History is rife with examples of societies disposing of women for not conforming to social norms. In Ireland, Magdalena Laundries exploited unwed, pregnant girls for free labor; America is infamous for its Salem Witch Trials of the 1600s, which put over 20 women to death for perceived witchcraft and nonconformity to Puritan standards. In O’Farrell’s novel The Vanishing Act of Esme Lennox, Iris tells Esme a story about women who were tortured and killed in a Scottish abbey for disagreeable behavior. However, few people know about the sinister practice of mass incarceration of women for perceived mental illness during the Victorian era, which lasted until the mid-20th century. In the tradition of female writers from the 18th and 19th centuries like Charlotte Brontë, O’Farrell incorporates Gothic elements into her story to highlight women’s physical, sexual, and emotional subjugation by various powers, and the deleterious effects they had on their mental health. Throughout the story, O’Farrell reveals how society misunderstood or ignored female mental health at the cost of thousands of women being forcefully incarcerated without hope of proper treatment or release.

The historical abuse of women’s mental health stems from a fundamental ignorance of the female body and brain. The term “hysteria” comes from the Greek word for “uterus” (“hystera”)—linking women’s mental health to their anatomy.