During the last two centuries, when male doctors observed female patients experiencing some of the symptoms that we now understand are caused by trauma, they diagnosed the condition as “hysteria.” And since hysteria was seen as a disease of the uterus (hystera in Greek), the remedy was as drastic as it was brutal—surgically removing the uterus (a hysterectomy). Nowadays, we have a clearer understanding of how trauma manifests in behavior, but as pop star Britney Spears’ explosive recent testimony at her conservancy hearings has made clear, modern-day America too often still pathologizes trauma and deprives trauma survivors of their bodily autonomy and basic human rights.
Spears has been under a court-ordered conservatorship since 2008, when her father was given control over her estate and many other aspects of her personal life, including her reproductive rights and—according to her testimony—even such minutia as the décor of her kitchen. (Her father refused her request to re-stain the kitchen cabinets, saying it was too expensive.) The conservatorship was a result of a very public unraveling that year, when Britney shaved her head and smacked a reporter’s car with an umbrella. She was also involved in an alleged stand-off with the police, refusing to surrender her sons. Yet the conservatorship is unusual because it is usually only granted in cases of severe cognitive impairment or developmental disability, not for "an individual who is young, who is working, who is very successful in their field — because that suggests a level of capability that wouldn't meet the standard for legal incapacity," said Leslie Salzman, a clinical professor of law at the Cardozo School of Law, in an interview with NPR.
Women are prone to being labeled “hysterical,” “neurotic,” or “hormonal”—our trauma dismissed as a particularly female over-emotionalism, the result of being at the mercy of our female reproductive organs. Spears did not undergo an unwanted hysterectomy, but it was shocking to learn her conservators forced her to have her uterus occupied by an IUD rather than the baby she wants. And by dint of conservatorship, her father is able to exert the same total control over his daughter—from her choice in marriage to her reproductive rights—that women experienced in the most restrictive days of the paternalistic past.
The male tendency to pathologize and police women’s bodies and emotions—especially the deep emotions that follow trauma—dates at least back to Plato and his concept of the "wandering uterus," which he explained in Timaeus was an affliction that he believed responsible for the symptoms we would now recognize as a panic attack. “Hysteria” has been applied to women’s emotional distress for four millennia and was only finally dropped by the American Psychiatric Association in 1952. The term (and its supposed origins in the womb) was the explanation for all manner of emotions that were incomprehensible and inconvenient to men. In the Middle Ages, women’s trauma responses were quite literally demonized—anything that was not attributable to disease was attributable to the devil, including hysteria and depression (or “melancholy.”) And when the British suffragists began agitating for the right to vote, the editor of the London Times ascribed the entire political movement to "nervous excitement."
In the second century A.D., Claudius Galen (the most prominent doctor in ancient Rome) wrote: “I have examined many hysterical women, some stuporous, others with anxiety attacks,” and concluded that “the disease manifests itself with different symptoms, but always refers to the uterus.” With our contemporary knowledge of trauma and its impact on the autonomic nervous system, trauma experts would interpret Galen’s observations very differently: Extreme anxiety, anger or panic are most often the result of being stuck in a hyper-aroused sympathetic nervous system, marked by a “fight or flight” survival response, whereas disabling numbness, lethargy, and depression come from being stuck in the hypo-arousal of the parasympathetic nervous system’s “freeze” survival response. Getting stuck in either extreme (or oscillating between the two) is a hallmark of trauma, a state wherein our body’s protective response to danger has been overwhelmed and cannot turn itself back off. Human survival responses developed to help us survive predatory animals in the wild, not the pervasive abuse we often encounter from other humans. As Judith Herman says in her 1992 book Trauma and Recovery: The Aftermath of Violence, what were once described as “hysterical” (or today “erratic”) behaviors are simply “normal human responses to extreme circumstances.”
We can only guess at the trauma that might have brought Britney Spears to the place where her extremes of behavior qualified her for a conservatorship. From the memoir Through the Storm: A Real Story of Fame and Family in a Tabloid World, written by her mother, Lynne Spears, we do know Britney has been using alcohol since the age of 13 and that her father is an alcoholic. The memoir also claims Britney was drugged and isolated by her former manager, Sam Lutfi (a claim Lutfi disputes). It is not unusual for trauma survivors to turn to substances to relieve their pain. According to Lufti’s lawyer, Spears used crystal meth and once took “all or most” of 30 prescription amphetamine pills within 36 hours. If even a small part of that is true, Spears clearly needed help, but then so did Kayne West, whose concerning behavior made world headlines in 2016. Still, for the last 13 years Spears has had to seek permission to make even the smallest purchases and is not allowed to drive a car, while the only restriction West experienced after his “psychiatric emergency” and self-confessed alcoholism was a 72-hour involuntary hold. He then had the freedom to spend $12 million of his own money running for the presidency of the United States.
After a breakdown involving substance abuse in 2013, another former child actress, Amanda Bynes, was put under the conservatorship of her mother. In 2020, Bynes got engaged to a man she met in rehab but cannot get married without the approval of her conservator mother. Plenty of male celebrities openly struggle with addiction and dysregulated behavior (Robert Downey Jr., Johnny Depp, Tiger Woods and Macauley Culkin come to mind) but have never been stripped of their autonomy, kept from marriage, or made to submit to involuntary contraception, like Bynes and Spears.
So far, Spears has been spared being consigned to an insane asylum—which is what happened to women in the past who were emotionally volatile—but still she is not free. When male lawyers discuss her case in the press, they say that she hurts her case by being too emotional, and should find witnesses who can attest to the absence of erratic behavior. But what may seem "erratic" to them is perfectly understandable to those of us who understand trauma.
The social media campaign #FreeBritney is not just about the fate of one woman living out her trauma very publicly; it is also a cry that echoes backwards in time for 4,000 years—and one that resonates with every woman who has ever been forced to fit herself into a male view of acceptable emotions and behavior, lest she be locked up and stripped of her rights.