Feminist Theories and Feminist Psychotherapies

Origins, Themes, and Diversity, Second Edition

J Dianne Garner, Carolyn Z Enns

• Publisher: Routledge
• Year: 2004
• ISBN:
  9781136785122
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

An updated, reader-friendly guide to feminist theory and therapy! Feminist Theories and Feminist Psychotherapies: Origins, Themes, and Diversity, Second Edition examines major feminist theoretical perspectives and links them to practical applications of feminist therapy. This book focuses on the evolution of feminist therapy and how histor

Chapter 1

Principles of Feminist Therapy

A carefully articulated and coherent theoretical grounding in feminist theory provides support for purposeful and ethical feminist practice. Feminist theory provides a lens for making one’s assumptions visible and transparent, which allows the therapist to practice with assurance as well as evaluate her or his actions on an ongoing basis (Halifax, 1997). In preparation for discussing the diversity of theory and practice in feminist therapy, this chapter describes the complexity of feminist therapy and summarizes the common principles and practices shared by feminist counselors and therapists. These commonalities include (1) a conceptual framework for understanding problems, (2) basic principles of feminist therapy as they relate to the therapeutic relationship and the goals of feminist therapy, and (3) distinctive techniques of feminist therapy. In this chapter, I refer to many of the original definitions of feminist therapy from the 1970s and 1980s in order to preserve the “herstory” and enduring, shared themes of feminist therapy. To demonstrate the continuity of central principles over time as well as emerging themes, I also cite recent definitions that build on original and influential statements about feminist therapy.

THE COMPLEXITY, DIVERSITY, AND VARIATIONS OF FEMINIST THERAPY

Feminist therapy has existed as an approach to psychotherapy since the early 1970s. At its most basic level, feminist therapy represents a conceptual framework for organizing assumptions about counseling and psychotherapy (Ballou and Gabalac, 1985; Ballou and West, 2000; Johnson, 1976; Kaschak, 1981; Marecek, 2001; Worell and Remer, 2003). Feminism, an important foundation of feminist therapy, is defined by bell hooks (2000) as “a movement to end sexism, sexist exploitation, and oppression” (p. 1). Feminist consciousness also includes a commitment to ending all forms of domination, oppression, and privilege that intersect with sexism and gender bias, including (but not limited to) racism, classism, colonialism, heterosexism, ethnocentrism, white supremacy, ageism, and ableism. Feminism empowers all people, including men, to build a world in which equality is experienced at individual, interpersonal, institutional, national, and global levels (hooks, 1981, 2000). This principle of inclusiveness is highlighted by the title of bell hooks’ (2000) book Feminism Is for Everybody. Mary Ballou and Carolyn West (2000) added that “feminist therapy is unwaveringly rooted in the search for and valuing of ALL women’s experiences” (p. 274).

Feminist therapy approaches were initially developed for women in order to correct the negative effects of sexism and bias in psychological theory, diagnosis, and practice, and to ensure that women gained access to gender-aware and gender-sensitive mental health services (Chesler, 1972; Weisstein, [1968] 1993). Because feminist therapy was developed initially by and for women, and because women are more likely than men to identify themselves as feminist therapists and to be consumers of feminist therapy, I often use pronouns that refer to women. However, the principles and practices of feminist psychotherapy are valuable for working with men, members of diverse cultures and racial backgrounds, and all those who view social justice issues as important to counseling and psychotherapy (Enns, 2000; Worell and Remer, 2003).

Feminist therapy was not founded by or connected to any specific person, theoretical position, or set of techniques (Brown and Brodsky, 1992). As stated by Deborah Leupnitz (1988), “Feminism is not a set of therapeutic techniques but a sensibility, a political and aesthetic center that informs a work pervasively” (p. 231). Feminism provides an umbrella framework, or a set of values for evaluating and orienting practice. Feminist counselors integrate complex bodies of knowledge about social structures, counseling methods, feminism, and the diversity of men’s and women’s lives. A wide variety of personality and counseling theories can be incorporated within a feminist approach (Dutton-Douglas and Walker, 1988; Rawlings and Carter, 1977); the only tools rejected by feminist therapists are techniques which are immersed in sexist theory or which encourage women and men to think in narrow, restricted ways about themselves and their options (Lerman, 1986; Rawlings and Carter, 1977). Thus, multiple forms of feminist counseling exist and are based on the unique combination of the counselor’s feminist orientation and counseling approach (Ballou and West, 2000; Dutton-Douglas and Walker, 1988; Worell and Remer, 2003). Although all theories of feminism focus on the importance of equality, beliefs about how equality can be achieved vary substantially; the counselor’s personal view of feminism is likely to have a significant impact on how feminist counseling is interpreted and conducted (Enns, 1992b; Kaschak, 1981).

On first glance, it may appear that combining feminist beliefs with feminist counseling is a fairly straightforward and uncomplicated task. Some individuals may conclude that because feminist theory is diverse and because multiple approaches to counseling exist, any mixture of feminism and counseling and psychotherapy theory is acceptable. However, the competent feminist therapist understands that effective feminist counseling is based on an ongoing and continuous examination of personal values, consistency between one’s theoretical orientations to feminism and counseling, and an understanding of how intersections of gender, race, class, economic status, and sexual orientation influence women’s and men’s lives (Ballou, Matsumoto, and Wagner, 2002; Brabeck and Brown, 1997; Feminist Therapy Institute [FTI], 2000; Brown and Brodsky, 1992; Wyche and Rice, 1997). When the “deep” integration of feminist principles and feminist theory occurs, feminist therapy is not just good therapy with gender awareness added; it becomes “a complete transformation of the way in which therapy is understood and practiced” (Hill and Ballou, 1998, p. 5).

In order to develop a fully integrated feminist counseling approach, it is important for the therapist to have working knowledge of a variety of academic and applied fields of study. These disciplines include but are not limited to the psychology of women and gender; women’s, gender, and sexuality studies; ethnic, multicultural, and global development studies; counseling and psychotherapy theories; sociological perspectives on gender, race, and class; and political science and social change strategies. Significant knowledge, research, and new theoretical work continue to proliferate within each of the fields that deal with gender issues; the task of staying informed about new developments is an ongoing challenge for persons who integrate feminism with counseling and psychotherapy. Laura Brown’s (1994) definition of feminist therapy emphasizes the necessity of depth and breadth of preparation:

Feminist therapy is the practice of therapy informed by feminist political philosophy and analysis, grounded in multicultural feminist scholarship on the psychology of women and gender, which leads both therapist and client toward strategies and solutions advancing feminist resistance, transformation, and social change in daily personal life, and in relationships with the social, emotional, and political environment. (pp. 21–22)

Therapists and clients are less likely to view feminism as a monolithic, prescriptive, or confining system of “politically correct” or formulaic views when feminist therapists recognize the variations of feminist theory and are able to communicate their complexity. Within feminism, there is room for diversity of practice and the opportunity for individuals to articulate a set of beliefs which are personally meaningful and which guide transformational practice.

A FEMINIST APPROACH TO UNDERSTANDING PROBLEMS

Feminist therapists hold several distinctive beliefs or assumptions about the problems of living, and these assumptions can be succinctly summarized under the following two themes: (1) the personal is political, and (2) problems and symptoms often arise as methods of coping with and surviving in oppressive circumstances. Consistent with these themes, Bonnie Moradi and colleagues (2000) found that self-labeled feminist therapists were more likely than other therapists to endorse behaviors which reflect the belief that the personal is political. Second, those who most strongly identified themselves as feminist therapists reported greater likelihood of attending to oppressions experienced by clients (e.g., racism, heterosexism, sexism) (Moradi et al., 2000).

The Personal Is Political

The “personal is political” conveys the assumption that personal problems are often connected to or influenced by the political and social climate in which people live. Many feminist therapists prefer to use the phrases problems in living or coping strategies rather than the term pathology to communicate the feminist view that counseling issues are inextricably connected to the social, political, economic, and institutional factors which influence personal choices (Brabeck and Brown, 1997; Butler, 1985; Gilbert, 1980; Wyche and Rice, 1997). Laura Brown (1992a) suggested that many of the problems experienced by persons with limited power in society can be conceptualized as reactions to oppression or “oppression artifact disorders.” These disorders reflect the psychological aftermath of stressors that are “embedded in the framework of the culture in which an individual develops” (p. 223) and, as a result, “may be subtle and difficult for either therapist or client to immediately identify” (p. 223). Building initial support for the connection between commonplace discrimination and psychological symptoms, a recent study (Klonoff, Landrine, and Campbell, 2000) found that compared to male respondents and women who indicated they had encountered little sexism, women who conveyed they had experienced frequent sexist discrimination reported significantly more psychological symptoms, such as somatization, interpersonal sensitivity, depression, anxiety, and obsessive-compulsive symptoms.

Intrapsychic explanations of problems and most diagnostic labels based within a medical model tend to decontextualize problems, support gender bias, or promote victim blaming. When counselors and therapists rely solely on traditional diagnostic labels, they are more likely to define problems as a set of internal characteristics and to emphasize goals that focus on overhauling internal deficiencies rather than promote healthy change and the alteration of oppressive environmental conditions. If clients are encouraged to look exclusively inside themselves for clues about the origins and dynamics of their problems, they are also more inclined to blame themselves, and to respond by adjusting to or changing themselves to fit the circumstances around them (Greenspan, 1993; Rawlings and Carter, 1977).

Because most formal diagnoses tend to label individuals without regard to contextual factors, feminist therapists face the challenge of negotiating complicated terrain. Health insurance reimbursement practices often require the use of diagnostic labels as outlined by the most recent edition of the American Psychiatric Association’s (2000) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Many feminist therapists believe that such labeling involves “pigeonholing” women’s concerns (Lerman, 1996); reducing “a complex set of social, economic, emotional and spiritual dimensions to the terms of a single diagnosis” (Greenspan, 1993, p. xxxi); “pathologizing nonmainstream behaviors and attitudes” (Kupers, 1997, p. 340); or, at a minimum, limiting the therapist’s ability to honor the context and personal meaning of a client’s concerns. As a result, many feminist therapists view themselves as engaging in “subversive practices” (Beardsley et al., 1998; Brown, 1994), which include using traditional diagnoses for the pragmatic purpose of ensuring that clients receive insurance coverage, but being open and honest with clients about the costs and benefits of such diagnoses, and collaborating with clients in identifying diagnostic categories that the clients view as nonoffensive (Ballou and West, 2000).

In addition to exploring external and contextual factors which contribute to problems is a hallmark of feminist therapy, feminist counselors and therapists attend to physiological, psychological, and intrapsychic factors that interact with external forces (Brown and Brodsky, 1992; Brown, 1994). For example, both the 1990 American Psychological Association Task Force on Women and Depression (McGrath et al., 1990) and the 2000 American Psychiatric Association Summit on Women and Depression (Mazure, Keita, and Blehar, 2002) recommended a biopsychosocial approach to working with depressed women (see also Sprock and Yoder, 1997). Through feminist analysis, clients learn to distinguish between internal/psychological and external/social aspects of the issues they are dealing with, and to identify both personal change and social change strategies that can be used to deal with these respective areas (Brown, 1994; Gilbert, 1980). More recently, Mary Ballou and colleagues Atsushi Matsumoto and Michael Wagner (2002) expanded this approach by proposing a feminist ecological model, which attends to individual dimensions, micro-level concerns (immediate interpersonal themes), exosystem concerns (e.g., those which are influenced by educational, political, religious, cultural, and ethnic systems), and macrosystem themes (e.g., world-views, ideologies, global issues).

In their work with major issues such as depression, many counselors and therapists who are trained in prominent (and dominant) psychotherapy traditions deal primarily with internal cognitive and emotional patterns that reinforce depression; their professional education often prepares them to focus primarily on the psychology of the individual. However, feminist counselors recognize that women who are especially vulnerable to depression include those who have experienced sexual and physical abuse, live in poverty, work in lower status employment positions, or are mothers of young children (Mazure, Keita, and Blehar, 2002; McGrath et al., 1990; Sprock and Yoder, 1997). Some of these factors can be influenced only through legal and social changes. These connections between internal and external worlds illustrate that the personal is clearly political; the cognitive, emotional, and behavioral changes that women make must be matched with institutional changes. As noted by Marcia Hill and Mary Ballou (1998), “the ultimate intention of feminist therapy is to create social change” (p. 3).

Symptoms As Communication and Coping Tools

Feminist counselors view clients as individuals coping with life events to the best of their ability. Many symptoms represent “normal” reactions to a restrictive environment (Greenspan, 1993). In her classic statement on the goals of feminist therapy, Marjorie Klein (1976) noted, “Not all symptoms are neurotic. Pain in response to a bad situation is adaptive, not pathological” (p. 90). Feminist therapists highlight the communication function of symptoms by defining them as behaviors that arise out of a desire to influence an environment that is constricting or oppressive. For example, symptoms may emerge as a consequence of coping with conflicting nontraditional and traditional demands of multiple roles. Alternatively, symptoms often reflect influence strategies that were taught or modeled by others in the environment, such as parents, peers, the media, schools, and intimate others. Coping behaviors that were functional or had survival value at one life stage may become less successful over time and contribute to the person’s distress as the client attempts to meet life tasks that require different or new skills (Greenspan, 1993).

For example, a symptom such as dependency may be a reaction to inequality. A person with limited power and influence attempts to vicariously experience some semblance of power by attaching herself or himself to people who hold greater power (Hare-Mustin and Marecek, 1986). If direct forms of power are not available to a person, she or he is likely to rely on “devious” strategies such as dependency, acquiescence, or manipulation (Gannon, 1982). However, the costs of such strategies are high, and they may increase one’s vulnerability to a range of problems such as depression and anxiety. When the focus of counseling is to label and remove a symptom without understanding the context in which it was shaped and the current context in which it is reinforced, clients may be deprived of the indirect influence of symptoms, such as dependency. Individuals may, in fact, feel even less powerful after counseling than before counseling (Halleck, 1971). Rather than viewing symptoms such as depression, dependency, anxiety, or passivity as problems to be eliminated, the feminist counselor views these patterns as indirect forms of expression that can be refocused in more direct and productive forms of communication as a client gains a stronger sense of self (Smith and Siegel, 1985; Rawlings and Carter, 1977). It is also helpful to reframe concepts such as dependency as “a process of counting on other people to provide help in coping physically and emotionally with the experiences and tasks encountered in the world when one has not sufficient skill, confidence, energy, and/or time” (Stiver, 1991, p. 160). Redefining dependency in this manner identifies the healthy and normal aspects of this behavior, highlights ways in which it may promote growth rather than stagnation, and frees the individual to try out a wider range of and more flexible behaviors.

The feminist therapist is also aware that symptoms are reinforced by one’s environment, and that change is not as simple as “being more assertive....

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Contents
• Acknowledgments
• Introduction
• 1. Principles of Feminist Therapy
• 2. Liberal Feminist Theory and Therapy
• 3. Radical Social Change Feminisms in Feminist Theory and Therapy
• 4. Cultural Feminist Theory and Feminist Therapy
• 5. Women-of-Color Feminisms and Feminist Therapy
• 6. Global/Transnational Feminisms and Their Implications for Feminist Therapy
• 7. Feminist Postmodernism, Lesbian/Queer Feminisms, and Third-Wave Feminisms
• 8. Developing a Personal Approach to Feminist Therapy
• References
• Index