Pathologized Since Eve: Jessica Taylor on Women, Trauma, and “Sexy but Psycho”

Our guest today is Jessica Taylor, author of Sexy But Psycho: How the Patriarchy Uses Women’s Trauma Against Them, which was published in March by Little, Brown and quickly hit the London Times bestseller list. Based in England, she is a chartered psychologist with a PhD in forensic psychology and more than a dozen years of experience working with women and girls subjected to abuse and other trauma.

She’s the founder and CEO of VictimFocus, a trauma-informed UK organization that challenges the blaming and gaslighting of victims—and advocates for change in how they’re treated. She’s also the author of the 2020 book Why Women Are Blamed for Everything: Exploring Victim Blaming of Women Subjected to Abuse and Trauma. 

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Amy Biancolli: Jessica Taylor, so grateful to have you here today.

Jessica Taylor: Thank you so much for having me.

Biancolli: At one point you say the book “has been burning away in my brain for years.” Why this book? Why was it necessary, why now?

Taylor: Ever since I figured out that mental health and psychiatry wasn’t what it looked like on the surface—which was many years ago, but it was quite a slow realization—I just had this urge to talk about it and to write about it. But at the time I was a little bit concerned that I was barking at the wrong tree, that I was some sort of conspiracy theorist. Then in my own practice, I saw mental health and psychiatry being used against women and girls on a daily basis. For me, it was this belief in the professionals, belief in services and authorities, that the best thing for them was to be diagnosed with a psychiatric disorder.

I just didn’t agree. That feeling got stronger and stronger and stronger as my career went on to the point where I just couldn’t ignore it anymore. I thought, isn’t this common sense? The things that I’m saying, they’re not that wild. I’m saying that if humans are traumatized, why would that constitute an illness and therefore, why would they require some sort of medication for distress? But actually, I realized that most people, when you make those arguments, don’t understand it. They’ve been really effectively groomed. They’ve been effectively persuaded that these people have illnesses inside their brains that are the equivalent to physical illnesses.

So when I started writing books, I had this thing in the back of my head that was, “Write it, write it, do it, put it out there, let people read it and lay the evidence out to everybody that women are being pathologized and oppressed via mental health and psychiatry.” When I got the multi-book deal with Why Women Are Blamed for Everything, the first thing that I said to my publisher when I first met him was, “I want to write a book on this topic—are you going to let me do that?” He said, “Absolutely do it.”

Biancolli: I want to address this quote—talking about why you titled it Sexy but Psycho. “Sometimes it strikes me that we are saying to women and girls: Look sexy. Be pretty. Act feminine. Be desirable. Be sexually available. Be fun. Be flirty. Be nice. But do not speak.” Then in a little bit you go on: “Do not talk about your traumas.” That’s such an universal experience in any context, but particularly after experiencing some form of trauma, some sexual violence. Could you speak to that?

Taylor: Women are so effectively objectified and sexualized in society that your only role, really, is to look pretty and sharp. There are slight deviations to that every now and then. But it won’t last very long. Like for example, if you’re a female politician you’re only really accepted if you’re also sexually attractive. If you’re a female politician that’s, for example, masculine presenting, or butch lesbian, or you don’t dress or look a certain way, then you’re very likely to be ignored or mocked relentlessly. The only role that you have in society as a woman is a sex object. If you step outside of that and have opinions—be assertive, or be challenging, or don’t want to conform to femininity at all, or you’re lesbian—then you are very quickly demonized in one way or another.

Biancolli: The absolute worst-case scenario is when a woman is a victim of violence—when she’s raped and she tries to talk about it. Obviously this is a big part of your book, and you tell the stories of different women. What happens to that woman who says, “Hey, this happened to me,” and wants to be heard?

Taylor: The most common response, which was found in research from the ‘80s onwards, is that the vast majority—and I think this is very important that women and girls know this—the vast majority of women and girls who disclose that they’ve been raped or abused will do so, first of all, to a family member or a friend. It’s never an authority first, generally speaking. But the findings from the ‘80s onwards found that about 80% of all of those women who speak to their family members or friends will be blamed, or disbelieved, or accused of lying by their family and friends. That’s actually the most common response from your family and friends—to be outcast, disbelieved, reframed as lying, attention-seeking or malicious. So that’s very common.

We all know that self-blame is extremely common. Even girls of the age of 11 years old will usually blame themselves and they will believe rape myths and stereotypes about what a real victim is, and they’ll measure themselves against that even from that young age.

Adult women do that as well. Something will happen to them in their relationship, by a stranger, or a friend or whoever it is that abused or raped them. The first thing a woman will start doing is measuring herself against this hierarchical stereotype of, “Am I a good enough victim? Was I drinking? Are there any witnesses? Who did I tell? What was I wearing? Did I bring it upon myself? Is there anything I could have done? Why didn’t I say something? Why didn’t I stop them? Why didn’t I shout? Why didn’t I fight back?”

Then also, “Is anyone going to believe me? They’re going to think I’m crazy. Are they going to think this is attention-seeking? Are they going to think this is some sort of mental health issue or a personality disorder?” We live in a society that is doing this, in my opinion—this really strange movement towards pretending that there’s no stigma in mental health and psychiatry, and that it’s completely neutral. But women at a deep level they know it’s not neutral, they know that there’s a chance that if they come forward and say, “I’ve been raped,” they’re going to get recast as hysterical, or mentally ill, or disordered in some way.

Biancolli: Repeatedly you make that point in the book—how women are instantly discredited as somehow psychopathic or mentally ill, which is a term that you completely reject. But I was also struck by that chart you have of two lists: ideal woman versus crazy woman, beautiful versus ugly, young versus old, disobedient versus obedient, dependent versus independent. You look at all this in the context of history. You talk about Eve—that women have been pathologized since Eve.

Taylor: Yes, that’s right. Because when I wanted to write Sexy but Psycho, I felt very strongly that it needed to be situated in the historical context of these things that we’re seeing—of women being positioned, as you say, as problematic and difficult and ill and disordered. This is thousands of years’ worth of narrative here. I spoke about ancient Greek philosophers who argued that women are defective versions of males.

Feminism is so in its infancy compared to the misogyny. The misogyny is thousands of years old, but feminism is a hundred years old. We are trying to undo, and we’re trying to unpick, embedded structures in society of women being inferior and seen as crazy that have been dominant for millennia. I wanted to make that clear in the book so that people could almost link the dots because, there’s so many of our systems today that are actually still based on things that are over a thousand years old, or 500 years old, or 300 years old. I think people have lulled themselves into a false sense of security that we’re a lot more progressive and intelligent than we think we are.

Biancolli: I think that happens with every generation, too: “We’re finally aware, we finally realize all our errors in the past, and now we’re a much shinier model than we used to be.” Is that a hurdle to overcome? Saying to people, “Hey, wait, wake up. No, things aren’t as great as you think they are”?

Taylor: Yes, I actually do think that, and that’s one of the things that people struggle with me the most—that I am often the voice of doom that goes, “We’re not as good as we say we are,” or “Actually, we don’t do that that well.” We are still kidding ourselves, all the time, that we’ve got this stuff figured out, that we know more about the brain than we do, that we know more about psychology than we do—and human behavior and human development. We have entire disciplines essentially built on this set of beliefs that we know much more than we actually do.

We need to take a massive step back and accept that a lot of what the public thinks about mental health and psychiatry is myth and assumption and stereotype and bias. That’s where people start to get very uncomfortable, because they don’t want to take a step back today.

Biancolli: As you pointed out, the system is designed to make us accept how things are: the patriarchy, the history of psychiatry, the DSM. You widen the lens to class, to race—the history of black people being pathologized. For instance, “drapetomania” as a diagnosis for enslaved people who were trying to be free. It’s the upper echelons of the patriarchy saying, “You’re innately wrong.” Women being told, “Your menses, you’re bleeding every month: you’re wrong. You’re going through menopause: you’re wrong. You have hysteria: we have to yank that uterus out of you.” Is that it? People in power saying to those without: “The fact that you have no power means you’re crazy. Basically, you’re disordered.”

Taylor: That’s essentially the conclusion that I’ve come to: that if you’re in power, you can define what’s abnormal and normal, and then you can place that on other populations. Which is what we already do anyway. Look at colonialism in history, when white people have gone over to another community, another religion, another country, and gone, “That’s all wrong. We’re getting rid of all that, we’re in control now.” People in power have been doing that forever. I don’t think psychiatry and psychology is any different.

It always makes me think about something my wife said to me a couple of years ago. We were talking about politics and psychology and ancient philosophy, and she said that a lot of these philosophers only had the reputation they do now because they were some of the only people in society that could read or write—so they basically just said whatever they wanted. They were rich, they were in power. They were the only people that could write down their thoughts and then communicate them to other people, and so they were seen as the most important thing—despite the fact that there were probably many other very intelligent thinkers that couldn’t read or write at the time. Therefore they were ignored because they were poor, or they were less educated.

So, basically, a bunch of men who were at the top of society at the time wrote some stuff down and everyone said, “That’s the way it works.” She just made me laugh. I think that’s what happened in psychology as well.

Amy Biancolli: Could you speak to that a little bit, and how it relates to the biomedical paradigm? The idea of everything being tied to something that’s wrong with us?

Taylor: That fascinates me, because one of the things that psychology is still not yet ready to do is accept that. Getting on to 60 or 70 years now, there’s been a crisis in psychology, whereby it tries to assert itself as a physical science. I really do believe that psychology’s obsession with trying to theorize human distress, human emotion, as these physical entities that can be measured and treated like illnesses is because psychology is trying to keep up with medicine, physics, biology and chemistry. Psychiatry has been trying to do the same thing. Psychiatry eventually, after a period of time, almost got seen as a version of, a branch, of medicine. However, it can never keep up with medicine. It doesn’t have the evidence base, it doesn’t have the measurability, it doesn’t have reliability or validity.

We’ve made zero useful discoveries in psychiatry and psychology in the last 100 years compared to medicine, and that’s the way it is. We need to accept that these disciplines are not as robust as they wish themselves to be. In one of my books, I said that psychology has moved more and more towards neuroscience and neuropsychology in the hope that the MRI machines will give us some insight into the brain and it will give us scientific data that looks like a physical science. It means that universities have cut their departments in order to afford MRI machines so that they can run studies with a sample of eight people. That is a ridiculous waste of money, because you can’t generalize. It’s not the same as the physical sciences.

I really love the fact that the brain doesn’t give away secrets. I really love the fact that you can’t dissect a brain and say, “There’s the thoughts, and there’s the memory, and there’s the consciousness.” The fact that we can’t figure out exactly how it works, and we can’t define consciousness, and we can’t define a thought, and we don’t know what dreams are for, and there are all of these things that we still don’t understand, I embrace that. But I know lots of scientists are looking for answers. They’re looking for resolution, they’re looking for a conclusion. Whereas I would rather remain open-minded and sometimes, cynically, I think maybe we’re not supposed to know, because we’re a horrible species.

Biancolli: It’s better if we don’t know.

Taylor: Yes.

Biancolli: That strikes me as parallel with what you were saying before. Professionals and people in psychology are saying, “We know what’s going on. Past generations didn’t know.” It’s like every generation has to be convinced that they’re at the cutting edge.

Taylor: Oh, yes, for sure. That really does come at the detriment of humility—that we can’t really explain it, that we are clutching a little bit at straws. If we look at it from that white-supremacist approach as well, we have ignored so much cultural wisdom around the world about the mind, and about what emotions mean and how humans behave.

That’s something that has really annoyed me in the last few years, that the sweeping control and influence of the DSM, psychiatry, and psychology as a white and very powerful and racist institution is then being pushed across the world—as a norm—that these disorders are all the disorders of humans. And now everybody has to fit into them, despite the fact that human behavior differs massively across religion, culture, language, society, community, tribes, everything. I find it so arrogant, I really do.

Biancolli: As you point out, women are seven times more likely to be diagnosed with borderline personality disorder, which has a reputation as being basically a garbage diagnosis. You call it the modern-day hysteria. Once somebody’s diagnosed with borderline, then anything they say is definitely not going to be taken seriously. My late sister really struggled with a stream of diagnoses, and she was on every conceivable medication. Was hospitalized 13 or 14 times. Ultimately died by suicide in ‘92. I will never forget her description of what happened when she got the borderline diagnosis, which was everybody stopped listening.

This is what women go through. Why is it not heard more often? What is it going to take until stories like that are heard?

Taylor: That is the power of the diagnosis, isn’t it? Those stories won’t be heard, because they’re not seen as legitimate stories, because the diagnosis overrides the legitimacy of the story. If you’ve been diagnosed with borderline personality disorder, especially as a woman, and then you try and speak out about it?

That diagnosis really just positions you as an attention seeker, a liar, unreliable, disconnected from reality, and also manipulative. That one annoys me the most, because there are so many professionals out there that I’ve spoken to and I interviewed for the book that were directly trained and told, “Do not listen to borderline patients. They will manipulate you, they will lie to you, they will control you, they will wrap you around their little finger, they’ll get you doing everything that they want you to do.”

Professionals will speak to me and they’ll say something like, “We don’t talk to the borderline patients, because they take information about you and then they’ll use it against you.” Whoa—how have you been trained? Even if, let’s say, for example, that borderline personality disorder is real, which I don’t think it is, but say it was. Let’s say that—let’s also accept that mental health is the same as physical health. These are just illnesses, they’re just the names of illnesses. How would you get away with training professionals not to listen to that particular set of patients?

Nobody in med school is told, “Don’t listen to the diabetics. They will lie to you, and they will control you and manipulate you.” Why is it allowed?

I’ve worked in violence against women and girls, now, for 12 years, and it is the most common diagnosis. I can usually predict it before it even happens—weeks or months before it’s come in. I know what’s going to happen, and then I know what medication. I know what the risk assessments are going to say. I know what the rest of their life is going to look like. It shouldn’t be like that. And the fact that it’s used as a slur by professionals as well, professionals in my own field—“She’s a bit borderline.”

Biancolli: Does that tell you that the DSM itself is innately misogynistic? Is there something in its essence, in the way that it’s compiled and the way that it’s spread almost like the gospel?

Taylor: The evidence base suggests already from previous pieces of research that the DSM is innately misogynistic, because being female positively correlates with every single diagnosis in the DSM. We also know from previous pieces of research that women are much more likely to receive multiple psychiatric diagnoses, whereas men are more likely to just get one diagnosis. As we know, with borderline personality disorder, you’re seven times more likely if you’re female to be given that. You’re also much more likely than that to receive a borderline personality disorder diagnosis if you’re bisexual.

Now, I find that fascinating, because bisexuality in women is seen as almost the ultimate deviance—that she sleeps with women and men, and that she’s sexually attracted to both. The DSM has always positioned that as an identity crisis: that if a woman is bisexual, it’s because she has problems formulating her identity. That, for me, is a red flag.

There’s a piece of research—a couple of years ago in the UK—that found that there is a higher proportion per ward of women with borderline personality disorder that are bisexual than straight or lesbian. Lesbians are definitely discriminated against. But I just find it fascinating that it’s bisexual women that are much more likely to be diagnosed with borderline personality disorder.

Biancolli: They’re demonized in a particular way, or in an additional way.

Taylor: Yes. Definitely, yes. 

Biancolli: Your work with VictimFocus.org, and calling out victim blaming—that’s been the focus of your career. You talked about all the different ways, in your book, how women are blamed via diagnosis. You say, “It’s amazing to think that there is no such thing as ‘men who batter women syndrome,’ but there is ‘battered woman syndrome.’”

Taylor: You want to just give up on everything, because it’s so obvious. It’s staring us in the face—the misogyny and the positioning of women who have been abused.

It is right there. For years, the argument was that women who say that they are being abused by their husbands or their fathers or boyfriends were the problematic ones—and so there never has been a formulation of some disorder for violent men who raped and abused women. But there are lots of psychiatric diagnoses for women who’ve been raped and abused by men. It’s not an illness to be distressed because you’ve been subjected to serious abuse, and violence, and oppression, and discrimination, and all the rest of it. That’s not a disorder.

But I also don’t think that committing those crimes is a disorder. Men live in a society that’s misogynistic and supportive of violence of all kinds, literally glorifying and sensationalizing violence of every kind, constantly.

These men that commit crimes like this, they’re not mentally ill. It’s not some sort of disorder, they don’t require therapy, they don’t require medication. They live in a society that congratulates them and sensationalizes what they do and actually supports what they do at every level. Actually, they’re behaving in a socially prescribed way. It’s not an illness.

Biancolli: Your work is focused on the idea that no, nobody’s really mentally ill, just everybody has gone through something. I know that’s a vastly simplistic way of explaining it. But how much of a shift does that require in thinking—rather than saying there’s something innately wrong with you, instead, let’s actually listen when you talk about your childhood abuse, or whatever it is that traumatized you?

Taylor: It does require massive systemic overhaul, and I get that scares people—and then it’s a lot of work. But it’s the only way to make the progress that we need to make in humanity. Because what we’ve done instead is we’ve set up very sophisticated and intelligent, progressive-looking systems that mean, for example, that you can only access welfare if you’ll take a psychiatric diagnosis and take the medication. You can only access certain forms of support if you’ll accept you’re mentally ill and take the medication. You can only get on therapeutic waiting lists if you’ll accept a psychiatric diagnosis and take the medication. Everything has become connected to these labels.

Biancolli: You were talking earlier about the effort throughout the history of psychology and psychiatry to rationalize, to justify themselves, as medical professions and as hard science. At one point in your book you say mental health is not the same as physical health. It’s not the same as a broken leg or painkillers.  The flip side hit me: When you break a leg after a fall and you go to the emergency room, we aren’t told there was a problem deep within our bones. We’re not told it’s in our genes. We’re not all told that it’s osteoporosis, unless we’re of a certain age. But they wouldn’t even say that without a test. The women you described in your book—and countless women—are told that they’re broken, that they are the problem. And in an almost existential way, right?

Taylor: Yes. There are many differences between mental health and physical health, but that is one of them—there is no test, and that it’s all just assumption and observation. There are no validated tests for any mental health issue—there’s no blood test, there’s no genetic tests, there’s no brain scans. There is nothing. We’ve created nothing in a hundred years.

The only thing that psychiatry and psychology relies upon is observational self-report measures, psychometric measures, and they are not a diagnostic test. They could change from one day to the next. They would change depending on how somebody understood the item, or whether they even spoke English as a first language. They are hugely biased.

People were extremely angry with me for saying that. I often wonder how much of that anger is that they want to believe that it’s a science, they want to believe that it’s scientific and that there’s proof that it’s genetic. Or that it’s some sort of neurotransmitter imbalance. Or maybe hereditary in some way. They want that because it sounds real and legitimate, and it almost validates how they’re feeling as a real illness. I think that people are scared that distress and trauma is just not good enough, like it’s not seen as a valid enough cause. Does that make sense or not?

Biancolli: I’ve been lucky to not get sucked into the psychiatric system myself, but I think back to after one of my kids was born. I had a regular checkup—and it was a young doctor I hadn’t seen before. He’s sitting there with a checklist, and he’s asking me various questions. He knew that I just had a baby. I’d mentioned that I wasn’t sleeping very well, and I confessed that I was down.

He whips out his prescription pad, and he writes out a prescription for Prozac. I say, “I’m not going to take that. I don’t want it.” He goes, “Well, here, just take it. You might change your mind.” “No, I’m not going to take it.” He says, “Take it.” He hands it to me. I went home and threw it out. I know I’m not the only woman who has given birth and been exhausted afterward, and then gone to the doctor and the doctor says, “Well, that’s abnormal.” What about this is abnormal?

Taylor: Yes, this is so important. I’m so glad you brought this up, because I wrote about this in the book—about pregnancy, birth, and periods and menopause. And also the postnatal period: I genuinely despise how likely you are to get pathologized in that period. And I’m sorry to anybody listening that has not yet had children—this is going to terrify you. But having children is really, really hard, okay? You get pregnant, your body changes in ways that you never imagined. You have a load of health issues that have come out of nowhere. Your birth could be traumatic or it could be fine, but either way, it hurts, and then you have to recover from that.

Then, all of a sudden, you’ve gone from being this individual with just your own choices in your own life to being the thing that keeps alive a small baby that you’ve never looked after before.

Loads of moms start off by having their baby sleep next to them, and they have this thing—“oh my God, is it still breathing?” Watching the chest go up and down. It’s terrifying. 

Then on top of that, you don’t have any freedom anymore. Your life revolves around the child and the sleep and the eating, and getting them changed and getting them ready, right? That is a normal, massive change. You would expect there to be some psychological impact—on top of the fact that you don’t sleep properly. Sleep deprivation kicks in after only two or three days. You are going to start feeling very ill very quickly, and that is normal.

Then if you’ve got no support, or if your partner is abusive, or if you’re a single mom, you’re going to get it even worse.

Biancolli: Did writing this book help in some way? Did it give you any insight or direction or understanding? Are there any positives that have come out of it? 

Taylor: I found writing the book quite difficult. There was the chapter on euthanasia that really upset me. I had to take several breaks whilst I was researching the use of euthanasia in psychiatry (in the Netherlands and Belgium) because that was when I started to get really angry. And there were a couple of the interviews with the women where I came out and just thought, “There’s no justice, there’s no appeal process, there’s no way of taking action or suing these wards for what they’ve done to these women.” At the end of the book, I talk about things that I want to create—the 10 or 11 things that we could do to actually change the system.

In terms of positivity, I know that there are quite a lot of large and very influential authorities that have read the book and are engaging with the arguments. I’m interested to see the meetings I’m having with them, and trying to convince them to look at an alternative away from the DSM, away from medicalization. There are a lot more people than we probably think reading the book and being, “Oh, hang on a minute, this does make quite a lot of sense, actually.” And so that keeps me going.

And I really want to build an advocacy scheme—that means that you can go and get an advocate that can sit in with you in these meetings, and challenge diagnosis and the use of medication. I really want to create that, and roll it out, and test it, and see if it works. Because a lot of women are in these appointments with a psychiatrist or a nurse or some other doctor, and they’re being told: “You’re mentally ill. Here, take this.” I just wonder, sometimes, if people could get an appeal or a second opinion, or they had somebody there. If a professional sat next to them and said, “Sorry, what is it that you’re prescribing, and why is it that you’re prescribing that?” Because if you’re in distress, you’re not necessarily going to be able to do that—but somebody else could.

I also want us to create an appeal process. There are a lot of women out there with psychiatric diagnoses on their file that is still harming them 20, 30, 40 years down the line—and they’re not even taking any medication anymore. They’re not even in any services, but the actual diagnosis is still on the file. I really want to see that taken off. You should have the right to have things removed. I want to build something around that, too.

The other thing from writing the book: The way I felt afterwards was almost, “Oh, thank God, I’ve got it all out. It’s all out. It’s in one book. It’s somewhere. It’s accessible. Anybody can pick it up and read it, and they’ll understand what I’m talking about.” I’m glad that I’ve done that. I don’t know where my life or my career has taken me. But I do know that that’s by far one of the most important things I’ve ever done, and I think that that book will outlive me.

Biancolli: Well, it was truly great to have you here today. Thank you for writing the book. Thank you for taking the time to share your insights with us.

Taylor: Thank you so much for having me.