This story is my own:

A few weeks ago, I received a new diagnosis. It’s a big one. I told a friend and she screwed up her face. It was a familiar expression. The one she pulls, unconsciously, when she thinks I’m stupid.

I recall these interactions, no matter how small. They are inescapable, so I collect them. Claim the language of pain as a literary approach. I express my ideas without preconceived notions regarding my disorders.

I can speak of my body and mind as one that is entirely and uniquely afflicted. Examine my suffering without shame and write in a style that is uniquely my own. Part of a long and legitimate tradition.



1. DSM is the Diagnostic and Statistical Manual of Mental Disorders, now in its 5th edition (2013).


Works cited: 


Alderman, N 2017 The power, New York: Little, Brown and Company

Caminero-Santangelo, M 1998 The madwoman can’t speak or, why insanity is not subversive, New York: Cornell University Press

Chopin, K 1993 The awakening, New York: Dover Publications

Cixous, H 1976 ‘The laugh of the Medusa’, Signs 1.4: 875–93

Frame, J 2008 Faces in the water, Sydney: Random House

Hoffmann, DE 2001 ‘The girl who cried pain: A bias against women in the treatment of pain’, Journal of law, medicine and ethics 29: 13–17

Hustvedt, S 2016 Men looking at women looking at men, London: Hodder and Stoughton

Jackson, S 1954 The bird’s nest, London: Penguin

Jamison, L 2014 ‘A grand unified theory of female pain’, in The empathy exams, London: Granta Publications, 185–218

Jamison, KR 1996 Touched with fire: Manic-depressive illness and the artistic temperament, New York:  Free Press

Kang, H 2015 The vegetarian, London: Portobello Books

Kaysen, S 2000 Girl, interrupted, London: Virago

Kraus, C 2015 I love Dick, London: Tuskar Rock Press

Mairs, N 1994 Voice lessons, Massachusetts: Beacon Press

Morrison, T 2016 Sula, London: Vintage

Oikkonen, V 2004 ‘Mad embodiments: Female corporeality and insanity in Janet Frame’s Faces in the Water and Sylvia Plath’s The Bell Jar’, Helsinki English Studies 3: 1–11

Perkins Gilman, C 1997 The yellow wallpaper, New York: Dover Publications

Plath, S 2001 Ariel, London: Faber & Faber

Showalter, E 1985 The female malady: Women, madness and English culture 1830–1980, London: Virago

Tucker, K 1994 ‘Rambunctious with tears’, The New York Times,
http://www.nytimes.com/1994/09/25/books/rambunctious-with-tears.html (accessed 30 March 2016)

Woolf, V 1947 ‘On being ill’ in The moment and other essays,

Wurtzel, E 1994 Prozac Nation: Young and depressed in America, New York: Riverhead

Zambreno, K 2012 Heroines, South Pasadena: Semiotext(e)