“I am a doctor, dear, and I know”

In their 2004 book Undoing Gender, American philosopher Judith Butler establishes that power is maintained through performativity, described as the process where norms are constructed through repetition (10). This repetition, which leads to a normalization, is prominent in the medical field, as those which are not “cisgender, cissex, straight, white and able-bodied male” are often recognized as inferior or erased within scientific and medical discourse (Sebring 1953). Through this normalization and categorization of certain bodies – those considered “bio-Others” – as lesser, medical gaslighting’s presence within scientific and medical discourse is customary. A form of psychological abuse which makes victims seem or feel crazy and unstable, gaslighting is given its power through social inequalities particularly those concerning gender and race (Sweet). Its presence, specifically in intimate partner relationships, is strengthened by the structural and social inequalities within these relationships. Hence, medical gaslighting concerns itself with the regulation of and erasure of bodies through psychological abuse. With the growing awareness of medical gaslighting in both contemporary society and discourses, Charlotte Perkins Gilman’s 1892 short story “The Yellow Wallpaper” can be read as a reflection of how power is upheld within both intimate partner relationships and doctor-patient relationships. “The Yellow Wallpaper,” partially influenced by Gilman’s time in the care of physician Dr. Silas Weir Mitchell, exemplifies how medical gaslighting can lead to a negation of bodies through disbelief, patronization, and the assignment of “the rest cure.” Following researcher Jennifer C.H. Sebring’s work, which argues for a sociological explanation of gaslighting, I utilize their term “bio-Other” to justify “The Yellow Wallpaper” as a text which represents medical gaslighting and its consequences.

Medical gaslighting in “The Yellow Wallpaper” exposes performativity in the healthcare system, as the narrator’s husband John doubles as her physician. Here, John employs medical gaslighting by downplaying the symptoms presented by the narrator. The narrator says, “he [John] does not believe I am sick! And what can one do?” (Gilman 647). John’s dismissal immediately impacts the narrator’s confidence, as his position of both husband and physician awards him power over the regulation of her body. French philosopher Michel Foucault’s term “biopower” concerns the regulation utilized by institutions of power to govern human life (qtd. in Sebring 1953). The healthcare system is a power institution, as reinforced by the constant denial of the narrator’s body – a woman’s body – in “The Yellow Wallpaper.” The “logic, reason and science above lived experience” (Sebring 1957) that regulates the bio-Other is prominent here, as John “scoffs openly at any talk of things not to be felt and seen and put down in figures” (Gilman 647). Medical gaslighting ultimately thrives in Western healthcare settings, as conventional medicine and science are accepted as the only truth.

In keeping with the history of medical gaslighting, the word “hysterical” was often used to classify women with mental illnesses and disorders in the 19^th century. Their sufferings were reduced to physical ailments. Hence, to classify a woman as hysterical was to disregard her suffering; to regulate and discipline her body through biopower. These diagnoses justified institutionalization, sterilization, and relegating women [and bio-Others] to the margins of society (Sebring 1953). The narrator is confined to the room with the yellow wallpaper because she is perceived to be only slightly ill. She must accept that she has little power over what happens to her, since John is both her husband and physician; her treatment is in his hands. The narrator asks, “If a physician of high standing, and one’s own husband, assures friends and relatives that there is really nothing the matter with one but temporary nervous depression – a slight hysterical tendency – what is one to do?” (Gilman 648). Thus, medical gaslighting operates through modes of performativity, as strengthened by John’s dismissal of the narrator’s body and the diagnosis of hysteria.

John not only undermines the narrator’s body and sickness; he patronizes her through verbalization. This is often a method of medical gaslighting, as it infantilizes the victim, making them seem weak or helpless. The narrator says, “He [John] is very careful and loving, and hardly lets me stir without special direction” (648). This may seem like a reasonable response when looking after someone who is unwell. However, it utilizes a gender-based stereotype. John’s constant infantilization of the narrator suggests that she is incapable of knowing what is best for herself, as he says, “‘What is it, little girl? . . . Don't go walking about like that­ – you’ll get cold’” (652). By referring to the narrator as a “little girl” and discouraging her from moving about, John regulates her movement because he believes her to be immature. The narrator’s wish to leave the house are met with negativity and further patronizing words, as John assures her that she is better. He says, “‘I am a doctor, dear, and I know’” (652). His insistence of the narrator’s betterment despite her contradictions continues when he says, “‘I beg of you, for my sake and our child’s sake, as well as for your own, that you will never for one instant let that idea enter your mind!’” (652). This is a reference to the narrator explaining she is only physically better. Making the narrator feel guilty for suffering is a gaslighting tactic. By mentioning their child, he makes the narrator rethink the severity of her pain, as she does not want her sickness to alter her child’s life. As a physician, John has the power to “pronounce what is real and what is not” (Sebring 1956). If he believes the narrator to be healthy, then that must be the truth. Bio-Others are given little room for suggestion in doctor-patient relationships. This is of course heightened when their physician doubles as their husband. Butler’s idea of performativity is present in John’s denial of the narrator’s verbalization of her pain. For Butler, “speaking is a sounding forth of the body . . . a stylized assertion of its presence. I am saying what I mean: but there is a body here, and there can be no saying without a body” (Butler 172). Hence, the bio-Other’s body is continuously denigrated through medical gaslighting, despite the verbalization and declaration of pain.

According to sociologist Paige L. Sweet, gaslighting is a gendered phenomenon, since women often do not have the cultural, economic, and political influence to gaslight men. Hence, gaslighting relies on stereotypes associated with feminized irrationality. John claims the narrator is letting the wallpaper get to her, believing “that nothing was worse for a nervous patient than to give way to such fancies” (Gilman 649). This attempt at control is rooted in the stereotypical gaslighting method that assigns women the label “crazy.” The notion of women as “overly emotional, irrational, and not in control of their emotions” has long permeated in the medical industry and healthcare system, utilized to gaslight women into believing that their pain and needs are invalid (Sweet).

This glossing over of pain led to the assignment of the “rest cure” for Gilman and many other women of her time. The rest cure, commonly referred to as “bed rest” in contemporary times, was pioneered by Dr. Silas Weir Mitchell. It is worth nothing that bed rest is still utilized today for serious circumstances which require a patient to heal after an injury. However, the rest cure was originally rooted in a gendered perception of mental illness. Silas Weir Mitchell became known for restoring women to their previous health. During the Civil War, he was a contract surgeon who treated soldier’s gunshot wounds, deeming many of their symptoms “as out of their control, caused by real but unseen changes to their nervous systems” (Horowitz 112). This seems to be the most prominent experience with his foray into nerve specialization. After the war, he became a specialist for those who had what were called “‘breakdowns’” and “‘mental disorders’” at the Philadelphia Orthopedic Hospital and Infirmary for Nervous Diseases (112). His various books and escapades solidified him as a leader in the study of the nervous system. I mention Mitchell’s medical background to corroborate that without his research and practice, “The Yellow Wallpaper” would not exist as it does. After marrying Charles Walter Stetson and giving birth to their daughter, Gilman suffered from post-partum depression/psychosis. Her husband believed her illness to be a “‘uterine irritation,’” and her doctor found nothing “wrong” (118). As her illness worsened, Gilman was placed in Mitchell’s care in May of 1887, after the suggestion came from some friends who were concerned for her. It is unfortunate and slightly ironic that Gilman was a eugenicist, as her work had much to say about the regulation of the body. This may, for good reason, dissuade many readers from thinking with the short story. However, “The Yellow Wallpaper” was written almost a decade before Gilman began advocating for racist eugenics and anti-immigration policies as a reformer (240). Still, at its core, “The Yellow Wallpaper” is a critique of the treatment (utilized loosely here) assigned to patients by Mitchell and the tactics of gaslighting that can be traced throughout said treatment.

The rest cure was a vicious routine for patients. The practice consisted of “a nurse [moving] a patient who wanted to turn in bed, total seclusion (nurses and masseuses were not to talk to patients), rubbing serious enough to raise the body temperature, and feedings every two hours, consisting of malt extract, raw beef, butter, and wine” (127). Cod liver oil was inserted up the patient’s rectum, and iron was placed in their food (127). Although helpful for few women, Mitchell’s rest cure was harsh and further debilitating for most. Many patients went through withdrawal of the narcotic drugs that they were given, with the severe rest and isolation worsening their depression (127). Sebring says, “The consequences of medical gaslighting on bio-Others are often a life-or-death matter, reinforced by the authority afforded doctors in patient care dynamics, and further stratified by race, class, age, gender, sex, ability, body size and sexuality” (1955). As an example, they cite the study “Differences in the self- reported racism experiences of US-born and foreign-born Black pregnant women.” Dominguez et al. emphasize the preventable deaths of Black women in America, who are “‘three to four more times likely to die from pregnancy-related causes than their white counterparts’” (qtd. in Sebring 1955). This lack of proper care for the bio-Other can also be seen in the rest cure. Those who prescribed it needed to control the bio-Other to maintain power. This power is evident in “The Yellow Wallpaper” by John attempting to lessen the movement and freedom of the narrator. The cruelness in regulating the movement of the body that is central to the rest cure is seen when family comes to visit the narrator. She clarifies that although John thought it would be helpful to see company, the narrator “didn’t do a thing” (Gilman 650). Remarkably, only a few paragraphs later in the story, John refuses to let the narrator visit her cousin. The narrator clarifies, “he said I wasn't able to go, nor able to stand it after I got there” (651). These contradictions suggest that John is not as sure of what is best for his wife as he believes himself to be, stressing his desire for control. By continuously ignoring her suggestions which she believes will lead to her betterment, John is able to confine her to the bedroom. In assigning her a rest cure regimen, John maintains control.

This is indicative of Gilman’s experiences with Mitchell. Her journals reveal glimpses at her mental state at given times. However, the act of journaling, writing, and working became something to be controlled by those in both the narrator’s and Gilman’s lives. Mitchell made women in his care reject what he considered “‘great exertion’” (Horowitz 134). This included, as he said, “‘that letter-writing, of which many women are fond’” (134). There is an irony here, as he found value in sewing and certain handiwork. This may very well be due to writing requiring further mental exercise. Hence, Mitchell was concerned with controlling both the physical and mental habits of women in his care. Similarly, the limitation in the narrator’s writing strengthens the representation of medical gaslighting in “The Yellow Wallpaper.” As the narrator writes in her journal, she says, “There comes John, and I must put this away, - he hates to have me write a word” (Gilman 649). There is a certain fear instilled in the narrator, as she is afraid her husband will see her writing. Further, John threatens to send the narrator to “Weir Mitchell” (650). Besides the obvious allusions to Gilman’s real life, this is also utilized to emphasize the narrator’s fear. She says, “I don’t want to go there at all. I had a friend who was in his hands once, and she says he is just like John and my brother, only more so!” (650). The narrator knows the severity of her situation as a bio-Other. Yet, both she and her illness are not taken seriously. As John takes away something the narrator loves, such as writing, she is further demeaned and gaslit, leading to her eventual breakdown.

My readings of “The Yellow Wallpaper” have always concluded that the woman in the yellow wallpaper reflects the narrator; that in having nothing to do besides stare at the yellow wallpaper, she conjures this woman. In this woman, she sees a free version of herself that is not being gaslit by her husband. This desperation only heightens the control she was under, emphasizing her body as that of a bio-Other. The normalization found in the performativity of medical gaslighting is not only represented in “The Yellow Wallpaper,” but established as consequential. Bio-Others are categorized as lesser, as seen by John’s actions towards his wife. Medical gaslighting’s presence in the story offers readers a look at the regulation of a body deemed unimportant. The upholding of medicine and science as truth in “The Yellow Wallpaper” harms the narrator, whose female body was (and is) often disregarded from medical and scientific discourses. Further, the verbalization of her pain is only met with patronization and disdain. The holistic nature of her treatment is representative of the rest cure assigned to women at the time. As a bio-Other, the narrator’s body (and thus, Gilman’s) is gaslit and controlled to the point of its breakdown. Gilman’s “The Yellow Wallpaper,” through contemporary revisiting, has become a sounding board for the bio-Other and an affirmation of their constantly disregarded existence.