by Sloane M. Perron

Fingernail marks scratched into the walls, barred windows, and a shadowy figure trapped in the wallpaper trying to escape–Charlotte Perkins Gilman creates a Gothic masterpiece in her short story, “The Yellow Wallpaper.” Written in 1892, this story blurs the line between reality and perception by following the mental unraveling of a woman after she is placed on complete bed rest because of her nervous behavior. Confined in a room, denied recreation of any kind, the narrator is plagued by a ghost-like woman who is trapped in the yellow wallpaper. The story reads like a supernatural thriller, but much of it was actually taken from the “rest cure” that was imposed upon Gilman to treat her postpartum depression.

Indeed, the depictions of postpartum depression and postpartum psychosis in the story are so realistic that Gilman’s work is being used to teach modern psychology to medical students. At the Medical School of the University of Oklahoma, medical students can take a class entitled, “Helping Medical Students Understand Postpartum Psychosis Through the Prism of ‘The Yellow Wallpaper’ by Charlotte Perkins Gilman.” Dr. Phebe Tucker is a specialist in psychiatry and has been a professor at the University of Oklahoma since 1989. She was also one of the faculty members who developed this program, which combines literary analysis with a practical, medical purpose. Dr. Tucker, whose undergraduate degree was in English from the University of Berkley, believes that this form of teaching made the medical studies “more alive” for the students since they were able to directly empathize with a character that has a mental illness. According to Dr. Tucker, the transition from English to psychiatry was very natural. “The humanities blend with psychiatry since everyone has their own narrative,” she said.

The course aimed to reduce the stigma related to mental illness, to analyze doctor-patient relationships, and to teach students to be more empathetic as they experienced the author’s depression and psychosis. Students were also tasked with finding symptomatic “clues” about postpartum psychosis within Gilman’s text. About 160 medical students participated. According to Tucker, “Psychiatry students were receptive to this form of teaching and most were open-minded. However, some students are used to concrete studies and they get frustrated if the course was too abstract.” In order to challenge these students to think creatively, voluntary after school activities were offered. For example, book groups with faculty allowed students from the class to interact with literature and think creatively.

“The Yellow Wallpaper” is an important work because it changed the way that postpartum psychosis, now known as Peripartum Onset Mood Disorder, was treated and publicly perceived. Many psychological disorders with which modern doctors are familiar were largely unknown to Victorian physicians. As a result, terms like “hysteria” and “nervous depression” became all-encompassing diagnoses used for women experiencing anxiety or depression shortly after giving birth. The common treatment for such a state was the “rest cure.” Developed by Dr. Silas Weir Mitchell, the rest cure was a course of treatment in which the patient was instructed to completely relax and to take part in minimal physical activity. The rest cure emphasized isolation. In some cases, women were not allowed to read, write, leave their beds, or even feed themselves.

In 1885, Charlotte Perkins Gilman gave birth to a daughter, Katharine Beecher Stetson. Shortly after, Gilman began to experience extreme depression and was placed on Dr. Michel’s rest cure. As weeks passed, the isolation and physical restrictions amplified Gilman’s symptoms and the inability to write or read stifled her. She had no creative outlet in which she could express herself. She escaped through her vivid imagination, which exacerbated her anxiety and depression. It was only after Gilman refused to take part in the rest cure that she slowly began to show signs of improvement.

Years later, Gilman wrote “The Yellow Wallpaper” in order to show the failure of Dr. Mitchell’s treatment. The story also emphasizes the oppressive and sexist nature of a cure that gives male doctors complete authority while female patients are treated as fragile, emotional beings incapable of making their own decisions.

The narrator in “The Yellow Wallpaper” integrates Gilman’s real life experiences with the drama and terror of a Gothic novel. The woman in the story arrives at a beautiful mansion that she and her husband, John, are staying at for the summer in hopes that she will overcome her “nervous condition.” John, who is a doctor, places his wife on the rest cure and prevents her from taking walks in the garden, writing, or having visitors. With nothing else to do, the narrator contemplates the surroundings of her new room from the barred windows, scratched floor and nailed-down bed, to the hideous, torn yellow wallpaper that covers the walls. As the weeks of complete rest pass, the narrator’s anxiety and paranoia grow as she starts to see the image of a woman in the wallpaper. The narrator shifts from hating the wallpaper to appreciating it as she starts to empathize with the shadowy woman lurking in the paper. The conclusion of the story signifies the narrator’s final break from reality as she becomes the woman in the wallpaper and finally breaks free from the wall and her husband. The damage to the room was actually caused by the narrator as she crawled around scratching the floor and tearing the wallpaper.

According to Dr. Tucker, the medical students who analyzed the story were trained to search for clues that would establish a diagnosis such as the protagonist’s concentration problems, lack of confidence, sleep disturbances, and psychotic elements. As a result, they concluded that in modern medicine the protagonist would be diagnosed with major depression with psychotic features and Peripartum Onset Mood Disorder. Dr. Tucker explained that the disorder typically occurs during pregnancy or during the four weeks following birth. It usually consists of a major depressive episode and can be accompanied by psychotic symptoms. Hormone imbalance is the cause, although some individuals may be born with a genetic predisposition. The narrator of the story also has psychotic breaks from reality. The narrator’s hallucinations of the woman behind bars in the wallpaper, sudden mood swings, paranoid suspicions about her husband and his sister as well as her hyperactivity of tearing the wallpaper and constantly crawling all demonstrate the psychosis. The narrator’s baby is only mentioned once in the story when the narrator says that she wants to be with the baby but that it makes her so “nervous.” This signifies the difficulty a sufferer may have in bonding with her child.

Gilman wanted to share her painful experiences with the public in order to shed light on the harmful results of Dr. Mitchell’s rest cure. In fact, after Gilman published her story, Dr. Mitchell eliminated the rest cure and developed new treatments. In modern psychiatry a combination of medications and therapy would be used to treat the protagonist of “The Yellow Wallpaper.” According to Dr. Tucker, if the protagonist was her patient, she would recommend interpersonal psycho-therapy to help the woman assert herself and develop more confidence, couples therapy to create a more supportive relationship with her doctor husband, support groups, and medication that would help her function on a daily basis. Journaling would be encouraged.

Underneath its Gothic dressing, “The Yellow Wallpaper” tells the candid story of an emotionally unraveling woman whose return to health is stifled by a misunderstanding of psychological disorders and the oppressive patriarchal society of her time.
By revealing her own struggles to the public, Gilman unleashed her own “woman in the wallpaper” and ultimately changed the way that women with postpartum depression were treated.

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Contributing Editor  and journalist Sloane Perron is a seniot at Anna Maria College, Paxton, Mass., studying English and Business. She will present her Honors Thesis, “The Many Faces of Guinevere,” at Keene State College, Keene, New Hampshire, this spring.