Radical Feminist Therapy: Working in the Context of Violence
“This is an interesting book. It may be useful for those who have not followed the debate on the experience of women in psychiatric services. It provides useful information on ways of working with more disturbed women. These are women whom psychiatric services often avoid or at least with whom they do little constructive work. The emphasis on offering therapy to these women instead of a bed in an institution was refreshing.” –Andrea Bennett in Clinical Psychology Forum How can counselors and clinicians help empower women in a sexist, racist, and homophobic society? How can they help women reclaim their bodies? Or repair their violated bond with womenkind? Taking feminist therapy one step further, this enlightening volume focuses on a central problem in our society–violence ...
- Front Matter
- Back Matter
- Subject Index
- Chapter 1: The Radical Feminist Foundations
- Woman as Body—Physical Violation
- Woman as Body—Labor Exploitation
- Dividing Woman from Woman
- Later Years
- Chapter 2: Psychiatry
- The History
- Psychiatry and Women Today
- Chapter 3: Basics and Beginnings
- Questions to Ask Ourselves
- Counselor Ethics
- Chapter 4: General Empowerment Work
- Strengthening/Repairing the Bond with Womankind
- Working with the Body
- Identity and Action
- Chapter 5: Difference: Working with …
- Native Women
- African American Women
- Jewish Women
- Immigrant Women
- Women with Disabilities
- Chapter 6: Problematic Territory
- Heterosexual Couples
- The Family
- Chapter 7: Working with Adult Survivors of Childhood Sexual Abuse
- The Work
- Other Resources
- The Special Situation of Ritual Abuse
- Chapter 8: Extreme Abuse by Male Partner
- Deeper Work
- The Political Overview
- Telling and Creating a Support Network
- Substantially Changing or Getting Out of the Abusive Situation
- The Legal Route
- Political Work
- Chapter 9: Working with Women Subjected to…
- Extreme Abuse by Female Partner
- Abuse by Pimps
- Stranger Rape and Date Rape
- Sexual Violation by Therapists
- Chapter 10: Self-Mutilation
- Shelter or Residence Work
- Chapter 11: Troubled Eating
- “Over” Weight and “Over” Eating
- Chapter 12: Drinking Problems
- Self-Help—A.A. and Others
- Chapter 13: Working with Psychiatric Survivors
- Details of the Counseling
- The Larger Commitment
- Chapter 14: Clients who are Considering Ending their Lives
- Direct Practice
- Attending to Ourselves
Copyright © 1992 by Bonnie Burstow.
All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.
For information address:
SAGE Publications, Inc.
2455 Teller Road
Newbury Park, California 91320
SAGE Publications Ltd.
6 Bonhill Street
SAGE Publications India Pvt. Ltd.
Greater Kailash I
New Delhi 110 048 India
Printed in the United States of America
Library of Congress Cataloging-in-Publication Data
Main entry under title:
Burstow, Bonnie, 1945–
Radical feminist therapy: working in the context of violence / Bonnie Burstow.
Includes bibliographical references and index.
ISBN 0-8039-4787-9 (cloth). — ISBN 0-8039-4788-7 (pbk.)
1. Abused women—North America. 2. Feminist therapy—North America. 3. Women—North America—Crimes against. I. Title.
97 98 99 00 01 02 03 10 9 8 7 6 5 4
Sage Production Editor: Tara S. Mead
As with almost everything that is worthwhile, many wonderful women have helped make this book possible.
The single largest contribution is from Kali Munro. Kali's uncompromising feminism instructs me. Kali is the only other person I know who has clearly integrated feminist therapy and antipsychiatry; it was a relief to have had her to talk with throughout the long two and a half years of writing. Thank you for painstakingly reading each chapter as it was written and for offering sensitive and astute feedback. Most of all, thank you for being there.
Linda Advocaat scrupulously read each section as it was written and provided ongoing, down-to-earth feedback. Margot Smith, as always, encouraged me, was supportive, and cared about what I was doing.
My editor at Sage was a “goddess-sent.” She recognized the value of the manuscript, moved with lightning speed, and had the guts to back a book that challenges so much. I am in debt as well to Don Weitz for his uncompromising antipsychiatry understanding and solidarity.
My students and supervisees throughout the years have guided me. The questions and dilemmas of, to name just a few, Kathy Canter, Robin Black, Jan Peltier, and Carol-Anne O'Brien gave me further insight into what needed to be written. The Native and immigrant students at Winnipeg Education Centre and the program itself taught me about work with Natives and immigrants. Special thanks to Kay Johnson and the other women of color at Carleton University who “confronted the hell out of all faculty.” It is women of color who have taught me the most about difference.
Finally and most particularly, I would like to acknowledge the contribution of my clients over the years. While I cannot name them for reasons of confidentiality, I know and they know that they have taught me what no one else conceivably could. It is to them—as women who resist, as survivors, as warriors—that I dedicate this book.
The context in which this book is written is the fundamental unhappiness and alienation of women. I am referring here not simply to the angst and pain that are inevitable parts of our human condition or primarily to the unhappiness that arises from individual circumstance. It is that unnecessary yet unavoidable, individual yet common, suffering born of the patriarchy and other systemic oppression.
Civilization as we know it is based on the violation and domination of subordinates by elites. All women are subordinate. Working-class women, women of color, lesbians, and women with disabilities are doubly or triply oppressed. Civilization is based as well on male hegemony, that is, on viewing, understanding, and naming the world from a rigidly male elite point of view and seeing this view itself as something that is neutral and given in the nature of things.
Violation, domination, and hegemony are common to all oppression. All oppression is heinous, dehumanizing, and confusing. And all has its own special torments and deceptions. What is especially insidious and psychologically destructive about sexism is its closeness. We do not have distance from it. It is in our homes and in our own families from the earliest years, and it comes under such baffling and seductive disguises as nurturance and romantic love. We are so mystified by it and caught up in it right from the start that it takes an incredible struggle for us to win back even the beginnings of our lost humanity. For a long time, individually and collectively, women have been waging this struggle. Feminist therapy or counseling may be seen as one small but very real part of the fight.
Feminist therapy is rooted in women's knowledge, in women's help and ways of help. The word therapy comes from the Greek word meaning “to attend” or “to minister” and only derivatively became connected with medicine. Our [Page ix]ancestors or precursors are women who attended to others. We date back to the witches, the midwives, the wise women who defied the patriarchy and brought women's help to those who wanted it. It dates beyond the patriarchy itself to the spiritual women of all classes and colors who were compassionate and gave counsel.
The immediate context for the emergence of feminist therapy was the growth of the women's movement. The larger context is the obscuring of our roots by male and malelike professionals and a growing dissatisfaction with the increasingly patriarchal counseling that resulted. Sadly, for some time now, especially in the Western world, an enormously high percentage of women who “give counsel” have taken training from and identified with the androcentric, racist, and classist “mental health establishment.” The woman's movement provided an opportunity to begin reexamining and disidentifying from that establishment. Individual women both inside and outside consciousness-raising groups targeted the “mental health system” as a particularly misogynous and oppressive substructure. Feminist researchers began studying the area. Their findings left us in little doubt. The so-called “mental health system” served the interest of the patriarchy; that is, it pathologized the socially created problems that women face and reinforced the sex roles that the patriarchy prescribes.
A particularly influential study that helped substantiate the claims of those of us who denounced the “help” given by “mental health professionals” is Inge Broverman's now classical research into sex role stereotyping by psychiatrists, psychologists, and social workers (see Broverman, Broverman, & Clarkson, 1970, pp. 1–7). The research was based on a questionnaire that contained listings of bipolar traits associated with sex role stereotypes—such bipolar sets as “very assertive/not at all assertive.” The research indicated that both male and female clinicians equate “socially competent adult” with “socially competent man” and see women as socially competent only when not acting like a competent adult. Feminists were quick to point out the implications of Broverman's study. Whether conducted by men or by women, therapy was a patriarchal institution whose vision and goals contributed to the infantilization and disempowering of women.
A second important study is by Phyllis Chesler. In her book Women and Madness, Chesler (1972) demonstrated psychiatry's role in the subordination of women. She saw psychiatry as a fundamentally androcentric institution whose purpose is to enforce sex role stereotypes. She argued convincingly that women are in double jeopardy: Women are institutionalized both for veering from their socially proscribed role and for overly conforming to it. Women of color are particularly jeopardized.
These denunciations and this research helped clarify the importance of pioneering a different approach to counseling even though the approach did not highlight the significance of our earlier history. It became abundantly apparent [Page x]that the “mental health” professionals’ claim to neutrality was androcentric myopia. Psychiatry was fundamentally patriarchal. And therapy clearly was not and could not be neutral. A counselor/counseling approach has either establishment beliefs/values and supports systemic oppression or liberatory beliefs/values and struggles against oppression. Feminists saw the humanistic approaches as preferable to everything else but concluded that a strictly humanist orientation was inadequate. No existing approach did not pathologize, did not individualize, and located itself fundamentally on the feminist side.1 Feminist practitioners and writers responded by attempting to create one.
Within a few decades self-declared feminist therapists and feminist therapy referral centers were in every major city in North America and Europe. Then came the articles and books. Particularly noteworthy in this regard is Greenspan (1983), who spelled out important practice differences among psychoanalysts, humanist therapists, and feminist therapists; and Sturdivant (1980), who articulated differences in underlying beliefs and values. Later Brown and Root (1990) and Fulani (1988) pushed farther, incorporating an understanding of racism and stressing multicultural approaches.
From the outset the new feminist approaches were based on the belief that the relationship between client and counselor must reflect female values and female ways of relating. The role of therapy was to help women understand their oppression and to find new, more empowering ways of dealing with it. The therapist-as-expert stance was defined as a masculine way of being, and on-going serious attempts were made to overcome it; symptoms were partially redefined as resistance; and a link was established between feminist therapy, consciousness-raising, and political action.2
The theory and practice of feminist counseling have continued evolving and redefining themselves over the past few decades. Important theoretic contributions have been made, and many women have been helped. Mothers who might otherwise have ended up with traditional family therapists who would have sacrificed them in the interests of the “family system” instead found allies and advocates. Families led by strong Black women stopped being called “dysfunctional.” And many incest survivors who might otherwise have been called “hysterical” and ended up institutionalized and drugged were recognized and helped to remember and reclaim self. We may legitimately be proud both of the individual work that has been done and of the theoretic groundwork that has been laid. At the same time, as in all human movements and activities, serious shortcomings and problems exist. These problems and shortcomings form one of the principal motivations for writing this book.
Despite the many achievements, despite the women who have been well served, a number feel profoundly betrayed and still more feel deeply dissatisfied. I have no doubt that some of the anger and disappointment and certainly [Page xi]some of the intensity with which it is felt stem from misogyny and traditional woman-blaming. Feminist therapists are blamed for charging for their services even though everyone knows that making a living is a necessity and that men charge considerably more without feeling guilty. Feminist therapists are blamed for not being the all-giving, perfect mothers that patriarchy has conditioned everyone to expect of women.3 This unfairness notwithstanding, some anger is also very legitimate, for some very serious problems exist.
Some women psychiatrists oppose the sexism they see, yet they try to hold onto psychiatry, mistakenly viewing themselves as “feminist therapists.” Some feminist therapists use “diagnoses” freely, including the phallocentric diagnoses of the psychiatric profession.4 A new rapprochement has even arisen between some streams of feminist therapy and psychiatry, with the result being co-optation in such psychiatrically defined and controlled areas as “eating disorders” and “multiple personality disorders.” Although a few are deeply sensitive to the damage wreaked by psychiatry and truly extend themselves to keep people out of the system, even some of these feminist have helped commit their clients involuntarily, without the client posing any threat whatever to the therapist or to any third party. Many do not open their doors to ex-psychiatric inmates. In fact I have been told by women working in a feminist therapy referral center that most of their counselors specifically list “psychiatric patients” as a client type that they do not wish to see. Many feminist counselors imitate their male counterparts by overcharging or by consistently charging what most women could not conceivably afford. Some seldom or never recognize when they are dealing with an incest victim or a battered woman, and others recognize but avoid. Many of those who do not avoid them nonetheless approach survivors in a heavy-handed or sensationalistic way and harm them in the process. Many feminist therapists violate their clients’ boundaries, sexually or otherwise. Many continue to try to patch together marriages that are profoundly oppressive. Most feminist therapists sometimes, and some feminist therapists often, draw indiscriminately from different counseling modalities without examining their compatibility with feminist principles. Most heterosexual therapists have their own lesbophobia and do not understand lesbian existence. Most of the white therapists do not understand racism, superimpose mainstream norms, and miss the interconnections between racism and sexism. Most counselors use highly direct modes of communication even when working with women from cultures that rely more on context and find such communication intrusive. Many counselors do not understand the special problems faced by poor women. And in North America the vast majority of feminist therapists do not have a clue how to work with women who mutilate themselves, with prostitutes, with women in conflict with the law, and with women with eating and/or drug problems.[Page xii]
These problems exist for a number of reasons. First, as with other professions, women who become feminist therapists are generally white, middle-class, heterosexual women who are not victims of racism, who have never prostituted or harmed themselves in ways that exceed societal norms, and who have never been institutionalized. Most have received no formal training in a feminist therapy orientation. Most have been trained, say, as a gestalt therapist or as a bioenergetics therapist or, more commonly, “eclectically” and have added feminist therapy to their already “busy” repertoire, sometimes actively striving to keep it all together, though often just going on faith that it will all work out. Others are not really feminists but use the label because it gives them access to referral centers and think that this is all right because they are, after all, “against sexism.” Many are feministically inclined but do not have a clear position. Others have a position that is clear but still preradical. Many are very good theoretically but are confused about what to do practically and so end up acting like either traditional therapists or no kind of therapist at all. Workers in feminist counseling centers avoid a number of these mistakes because more come from the working class, more are lesbian, and more are of color. Consequently these counselors have a solid, practical bent and are often among the most helpful workers that women in trouble encounter. Nonetheless they frequently lack an overview because of the piecemeal nature of their training (experience while being overworked plus sporadic workshops). And they do not have an understanding of process. Workshops themselves give help while also adding to the problem. With new understanding coming rapidly, we naturally turn to workshops for new information and approaches. The workshops that are attended by therapists and counselors alike leave us with the illusion that we understand more than we do. And they range from excellent information and approaches on one hand to sensationalism, fad, and heavy-handed intrusion on the other. Additionally, despite their backgrounds, most therapists and counselors have received no training in how to depathologize and have been given no information about the nature of psychiatric “treatments.” All are in a profession and a society “spooked” by psychiatry. The training received by most is ethnocentric. It promotes directness, explicitness, confrontation, and individualism over the implicit, nonintrusive, and communal. All have the opportunity to violate their clients as professionals. And the legitimate feminist attempt to get away from the rigid boundaries of mainstream counseling can itself result in blurred boundaries and violation.
Therapists with any of these difficulties, and we all have some, can find help in many of the feminist therapy books written to date. Unfortunately, though, valuable and powerful as much of the literature is, it is marred by a number of the same flaws and shortcomings. The literature too has been written primarily by white, middle-class, Anglo-Saxon women who have not prostituted, have not damaged themselves in ways that exceed societal norms, have never been [Page xiii]institutionalized, are able-bodied, and have not suffered from racism. Progressively writers are stretching themselves as indeed we all must in the attempt to understand and to articulate, and this is wonderful to see. Much more stretching, understanding, and articulation is needed, though. Until recently lesbian existence was excluded from a great deal of the literature; the implications of lesbian existence for heterosexual women are still never spelled out. Although there is now more inclusion of lesbians and recognition of woman-woman love as “healthy,” with only a few exceptions (e.g., Goodrich, Rampage, Ellman et al., 1988) the inclusion and validation of woman-woman love is generally compromised by lesbian-relating being viewed through a psychoanalytic lens that reduces it to the pre-Oedipal.5 Except in works written by women of color and Jewish women, and I am thankful for these contributions, white, Gentile clients are generally assumed. Sporadic references are now being made to differences, for most feminists are trying to do better. Still a tokenism generally exists about such references. Although we encounter the occasional delimiting statement and some clearly well-meaning apologies, what is true of white Gentile women is generally treated as The Truth about women in this society. Some of the books are not very feminist. None take a radical feminist line, although Greenspan (1983) and Sturdivant (1980) come very close. Prostitutes, ex-inmates, women who are drug dependent, and women who self-mutilate are generally given short shrift, if they are mentioned at all.
The guidance given in regard to psychiatry is more problematic. Rosewater and Walker's (1985) amalgam of psychiatry and feminism is misleading and confusing. Rivera (1988) writes in a psychiatry-identified way about the “mental illness” called “multiple personality disorder,” referring in detail to psychiatric “discoveries.” Feminist theoreticians like Caplan (1989), whose opposition to mother-blaming and to the notion of female masochism represents an important feminist thrust, nonetheless fail to see the inherent sexism and oppressiveness of psychiatry and treat it simply like any other field that needs to be tidied up. Having identified the diagnosis “masochistic personality disorder” as sexist, and having worked hard to remove it from the Diagnostic and Statistical Manual of Mental Disorders (DSM), Caplan (1987, pp. 241–269) expressed dismay when it reappeared under the new label “self-defeating personality disorder.” She continued to write, however, as if this were simply the fault of individuals at the convention and as if reform were possible and sufficient. Neither Rosewater nor Rivera nor Caplan objects to such diagnoses as “borderline personality disorder” and “schizophrenia.”6 Rosewater just asks that we distinguish between “real borderlines” and “schizophrenics” on one hand and battered women who only look as if they are “borderline” or “schizophrenic” on the other. Unlike the “borderlines” and the “schizophrenics,” Rosewater tells us, battered women really are the victims of overwhelming violence and should be treated accordingly. Treatment for the “schizophrenic” [Page xiv]woman, says Rosewater, should be “based on helping her, at whatever pace is suitable for her, to deal with the discrepancies between her own perceptions and her external realities” (Rosewater & Walker, 1985, p. 224). This is worrisome advice in itself because most so-called “distortions” have at least a kernel of truth and because women's history is already seen as deficient and discounted. It is especially worrisome if we consider the equation that Greenspan and Chesler make between rejecting sex role stereotypes and being diagnosed “borderline” or “schizophrenic.” Counselors who give credence to Rosewater's writings would approach only some women with a feminist orientation, while continuing to invalidate and “correct” others. They would be compounding oppression and adding to the disempowerment of those women whom the patriarchy most stigmatize and most fear—all this, confusedly, in the name of feminism.
Theorists like Greenspan and Sturdivant stand in sharp contrast to Rosewater and Rivera. Greenspan (1983) and Sturdivant (1980) offer sharp critiques of psychiatry and are good at cutting through diagnoses to expose the sexist core. Even these theoreticians, however, are limited in their psychiatric critique; they offer few practical suggestions on how to work with women who have already been psychiatrized or who are at strong risk of being so. Feminist therapists looking to them for guidance in the psychiatric area would be benefitted but would still come up short.
Still more significant, feminist counseling literature has not provided the concrete guidance needed. The literature is divided between weak theory with detailed practice suggestions on one hand and powerful theorizing with only general remarks and examples about how to put it into practice on the other. This deficit is a sizable one, for good feminist counseling is itself the concretization of good theory. As counselors we need good theory, and we need to know how to work with it.
Additionally, although specific types of violence against women are the topic of many feminist counseling books, violence against women overall is seldom given centrality in generalist feminist counseling texts. Violence against women is central to our existence as women and as such is an issue that we can no longer afford to marginalize.This Book
Radical Feminist Therapy attempts to radicalize feminist therapy further and to offer detailed and grounded guidance. It is written for feminist practitioners both new and experienced who are open to unlearning and relearning. It is written for the feminist counselor, the therapist, the supervisor, the educator, the [Page xv]student, the client, for anyone, in fact, who wishes to make her or our feminist counseling more truly feminist and is reaching out for orientations and understandings that embrace more and more women. A large book that covers many areas in depth, it attempts to address the needs both of students who want a comprehensive introductory text and of practitioners who want something that can be used as an ongoing resource.
The central emphasis of the book is violence against women. The operant premises are:
- Women are violently reduced to bodies that are for-men, and those bodies are then further violated.
- Violence is absolutely integral to our experience as women.
- Extreme violence is the context in which other violence occurs and gives meaning to the other forms, with which it inevitably interacts.
- All women are subject to extreme violence at some time or live with the threat of extreme violence.
Considerable emphasis is placed on childhood sexual abuse, rape, and battery continuums, as well as on women's responses to this violence (depression, cutting, splitting, troubled eating, and protest). In line with the commitment to inclusion, the book also includes detailed exploration of feminist ways of working with women and issues that are generally either omitted or pathologized in generalist feminist counseling texts. Examples include Native women, Jewish women, women with disabilities, prostitutes who are battered by pimps, women who self-mutilate, psychiatrized women, women with drinking problems, and women who are considering killing themselves.
The second half of the introduction and the first two chapters lay initial foundations. The remaining 12 chapters rigorously integrate theory and practice. Each chapter ends with a list of suggested readings to assist learners who have a special interest in the area.
Each practice chapter is grounded in and includes reference to concrete interactions with clients. Contrary to standard practice, references are kept short and general for purposes of confidentiality. Features from different clients have been combined together, and stories have been purposively altered.Different Theoretical Perspectives
Radical Feminist Therapy is grounded in a number of related and interconnected perspectives that combine to shape the understanding and guidance offered.
The first and by far the most important perspective is radical feminism—the perspective highlighted in the title. Radical feminism sees oppression against [Page xvi]women as connecting with but not reducible to all other systemic oppressions and places special emphasis on the physical violation of Woman as Body. With our growing awareness of partner and child abuse and other forms of male violence, the importance of this perspective for feminist therapy is becoming increasingly clear.7
A secondary though important perspective also found in the book's title is radical therapy. Radical therapy is the counseling and political movement that grew out of transactional analysis. It starts from the premise that problems in living are rooted in systemic oppressions—classism, sexism, and racism in particular. It involves consciousness-raising and leads to action. It is built on two basic equations (Wyckoff, 1980, pp. 15–16):
Oppression + Lies + Isolation = Alienation
Action + Awareness + Contact → Power
The third perspective is antipsychiatry, and it is one that is officially endorsed by radical therapists.8 Antipsychiatry is a combined movement/perspective that views psychiatry as a fundamentally oppressive institution propped up by hegemony and built on mystification, subordination, and violence. It involves analysis, demystification, and liberation.
All three perspectives are grounded theoretically in a more general perspective called structuralism. Structuralists see power deferential and “power over” as figuring significantly in the problems that people have in living. All see traditional therapy as oppressive.
The final perspective and one that somewhat qualifies the structuralism is existentialism. Existentialism views the human being as freedom that is severely and often brutally conditioned but not totally “determined” by our social and human situation. Such prominent existentialist themes as otherness, freedom, objectification, and alienation have already entered into feminist thinking via de Beauvoir (1964) and into liberationist thinking generally.Personal Grounding and Purpose
I am a therapist, consultant, supervisor, and social work professor who has spent many years working with and helping others work with violated women. I am grateful to clients and students, for they have taught me more than books and articles ever could. I continue to develop my understanding out of my ongoing interaction with them.
More personally and just as significantly, I have been subject to hardships and oppression that predispose me toward certain types of understanding and that have made me the kind of feminist therapist, educator, and thinker that I am. I am of lower class origins. My childhood was forever being interrupted by [Page xvii]those ongoing desperate financial crises that characterize the welfare class. For long periods the four of us lived in a small one-bedroom flat. I remember having to use windows as exits to avoid the debt collectors who were waiting at the door. We were forever moving, beating hasty retreats because we could not pay the rent.
My father was a “psychiatric patient” who went from hospitalization to hospitalization. My family was thrown into crisis after crisis by the frequent “committals,” by his threats and mood swings, and by the important things that he kept forgetting as a result of the memory loss caused by ongoing electroshock.
I am an incest survivor. I am also a survivor of extreme childhood battery more generally, and like many other abused children, I coped for years by withdrawing, by distancing, by self-mutilating. Needless to say, this left me at risk of psychiatrization, and indeed attempts were made to “interfere with” me in my earlier years, but I had seen enough, thankfully, to protect myself.
Except during those vulnerable times that we all have, the worst aspects of my childhood seem very distant to me now. I am glad that they are remote, for I would not wish them on anyone, myself included. At the same time, I am strangely grateful that I can call on them, for they tremendously benefit me as a practitioner. I have seen many incest survivors and have worked well with them at a time when they were still considered a rarity by most feminist therapists and when most of my colleagues were floundering with these women.
Both adult and child experiences that were nowhere near as tortuous have similarly instructed me. I have the knowledge that comes from being a Jew in an anti-Semitic Christiancentric world. I have the knowledge of being disabled and in physical pain in a world built for the able-bodied and the pain-free. And I have the knowledge that is forced on you when you are a woman with a woman partner in this lesbophobic society, in which heterosexuality is compulsory and in which woman-woman love is often punished, is always marginalized, and is at best tolerated.
Like the more formal schools of thought already delineated, this knowing that exists at the core of my being enters into my understanding of patriarchy and of feminist therapy. And it too underlies the redirections and the deepening in this book.
I am also white. I know that having white privilege distorts my vision and detracts from the book. As a counselor, teacher, supervisor, and writer, I have been struggling to access other vision and believe that this book has been greatly enriched through that struggle. At the same time, I am painfully aware that my section on Jewish women is considerably more powerful than my section on African American women despite the extra efforts devoted to the latter.
From the opposite side, I know as well that the very oppressions to which I am subject sometimes blind me to the experiences of women on the opposite side of that oppression. As Audre Lorde (1982, 1984) so astutely points out, [Page xviii]although seeing from the outside in allows the oppressed to understand the oppressor better than the oppressor understands the oppressed, it too is a limited vision involving its own bias. From both sides, I regret whatever misrepresentation or insensitivity has resulted. And I look forward to correction from women who are differently situated.Notes
1. One possible exception is transactional analysis. See Steiner (1975).
2. Theorists, like practitioners, vary on their degree of political understanding and commitment. For a particularly strong position, see Greenspan (1983).
3. At the Tenth International Conference for Human Rights and Against Psychiatric Oppression, for example, feminist therapists were repeatedly criticized for not giving of their time for free, for pretending that they had any knowledge, and for not making themselves completely and always available.
4. See, for instance, Rosewater and Walker (1985), pp. 215–225.
5. In this regard, see, for example, Burch (1982, 1985) and Chodorow (1978).
6. Caplan's recent antipsychiatry speeches suggest that she is becoming significantly more radical. I applaud the shift and look forward to future books and articles that reflect it.
7. Readers wanting to know more about radical feminism are referred to Daly (1978); Koedt, Levine, and Rapone (1973); and Redstockings Collective (1978).
8. Antipsychiatry's most famous and most articulate spokesperson is Thomas Szasz. See Szasz (1974, 1977, 1987). For radical therapy statements on antipsychiatry, see Agel (1973). For inmate statements, see any copy of the current Canadian magazine Phoenix Rising or the now defunct American publication Madness Network News.
Appendix: Example of a Client Handout[Page 283]Working Together
This sheet is intended to give you some general information about my background, what I believe, and how I work. My hope is that it will be of some help to you in deciding whether to work with me and in clarifying what you might expect of me and what I expect of you and that it will generally assist us in creating a good working alliance. If you disagree with any of the views, ideas, or ways of operating, and/or you are not sure what I mean, let's discuss it and see what we can work out together.Education
I have a Ph.D. and an M.Ed. in Adult Education and Counseling from Ontario Institute for Studies in Education (OISE), as well as a second master's degree. I have also taken training from Toronto Psychosynthesis Institute, The Bioenergetics Institute, and Toronto Institute for Human Relations and have done an internship at the Counselling and Development Centre at York University.Experience
I have been in private practice since 1979. I have done considerable agency work, supervising and training counselors. I have taught social work as a full-time faculty member both at the BSW program at the University of Manitoba and the MSW program at Carleton University. I supervise many therapists in private practice. And I have published extensively in the areas of counseling and psychotherapy.[Page 284]Overall Perspective
I am a structuralist/feminist. What this means is that although I will not necessarily stress the political,
- I see external systemic oppression (sexism, racism, classism, ageism, ableism, and heterosexism) as fundamental to the problems that we find by living in the world.
- I see the internalizations of oppression as fundamental to our problems in living.
- I do not regard myself as The Expert, nor you as the Passive Recipient of My Expertise. I regard us both as adults, each with our own knowledge and skill, who are working together on issues that are meaningful to you.
Guidelines, General Expectations, Invitations, and Requests
- The counseling modalities that I draw on tend to be from the political and the humanistic streams. I draw primarily on radical therapy and secondarily on transactional analysis, gestalt, Rogerian, bioenergetics, dialogical, psychosynthesis, and existential analysis. I do not adhere to a single modality but rather go between modalities, trying to use whatever seems helpful to a client at any particular time.
- I believe that genuine dialogue is the hallmark of good counseling, and I try to ground myself in dialogue. In other words, I share what I am thinking and feeling.
- Deciding to work together is dependent on our both sensing that a fit exists between what I can offer and what you need and/or want. I will ask the questions that I need to ask in order to arrive at my decision. Please feel free to ask any questions that you may need to ask to arrive at yours.
- Deciding not to have counseling and/or therapy is a perfectly respectable decision. It is an option, accordingly, that I often explore with clients.
- These sessions are for you. Make sure that you get what you want out of them. It is your goals, not mine, that are ultimately the most meaningful. Please come in with your own agenda and feel free to change the agenda. If you disagree with something that I have said or have suggested, don't just go along with it. If you feel uneasy about how I have responded to something, please give me feedback. “Disagreement” is not a “sign of resistance.” It is the reality of being separate human beings.
- If I say or do anything that is oppressive, whether it be ethnocentric or ableist, please let me know about it so that I can shift. Nothing of this nature is insignificant or “too small to mention.”
- Except when conferring with a colleague (and here I try to be careful that you not be identifiable), and/or except when someone else's life is in danger, these sessions are [Page 285]absolutely confidential. That is, I will not divulge to anyone that you are seeing me. I will not discuss you with your family or friends unless you explicitly ask me to do so. I will not testify against you at a court of law even if required by law to do so.
- Because I view psychiatry as fundamentally oppressive, I do
- not consult with a psychiatrist.
- not assist anyone wanting to institutionalize anybody.
- not use medical backup, because that could leave a client vulnerable to unwanted psychiatric intervention.
- I have a sliding scale to be as sensitive as possible to people's different financial situations. Insofar as possible, I try to let people place themselves within the range. I can take only a certain number of people within each of the lower fee categories, so it may sometimes happen that no vacancies are available for a certain fee category. When this occurs, and when a low fee is in order, I will go to the next available fee.
- It is important that we be able to rely on each other. Except in the event of a genuine emergency, I give and expect at least 24 hours’ notice of a cancellation or change of appointment.
- If you are having trouble and wish to talk with me between sessions, feel free to call. A good time to call would be after 10:00 a.m. and before 9:00 p.m.
- Please do not feel restricted to the once-a-week formula that has tended to typify counseling. Although this is most people's preference, I have had clients who have chosen to come as seldom as every 4 months and others who have come as often as twice a week. It is all a question of your specific needs or wants.
- People often remain in therapy that is not helpful to them, or long after it has ceased to be helpful, or after the returns have greatly diminished. I do not think that this is in the client's best interests. Accordingly I build in periodic evaluations.
- I see termination as an important part of the counseling process. When the time comes for our sessions to end, let's give this part of the process its due. As with any kind of important relationship, we will not be able to get closure with each other unless we take the time to say “good-bye.”
References[Page 286]Agel, J. (ed.). (1973). Rough times. New York: Ballantine.Alcoholics Anonymous. (1939). Alcoholics Anonymous. New York: A. A. World Services.Alcoholics Anonymous. (1957). Alcoholics Anonymous comes of age. New York: Harper & Row.1986). The sacred hoop: Recovering the feminine in American Indian traditions. Boston: Beacon.(American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed.rev.). (DSM III R). Washington, DC: Author.1976). Mortality in depressed patients treated with electroconvulsive therapy and antidepressants. Archives of General Psychiatry, 33 (9), 1029–1037. http://dx.doi.org/10.1001/archpsyc.1976.01770090019001, & (1978). Chemotherapy. In A.Nicholi (ed.). Harvard guide to modern psychiatry (pp. 387–432). Cambridge: Harvard University Press.(1976). The structure of magic (Vol. II). Palo Alto, CA: Science Books., & (1982). Stopping Valium. New York: Warner., , et al. (1979). Female sexual slavery. New York: Avon.(1956). Toward a theory of schizophrenia. Behavioral Science, 1, 251–264. http://dx.doi.org/10.1002/bs.3830010402, , , & (1991). Therapy's double dilemma: Anti-Semitism and misogyny. In R.Siegel & E.Cole (eds.), Jewish women in therapy: Seen but not heard (pp. 19–30). New York: Harrington Park.(1973). Outsiders: Studies in the sociology of deviance. New York: Free Press.(Bell, L. (ed.). (1987). Good girls/bad girls: Sex trade workers and feminists face to face. Toronto: Women's Press.1978). Current approaches to the etiology and treatment of anorexia nervosa. Psychological Bulletin, 85 (3), 595–617. http://dx.doi.org/10.1037/0033-2909.85.3.593(1985). A trust betrayed: The Keegstra affair. Garden City, NY: Doubleday.(1973). Games people play. New York: Ballantine.(1958). The case of Ellen West: An anthropological-clinical study. In R.May, E.Angel, & H.Ellenberger (eds.), Existence: A new dimension in psychiatry and psychology (pp. 237–364). New York: Basic Books. http://dx.doi.org/10.1037/11321-009(1988). Still sane. In B.Burstow & D.Weitz (eds.), Shrink-resistant: The struggle against psychiatry in Canada (pp. 44–51). Vancouver: New Star., & (Boston Lesbian Psychologies Collective (Ed.). (1987). Lesbian psychologies: Explorations and challenges. Chicago: University of Illinois Press.[Page 287]1989, February 15). Sexual involvement with clients. Workshop presentation, Toronto.(1979). Electroshock: Its brain-disabling effects. New York: Springer.(1983). Psychiatric drugs: Hazards to the brain. New York: Springer.(1959). Relative effectiveness of various components of electroconvulsive therapy. Archives of Neurological Psychiatry, 81, 627–635. http://dx.doi.org/10.1001/archneurpsyc.1959.02340170093010, , (1970). Sex role stereotypes and clinical judgments of mental health. Journal of Counselling and Clinical Psychology, 34 (1), 1–7. http://dx.doi.org/10.1037/h0028797, , , et al. (Brown, L., & Root, M. (eds.). (1990). Diversity and complexity in feminist therapy. New York: Hawthorne.1987). When battered women kill. New York: Free Press.(1982). Psychological merger in lesbian couples: A joint ego psychological and systems approach. Family Therapy, 9, 201–207.(1985). Another perspective on merger in lesbian relationships. In L.Rosewater & L.Walker (eds.), Handbook of feminist therapy: Women's issues in psychotherapy (pp. 100–109). New York: Springer.(1981). A critique of Binswanger's existential analysis. Review of Existential Psychology and Psychiatry, 17, 245–291.(1982). Psychiatry's assumptions are biased and unscientific. Phoenix Rising,. 3 (1), 35–38.(1984). Electroshock: A cruel and unusual punishment. Phoenix Rising, 4 (3 and 4), 10A–12A., & (Burstow, B., & Weitz, D. (eds.). (1988). Shrink-resistant: The struggle against psychiatry in Canada. Vancouver: New Star.1969). American drinking practices. New Brunswick, NJ: Rutgers Center of Alcohol Studies., , & (1987). The myth of women's masochism. New York: Signet.(1989). Don't blame mother: Mending the mother-daughter relationship. New York: Harper & Row.(1972). Women and madness. New York: Doubleday.(1978). The reproduction of mothering: Psychoanalysis and the sociology of gender. Berkeley: University of California Press.(1976). Changes in problem drinking over a four-year span. Addictive Behavior, 1, 251–259. http://dx.doi.org/10.1016/0306-4603%2876%2990018-6, & (1980). Deviance and medicalization: From badness to sickness. St. Louis: C. V. Mosby., & (1987). Anorexia and bulimia: The political and the personal. In M.Lawrence (ed.), Fed up and hungry: Women, oppression, and food (pp. 175–192). London: Women's Press.(1980). Special problems of psychotropic drug use among women. Canada's Mental Health, 28 (2), 3–5.(1978). Gyn/ecology: The metaethics of radical feminism. Boston: Beacon.(1963). Normal drinking in recovered alcoholic addicts. Quarterly Journal of Studies of Alcohol. 24, 109–121, 331–332.(1971). Electroconvulsive therapy instruments: Should they be reevaluated?Archives of General Psychiatry, 25, 97–99. http://dx.doi.org/10.1001/archpsyc.1971.01750140001001, , & (1964). The second sex. New York: Knopf.(Disabled Women's Network. (1990). DAWN Toronto brochure. Toronto: Author.Dollars and Sense Editorial Board. (1983). Single parent families. Dollars and Sense, 2, pp. 12–15.1990). Redefining difference: Disabled lesbians resist. In S.Stone (ed.). Lesbians in Canada (pp. 61–72). Toronto: Between the Lines.([Page 288]1974). Woman haling. New York: E. P. Dutton.(1976). Seasonal patterns of suicide, depression, and electroconvulsive therapy. British Journal of Psychiatry, 129, 472–475. http://dx.doi.org/10.1192/bjp.129.5.472, & (1988). Madness and civilization: A history of insanity in the age of reason. New York: Vintage.(1970). Pedagogy of the oppressedNew York: Seabury.(1973a). Introductory lectures on psychoanalysis (J.Strachey, Trans, and Ed.). The Pelican Freud Library, Volume I. New York: Penguin.(1973b). New introductory lectures on psychoanalysis (J.Strachey, Trans and Ed.). The Pelican Freud Library, Volume II. New York: Penguin.(1988). The psychopathology of everyday racism. New York: Harrington.(1961). Asylums: Essays on the social situation of mental patients and other inmates. New York: Anchor.(1985). Feminism and family therapy. Family Process. 24, 31–46. http://dx.doi.org/10.1111/j.1545-5300.1985.00031.x(1988). Feminist family therapy: A casebook. New York: Norton., , , & (1977). Specific antimanic-antidepressant drugs. In M.Jarvis (ed.), Psychopharmacology in the practice of medicine (pp. 257–273). New York: Appleton-Century-Crofts., & (1982). Cultural awareness in the human services. Englewood Cliffs, NJ: Prentice-Hall.(1983). A new approach to women and therapy. New York: McGraw-Hill.(1981). Binge-eating and vomiting: A survey of a college population. Psychological Medicine, 11, 697–706. http://dx.doi.org/10.1017/S0033291700041192, , & (1977). Psychologists’ attitudes and practices regarding erotic and nonerotic physical contact with patients. American Psychologist, 32, 843–849. http://dx.doi.org/10.1037/0003-066X.32.10.843, & (1984). Feminist theory: From margin to center. Boston: South End.(1985). Oak Ridge: A review and an alternative. Report to the Ontario Ministry of Health.(1985). Transforming the body image: Learning to love the body you have. New York: Crossing.(1984). Testimony on electroshock. Phoenix Rising, 4 (3 and 4), 21A–22A.(1980, December 20–27). The Northwick Park ECT trial. Lancet, 9, 1317–1320., , , et al. (1973). A survey of physicians’ attitudes and practices regarding erotic and nonerotic contact with patients. American Journal of Psychiatry, 130 (10), 1077–1081., , & (1988). Surviving sexual violence. Minneapolis: University of Minnesota Press.(1978). Turnabout: Help for a new life. New York: Doubleday.(Koedt, A., Levine, E., & Rapone, A. (eds.). (1973). Radical feminism. New York: Quadrangle.1965). The divided self: An existential study in sanity and madness. New York: Penguin.(1978). A controlled comparison of simulated and real ECT. British Journal of Psychiatry, 113. 514–519. http://dx.doi.org/10.1192/bjp.133.6.514, & (1989). The anorexic experience ((rev. ed.). London: Women's Press.Lobel, K. (ed.). (1986). Naming the violence: Speaking out about lesbian battery. Seattle: Seal Press.1982). Zami: A new spelling of my name. Freedom, CA: Crossing.(1984). Sister outsider. Freedom, CA: Crossing.(1976). Bioenergetics. New York: Penguin.([Page 289]1977). The way to vibrant health: A manual of bioenergetics exercises. New York: Harper & Row.(1982). Feminism, Marxism, method, and the state: An agenda for theory. In N.Keohane, M.Rosaldo, & B.Gelpi (eds.), Feminist theory: A critique of ideology (pp. 1–30). Chicago: University of Chicago Press.(1984). The assault on truth. Toronto: Collier.(1988). Against therapy: Emotional tyranny and the myth of psychological healing. New York: Atheneum.(1942). In , , & . Fatalities following electric convulsive therapy. Transactions of the American Neurological Association, 68, 36–41.(1990). The loony bin trip. New York: Touchstone.(1974). Families and family therapy. Cambridge, MA: Harvard University Press.(1989). You can be free: An easy-to-read handbook for abused women. Seattle: Seal Press., & (Ontario Coalition to Stop Electroshock. (1984). The case against electroshock. Submission to the Ontario government's Electroconvulsive Therapy Review Committee.1979). Fat is a feminist issue. New York: Berkeley.(1988). Hunger strike: The anorectic's struggle as a metaphor for our age. New York: Avon.(1977). Emerging concepts of alcohol dependence. New York: Springer., , & (1986). Sexual intimacy between therapists and patients. New York: Praeger., & (1979). Sexual intimacy in psychology training: Results and implications of a national survey. American Psychologist, 34, 682–689. http://dx.doi.org/10.1037/0003-066X.34.8.682, , & (1986). Sexual attraction to clients: The human therapist and the (sometimes) inhuman training system. American Psychologist, 41 (2), 147–158. http://dx.doi.org/10.1037/0003-066X.41.2.147, , & (1984). Double vision: Nonverbal behavior east and west. In A.Wolfgang (ed.), Nonverbal behavior: Perspectives, applications, intercultural insights (pp. 139–167). New York: Hogrefe.(Redstockings Collective. (1978). Redstockings: Feminist revolution. New York: Random House.1985). Women against violence against women. London: Onlywomen Press., & (1986). Blood, bread, and poetry: Selected prose 1979–1985. New York: W. W. Norton.(1984). Dr. Caligari's psychiatric drugs. Berkeley, CA: Network Against Psychiatric Assault.(1988). Am I a boy or a girl?: Multiple personality and gender differences. Resources for Feminist Research, 17 (2), 41–46.(1973). On being sane in insane places. Science. 179, 250–258. http://dx.doi.org/10.1126/science.179.4070.250(Rosewater, L., & Walker, L. (eds.). (1985). Handbook of feminist therapy: Women's issues in psychotherapy. New York: Springer.Samunda, R., & Wolfgang, A. (eds.). (1985). Intercultural counselling and assessment: Global perspectives. New York: Hogrefe.1981). The invisible alcoholics: Women and alcohol abuse. New York: McGraw-Hill.(1956). Being and nothingness: A phenomenological essay on ontology. New York: Pocket Books.(1961). The age of reason. New York: Penguin.([Page 290]1988). Mental health law in Canada. Toronto: Butterworths., & (1989). Sexual involvement with clients: Intervention and prevention. Minneapolis: Walk-In Counselling Centre., & (1977). Decarceration: Community treatment and the deviant: A radical view. Englewood Cliffs, NJ: Prentice-Hall.(1987). The female malady: Women, madness, and English culture, 1830–1980. New York: Penguin.(1985). Understanding wife assault: A training manual for counsellors and advocates. Toronto: Publications Ontario.(1968). Influences of Cyclert upon memory changes with ECT. American Journal of Psychiatry, 125, 837–840., , & (1975). Women and psychiatry. In D.Smith & S.David (eds.), Women look at psychiatry (pp. 1–17). Vancouver: Press Gang.(1975). Women look at psychiatry. Vancouver: Press Gang., & (1948). Malleus malefìcarum (M.Summers, Trans.). London: Pushkin. (Original work published 1496), & (Statistics Canada. (1988). Canada yearbook 1988. Ottawa: Author.1975). Scripts people live: Transactional analysis of life scripts. New York: Grove.(1979, December 8). Psychiatry's drug addiction. New Republic, pp. 14–18.(1985, May). We'll always be fat but fat will be fit. Ms, pp. 66, 68, 142–144, 146, 154.(1986). Toward an understanding of risk factors for bulimia. American Psychologist, 41 (3), 246–263. http://dx.doi.org/10.1037/0003-066X.41.3.246, , & (1980). Therapy with women: A feminist philosophy of treatment. New York: Springer.(1974). The myth of mental illness: Foundations of a theory of personality conduct. New York: Harper & Row.(1977). The manufacture of madness: A comparative study of the Inquisition and the mental health movement. New York: Harper & Row.(1987). Insanity: The idea and its consequences. New York: John Wiley.(1988). Never too thin. Toronto: Women's Press.(1973). Cognitive functioning and degree of psychosis in schizophrenics given many electroconvulsive treatments. British Journal of Psychiatry, 123, 441–443. http://dx.doi.org/10.1192/bjp.123.4.441, , & (1979). The battered woman. New York: Harper & Row.(1989). Sexual abuse in therapy: A call for participants. WCREC Newsletter, 1 (1), 1.(Wolfgang, A. (ed.). (1984). Nonverbal behavior: Perspectives, applications, intercultural insights. New York: Hogrefe.Intensive treatment of bulimia and body image disturbance. Cincinnati, OH: University of Cincinnati, Psychiatry Department, Eating Disorders Clinic., & (no date).1980). Eating disorders: Obesity and anorexia. In A.Brodsky & R.Hare-Mustin (eds.), Women and psychotherapy: An assessment of research and practice (pp. 134–158). New York: Guilford., & (1986). The Beverly Hills disorder: the mass marketing of anorexia nervosa. International Journal of Eating Disorders, 1 (3), 57–69. http://dx.doi.org/10.1002/1098-108X%28198221%291:3%3C57::AID-EAT2260010307%3E3.0.CO;2-K, & (1975). Banal scripts of women. In C.Steiner (ed.), Scripts people live: Transactional analysis of life scripts (pp. 210–234). New York: Bantam.(1980). Solving problems together. New York: Grove.(
About the Author