
- •Introduction: Feminist Therapy—Not for Women Only
- •Women and Madness: Exposing Patriarchy in the Consulting Room
- •Kinder, Kuche, Kirche as Scientific Law: Misogyny in the Science of Psychology
- •Sex Role Stereotyping and Clinical Judgments of Mental Health: Science Supporting Politics
- •Difference Feminism and Feminist Therapy
- •Difference/Equal Value Feminism and Feminist Therapy
- •Multicultural, Global, and Postmodern Feminisms and Feminist Therapy
- •Power in the Intrapersonal/intrapsychic Realm
- •Interpersonal/Social–Contextual Power
- •Power in the Spiritual Realm
- •The Egalitarian Relationship
- •Power Dynamics in Therapy: Symbolic Relationship
- •Diagnosis?
- •Bem’s Gender Schema Model
- •Chodorow and the Reproduction of Gender
- •Kaschak’s Self-In-Context
- •Root’s Ecological Model of Identity Development
- •Gender as an Artifact of Power
- •The Question of Formal Assessment in Feminist Practice
- •Micro-Aggression and Insidious Trauma
- •Interpersonal Betrayal as Disempowerment
- •Hays’s addressing Model
- •Root’s Model of Multiple Identities
- •Integrating the Somatic, Intrapsychic, Social, Contextual, and Meaning-Making Dimensions: The Case of Heidi
- •Effectiveness of a Feminist Empowerment Model
- •Feminist Therapy’s Integration With Other Models
- •With Whom Do Feminist Therapists Work?
- •Difficult Contexts
- •Difficult Client Characteristics
- •Feminist Practice in the Absence of the Capacity for Empathy
Root’s Ecological Model of Identity Development
Root (2000) has proposed an ecological model of identity development, founded in the experiences of racially mixed people, that situates gender among other factors influencing identity and posits an interactive process by which gender and other social constructions are internalized in a continuously transforming process. Her paradigm is similar to that proposed by Bern; what differs is that Root, reflecting the expansion of feminist scholarship to include other aspects of identity, argues that gender is not invariant but is rather interactive with culture, age cohort, social class, nationality, and other variables that inform the development of identity. Like Bern, she proposes a biopsychosocial model of gender occurring in response both to the stimulus of sex and those of culture and context, thus clarifying the vision of gender as a socially constructed, culturally informed phenomenon subject to temporal shifts and changes in the social environment.
Gender as an Artifact of Power
Unger (1989), reporting on the findings of a series of interesting experiments, manipulated the variables of sex and power for the participants in a group problem-solving dilemma. Her findings are provocative. When women in the group were placed in the powerful role as defined by the experimenter, their expressed behavior resembled characteristics that are gendered masculine in U.S. culture. Men placed in the subordinate position behaved consistent with so-called feminine attributes. Because women have long been subordinated in patriarchies, it is not surprising that the experience of subordination has become conflated with sex; what is intriguing is how quickly social position and disempowerment can overcome gendered socialization even in the brief context of the social psychology experiment.
What is similar throughout these feminist models, all of which initially derive from quite different schools of identity development, is their assertion that identity’s usual trajectory toward a gendered self (and a gendered self is a usual trajectory in most cultures, and clearly within Western and industrialized societies) is interactive and biopsychosocial/spiritual in nature. The sex of the body becomes a psychosocial stimulus serving as the catalyst for interpersonal interactions that are gendered, leading to a self that is gendered, leading to behaviors and relationship to body and self that are gendered, leading to a relationship with spiritual and meaning-making systems that is gendered, and leading back again into one another in a continuous, fluid, and interactive process that, like many human experiences, becomes invisible until it is made foreground and interrogated in the context of feminist practice. Gender is also continuously denoted as having specific meaning and value because, in patriarchies, everything considered female is assessed as lesser-than; this overvaluation or devaluation of self as connected to gender then enters into experiences of power, powerlessness, and potential avenues available for empowerment.
Gender role analysis (Worell & Remer, 2003) is one of the original tools of feminist practice and continues to be integrated into the work of feminist therapists. Doing gender role analysis takes the discussion of gender’s social constructions into account, allowing the therapist to consider how her or his experiences and those of the client are informed by gender. Unpacking and making transparent the assumptions about sex and gender that are profoundly rooted in cultural norms can be an effective feminist empowerment strategy.
Eli mentioned in passing to his therapist, Monica, that he was going to take off the week that his baby was due, “and then I have to get back to work.” Monica was aware that Eli’s employer, a local software firm, had extremely generous parental leave benefits, and asked, “So why so fast?” Eli was surprised at her question, “Why shouldn’t I go back to work? I mean, it’s not like the dad can do much at that point in things. No breasts, you know.” Monica heard the gendered assumptions about men as parents, and the role and value of a father to a newborn (see Silverstein & Auerbach, 1999, for an in-depth feminist analysis of the patriarchal narrative of fatherhood), and, using the humor that she and Eli had both found useful as an invitation to change, said, “So, you don’t have arms, eh? Can’t hold the kid without breasts?” Eli laughed and was able to talk about his fears of being useless, because male, and teased by male coworkers, because of his strong desires to stay home with his wife and the newborn, their second. “I missed out on so much of Taylor because I was working too much when she was born. I envy Bonnie. But maybe I don’t have to.”
ADDING SOCIAL LOCATION TO GENDER
Both Root (2000, 2004) and Hays (2001, 2008) have proposed multicultural feminist identity models integrating other components of identity into gender. As feminist therapy has grown more committed to that integration of human diversity and complexity, so feminist therapy has come to rely more on paradigms for the trajectory of identity development that are themselves inherently diverse. These models are similar to those proposed by other feminist theorists of identity; the difference is in the explicit attention to both the process and effects of gender emerging in the context of other social factors. These models perceive identity as an ever-changing gestalt in which different components of social experience combine in different amounts to become foreground for identity development in the context of varying social and intrapsychic needs. Root, for example, has demonstrated that within a given family of racially mixed siblings, each sibling, even those of the same sex, is likely to define ethnicity in a unique manner and also to report having defined ethnicity differently depending on age, stage of development, and a variety of social/contextual variables (1998).
Comas-Díaz (2008) has recently proposed a womanist (woman of color feminist), mujerista (based in Latina experience) identity model explicitly integrating the spiritual into gendered experiences. Using the experiences of Latina women as her template for understanding identity development, she explored how identification with culturally informed spiritual images that are highly gendered has created powerful self-development trajectories for these women. She also draws upon images and information from global women’s spiritualities, particularly those present among dark-skinned women of the Global South, illustrating how denigrated gendered identities are transformed through spirituality and meaning-making experiences, frequently in conjunction with imagery of a dark-skinned female incarnation of divinity, into sources of resilience, personal power, and social influence. Comas-Díaz’s model represents the current direction of feminist therapists’ attempts to explore gendered identities as sources of power and powerlessness through a more global lens. It is among the first feminist psychological models to explicitly describe the spiritual realm as a component of empowerment within the lens of gender.
Implicit in these discussions of gender and other social locations is that, because they are sources of power and powerlessness, they are also factors in the development of distress and dysfunction due to the inextricable linkage of gender with sexism, misogyny, and other forms of bias and oppression. A further key concept of feminist therapy is that of resistance to disempowerment and the manifestations of this resistance as so-called psychopathology that are reframed in feminist therapy as evidence of resilience and strength.
DISTRESS, DYSFUNCTION, AND RESISTANCE: FEMINIST DIAGNOSIS
Due to the toxic nature of normative gendered experience, almost every usual trajectory of identity development within patriarchy has the potential to generate distress and/or dysfunction on any of the biopsychosocial/spiritual–existential axes. Distress and behavioral dysfunction are terms used by feminist therapists in preference to the word psychopathology (Ballou & Brown, 2002; Brown & Ballou, 1992). As Brown and Ballou noted in the Forward to their most recent text exploring feminist analyses of the concept,
. . . we see that the decision to call nonconforming thoughts, values, and actions psychopathology does two things. First, it discounts she or he who is described as such. Second, it blocks our ability to look outside the individual to see forces, dynamics, and structure that influence the development of such thinking, values and actions. (2002, p. xviii)
Feminist therapy refers, not to psychopathology, but to distress, the subjective experience of ill-being or misplaced well-being and dysfunction, behaviors, and ways of being that create difficulties in life. Pathology is construed as existing in the larger cultural context of patriarchy with its oppressive and disempowering norms and its rigid constructions of gender and other identities. Thus, as noted previously, a feminist therapist is likely to eschew thinking of people in DSM terms, although she or he is also likely to be quite knowledgeable about the DSM and the many problems of reliability, validity, and cultural incompetence with which that volume is rife (Caplan, 1995; Klonoff & Landrine, 1997; Kutchins & Kirk, 1997).
Although in psychotherapy the individual is tasked with solving the problems arising from her or his exposure to this toxic emotional, psychosocial, and spiritual environment, the feminist therapist is always tasked with communicating the power of that patriarchal context and its role as the ultimate distal source of the client’s problems. This externalizing of the basis of a client’s problem is seen as empowering because of the shifting of blame for powerful social forces, over which no one has control, off the shoulders of an individual in distress, who has most often internalized that blame as evidence of weakness, incapacity, or some other shameful personal attribute.
ETIOLOGIES OF DISTRESS AND DYSFUNCTION
The etiology of most distress is postulated to represent evidence of the effects of internalized oppression (Brown, 1992a); the feminist model of distress emphasizes the psychosocial/spiritual realms as etiological, with the somatic realm providing the foundation shaping the form of the distress, in a stress/diathesis paradigm. This construct suggests that repeated encounters with oppression, bias, and stereotype create problematic self-schemata for each person that become woven into aspects of identity, so that the voice of the oppressor becomes mistaken for the voice of self. The limitations ascribed to people because of sex, phenotype, age, sexual orientation, disability, social class, or other characteristics by patriarchal culture become firmly woven into their felt sense of who they are. Because, as noted earlier, these introjects often are in place preverbally, they frequently feel profoundly true and immutable (Bern, 1993; Kaschak, 1992).
These gendered, raced, and otherwise contextually driven identities interact, in turn, with the biological capacities and vulnerabilities of the individual, so that distress will be manifested in ways that are most consistent with those capacities and vulnerabilities. For example, a person whose temperament is easily arousable autonomically and who has internalized the “expressing fear or sadness is evidence of weakness” message of sexist society may experience increases in anxiety when feeling or overtly expressing fear or sadness. Likewise, a person who has a pessimistic temperament or a biological predisposition to depression may evidence depressed mood when finding herself consistently unable not to violate internalized oppressive social norms.
Oppression may be overt and direct; this can lead to wounds to body, mind, and spirit. Post-colonial syndrome (Duran, Duran, Brave Heart, & Yellow Horse-Davis, 1998) is an example of the biopsychosocial/spiritual effects of direct and multigenerational oppression. Sexual assault or sexual abuse, which feminists have theorized to be methodologies of patriarchy for maintaining subordination (Dworkin, 1981), are another such direct and highly gendered violation. Distress and behavioral disturbance and dysfunction in response to such violations can be severe, reflecting the disempowerment that is foreground to these forms of overt oppression.
The social norms of the past decades have placed greater stigma on overt expressions of bias and stereotype, reducing the absolute frequency with which people in U.S. cultures are exposed to this form of oppression (Bobo, 2001; Nail, Harton, & Decker, 2003). As a result, encounters with bias are even more likely today to include many exposures to micro-aggressions or insidious trauma (Root, 1992), experiences of interpersonal betrayal (Freyd, 1996), or other experiences of powerlessness inherent in the absence of social privilege. Even when there is a strong biological etiology for a particular pattern of distress or dysfunction, feminist therapy theory argues—and more recent research empirically validates (Gold & Elhai, 2008)—that exposures to both overt and covert oppression, disempowerment, and violation, which are most likely to occur in the context of socially devalued roles and identities, are implicated in the ultimate expression of any presumed biological vulnerability to psychosis, depression, or anxiety.