Feminists and Non-Feminists in Psychotherapy
As a therapist I have seen feminists and non-feminists in treatment. The women I refer to as non-feminists did not initially mention women’s rights, nor did they claim participation of any kind in the Women’s Liberation Movement. When we later discussed this issue, their reactions ranged from indifference, to sympathy for some (usually less radical) as pects of the movement, to open hostility In contrast, the women I call feminists referred to themselves as such and explicitly supported various aspects of the women's movement. All of them believed that women as a group are oppressed, handicapped or otherwise impeded in their full development by external forces, whether social institutions, cultural mores or men. While they varied in the degree of their actual participation in the move ment, all of them had experience in consciousness-raising groups. Most of them chose to see me primarily because I am a woman, being fairly convinced that a woman would view their concerns with more understanding, that she would be less biased than a man, or simply that they could talk more freely with a female.
I have been struck by the differences be tween these two groups in their views of their problems, their behavior in our sessions, and their relation to the therapist. And perhaps even more important, I have found that feminists appear to have resolved successfully developmental stages that non-feminists have avoided. Let me briefly explain. Since feminists seek changes in others as well as in themselves, they develop more interpersonal skills and an ever-increasing sense of self. They are less afraid of their aggressive impulses — in particular, anger. They question the requests and expectations of others. Feminists do not dislike their sex and have discovered bonds with other women. They have achieved separation from important others, whether parents, husbands or children. They have asserted their autonomy by defining, protecting and defending their own needs, establishing their own goals and directions, with increasing trust in their own perceptions, judgment and experience. All of these are characteristics of the healthy adult, although feminists are outside the culturally defined "norm" for female behavior.
My observations are based on a study of 60 women — 32 non-feminists and 28 feminists, ranging in age from 18 to 45, from varied racial and educational back grounds, including single, divorced and married women in both groups. The feminist group was younger on the average, the oldest woman being 35. My descriptions of the behaviors encountered are based on the first two or three interviews with these women, although my hypotheses are based on longer observation periods during which I intervened as a therapist.
The non-feminists sought psychiatric help for complaints ranging from vague, chronic feelings of dissatisfaction, alienation or depression to marital conflicts, in ability to be creative, inhibitions in sexual functioning, phobias or problems with their children. All of these women, with out exception, presented their problems as signs of personal inadequacy. Frequently, they were baffled by their discontent, simultaneously pointing out all the advantages of their daily lives. As one of the patients put it, “I have a kind husband, three healthy children, no financial problems, freedom to study and l’m not happy — what’s wrong with me?" This last question was implicit in the statements of most of the non-feminists who expressed their malaise in terms of symptoms, had no coherent way to explain them, and saw these symptoms as something in them selves that needed correction or change. A few stated their wish for understanding, but on further inquiry it became clear that for them "understanding" was something that would automatically "dissolve" their discomfort. Others who wished to know themselves saw a successful outcome as contingent on their ability to correct "whatever I am doing wrong.
If one couples these statements with the behavior of the non-feminist patients in the office, one finds a remarkable congruence: these women were not assertive, they behaved in a compliant and submissive manner, and they never questioned the examiner. They found it hard to be critical of others, while they downgraded their own perceptions and feelings, as if they doubted their validity. Their emotional responses tended to be limited to the expression of sadness, desolation, pain, very frequently accompanied by crying.
Passive self-references predominated. The non-feminist often responded to questions by repeating observations others had made of her behavior, her needs or the purposes of her acts. The absence of an active self-referent was so striking, that I began to pay attention to how often and in which context the personal pronoun I was used. Comments like "it feels better," “my mother says, "friends don’t like me to" or “my husband gets irritated at me if" were frequent. My impression was that of a woman accustomed to relying on others’ understanding or reactions to her and unable or unwilling to attempt a more active and self- directed search for definition. This characteristic of defining the self via others was found among the non-feminists regardless of their education, intelligence, age, race and marital status. It was even present in those “active" women who demonstrated competence, at home or at work, in areas requiring a certain level of decisiveness and organization.
In contrast, the feminist patients' complaints were largely related to a set of already established ideas or goals. They were dissatisfied at finding remnants of old behaviors that contradicted their present goals, at their self-defeat in attempting to defy the old order, at the failure of their behaviors to elicit the desired good feeling about themselves, at their excessive sensitivity to criticism or conflicts originating in their attempts to alter their heterosexual behavior and relationships. Some of the most militant were attempting to introduce changes in traditional organizations or institutions, or worked in pre dominantly masculine occupations and were faced with tremendous pressure to conform to mores at variance with their own. Their discouragement and distress at the frequently negative responses they encountered led them to reexamine their goals and their behavior in order to find a compromise that would permit them to continue their own development or interest at less cost to the self. If they had "symptoms" such as anxiety, depression, periods of low self-esteem, sexual inhibitions or guilt feelings, it was not the symptoms they focused on but the behaviors, interactions and conflicts that in their opinion resulted in those symptoms. These women appeared to have already made a fairly exhaustive analysis of the cause-effect relations between their behaviors and experiences and the symp toms they generated. They were explicit about their goals and aware of both intrapsychic and interpersonal conflicts.
In this regard, the feminists’ awareness of external sources of pain and confusion, for which they did not feel responsible, seemed to help them make more and more discriminating judgments between their problems and those of others. Their conscious and purposeful engagement in altering the social context in which they lived or the persons to whom they related did not hinder their examination of their own motives, needs or inadequacies. This capacity was largely responsible for these feminists' positive attitude toward their "problems." For although they saw them selves as not quite equal to their expectations, they also saw their attempts as a desire to grow, to become more capable, more self-reliant and more flexible.
Awareness of their inadequacy to reach desired goals did not lead these feminists to question their sanity or their intrinsic neuroticism. Since for the most part they believed that the traditional labels ’ill" or neurotic" had been incorrectly attached to the victims of oppression whenever they gave signs of their pain, their whole view of "treatment" and the psychiatrist’s role in it was very different from that of the non-feminists. The feminists were more selective in their choice of therapist, more critical of his/her views, more knowledgeable of and attentive to therapists' tactics or ideologies that smacked of disguised oppression. While the feminist patients sought alleviation of their pain and discomfort, they rejected symptomatic treatments. Drugs and biological treatments were suspect as repressive tools. Their active, inquisitive and critical attitude toward the therapist contrasted with the pliable, unassuming, dependent stance the non-feminists took in the beginning of therapy.
The non-feminists often portrayed the behavior of others in a way that left the listener with no doubt that the behavior was destructive, hostile or decidedly unjust. Yet they voiced no criticism, nor did they react with open anger. When questioned about their feelings, they seemed to have great difficulty voicing their anger, particularly toward those upon whom they were dependent financially or other wise; more often than not, their quick acknowledgment of anger was followed by guilt, self-incrimination and doubts about their femininity. These women appeared to dread becoming the stereotype of the "bitchy," “castrating” or otherwise aggressively destructive female. Anger toward men, in particular intimate male partners, was frequently subdued, avoided or quickly turned into aware ness" of their own “demandingness" or unreasonable dissatisfaction. The listener was, however, simultaneously briefed about these men’s demanding attitude, their insensitivity, exploitation and other blatantly hostile behaviors, as if the patient needed outward sanction of these feelings by having the therapist voice them first.
Anger was more freely expressed toward other women. The non-feminists tended to see other women as shallow, empty-headed, jealous and untrustworthy. Aside from one or two exceptional" female friends, these women seem ed to believe that women (themselves included) were justifiable targets of contempt, tending toward envy, selfishness and manipulativeness. They thus found themselves isolated from other women and considered their company uninteresting and unsatisfactory. While they did not voice such feeling in relation to me, when questioned they did state that they were concerned about having a female therapist or that I might be one of the exceptions" they could trust. On further exploration, it became clear that they had mixed feelings. They felt freer speaking to a woman, but this was partly due to their low esteem for women. They clearly felt that the important judges of their worth and attractiveness were men and that it mattered much less whether a woman found them satisfactory. My status as a psychiatrist did, however, tip the scales to the other side. Their tendency to respect my role as an "expert" and to trust my opinion somewhat uncritically was in line with their tendency to respect "authority (particularly malelike authority) and their compliance with it.
The feminists, on the other hand, displayed a greater capacity for critical judgment—of the therapist as well as of their cultural milieu—which was in direct relation to their tolerance of and ability to voice angry feelings. Although at times the intensity of their anger had a disorganizing and even paralyzing effect on them, the freedom to express anger verbally and the ability to channel some of it into groups or personal goals (fighting school boards, the political system, legislation or simply husbands and bosses), plus the sense of inner rightness about their claims, clearly differentiated them from the non-feminists.
Anger was sanctioned and indeed encouraged in groups in which these feminists found validation and support for their perception of what made them angry. Although they had been or still were fighting the image of the “castrating" female, they believed that this specter had been raised to dissuade them from openness about their dislikes, or from confronting people with their contradictions and put-downs. “C-R groups" gave them an additional chance to contradict such stereotypes, for these groups provided a great deal of nurturance and mutual support.
In this regard, an important difference between the two groups was found. The feminists were able to feel a bond of loyalty and a common source of concern with all women—an important developmental stage for females. Their newly found "sisterhood"—based on attempting honest friendship, support without moralistic judgment, openness and trust, and on the sharing of deep feelings and experiences—was of extraordinary import in their ability to channel, utilize and tolerate angry and destructive feelings. Although aware that most women would part company with them on sticky issues, they envisioned a potential union with them and were sympathetic to the plight of women in general. They explained other women’s hostilities as the result of their fear of awareness, their indoctrination to see women as enemies, their competitive strivings around men and the utterly dependent state of most women.
The non-feminists were isolated from this realm of female experience, having had perhaps a few close women friends, but neither knowing nor believing in women’s capacity to help one another and to join in creative action. Being alone, and usually able to communicate their deepest worries only to the psychiatrist or minister, they had no way of realizing how common their concerns were to those of other women, or of discovering their own potential capacity to understand, help and decide about their own lives. The feminist women had already tested this ground in “rap groups" where they had validated their own perceptions, gained confidence in their own experiences, achieved a new sense of self-enhancement and the ability to assert the self (yet not at the expense of others). Although the feminists felt alienated from much of conventional society and had to bear consider able stress, they were not alienated from their own sex, and they believed that not knowing who they were or what they wanted was more insidiously destructive by far than a rude awakening.
My underlying contention is that feminists have advanced further on the developmental ladder and are at a psychological advantage compared to non-feminists. I regard as crucial the role the liberation of aggressive impulse plays in regain ing self-esteem, achieving separation-individuation and making discriminating critical judgment possible. The freedom to tolerate anger, to voice it and to channel it into meaningful activity is a prerequisite for further change. The pervasive inhibition of aggressive impulses in non-feminists drains them of energy; those impulses tend to be directed against the self, result ing in self-depreciation, depression and feelings of worthlessness. This state of affairs prevents moves toward self assertion since these moves are perceived as threatening the precarious balance of dependency on others. In contrast, feminists' attitude of defiance is an affirmative stance that provides the ability to weather disapproval and criticism from others. Independence and autonomy are achieved by struggling against confining expectations at variance with those of the self. This posture of feminists forces active interaction with others and opens the way for individuation and self-control. It seems important to conduct a further study of feminists and non-feminists who do not seek treatment. The findings discussed here are relevant only to those women who have actively sought help.
Teresa Bernardez-Bonesatti is a feminist psychiatrist whose special research interest is women and mental health. She is an associate professor of psychiatry at the College of Human Medicine, Michigan State University, and chair person of their Affirmative Action Committee.