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THERAPY WITH WOMEN
How Is Therapy With Women Different?
Feminist scholars have raised questions about the psychotherapy of women that have to be considered if we are to know whether the recommendations made in earlier chapters apply to the therapy of women as well as to the therapy of men, and if we are to know how therapy should be carried out depending on whether the client is a man or a woman.
Because feminist scholars—like scholars in any orientation—do not always agree with each other, the opinions of the feminists that we cite should not be taken as presenting the views of all, or even of a majority of, feminists. Further- more, we want to make clear that we are not citing the views of feminists to contradict them. Rather, we cite these views because we want to consider them seriously; and the reader will find that we agree with many of these opinions.
Sigmund Freud’s views on the psychology of women changed during his lifetime. In the chapter on femininity in his New Introductory Lectures (1932/ 1964c) he softened the distinction he had previously made between the “active” man and the “passive” woman; he said, “I shall conclude that you have decided in your own minds to make ‘active’ coincide with ‘masculine’ and ‘passive’ with ‘feminine.’ But I advise you against it. It seems to me to serve no useful purpose and adds nothing to our knowledge” (p. 115). Acknowledging his incomplete understanding, Freud had conceded in an earlier work, “after all, the sexual life of adult women is a ‘dark continent’ for psychology” (1926/1959b, p. 212).
Keeping in mind these limitations, we proceed with our survey of feminist and of psychoanalytic views. We acknowledge that the disparagement of psy- choanalysis because it supposedly devalues women is less hotly debated in this new millennium than it was when the first edition of this book was published— not, we think, because psychoanalysis is better thought of, or because it is bet- ter understood that psychoanalysis does not devalue women, but because many people have decided that psychoanalysis is dead. As we hope has been well proven in the preceding chapters, psychoanalysis remains a vital and effective method of therapy. For this reason, it is still relevant to discuss issues sur- rounding women and psychoanalytic therapy.
Criticisms of Psychoanalytic Theory and Therapy
Some writers (e.g., Chesler, 1972; Friedman, 1979) have argued that Freud altogether misunderstood the psychological functioning of women. If Freud did
217 http://dx.doi.org/10.1037/11084-016 Resolution of Inner Conflict: An Introduction to Psychoanalytic Therapy (2nd Ed.), by F. Auld, M. Hyman, and D. Rudzinski Copyright © 2005 American Psychological Association. All rights reserved.
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218 SPECIAL ISSUES IN PSYCHOANALYTIC PRACTICE
misunderstand the psychological functioning of women, the argument runs, a therapy that is based on Freud’s theory of the psychological development of women is necessarily headed in the wrong direction and must do more harm than good.
Others (e.g., Gilligan, 1982; Lerner, 1988) have argued that there are spe- cial issues, particular aspects of human living that apply to women and not to men, or at least apply with greater pertinence to women. The therapist, these authors say, has to have a sensitivity to these particulars.
Some, indeed, have urged that the oppression of women in our society (in all societies? in most societies? in all patriarchal societies?) is so important to a woman’s psychological functioning that this oppression must always be the fo- cus of any woman’s psychotherapy. Gilbert’s chapter in Women and Psycho- therapy (Brodsky & Hare-Mustin, 1980) defined feminist therapy pretty much along these lines. Rawlings and Carter (1977) advocated a feminist therapy that incorporates the political tenets of feminism. Feminist therapy, however, can either recognize the importance of the oppression of women in our society while dealing with other issues that the woman client may face in her life, or, if the therapist is quite single-minded, focus on this issue to the exclusion of any other problems in the client’s life.
Finally, there is the question of whether it is better for a woman to get psychotherapy from a female therapist than from a male therapist. Marecek and Johnson (1980), participating in 1979 in a conference that assessed research on psychotherapy and women, reviewed the research that showed “the influ- ence of therapists’ and clients’ gender on the process of therapy; . . . the influ- ence of sex-role stereotypes on therapists’ behavior toward their clients; and . . . the incidence of sexist statements and actions by therapists during the course of therapy” (p. 67). They lamented the sparseness of research on these topics, especially the lack of research that made use of observation of real thera- peutic interactions. Bernstein and Warner (1984) addressed this issue in a book called Women Treating Women: Case Material From Women Treated by Female Psychoanalysts. This book does not attempt to answer the question “Is it better for a woman to get psychotherapy from a female therapist?” through a system- atic comparison of therapy done by women and that done by men. Instead, the book presents fascinating clinical vignettes indicating some of the issues that arise in the analysis of women by women.
Did Freud Misunderstand Women?
We acknowledge that some of Freud’s beliefs about the psychological develop- ment of women were erroneous. We arrive at this conclusion both from our own clinical experience of psychotherapy with women and from reading some of the extensive writings on psychoanalysis and women. We have found the discus- sion of these issues in Women and Analysis (Strouse, 1974) particularly thor- ough and illuminating.
When we grant that Freud made some mistakes in his theory of the psy- chological development of women, we do not concede that such errors make a psychoanalytic approach to the therapy of women misguided. If one takes psy-
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