THE POLITICS OF GENDER IN FAMILY THERAPY

Journal of Marital and Family Therapy 1997, Vol. 23, NO. 4,421-437

THE POLITICS OF GENDER IN FAMILY THERAPY

Carmen Knudson-Martin Montana State University

This article provides an overview of the political implications of various approaches to gender within the clinical literature. It emphasizes the process of therapy within the social context of gender relations and identijies the political consequences of various clinical responses. Issues surrounding the appropriate role and stance of therapists relative to gender are identijied, ethical issues such as neutrality and client welfare are re-examined, and suggestions for practice are addressed.

This article addresses political questions associated with gender in the practice of marital and family therapy. In this paper, “political” refers to those processes maintaining or changing power relations within any social or interpersonal system. To examine the political aspects of an issue is to ask whose interests are served by a particular set of social relationships and practices, how our assumptions, beliefs, and values reflect and support particular social structures, and how our theories and processes for scientific inquiry are embedded within or are part of political processes. It is also to examine how professional decisions and interventions affect political processes. Until recently it has been unfashion- able, perhaps even unethical, to openly acknowledge political agendas within our clinical practices. Yet, what we do as marriage and family therapists is not separate from the ongoing power relations between social groups (e.g., races, classes, genders, etc.).

Because politics are part of ongoing personal and social relationships they are often difficult to see. For example, though gender, a social category ascribed at birth (Lindsey, 1997), affects nearly every aspect of our lives and results in different expectations, roles, behaviors, and status for women and men, the politics associated with gender statuses are often beneath the surface and not openly addressed. This is true for therapists as well as their clients. The purpose of this paper is to make visible the political implications of various approaches to gender within family therapy and to examine the ethical issues raised by them. As agents unavoidably engaged in the political arena of social change we must consider how our theories and strategies support one agenda or social structure or another and we must make conscious decisions about them. Basic ethical principles such as neutrality and client welfare also require re-examination and redefinition.

Portions of this paper were presented at the 1996 annual meeting of the National Council on Family Relations, Kansas City, MO.

Carmen Knudson-Martin, PhD, is an Associate Professor and Program Leader of Marriage and Fam- ily Therapy, Department of Health and Human Development, Herrick Hall, Montana State Uni- versity, Bozeman, MT 59717.

October 1997 JOURNAL OF MARITAL AND FAMILY THERAPY 421

GENDER STUDY AS POLITICAL ENTERPRISE

The recognition of gender as a key component ordering family life has had a major political impact on the field of family therapy. It has increased attention to the experiences of women, raised areas for study that had previously been ignored or deemed unimportant, and challenged many established clinical practices. It has caused us to examine ways that our practices and theories, developed within an androcentric context, have been biased against women, and it has stimulated the development of new theories and practices that do not disadvantage women. Yet, a recent study (Leslie & Clossick, 1996) found that training in gender did not necessarily result in practices that discriminated less against women; that is, not all approaches to gender had the same political impact.

One of the most debated and potentially political topics within gender studies is how to define the nature and extent of gender differences. While most scholars agree that there is a large overlap between the traits, skills, and abilities of men and women and that variations within each gender are considerable (Lindsey, 1997; Lips, 1997), the explanatory models used to guide research questions and interpret the findings have different political consequences. For example, models that emphasize the biological elements differentiating the sexes without also taking into account institutionalized power differences between the genders almost inevitably transform male-female differences into female disadvantage (Bem, 1993). Similarly, “gender-neutral” models that minimize, discount, or individualize gender differences also support the status quo by ignoring the power of the social order to affect individual experience according to gender. In contrast, models that critically examine the social context tend to promote social change by emphasizing gender inequalities and the limitations accompanying culturally reinforced gender stereotypes.

Conclusions about appropriate clinical responses to the research and discourse regarding gender differences differ according to which literature one reads and which political agenda one supports. To help marital and family therapists sort through this dilemma, the first part of this paper examines how contradictory forces within the social context affect gender and power relations in ways that both support and inhibit change toward gender equality. The second part looks at how approaches to gender and power issues differ within the clinical literature and have different political implications. The third part outlines ethical issues associated with the political dimensions of practice and suggests ways to respond to them.

THE SOCIAL CONTEXT OF GENDER RELATIONS AND CLINICAL PRACTICE

There are three ways the social context of gender relationships is important to the politics of gender in therapy. (1) Most clients are unaware of the ways social conditions and collective images of appropriate behavior for men and women influence the patterns of their lives. They experience themselves and their partners as making their own unique and personal decisions and creating their own successes and failures, joys and disappointments. (2) The social influences on gender patterns and relationships are contradictory and confus- ing. There are social factors that encourage gender equality and social factors that inhibit it, resulting in hidden gender dilemmas, which women and men must in some way resolve. (3) Clinical symptoms and relationship issues may be related to the tension stemming from contradictory social forces, yet therapists may be reluctant to raise political issues that clients themselves do not see or consider a problem.

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Contradictory Social Factors On the one hand, collective relationship ideals in the United States have shifted toward

an increasing preference for gender equality, particularly within intimate relationships (Fleming, 1988; Rossi, 1996). Laws that used to institutionalize male dominance are being changed. Men and women enter relationships expecting to be equal partners and expecting that their relationships will provide emotional closeness and intimacy. Attitudes regarding employment outside the home and the division of labor within the family are more egalitarian, especially among women, younger persons, urban residents, and higher socio-economic groups (Keith & Schafer, 1991).

Changes in the economic environment have also promoted new gender definitions and expectations. Today female labor force participation is the norm. Economic conditions and social expectations encourage both mothers and fathers to work outside the home. Since working for wages represents a change from traditional constructions of the female role, working outside the home requires behavior change for women, shifting what it means to be female. It also redifines masculinity, though how it does depends to a large extent on what happens within couple relationships. Thus, changing gender ideals and labor force participation challenge the traditional construction of gender, encouraging women and men to devise new gender patterns.

On the other hand, there continue to be social factors that make the achievement of gender equality difficult. Traditional gender socialization continues to be a strong force in the construction of gender relationships (Horst & Doherty, 1995). Individuals absorb a set of expectations early in life, which structures their social experience according to gender and which women and men bring into their day-to-day interactions without being fully aware that they are doing so. As a result of this socialization, women tend to enter relationships more oriented toward maintaining the relationship and are, therefore, more likely to make accommodations and to attend to their partners’ needs. Men are likely to have less perceived need for the relationship, which gives them greater power to define the relationship in a way that serves their needs (Zimmerman & Dickerson, 1994). Gender socialization also teaches people that women and men are responsible for different tasks and that women’s tasks are less important than men’s (Chafetz, 1988; Crosby, 1991).

Because we are all socialized to some extent within a male-dominant social context in which women hold lower status, the assumptions underlying and maintaining gender inequalities often feel natural and are difficult to see. Yet, the economic environment continues to support a division of labor based on gender and offers different economic opportuni- ties to women and men (Coleman, 1988; Davis, 1988; Moen, 1992; Stobber, 1988). Women usually earn less than men-even when they do the same work-and carry these economic disadvantages into family life. Thus, women and men seldom enter relationships with equal power, though that is often their ideal.

Socialized gender differences combine with unequal power to reinforce traditional gender patterns even though the ideals and circumstances of people’s lives may require changes. These contradictory forces create tension, i.e., gender dilemmas, which must be resolved within the day-to-day course of living. However, since gender issues tend to be masked or beyond awareness, these tensions are likely to be expressed in other ways such as fatigue, stress, relationship conflict, depression, or low self-esteem. For example, Mary and John sought relationship therapy because they are having frequent arguments. Mary is very angry that John does not spend more time with her, and she wants “more communication.”


John is confused. He reports loving his wife and making efforts to be with her, but finds her demands for togetherness irritating. Though they want a close, intimate relationship between equals, they are unaware of the ways in which their responses to each other and the structure of their relationship have been influenced by traditional gender and power differences, making achievement of their goal difficult. Similarly, Susan, who called for help because she “is about to fall apart,” is also unaware that her depression and anxiety are in large part related to her conflicting role expectations. Instead, she describes herself has “having low self-esteem and feeling incompetent.”

Dealing with Gender Dilemmas Previous studies have found that most people avoid dealing directly with gender and

power issues (Hochschild, 1989; Hood, 1993; Stelmack, 1994; Whitbourne & Ebmeyer, 1990; Zvonkovic et al., 1996). Only when people consciously negotiate their relationship patterns is it likely that they will devise patterns less influenced by traditional gender training (Blaisure & Allen, 1995; Mahoney & Knudson-Martin, 1996; Zvonkovic et al., 1996). Even then, gendered ways of perceiving and responding tend to limit their ability to achieve the egalitarian and intimate relationships they seek. As Horst and Doherty (1995) have described, traditionally gendered scripts tend to discourage the sharing of power, and without structural relationship equality intimacy is unlikely.

Tension from the conflicting pulls of contradictory social forces affect individuals and relationships at multiple levels and in many ways. At the relationship level, men and women tend to give each other mixed messages. There is often disparity between beliefs about gender relationships and behavior (Blaisure & Allen, 1995). Decisions about work and family life may be based on a set of values and beliefs that conflicts with values of equality, partnership, and intimacy. Women and men may hold themselves and each other to both the traditional and new standards, falling short of each. At the individual level, women need their experiences to be valued, judged, and understood within their own terms, yet also need to gain power within the larger social and economic context. Men, too, need their experiences understood within their own framework, yet may also need to examine ways in which masculine socialization toward independence and control can be harmful to relationships (Meth, 1990). Being unaware of the internal and relational conflicts fostered by contradictory social forces, people frequently respond to the stresses in their lives in ways that leave in place the unexamined inequalities, but maintain relationship stability and, politically, do not threaten the status quo (Hochschild, 1989; Mahoney & Knudson-Martin, 1996; Zvonkovic et al., 1996). Unfortunately, these responses create a myth of equality, but leave in place the tensions, symptoms, and disappointments that tend to accompany gender inequality.

The family practitioner must, then, decide how to approach gender issues. To what extent will he or she recognize and validate the different developmental experiences of women and men and help them to understand each other, reducing instability and conflict? When will he or she raise issues of inequality or power, potentially challenging relationship structure and internalized, gendered ways of seeing and responding to the world and to each other? Are gendered characteristics and identities the property of the individual or are they part of a process that is socially maintained and constructed? How would the practitioner decide if his or her approach better serves one gender than the other?

APPROACHES TO GENDER IN THE LITERATURE

The political dimensions of approaches to gender in the literature vary primarily according to whether existing gender differences are reinforced or challenged. Some ap-


proaches emphasize understanding the biological, psychological, and interactional differences between men and women and using that information to more effectively relate to each gender and resolve communication differences. Other approaches focus primarily on structural power differences between men and women; these approaches tend to emphasize the social and political context of gender relations and see gender differences as reflections of social inequalities between women and men that need to be changed. A third, more integrative approach is to focus on the ongoing interactional processes between men and women in which existing gender and power differences are either reinforced or challenged.

Focusing on Men and Women as Different Cultures A culture is a group of people who share particular interpretations of the world because

shared circumstances lend a degree of homogeneity to their perspectives (Pare, 1996). The gender as culture approach focuses on how collective socialization experiences for males and females are internalized within individual identity structures. According to this view, women and men come to see the world through different lenses and develop different styles of relating, primarily because of differences in separation-individuation processes. Though the degree to which these kinds of differences are “real” or perceptual and their relevance to other ethnic and socioeconomic groups continue to be questioned (e.g., Pratt, Panck, & Hunsberger, 1990; Skoe & Diessner, 1994; Walker, 1989), this strain of literature has re- sulted in the introduction of a female psychology that emphasizes and values traits com- monly associated with femininity and has popularized a view that misunderstandings between women and men are common because they “come from different places.”

Among the first to articulate different processes for male and female identity development was Margaret Mead (1949), who observed that learning to be a boy involves having to do things to transcend being female. Later, Nancy Chodorow (1978) suggested that men and women develop different internal psychic structures because parenting of both girls and boys is usually done by mothers. The most influential contributions to the gender as culture perspective, however, have been studies focusing on processes through which women define and construct a relational, connected sense of self (Belenky, Clinchy, Goldberger, & Tarule, 1986; Gilligan, 1982; Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Josselson, 1987; Miller, 1976). These authors suggest that developing a relational self requires a complex integration of self with other based on empathy, caring, and interdependence. They contrast this self construction to a more masculine one based on independence, justice, and power. Similar male-female differences in conversation patterns have been identified by the sociolinguist Deborah Tannen (1990).

The practical implications and political consequences of the gender as culture approach depend on whether the practitioner validates or challenges the different cultures. Though Chodorow (1978) argued that we need to change the social conditions that perpetuate these gender differences, most cultural feminists advocate reconstructing what constitutes healthy development by developing new models for thinking about and conceptualizing mental health and relational issues that emphasize and utilize the positive aspects of qualities, such as connection and caring, associated with women (Jordan et al., 1991; Worell, 1996). The most change-oriented seek to replace previous “separation-individuation” models with newer “connection-mutuality” models. Bergman and Surrey (1992), for example, frame their work with both women and men within a relational paradigm.

For many clinicians, however, the challenge is how to validate and interpret the experiences of both genders so that clinical interventions are more effective and “gender appro-


priate.” The goal here is to include female experiences in reformulations of developmental and clincial theories and to re-examine constructions of both masculinity and femininity (Betcher & Pollack, 1993; Boss & Weiner, 1988; Knudson-Martin, 1994, 1996; Luepnitz, 1988; Meth, 1990). Efforts are made to appreciate, accept, and value both masculine and feminine experiences, and neither is held out as “better” or “more mature.” These therapists attempt to open awareness that appropriate, healthy behavior does not automatically approximate traditionally “male” behavior (i.e., separated, individuated, less influenced by others) and help to make visible the limitations of each gender’s typical ways of relating (i.e., too much focus on others for women, too much emphasis on independence for men).

For example, such a therapist might explicitly frame Mary’s desire for togetherness as positive, rather than as a sign of poor differentiation (as a non-gender-sensitive approach might), and challenge the idea that John’s autonomy and independence are more mature (and therefore “better”) than Mary’s desire for togetherness. If he or she encouraged John to be more attentive to Mary’s needs, the political impact of the therapist’s actions would be toward realigning or challenging social inequalities between men and women. Such action would require a deliberate departure from more prevalent “separation-individuation” approaches that tend to equate healthy relationship functioning with the autonomy of its members (Fowers & Richardson, 1996; Knudson-Martin, 1996).

More often, however, gender culture approaches are less change-oriented. In this case the differences between men and women are not considered inherently problematic. The focus is not on changing the differences but on how to appreciate and work with them. According to this strand of literature, communication differences and conflicts are inevi- table because women and men hold different world views. Thus, the goals of practice are to understand and validate both orientations, so as to work more effectively with each gender and to help men and women to understand each other and communicate more effectively. Heterosexual partners can be encouraged to be more accepting of each other, and behavior that feels hurtful can be reframed as misunderstanding.

For example, during the course of therapy Mary and John could be helped to understand their behavior and relationship struggles as the result of different orientations to relationships typical of their genders (i.e., she seeks togetherness and he seeks independence) without attempting to challenge these orientations. The outcome of this therapy would likely be that the relationship patterns change very little. Mary still spends most of her day alone, taking care of their home and child. The amount and type of time the couple spends together is still largely determined by John’s schedule and needs. But Mary now has a different way to think about their relationship, is less angry, and the couple reports more relationship satisfaction. This outcome, which serves to maintain the existing status quo between women and men, would not be an unusual for therapy that focuses on reducing misunderstandings and communication impasses by working with gender differences (Hawkins et al., 1994; Knudson-Martin & Mahoney, 1996).

A problem with cultural differences approaches to gender is that collective social influences tend to be reduced to the level of the individual, confounding individual and social processes and making it difficult to address their interaction. Individual gender-influenced identities can seem predetermined by the social context and rather inflexible, making it easy to perpetuate stereotypes and difficult to think and work in ways that do not reinforce existing power relations between women and men. The gender as culture approach can challenge the existing merit or worth apportioned between traditionally masculine and feminine styles of thinking, being, and relating, and if men and women relate from positions of


more equal value as a result, the outcome may be political change. However, this approach seldom directly addresses issues of power or how stereotypical differences between women and men can reinforce existing gender inequalities in the larger social context.

Focusing on Power Differences This perspective sees power as the “true” difference between men and women. Ac-

cording to this view, gender differences such as those described above are reflections of unequal power. If women seek more connection and attend more to others, it is because they hold lower status within society. This strain of literature has roots in the feminist social construction of reality literature focusing on how collective knowledge bases are constructed and maintained (e.g., Flax, 1983; Harding, 1983; Hartman & Messer-Davidow, 1991; Hubbard, 1983). These authors revealed ways that even scientific knowledge is shaped by the beliefs, values, and ideals of those who have the power to define what is “real” and what is “true.” From this perspective women must function in a male-defined world and learn that their experiences are not real or are wrong. To be female, according to Kaschak (1992), is to be second-class, invisible, or defined by illusion.

Gender theorists who focus on power differences suggest that male separateness is an illusion that ignores female supports. They emphasize that women and men are both socialized in ways that maintain the status quo. For example, women seek to maintain relationships at the expense of their own autonomy and men learn that power or control over women is central to the definition of masculinity. Family therapists such as Judith Meyers Avis (1985), Virginia Goldner (1985), Rachel Hare-Mustin (1987), and Thelma Goodrich (1991) have argued that culturally defined differences in power between men and women are central to expectations and behavior within relationships and our theories about them. For example, femininity is defined such that powerlessness is appealing and women believe they are completed by men and expect to attend to them.

Practicing from the power differences perspective tends to be a consciously political enterprise with deliberate attention to correcting inequalities between women and men and to addressing ways that family life can be destructive to women physically, emotionally, and economically. From this perspective the goal in therapy is to create new, more equal relationship structures. Attention to biological and psychological “gender differences” are viewed as counterproductive since they reinforce existing power differences, therefore serving more the interests of men than of women.

In the case of Mary and John, the therapist would interpret Mary’s anger in context of a power imbalance in the couple’s relationship. He or she would help John and Mary to examine and change those behaviors and patterns that foster relationship inequality at Mary’s expense, such as Mary’s focus on John’s needs, their automatic acceptance of traditional gender roles, and John’s expectation that his work and school needs take priority. Mary would be encouraged to increase her ability to define the relationship in a way that supports her well-being, and John would be helped to become more comfortable with less power and to be more attentive and responsive to Mary.

The power differences approach to gender in therapy focuses on the ways the social context shapes lives. Politically it is oriented toward changing the status quo. One of its limits, however, is that like the cultural differences approach, the power differences approach tends to be deterministic and linear (i.e, power differences cause individual behavior), making it easy to lose sight of the contributions of individual processes and the possi- bility of individual differences and personal choice. Another problem is that this approach


can result in a victim-aggressor construction of gender relationships. This can make it difficult to address reciprocal aspects of masculine and feminine roles and identities and can limit options available to clients and their therapists.

Gender as Process For many years theorists and practitioners whose focus and interest was on the relation-

ship system tended to ignore the influence of gender. Within the last decade awareness regarding the centrality of gender to family processes has been increasingly recognized, yet often remains not well-integrated into ongoing research and systemic theory (Ferree, 1990; Thompson &Walker, 1995). Within family therapy much of this awareness was made visible by Walters, Carter, Papp, and Silverstein (1988) and by McGoldrick, Anderson, and Walsh (1989). Helpful to the integration of gender within family theory is a process view of gender, emphasizing both the institutional and interactional levels of analysis, which explains how gender is created in the day-to-day social relations between women and men (Ferree, 1990; Risman & Schwartz, 1989). Such a view allows a therapist to validate clients’ experiences by recognizing and understanding developmental differences between males and females, yet to also acknowledge the social context in which such differences occur.

The gender as process perspective defines gender as a part of interpersonal processes. It focuses on the interactional context in which people experience being male or female and how existing, ongoing relationship patterns construct and maintain gender (Knudson-Mar- tin, 1995). Since the experience of gender always occurs in relation to others, the psychological and power aspects of gender roles and identities are not merely properties of the individual, but are integral to their overall system of relating. Since they exist reciprocally, masculinity and femininity cannot be understood apart from each other or the power structure within which they are embedded.

Viewing gender as a process lends itself well to working within a family systems framework, but requires making the gender construction processes visible. While family systems therapists are used to considering individual traits and identities to be maintained or changed within ongoing, day-to-day relationship patterns, many do not automatically think of these processes as also created by and maintaining existing gender patterns. Yet, internalized constructions of gender identities and social structures that accord more power to men typi- cally serve as “metarules” defining behavior within the relationship (Knudson-Martin, 1995). When rules such as “Mary notices John’s stress and tries to attend to him” or “John responds to Mary’s attention with irritation and distance” are made visible and understood within their gender context, constructing new gender patterns is more possible.

A process view of gender would see John and Mary struggling within relationship patterns that were influenced by, yet reinforce and contribute to, gendered individual identity constructions and societal power differences between men and women. The therapist would believe that it was important to understand the clients’ issues within both the cultural differences framework and the power differences framework, but would be most interested in the unique way Mary and John construct gender between them and would expect that their established gender patterns be somewhat flexible and open to change. Thus, Mary’s anger would be seen as reflecting her disappointment that the relationship is not satisfying her needs for connection and as a reaction to established relationship patterns in which Mary has shaped her life around John’s and he has expected such accommodation.

To understand the political implications of this therapy, however, the therapist must also consider how Mary and John’s responses to each other are part of larger social patterns.


For example, Mary’s reluctance to allow John to define the amount and types of couple involvement is likely influenced by contemporary societal ideals promoting equality and intimacy among partners. How they resolve their relationship dilemma will contribute to or inhibit social change in gender equality. From a gender as process perspective, the marital conflict is a potential challenge to existing gender relations. How the therapist responds and what happens next for the couple has political consequences; that is, the resulting relationship structure will either reinforce previous gender differences and inequalities or move toward more equality and shift what it means to be male or female in relation to the other.

Let us imagine that in the course of the therapy the therapist attempts to help the couple consider options different from their existing pattern (e.g, Mary feels ignored, gets angry, and insists on John’s involvement, to which John responds by feeling irritated and distanc- ing, making Mary feel more ignored). Politically, this is a pattern in which Mary is not able to define the relationship in a way that serves her needs. If, during the course of therapy, Mary learns that John finds her demands irritating and backs off, making John less irritated and more comfortable with his space, though her anger has been mollified and the relationship is stabilized, the gender construction process has actually intensified a gender experience in which John’s needs are more important than Mary’s. A therapist who does not want to unwittingly collude in recreating gender inequality would point out to the couple that they made the relationship more comfortable in a way that required that Mary give up her need, making the gender construction process visible. If, during the course of therapy, John was challenged to find ways to respond to Mary on her terms, the therapy would help to create new, more equal gender constructions.

An advantage of the process view of gender is that it encourages a more unique and fluid view of gender relationships. Gender differences and power differences are recognized as part of relatively stable, socially influenced patterns of behavior, but with each interaction new ways of relating are potentially possible. Since gender is considered to reside within or be experienced within the relationship, how individuals experience themselves as women and men may change. A potential problem in the process view of gender is that the therapist might focus primarily on the dynamics of the couple and ignore the social context in which the relationship occurs or minimize the role of gender. Yet, since the ongoing interaction patterns either reinforce or change existing gender patterns within their relationship and within the larger social context, what happens in therapy is political whether consciously so or not.

ETHICAL DILEMMAS OF POLITICAL INTERVENTIONS

If we accept Goldner’s (1985) suggestion that family therapists view gender as a central, organizing force shaping family life, gender is not merely one of many potential “outside influences” on a particular situation or problem but is intrinsic to the very nature of the relationship. Just as one cannot not communicate, one also cannot not do gender. To not place the symptom or problem in its gender context is as incomplete as not placing it within its systemic, relational context. The meaning of the client’s behavior and experience does not make sense unless understood within its gender framework. Therapists who accept this premise, therefore, find themselves in the position of having no choice but to think about and respond to clinical problems in relation to gender. The question is not whether to address gender, but how.


If gendered beliefs, ideals, and behaviors were the result of conscious choice, the associated ethical issues would be mostly about balancing client values regarding gender and power against one’s own. What makes dealing with the politics of gender more difficult is that the gender and power aspects of issues are usually invisible to clients and not likely to be raised by them. Therapists must decide if and how to respond to the hidden gender implications of a case. The ethical issues involved are complex, sometimes contradictory, and part of larger debates regarding the therapist’s use of power and self, neutrality, and the moral consequences of our therapeutic stance for clients and for the larger society.

The Social Context of the Therapeutic Role Clients seek the help of a therapist. Therapy begins, therefore, with a hierarchial premise.

Clients and therapists alike hope the therapist or the therapeutic process will have some power to improve the clients’ lives or help them make the changes they desire. How therapists should handle the power implicitly associated with their roles is currently a subject of intense interest within family therapy (Amundson, Stewart, &Valentine, 1993; Fine &Turner, 1991; Flemons, Green, & Rambo, 1996; Pare, 1996; Zimmerman & Dickerson, 1994). At issue are political questions: Who defines what is real? Who should define the problem and the direction of the therapeutic conversation? To what extent does the professional hold a privileged position relative to the client, allowing the therapist’s voice more power? As therapists attempt to address these issues they necessarily also define the nature of the therapist’s responsibility, determining some kind of resolution between respecting and trusting the client’s power to define his or her own “truth” and the therapist’s responsibility to hold and use professional knowledge in the service of clients.

Frequently, the “politics of therapy” debate is limited to the relative power between client and therapist as if therapy were occurring in an otherwise neutral context. Yet the constructions and meanings clients bring to the therapy room are not neutral. They are influenced by the social and political contexts within which they are situated (Knudson- Martin & Mahoney, 1996; Pare, 1996; Zimmerman & Dickerson, 1994). Depending on the number of contexts within which a particular client is embedded, he or she may hold many different cultural selves, not all of which may have equal voice or expression (Pare, 1996; Penn & Frankfurt, 1994). The individual stories of women and other subordinate groups include self perceptions based on the dominant culture as well as their own. Thus, not all persons are equally free to define or re-author their own stories and not all selves have voice. Thus, responding to the political consequences of gender in therapy requires some way to address the therapist’s role in relation to both the client and the larger context. The therapist becomes a broker or sorts, standing between or bringing together many different voices and cultures, even if the client is only one individual. Ethical decision-making requires determining how to deal with silent but influential gender voices.

The Power to Define the Conversation One of the major sources of power available to the therapist is the ability to direct the

therapeutic conversation. Therapists respond to some of the client’s statements and not to others. The therapist may introduce hidden, cultural voices. These are political positions, determining which voices get heard and whether new ones are introduced into the conversation. If the therapist elects to introduce only those voices already visible to the client, the therapy will tend to support the status quo. If the therapist raises gender issues visible to him or her, the political consequences depend on how gender is framed within the therapy.


Talking about gender from the cultural differences perspective suggests that the differences between women and men are natural or to be expected and encourages clients to respect and understand each other within that frame. This way of talking tends to be oriented toward stability and first-order change, i.e., helping people develop better ways to deal with their situation without questioning or challenging their basic relationship structure. But this depends on the extent to which the therapeutic conversation encourages clients to question their gendered behavior and to think and behave in less typical ways.

Talking about problems or issues from the power differences perspective encourages clients to look at the structural conditions within their relationships. Clients may see inequalities they did not previously see or be motivated to take actions that could disrupt the stability of their relationships. The therapist may be faced with how to address the tension between the clients’ desire for relationship stability and the political implications of not helping them examine the ways unequal relationship patterns may be serving the well- being of one partner at the expense of the other. Revealing hidden inequalities can open new options and relationship possibilities for clients, but also opens potential areas for conflict and challenges the status quo.

Talking about gender as a process avoids some of the problems associated with the other two approaches. The therapist can take the stance of a curious observer rather than an interpreter. The focus can be on what is happening within relationships, how one person’s behavior is connected to another’s and to the larger social context, and how the patterns are working for the clients. Discussion of the outcomes or consequences of these processes for each gender can be facilitated. In this case, the therapist is not taking an expert position by labeling the problem, but does become a part of the gender construction process. His or her observations and contributions are influenced not only by what the clients say and do but by what the therapist knows, says, and does. Thus, though the therapist’s role may be more collaborative, it is not really neutral (Becvar & Becvar, 1996).

Neutrality in a Non-neutral World In family therapy, as in nearly all mental health disciplines, therapist neutrality and

objectivity are time-honored principles. Though many therapists today question our ability to achieve either, being able to differentiate our own agendas from our clients’ is still an important ethical issue and being as neutral and objective as possible is still important to many. In working toward this end and in an effort to avoid imposing our own partial, subjective reality on clients, we may easily confuse neutrality with passivity and silence with objectivity. However, maintaining a neutral position in a politically non-neutral world must be a deliberate and active endeavor. If neutrality is defined as using theories and practices that support equally both genders, neutrality requires active involvement and participation on the part of the therapist. To be neutral may therefore require making visible the gender and power aspects of a case and actively correcting clinical practices that reinforce gender inequalities (Knudson-Martin & Mahoney, 1996). Furthermore, as Flemons, Green, and Rambo (1996) have argued, ethical and responsible decision-making in the context of subjective truth may require making one’s position visible and taking a clear stand.

There are both objective and subjective ways to be actively neutral. The more subjective way suggests that therapists bring their whole person into the therapy room. Advocates of this approach to gender and power tend to de-emphasize the therapist as expert and emphasize the therapist as human. As a human in relationship with other humans, the therapist is called upon to bring into the therapy process his or her thoughts, images, ideas,

October 1997 JOURNAL OF MARITAL AND FAMILY THERAPY 43 1

and responses. The therapist might say, “When I see you so focused on how he thinks and feels, I wonder how you do that day in and day out?’ Or, “It’s been my experience that when women and men have unequal relationships, the kind of intimacy you talk about is almost impossible.” In these examples, the therapist does not avoid sharing his or her ideas about gender and power, but they are presented as contributions to the therapeutic pot rather than as directives or facts. The therapist brings new, previously invisible, or under the surface issues into the therapy, but sees it as the client’s responsibility to decide what to do with them. Clients have access to the therapist’s experiences and perspectives. Thus, what happens in the therapy is highly dependent on the particular therapist, making it difficult to dissociate client outcomes from the therapist’s beliefs, values, and experiences.

The more distant, objective approach attempts to limit the intrusion of the therapist’s self into the therapeutic process, but uses professional knowledge to guide and direct the conversation. Such a therapist might adopt an educator’s stance, sharing information from research and other more objective sources, but trying to limit the emotion and values associated with gender and power. The therapist might say, “Your experience of not being able to relax when other people are in the house fits research that shows that women seldom report being able to relax at home because their sense of their responsibility for others in the household is nearly always present.” Or the therapist’s knowledge about gender and power might shape his or her questions, for example, “You say your mother was a strong woman. How did other people react to her strength? How is it for you, being strong?’ In this case, how the therapist responds to what he or she hears is shaped by his or her gender conscious- ness. Though the therapist’s opinion may not be overtly expressed, he or she is actively including gender within the core of the therapeutic conversation in ways that make possible challenge of traditional gender constructions. To not do so would limit gender neutrality and be likely to politically disadvantage women.

Moral Consequences of Therapy When we examine client welfare in relation the political consequences of our work, we

must ask whose welfare we serve. Even when we are clear that do not want to promote one gender’s advantage over another, this is not always a simple question. Is it in a woman’s interest to raise issues that could make achieving relationship stability more difficult when maintaining the relationship is important to her? Should she be encouraged to develop the skills necessary to make it in a “man’s world” if this means she must give up or hide parts of herself that are less valued in a male-dominated culture? Should a man be encouraged to deal with his stress and anxiety by “following his own dream” when his family is finan- cially dependent on him? The consequences of how we respond to these questions are political. Embedded within them are moral issues regarding how our own behavior affects clients and how clients’ behavior affect others.

Doherty (1995) persuasively argues that when therapists disassociate themselves from moral issues or refuse to take stands regarding appropriate human behavior they justify flights from responsibility and moral accountability. Thinking about the therapist’s role as including that of a moral consultant challenges previous professional ideals and raises new questions. The question is not so much whose morality is introduced or who decides what is right or wrong, but how to include responsibilities and ethics within the heart of therapeutic dialogue. The idea is to help clients to identify and explore issues of right and wrong, rather than escape or avoid them. Within this framework, helping clients to identify injus- tices and inequalities within their relationships and examine them in relation to questions of


right and wrong is part of the therapist’s role, as is examining the consequences for clients of using one theoretical approach to gender versus another. A therapist does not have to tell clients how men and women should behave, or act as a moral judge. Rather, he or she has to be willing to recognize gender and power issues as having moral consequences that are a legitimate focus of therapeutic conversation.

Not all would agree that it is appropriate to raise the moral aspects of gender and power issues in therapy. Yet, as I have shown earlier in this paper, men and women today make decisions about the day-to-day aspects of their lives with little awareness of how their decisions regarding who does what and how they relate to each other are influenced by social structures, traditions, and economic forces, and with little awareness of how those decisions may favor the well-being of one gender more than another over the long term or limit the intimacy and equality that they seek (Mahoney & Knudson-Martin, 1996). The decisions for clients are complex, often with no easy solutions. Whose career shall we follow? How will the needs of children be met? When is a relationship so unsatisfactory that it justifies foregoing one’s commitment and obligation? How much of one’s own “nature” should be put aside for career advancement or for the well-being of a spouse or child? When the moral aspects of these issues are not addressed, gender and power issues are either ignored or over-simplified. Few would suggest that it is the therapist’s role to make these decisions for people. Yet, unless a therapist has a way to make these issues visible and address them, he or she may contribute to decisions that perpetuate inequalities between men and women, fail to recognize the unique experiences of each gender, and support the well-being of some family members over others without their conscious agreement.

Suggestions for Practice The social context encourages new gender patterns but also inhibits such change. Women

and men are influenced by contradictory but invisible social forces. How they respond to the tensions created by these contradictory forces affects their personal and relational well- being and either reinforces existing societal patterns or challenges them. Since gender and family can not be separated, family therapists find themselves inevitably engaged in the social construction of gender (Knudson-Martin, 1995). How we respond has political consequences for our clients and for the larger society. My view integrates an appreciation of the different developmental experiences of women and men within a changing societal context that advocates gender equality but makes it difficult to achieve. Politically, I position myself so as to avoid unintentionally reinforcing existing gender biases and inequalities and to encourage personal and relationship patterns that equally serve both genders. The suggestions that follow are based on my understanding of gender as process and my view of the therapist’s role as making invisible processes visible, so that women and men can make more conscious decisions regarding their patterned ways of relating.

Develop sensitivity to how gender shapes experience and infuses relationship structures. Because gender is intrinsic to us all, developing sensitivity requires standing back and asking how gender is part of what is happening. If we fail to look or ask, previous gender patterns will remain unexamined and are likely to be reinforced. This includes recognizing at the personal level how gender constructs what we see or understand and questioning our own assumptions.

Do not assume equality or no gender bias. If we respond to people as though they are equal when they are not, the unequal person will be at a disadvantage. Within systems theory this means recognizing that even though patterns may be reciprocal, it does not mean


that each person has equal power to shape the pattern or benefit by it. It also means recognizing how interventions focusing on helping people separate or individuate may miss the positive aspects of affiliative, attentive behavior (Knudson-Martin, 1996) and how frequently used interventions, such as reframing unfairness to something more acceptable, may sometimes reinforce relationship inequality (Knudson-Martin & Mahoney, 1996).

Do not confuse neutrality with no response. If a therapist’s intention is to not take one person’s side over another, this may require deliberate action. For example, the female tendency to accommodate or be satisfied by understanding the other person’s side may be easily exploited in order to create relationship stability (Hawkins et al., 1994). Avoiding gender bias may requiring actively encouraging male accommodation as well.

Ask “gendercentric” questions. This is a form of circular questioning that is informed by placing gender in the center of relationship processes. It includes questions such as who is attentive to whom, how the relationship encourages one partner to be more stressed than another, or who benefits by a particular relationship pattern. It means asking how decisions were made, how experiences differ when viewed through the other gender’s eyes, or how a particular response is related to being male or female. These questions are not more important to therapy than other kinds of questions, but they are ones that frequently are not addressed directly.

Focus on process. When we address gender in the context of the ongoing interactions in daily life, there is less opportunity for moralizing and theorizing and more opportunity for making invisible interaction patterns visible. As in other areas, when clients see their relationship patterns it is possible to see other options and there is an opportunity for conscious decision-making.

Articulate the issues. Part of the therapist’s role is to help identify and put into words the gender construction issues at hand. Perhaps a woman or man is struggling to fulfill both new and old constructions of gender. Perhaps a couple caught in a power struggle is trying to determine whose needs are more important. Perhaps partners are having a difficult time understanding each other’s gendered experience, language, and behavior. Perhaps a woman is struggling to incorporate a divorce into her vision of herself as a relationship maintainer. Depending on how the therapist chooses to use himself or herself in the therapy, articulating the issues may involve an educational role, a leap into the expert role, or a collaborative role. But failure to articulate the gender and power issues embedded in the therapeutic conversation means they will probably go unnoticed and unaddressed.

Externalize. One of the benefits of framing issues in the context of gender is that problems can be linked to the larger culture. This helps clients to see their problems as more than their own personal struggle-as part of collective struggles. Without externalizing, a woman may experience herself as incompetent rather than as carrying more than her share of the burden; a man may experience himself as powerless in relationships rather than as having not learned how to attend to others. Externalizing makes the social context visible and change more possible.

CONCLUSION

Discussions about gender in therapy can stir strong passions and disagreements. While there is usually consensus regarding issues such as the value of clear communication or the harmfulness of child abuse, the issues relating to the politics of gender in therapy are still


sensitive and the appropriate role or stance of a therapist not clearly defined. That these issues remain controversial is not surprising since the political implications of our actions either support or challenge the societal status quo regarding gender relations. The purpose of this article has been to bring some clarity to the political dimensions of gender in therapy with the hope that it will help therapists to determine the response they find most appropriate. I have offered suggestions for ways to respond when utilizing a process approach to gender that avoids reinforcing gender inequalities. It is important that individual therapists consciously address their roles in relation to the politics of gender. Otherwise, we respond to gender not on the basis of professional judgment and a clearly defined position but on the basis of social influences beyond our conscious awareness.

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THE POLITICS OF GENDER IN FAMILY THERAPY

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