By Sophie Coldicott
CN: Discussions of mental health
On the 2nd July, Vogue Portugal revealed its concept and four covers for its July/August issue. The issue was to be about “love”, “life”, “us”, “you”, and finally, “health”; specifically, “mental health”.
Supposedly encapsulating this slew of buzzwords was the first cover, depicting a beautiful, naked woman hunched in a bathtub whilst water was poured on her by two nurses – the implication being that she was a patient in a psychiatric hospital. The title of the issue was to be “The Madness Issue”.
Naturally, this was met with immediate backlash. The top liked comment on the Instagram post reads “these types of photos should not represent the mental health conversation!”, whilst another states “psychiatrized people are not a trend.” The consensus in the comments section, and across social media at large, was that the depiction was outdated and offensive.
Vogue’s imagery of the stigmatised ‘asylum’ has a long history in fashion, providing basis for historic shows such as Alexander McQueen Spring 2001. In the show, lauded by Vogue Runway as “nothing short of monumental”, bandaged models walk around a mirrored glass cube that resembles the wards of a psychiatric hospital, swatting at invisible flies and pushing against the glass separating them from the audience. More recently, Gucci opened its Spring/Summer 2020 show with models stood on a conveyor belt dressed in white, heavy, buckled clothing, obviously referential of straight jackets. These items were not part of the collection “Gucci Orgasmique” but used as a device for the ‘spectacle’ of the show. This produced the iconic image of model Ayesha Tan Jones protesting during the show by holding up their hands with the words “mental health is not fashion” written on them, having covertly biro-ed them on in the bathroom before walking – a moment unsurprisingly scrubbed from the official show recording.

Fashion’s troubled relationship with mental health is also a gendered one. French philosopher Michel Foucault’s Madness and Civilization argues that ‘madness’ is not an abstract concept, but a construction informed by the society it is produced by. Thus, ‘madness’ is an explicitly gendered concept; in Women and Madness, Phyllis Chesler writes that “what we consider ‘madness’… is either the acting out of the devalued female role or the total or partial rejection of one’s sex role stereotype.” What is medicalised as ‘madness’ is inextricably bound to patriarchy, and is weaponised as a mechanism of patriarchal control. This is a key idea of feminist thought, appearing across a variety of works from Mary Wollstonecraft’s Maria (1797) to Charlotte Perkin Gilman’s classic The Yellow Wallpaper (1892). Historically, women have been more likely to be deemed ‘mad’ and institutionalised as a consequence, a fact naturalised by patriarchal medicine that located women’s imagined predisposition to ‘madness’ in their biology.
18th century charges of sensibility, defined by Samuel Johnson in 1755 as a “quickness of sensation; quickness of perception” and a “delicacy” expressed in a hyper-sensitivity and emotionality, were made most frequently against women. Whilst both men and women were accused of sensibility, women were thought to have a more natural receptivity to sensibility due to their nervous systems that had a greater sensory perception and thus greater capacity to “feel”. As John Perkin’s 1790 domestic instruction novel wrote, the “peculiar ordering of [women’s] frames” made them distinctly more prone to sensibility. This upheld the Enlightenment model of sexual duality that denied women’s reason and rationality. Wollstonecraft, a contemporary critic of sensibility, summed up this belief that “man was made to reason, woman to feel: and that together, flesh and spirit, they make the most perfect whole”.
The 19th century diagnosis of hysteria was the successor to sensibility in providing medical basis for patriarchal control of women. Hysteria, coming from the Greek word Hystera, meaning womb, was an all encompassing diagnosis for women that exhibited symptoms such as shortness of breath, anxiety, sexual forwardness, hallucinations, and spasms, believed initially in the 16th and 17th century to be caused by a wandering womb, and later, by a hereditary neurological fault. Hysteria was considered grounds for institutionalisation.
The leading authority on hysteria in the 19th century was Jean-Martin Charcot, a French psychiatrist based in the Parisian Pitié-Salpêtrière Hospital. At the height of the Salpêtrière in 1873, 3,633 women and 103 children were interred there, a population made up of paupers, vagabonds, “decrepit women”, old maids, epileptics, “women in second chidhood”, “misshapen and malformed innocents” and incurable “madwomen”. The overall cure rate in 1863 was just 9.72%.
Famously, Charcot would put on displays of his ‘hysterical’ patients who would perform their ‘madness’ in public lectures every Tuesday. Patients would be hypnotised and made to hysterically fit on command. One ‘act’ known as the “mariage-a-trois” would have the patient hypnotised to believe that each half of her body had a separate husband. The men could fondle their respective half of the patient’s body freely, but would receive a slap should they go past the boundary. Charcot, like Vogue Portugal, also attempted to image the ‘mad woman’ in order to discover a universal set of symptoms for hysteria. Many of these images also feature the patients in a state of partial undress, following artistic conventions that depicted the ‘mad woman’ in ecstasy with an exposed or near exposed breast.

In aestheticizing the ‘mad woman’ as a symbol of mental health, Vogue Portugal’s cover invokes this legacy of patriarchal suppression. Whilst Vogue’s statement defending the cover claimed the shoot explored “the historical context of mental health” and modern “real life … authentic stories” based in “deep research”, the image simply reproduces harmful notions about the “mad woman” whilst divorcing itself from the long history of suffering psychiatrization has wrought and its specifically misogynistic practices.
Undeniably, mental health is a defining issue of the modern era. In October 2019, the WHO estimated that one in four people globally will suffer from a mental illness at some point in their lives, a figure that is expected to be worsened by the Coronavirus pandemic. The fashion industry is no exception, with the growing number of testimonies from those in the industry such as Kate Moss and Adwoa Aboah and the tragic deaths of designers Alexander McQueen and Kate Spade highlighting the ongoing crisis within the industry. Fashion can provide a legitimate platform for the exploration of mental health – but this cannot be achieved through the same harmful and offensive references. The industry must pledge to do better.