The Contributions of Feminist Therapy in Working with Survivors
© Tammie Byram Fowles, MSW, Ph.D.
From: Finding the Forest: Treating Survivors of Trauma Integrating Brief, Holistic, and Narrative Techniques by Tammie Byram Fowles
"Therapy must be geared to helping the client see that she must be her own rescuer - that the power she longs for is not in someone else but in herself."Miriam Greenspan
My work has been significantly influenced by a number of feminist therapists including (but not limited to) Toni Ann Laidlaw, Cheryl Malmo, Joan Turner, Jan Ellis, Diane Lepine, Harriett Goldhor Lerner, Joan Hamerman, Jean Baker Miller, and Miriam Greenspan. I've found that what seems to be the universal core of feminist therapy is that clients and therapists are perceived as equal participants and companions in the therapy endeavor.
In her book, A New Approach to Women and Therapy, (1983) Miriam Greenspan explores the impact of both 'traditional' and 'growth' therapies on women clients and provides a thoughtful and articulate description of feminist therapy in action. Included in her analysis are the following assertions:
The therapist's most essential tool is herself as a person.
On countless occasions during my years as a therapist I've sat speechless with a client, knowing all too well that there are no words that will comfort, justify, or explain the pain away. There have been so many moments when all my years of studying the human psyche and condition still render me helpless to alter a particular circumstance, belief, or feeling. During these times, I am left with only my caring, my understanding, and my faith. While I'm always humbled during these periods, I'm not disempowered. I'm sustained by my belief that in joining another human being in her pain; in being a steady and present witness; in respecting the magnitude and depth of her feelings, while I may not be able to lead her out of her darkness, I can stand beside her.
It's imperative that therapy be demystified from the beginning in order for clients to achieve a sense of their own power in therapy.
I was visiting with a very special friend and fellow therapist one day discussing memorable movies we'd seen over the years when she recounted one scene in particular that had struck her. In this scene, the main character is at a rather large party and runs into her therapist who is also attending. She and her therapist chat for a few moments before parting company. A friend approaches the main character and asks her who the woman was that she had been talking to. The heroine responds, "that's no woman. That's my therapist!"
This scene serves to illustrate the mystique that therapists often have with their clients. While intellectually our client's realize that we, too, are imperfect and possess our own challenges and short-comings, they all too often still manage somehow to perceive us as somewhat larger than life. They often look to us to provide answers, direction, and tell them how to fix some aspect of their lives that they perceive as broken. Our responsibility is not to oblige them (even if we could), but rather to assist them in learning to trust in their own power and wisdom.
Expectations of the therapeutic relationship should be overtly stated and mutually agreed upon.
This doesn't mean that the therapist explains the rules in which the client is expected to adhere to, but rather that the client and therapist explore their expectations of one another and jointly come to an agreement regarding what each person's role and responsibilities will be.
Within every symptom, no matter how painful or problematic, there exists a strength.
Helen Gahagan Douglas in The Eleanor Roosevelt We Remember, reflected, "Would Eleanor Roosevelt have had to struggle to overcome this tortuous shyness if she had grown up secure in the knowledge that she was a beautiful girl? If she hadn't struggled so earnestly, would she have been so sensitive to the struggles of others? Would a beautiful Eleanor Roosevelt have escaped from the confinements of the mid-Victorian drawing room society in which she was reared? Would a beautiful Eleanor Roosevelt have wanted to escape? Would a beautiful Eleanor Roosevelt have had the same need to be, to do?" (Douglas,1963)
Perhaps Eleanor would have still achieved all that she was to accomplish in her lifetime, beautiful or not; however, it's been reported that Eleanor herself confided that her insecurity about her looks often motivated her to work harder.
"In "Legacy of The Heart: The Spiritual Advantages of a Painful Childhood, (Muller, 1992) Wayne Muller notes that those who've suffered in childhood, while bearing painful scars, invariably exhibit exceptional strengths; including remarkable insight, creativity, and a profound inner wisdom. He challenges such individuals not to perceive themselves as broken and damaged, nor to eliminate parts of themselves, but rather to strive to reawaken that which is wise, whole, and strong within them. In working with victims of childhood trauma, he observed that while still haunted by their past, they also develop an acute sensitivity to others as well as a tendency to seek beauty, love and peace. Muller reflects, "seen through this lens, family sorrow is not only a painful wound to be endured, analyzed and treated. It may in fact become a seed that gives birth to our spiritual healing and awakening."
It's been my experience that this is often the case with survivors of childhood trauma. While not all such individuals with whom I've worked possess the characteristics Muller so respectfully describes, I'm so often struck by the strength and depth of survivors. Each client has brought to therapy unique skills and abilities fostered to a significant degree by the very pain she sought to escape.
Muller assures the reader that suffering and pain are not exceptions to the human condition. Instead, they are inevitable threads in the tapestry of life. He cautions us not to become trapped by memories of childhood suffering, thus allowing the suffering to become the one thing that is the truest about our lives. He also points out that many of us would prefer to explain our hurt rather than feel it. He advises that we accept the pain we are given and identify the lessons it will inevitably teach if we only look and listen, particularly to the wisdom contained within the depths of our own souls.
While I don't under any circumstances wish to minimize the pain of another, nor suggest that he or she be grateful for suffering, I do believe that in order to empower another, it's important that the value of all experiences in a persons life be acknowledged. While there are many experiences I would have adamantly refused to struggle with in my own life had I been given the choice, to deny the value of the message in spite of how painful the lesson or unwelcome the messenger, only serves to add insult to injury. If one has no choice but to toil on a particular path, at the very least - claim every available compensation along the way. "
In the introduction of Healing Voices: Feminist Approaches To Therapy With Women, therapists, Tony Ann Laidlaw and Cheryl Malmo, (1990) assert that feminist therapists welcome their clients' inquiries about the therapist's values, methods and orientations. They also:
|At appropriate times share about their own experiences in order to assist their clients;|
|Encourage their clients to take an active part in making decisions about the course of therapy;|
|Allow the client final say over the content of a session, the choice of method, and the pacing of therapeutic work.|
The degree of therapist self-disclosure is an area in which a wide range of opinions exist. For some, personal information should not be provided by the therapist to the client in almost any circumstances. Others firmly maintain that some personal information is not only acceptable at times, but advisable. I find myself agreeing with the latter. In order for a true therapeutic relationship to develop, in my opinion, therapist and client generally must achieve some level of intimacy. I don't believe that such intimacy can exist without the therapist sharing some limited aspects of his or her own life at times. Carl Rogers urged therapists to be genuine. How can one be genuine when conscientiously hiding all personal aspects of oneself? When a client asks if I am frustrated with them and I say that I am not (after all, therapists should never experience anger toward a client) when in fact I am frustrated, I'm not only being disrespectful, I am inflicting damage. When a client observes that I look like I have had a hard day, and I deny that I have, when in fact, the day has been extremely difficult, I have become a liar to someone whose trust is extremely important. This doesn't mean that I should proceed to describe my day to the client, but that I merely acknowledge that the client's observation is a perceptive and accurate one.
Lenore E. A. Walker, in her piece, "A feminist Therapist Views The Case" from "Women as Therapists, (1990) provides an overview of the guiding principles of feminist therapy, including:
|Egalitarian relationships between clients and therapists serve as a model for women to take personal responsibility to develop egalitarian relationships with others instead of the more traditional passive, dependent female role. While it is excepted that the therapist knows more in terms of psychology, the client knows herself better. That knowledge is as critical as the therapist's skills to make the therapy relationship succeed.|
|The feminist therapist focuses on the enhancement of women's strengths rather than remediation of their weaknesses.|
|The feminist model is nonpathology-oriented and non-victim blaming.|
|Feminist therapists accept and validate their clients feelings. They are also more self-disclosing than other therapists as they remove the we-they barrier between women therapists and their clients. This limited reciprocity is a feminist goal that is believed to enhance the relationship.|
Milton Erikson spoke often of the importance of joining with our clients. It's difficult from my perspective to accomplish this if we are placed somewhere above our clients and often out of their reach. To truly understand another, we must be willing to get close enough to really see; we miss much when keeping back a safe distance. Perhaps, in part, the distance is recommended because it is not possible to observe imperfections and vulnerabilities close up without risking our own being exposed from time to time. Therapists need not be perfect in order to be effective; in fact, they don't even need to be smarter.
Still, as much as I strive towards equality in my work with clients, realistically, the relationship inherently possesses certain characteristics that prevent it from being firmly based in equality. As Deborah Lot points out in her wonderful book, In Session: The Bond Between Women and Their Therapists, (1999) when describing her own experiences as well as those of other women in therapy, "We found the very structure of the therapeutic relationship problematic. It was inherently unequal: We needed our therapists more than they needed us, they were much more important to us than we were to them, and the whole alliance was sustained by our paying considerable fees."
No matter how much we might genuinely wish it were not so, there is a very real power differential that exists in therapy. To deny it doesn't make it go away. What becomes absolutely essential is that we use our power respectfully and responsibly.
Janet O'Hare and Katy Taylor in the book, Women Changing Therapy, (Robbins and Siegel, 1985) provide a number of insights and recommendations for working with victims of sexual abuse including:
A controlling therapist is too much like the abuser to be helpful.
We often threaten survivors when we assume control of the therapeutic process. Many Survivors have been told what to do for much of their lives, and voluntarily surrendering now to the mandates of yet another feels all too often uncomfortably familiar. Survivors need to be empowered to act in their own best interests, to make their own decisions, and communicate their needs effectively. Attempting to acquire these abilities in the presence of a controlling "expert" is hardly conducive to producing these results.
The client must be encouraged to recognize her own strengths.
Often survivors of abuse are acutely aware of their inadequacies and have little faith in their ability to heal. When fostering hope it's important that the therapist focus on and strive to develop strengths and resources rather than honing in on and seeking to remediate inadequacies. In fact, many of the tendencies that survivors (and some therapists) perceive as weaknesses are in fact just the opposite - assets to be recognized and appreciated.
The therapist must honor the client's unique healing process and allow the healing to proceed at the client's own pace.
Not being controlling doesn't necessarily translate into being non-directive. In operating from a brief treatment perspective it's absolute necessary that the therapist remain active and willing to provide direction. Still, from my perspective, therapists should serve as guides and facilitators when working with survivors. When one engages the services of a guide while embarking on a journey, it's ultimately the role of the one to be guided to determine the destination, the limits of the distance to be traveled, the stops along the way, and the overall pace. It is the guides responsibility to meet the objectives of the guided.
Broedy, Claire (1984). Women therapists working with women. New York: Springer.
Collier, Helen (1982). Counseling Women: A guide for therapists. New York: The Free Press.
Douglas, Helen Gahagan (1963). The Eleanor Roosevelt We Remember. New York: Hill & Wang.
Duerk, Judith (1989). Circles of stones: Woman's journey to herself. San Diego, CA: Lura Media Press.
Greenspan, M. (1983). A New Approach to Women and Therapy: How psychotherapy fails womenóand what they can do about It. New York: McGraw Hill Companies.
Herman, Judith (1992). Trauma and Recovery. New York: Basic Books.
Laidlaw, Toni Ann and Cheryl Malmo (1990). Healing Voices: Feminist approaches to therapy with women. San Francisco: Jossey-Bass.
Lott, Deborah A. (1999). In Session: The bond between women and their therapists. New York: W. H. Freeman.
Miller, Jean Baker (1976). Toward a new psychology of women. Boston: Beacon Press.
Muller, Wayne (1992). Legacy of the Heart: The spiritual advantages of a painful childhood. New York: Fireside.
Robbins, Joan and Rachel Siegel, eds. (1985). Women changing therapy: New assessments, values, and strategies in feminist therapy. New York: Harrington Park Press, Inc.
Rogers, Annie (1995). A Shining Affliction: a story of harm and healing in psychotherapy. New York: Viking.
Walker, Lenore (1990) A Feminist Therapist Views the Case. In Dorothy W. Cantor (Ed.), Women as Therapists, (pp. 78-79). New York: Springer Publishing Company.
Worell, Judith (1992). Feminist Perspectives in Therapy: An empowerment model for women. New York: Wiley.
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