by Josephine Machado

Graphic design by Josip Petrusa  

“To the person in the bell jar, blank and stopped as a dead baby, the world itself is the bad dream.”

Stigmatized for decades, women’s mental health has been made a weaponised issue used to falsely imply that the capabilities of females in society are inferior to that of their male counterparts. Sylvia Plath’s semi-autobiographical novel, The Bell Jar (1963), addresses this concept through the lens of protagonist Esther Greenwood. Esther is an ambitious, independent, 19-year-old college student pursuing a prestigious internship in New York City during the summer of 1953, who gradually spirals into a profound depression as she navigates the intricacies of societal pressures on women, mental health struggles, and complex manifestations of intrapersonal conflicts. The poetic nature with which Plath speaks about topics of such serious and vulnerable nature reflects the struggles endured by many women in the 50s and 60s—a product of a culture that dismissed psychological suffering as feminine weakness, when in actuality, this suffering was a result of the biases directed towards women in their various pursuits. As illustrated in the introductory quote, Plath’s bell-jar-metaphor is a representation of an era in which gender-based prejudices were evoked by both psychiatric professionals and society at large, revealing how women’s distress was often treated, not with empathy, but with alienation and imprisonment.

As Esther’s mental health worsens throughout the progression of the novel, the commonality of medical misconduct during that period of history becomes more apparent—particularly misconduct directed towards women. Soon after seeking psychiatric help, Esther receives electroshock therapy (ECT), a treatment that remains controversial today. Her first treatment—administered by a male doctor—is brutal and inhumane, as it was performed without anesthesia. He doesn’t bother to explain the procedure to Esther or earn her trust. She recounts, that she had “wondered what terrible thing it was that I had done” to deserve such pain. The doctor’s indifference to Esther’s pain reflects the broader objectification of female suffering, where women’s bodies are treated as passive sites for intervention as opposed to individuals deserving empathy and informed care. However, her second doctor, a woman named Dr. Nolan, confirms that it’s “not supposed to be like that…if it’s done properly, it’s like going to sleep.” She assures Esther by stating “I’ll tell you about it beforehand and I promise you it won’t be anything like what you had before.” For almost 30 years, anesthesia was not administered to patients receiving ECT, leaving them at risk for fractures, psychological trauma, and cardiovascular events. Plath criticizes how pseudoscientific and crude practices were inflicted on vulnerable patients, especially young women, without consent or discussion, despite the information for proper protocol being available at the time. Two recent studies led by the Centre for Addiction and Mental Health (CAMH) have shown the efficacy of ECT when administered properly. Their analyses reveal that among individuals admitted to the hospital with depression, ECT has shown no evidence for a clinically significant increased risk for serious medical events, and is associated with a significantly reduced risk of death by suicide in the year following discharge.^2,3  This contrast underscores that even therapies that are proven effective, can still be made a traumatic experience, when proper bedside manner is not made a priority in patient care.

The novel highlights the stigmatization of women’s mental health, particularly through Esther’s mother, who cannot accept her illness. After a moment’s believing her daughter had recovered, she states “I knew my baby wasn’t like that…like those awful dead people at that hospital. I knew you’d decide to be all right again.” Esther’s mother likening her to “dead people” encapsulates the abandonment at the heart of Plath’s critique by illuminating society’s propensity to assign women struggling with mental illness to a liminal state between life and death. She highlights the issue of women’s potential being confiscated prior to even being given the chance of recovery, and the false idea that mental health struggles are a “choice.” Esther’s mother is not the only one who lacks respect for her hardships, as her ex-boyfriend regards her condition as an obstacle ruining her marital prospects, reciting “I wonder who you’ll marry now, Esther, now you’ve been here.” The intersection of stigmatization and misogyny is made evident by his implication that she has been rendered tainted and undesirable as a woman who has endured mental health struggles.

Esther’s experiences of sexism prior to her stay in the asylum are one of many avenues by which she was led there. Prior to her admission, Esther attends a party, and is assaulted by a man named Marco, who during the attack utters the words “Yes or no, it is all the same.” Esther fights Marco off by punching his nose, but is left shaken and disoriented, having suffered a heinous, life-altering experience. The terror in this scene exemplifies the violent and dehumanizing attitudes with which many women have been both regarded and treated. His actions are a true expression of the objectification of women, illustrating how society at large can be just as hostile towards young women as the asylum itself. 

In addition to the violence she experiences, it is evident that Esther feels the pressure of the mid-century feminine ideal to be conventionally attractive, pleasant, and compliant—which directly conflicts with her ambition during a time in which the idea that women can be multifaceted was often rejected. This paradox is represented in what may be the most famous lines to come from Plath’s novel, often regarded today as the “Fig Tree Analogy”:

“I saw my life branching out before me like the green fig tree in the story. From the tip of every branch, like a fat purple fig, a wonderful future beckoned and winked. One fig was a husband and a happy home and children, and another fig was a famous poet and another fig was a brilliant professor…I saw myself sitting in the crotch of this fig tree, starving to death, just because I couldn’t make up my mind which of the figs I would choose. I wanted each and every one of them, but choosing one meant losing all the rest.”

The cumulative effect of these societal pressures contributes to Esther’s sense of suffocation, communicated through the analogy of the “bell jar” feeling of being trapped, confined, and unable to breathe freely under the weight of expectation. Society’s expectation of what a “true” and “pure” woman should emulate sparked an internal conflict in Esther’s mind. Ultimately, this conflict had fractured her self-perception and contributed to her descent into major depression.

In telling Esther’s story, Plath exposes the systemic neglect and punitive practices surrounding women’s mental health, urging us to reconsider how we perceive and respond to female suffering. The issue of women’s mental health is not new—and must not to be forgotten. We’ve come a long way since Plath’s lifetime, launching multiple initiatives to challenge mental-health stigmas and empower women. Organizations like the National Suicide Hotline and Kids Help Phone, as well as activism movements such as “Bell Let’s Talk” and #MeToo, demonstrate how individuals of diverse backgrounds have banded together to advocate for those who aren’t being heard. However, the fragility of this progress should not be overlooked. It is imperative that we continue to rise and advocate for one another, as to avoid returning to a darker time. 

“How did I know that someday—at college, in Europe, somewhere, anywhere—the bell jar, with its stifling distortions, wouldn’t descend again?”

References 

1. Plath S. The Bell Jar. 1st Harper Perennial Modern Classics deluxe ed. New York: HarperPerennial; 2006. 244 p. (Harper Perennial modern classics). 
2. Kaster TS, Vigod SN, Gomes T, et al. Risk of serious medical events in patients with depression treated with electroconvulsive therapy: a propensity score-matched, retrospective cohort study. The Lancet Psychiatry [Internet]. 2021 Aug [cited 2025 Aug 2];8(8):686–95. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2215036621001681
3. Kaster TS, Blumberger DM, Gomes T, et al. Risk of suicide death following electroconvulsive therapy treatment for depression: a propensity score-weighted, retrospective cohort study in Canada. The Lancet Psychiatry [Internet]. 2022 Jun [cited 2025 Aug 2];9(6):435–46. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2215036622000773