History of Feminist Therapy PDF

1 History ORIGINS OF FEMINIST THERAPY Feminist therapy has its clinical roots in the humanistic psychotherapies that were practiced by many of its initial adherents before their engagement with the Womenʼs Movement at the end of the 1960s. The “third fo...

1 History ORIGINS OF FEMINIST THERAPY Feminist therapy has its clinical roots in the humanistic psychotherapies that were practiced by many of its initial adherents before their engagement with the Womenʼs Movement at the end of the 1960s. The “third force” psychotherapies that emerged strongly during the 1960s were experienced by many women practitioners as offering a viable alternative to what was seen as the determinism and misogyny of psychoanalysis and the mechanistic view of humans that then defined behaviorism in the days before cognitive and mindfulness components were integrated into behavioral practice. Carl Rogersʼs (1957) then-radical notion that a therapist ought to be seeing the person across the room as a prized fellow or sister human rather than a specimen of a particular diagnosis, as well as his emphasis on the quality of relationship between therapist and client, opened a theoretical door. Feminist therapy followed through that door when practicing psychotherapists began to notice how much of the sexist reification of clients by psychotherapists mirrored the reification and objectification of women  2 in the culture surrounding them. One cannot prize a person who one is objectifying and placing unmindfully into boxes constrained by misogyny. Yet many of the women, all cisgender, who created early feminist therapy eventually found the humanistic psychotherapies to be insufficient as a framework for understanding their experiences, particularly as those women joined feminist consciousness-raising (CR) groups and began to critique gender relations in the humanistic psychotherapy movements. The intersection of CR with the lives of psychotherapists was the catalyst for the emergence of a specifically feminist commentary on the practice of psychotherapy (Rawlings & Carter, 1977). In CR groups, women met without a leader and shared personal experiences of their lives, including experiences of discrimination. The only authority in a CR group was the woman speaking; CR groups became a place in patriarchy where a womanʼs voice could be heard and valued, rather than dismissed and denigrated as “anecdotal evidence” or mere gossip. In these groups, the original feminist therapists who were themselves participants began to notice themes and trends common to many womenʼs lives and, in particular, common to the experiences of being trained as a psychotherapist and being a client in psychotherapy. In parallel with raised consciousness about sexism and misogyny in the culture at large, an awareness of these pervasive biases in the psychotherapy profession emerged. Because they were listening to other women describe parallel experiences, feminists in the psychotherapy professions began to feel less alone, less crazy, and more empowered to take steps to change their own disciplines (Rosewater & Walker, 1985). As a separate model of psychotherapy, feminist therapy in psychology has its most traceable conceptual origins in three documents, two of which were written by psychologists active in the Womenʼs Movement and one of which reflects feminist questions and sensibilities but was framed in the language, and published in the context, of scientific psychology. These documents can be said to have functioned as large-scale CR tools for the psychotherapists who read them; many of the first generation of feminist therapists mark the moment of their epiphanic association with feminist therapy to reading one or more of these pieces (Brown, 1994; Chesler, Rothblum, & Cole, 1995; Kaschak, 1992). These three pieces were Phyllis Cheslerʼs (1972) book Women and Madness, Naomi Weissteinʼs (1968) essay Kinder, Kuche, Kirche as Scientific Law: Psychology Constructs the Female, and the 1970 journal article “Sex-Role Stereotypes and Clinical Judgments of Mental Health” by Broverman, Broverman, Clarkson, Rosenkrantz, and Vogel. These three works are discussed in detail in this chapter, and each presaged developments to follow in the  3 emergence of feminist therapyʼs theory and practice. For their readers, these writings had the effect of initiating the first step in any process of feminist therapy, which is the arousal of feminist consciousness in the individual, a consciousness without which feminist practice cannot occur. What is feminist consciousness? Historian Gerda Lerner (1993) defined it as the development of awareness that oneʼs maltreatment is not due to individual deficits but to membership in a group that has been unfairly subordinated and that thus society can and should be changed to give equal power and value to all. Specifically, as to feminism within the psychotherapy professions, this consciousness took the form of realization that almost all of what had been written about women up to the late 1960s was distorted by the sexist and at times overtly misogynistic biases inherent in the mental health professions. Feminist CR highlighted the reality that, at that time, the very practice of psychotherapy itself was imbued with oppressive norms and values that were harmful to women because of how those norms replicated barriers to women and associated a womanʼs noncompliance with those barriers with inadequate mental health. In many instances this epiphany was accompanied by a cognitive reappraisal of personal experiences with sexist and misogynist psychotherapy and/or professional relationships in which the difficulties encountered therein were reinterpreted as reflecting the sexism of the other person or the situation, rather than oneʼs own inadequacy as a woman. Feminists who were psychotherapists noted the powerful effects of this raised consciousness on their own well-being. Informally, and then in more organized fashions, feminists found one another and began to write papers and present symposia on their new insights. Feminism teaches that “the personal is political.” For this group of early feminist therapists and feminist psychologists, the development of feminist consciousness and politics arose from their own experiences as graduate or medical students, therapists, and sometimes clients within the patriarchal system of psychotherapy as practiced universally before the early 1970s (Bernardez, 1995; Caplan, 1995; Chesler, Rothblum, & Cole, 1995; Denmark, 1995; Gartrell, 1995; Greenspan, 1995; Miller & Welch, 1995). For Phyllis Chesler and Naomi Weisstein, those experiences of sexism and discrimination in their professional settings were the genesis of two of feminist therapyʼs founding documents. Women and Madness: Exposing Patriarchy in the Consulting Room Trained as a research psychologist in the mid-1960s, Chesler authored Women and Madness (1972) as a protest against what she saw as unjust and sometimes  4 inhumane conditions for women in psychotherapy. In a personal memoir (Chesler, 1995), she describes returning home from the 1969 convention of the American Psychological Association, at which a feminist protest that became the first meeting of the Association for Women in Psychology had occurred, feeling compelled to use her skills as a researcher to document empirically how psychotherapy oppressed women. She also used early tools of feminist analysis, focusing attention on how problematic societal gender relations were replicated in the psychotherapy relationship. She argued persuasively that in psychotherapy, the conditions of a sexist and oppressive society were reproduced, with the ultimate outcome of harm done to women in a place where they had gone to seek healing. Cheslerʼs observations and qualitative research findings occurred within a particular professional and historical context. At the time of her writing, most doctoral psychotherapists were male and, as noted by Guthrie (1976), predominantly European American. The majority of practicing psychotherapists through the middle of the decade of the 1960s either were trained in the U.S. psychoanalytic orthodoxy of the day, which implicitly denigrated women in its particular interpretations of psychoanalytic theory (Bernardez, 1995; Luepnitz, 1988) or were proponents of some variety of humanistic psychotherapies; behavioral and cognitive-behavioral models were still in very early stages of development and not perceived as influential. Although the humanistic therapies were more apparently open and accepting of womenʼs experiences, they also often lacked boundaries to sexual contact between therapist and client and continued to reinforce social norms about gender for women even while preaching self-actualization. The nascent family therapies of that era were also deeply sexist, blaming women, particularly mothers, for many of the ills of families (Hare-Mustin, 1978) without questioning how the role of motherhood was socially constructed or how womenʼs roles as mothers were unsupported by institutionalized sexism. Then, as today, a majority of people seeking private psychotherapy were women, frequently women struggling to make sense of conflicts between pursuing their goals, desires, and interests and societal demands that European American, middle-class, educated women work as unpaid homemakers and full- time parents. When women of color sought psychotherap —then as now an infrequent occurrenc —they were often greeted with numbing medications and conceptualizations of their distress that were both racist and sexist (Bernardez, 1995; Greene, 1986; Morris & Espin, 1995). Chesler noted that in this configuration of male authority and female distress, women, especially European e y  5 American cisgender women, were defined as dangerously disturbed simply because of desires to work in professions, not to parent full time, or in some other manner to violate gender norms for their time. She suggested that in therapy as in life outside the consulting room, a woman was defined as a wife or daughter to the male psychotherapist who assumed the complementary role of husband or father. This state of affairs was considered normative, its potential to harm women overlooked. Chesler was the first author to document the existence of hitherto denied or minimized sexual boundary violations in therapy and to compare such violations and their effects to other forms of sexual assault. While in the 21st century therapists take for granted a prohibition on sexual contact with clients, Cheslerʼs work occurred in an era when some well-known psychotherapists, among them some of the founding fathers of certain humanistic approaches, were publicly and in print flaunting sexual relationships with their clients. At that time womenʼs reports of any form of sexual violation, in or outside of therapy, were routinely dismissed as fantasy productions arising from a womanʼs own repressed sexual needs or attributed to the womanʼs own so-called seductiveness. One of the founders of Gestalt therapy detailed such activities in an autobiography (Perls, 1969). Cheslerʼs work was both revolutionary and controversial when it was published. Her willingness to state that psychotherapy as usual could be harmful to women because of its replication of oppression was itself consciousness- raising to many of her readers, allowing them to experience validation of what they had personally encountered in psychotherapy from both sides of the couch and helping them to develop the feminist consciousness that they were neither alone in their suffering nor the source of the problem. Her insights as to how psychotherapy needed to be transformed to render it both nonharmful to women and potentially contributory to feminist social change laid the groundwork for what was to follow. Women and Madness remains relevant 5 decades later; although much of the very overt sexism and misogyny that she documented has been reduced, covert forms of patriarchy remain present. Kinder, Kuche, Kirche as Scientific Law: Misogyny in the Science of Psychology The second founding document of feminist therapy, developed in an explicitly feminist context and also written by a psychologist, was the late Naomi Weissteinʼs Kinder, Kuche, Kirche as Scientific Law: Psychology Constructs the  6 Female (1968). Weisstein was trained as a comparative and physiological psychologist at Harvard in the early 1960s, doing her doctoral research on parallel processing in the brain. She achieved her doctorate in the context of extreme sexist discrimination, including denial of access to libraries and lab facilities (Lemisch & Weisstein, 1997) and was a feminist community activist and rock musician in addition to being a psychological scientist before being disabled by the illness from which she died in 2015. Weissteinʼs article, which developed through several iterations from 1968 until its eventual publication in the feminist anthology Sisterhood Is Powerful (Morgan, 1970), constituted the emergence of the feminist voice within psychological science. She critiqued several taken-for-granted assumptions about womenʼs functioning that were ubiquitous in the psychological science taught at that time and represented in the practices of clinicians, and she used the tools and methods of that same science to expose its sexism and misogyny. Her articleʼs title was provocative, as the German phrase she used was a quotation from Nazi writings about womenʼs appropriate social roles. By suggesting that psychology was, at its core, no more enlightened about women than fascism, Weisstein threw down the gauntlet to psychological science. Weisstein began her critique by noting that women were actually rarely the actual subjects of study on which commentaries about womenʼs behavior were based. While the absurdity of the notion that one could comment on human women by observing female rats or chimpanzees appears obvious to 21st- century readers, Weissteinʼs analysis of the scientific literature of psychology was accurate in depicting this immens —and at the time completely accepte — lacuna where the study of actual women was concerned. She skillfully analyzed research in several areas of psychological science to demonstrate that participant samples from which generalizations were made to and about women were routinely composed only of men, female rats, or female chimpanzees (and those men were almost always European American college students, presumably heterosexual and cisgender) and that this generalization in the absence of empirical support occurred without protest from peer reviewers and editors of journals who would endorse and publish this work. Exclusion of women as a data source about women was business as usual in psychological science of the prefeminist psychology day. Weisstein pointed out that womenʼs behavior was frequently explained by means of extrapolation from and comparison to findings of research with nonhuman animals. Her critique presaged more recent feminist critiques of early evolutionary psychology writings about women and gender in which strategies e d  7 similar to the ones discredited by Weisstein are used to define gendered behaviors as fixed and immovable (see Contratto, 2002). Long after Weisstein, commentators such as primatologist Sarah Blaffer Hrdy (1990) have demonstrated through their critiques of sexism in ethology and anthropology that the nonhuman animal research literature itself contained interpretations of the behavior of female animals that were rife with sexism, rendering the generalizations to female humans even more specious. Thus, if female rats appeared to instinctively engage in certain behaviors, which were interpreted through the lens of sexist gender assumptions by (usually) male scientists, women ought to have a similar instinct, and women who did not behave similarly were ipso facto pathological. That such “instinctual” behaviors have been later found to be affected by such variables as population stress and availability of food and water only added to the absurdity of these essentialist notions about human female behavior. Weisstein also took aim at psychoanalytic formulations of women. Although psychoanalysis had begun as a theory that liberated women by acknowledging them as sexual beings, orthodox analytic theories in the United States had become contaminated with cultural sexism and were complicit in its enforcement. Thus, Helene Deutschʼs (1944) Psychology of Women, the then- authoritative psychoanalytic text in which women were defined as inherently passive and masochistic, had become the primary source about women for many practicing psychotherapists by the middle of the 20th century. Weisstein, perhaps echoing Karen Horneyʼs (1967) earlier (and much discredited by mainstream psychoanalytic thinkers) observation that the concept of penis envy might simply reflect the egocentric musings of a now-grown male child who was himself so attached to his penis that he could not imagine how those not possessing one would not envy him, critiqued then-pervasive psychoanalytic formulations of women as being less morally capable, more dependent, and less fully adult than men. She pointed out the complete absence of empirical, research-based support for these assertions on which most of psychotherapy with women at that time had been founded. While today such assertions about women might seem outrageous, rereading Weisstein reminds us that in 1968 and for many years afterward, they were the conventional wisdom about women ascribed to by almost all practicing psychotherapists. Weissteinʼs article served as the foundation of the science of feminist psychology, with many social, developmental, and other research psychologists rising to her challenge in subsequent years to develop empirical data about womenʼs actual functioning. Her article was also a prophetic comment as to  8 what would be the findings of the final founding document of feminist psychology, which appeared in the Journal of Consulting and Clinical Psychology in January 1970. “Sex-Role Stereotypes and Clinical Judgments of Mental Health”: Science Supporting Politics This next founding document, authored by clinical psychologists Broverman, Broverman, Clarkson, Rosenkrantz, and Vogel (1970), reported the findings of a study in which experienced practicing psychotherapists, both women and men, from the range of mental health disciplines were asked to describe three people on a 102-item scale of bipolar adjectives (e.g., “Functions well in a crisis vs. Does not function well in a crisis”) separated by a 100-point continuum. Presented in random order, the persons to be described were the Mentally Healthy Adult Male (MHAM), the Mentally Healthy Adult Female (MHAF), and the Mentally Healthy Adult (MHA). The authorsʼ findings constituted early empirical support for what Chesler and Weisstein had asserted in their critiques and validated the realities of women psychologists participating in CR groups. The MHAM and the MHA were found to be essentially the same constructs, and both constructs constituted ways of being human that were highly socially desired. The MHAF was found to be significantly different from both the MHAM and, importantly, the MHA; this construct was also significantly less socially desirable. Women, not those diagnosed with disorders but seen as exemplars of good function, were being defined as having a different “normal” than were me —or adults. The mentally healthy adult woman was not, in fact, an adult; in the eyes of the typical psychotherapist of the time, she was not simply different from a man but was a lesser being whose attributes were less socially desirable. CLINICAL CONTRIBUTIONS TO THE DEVELOPMENT OF FEMINIST THERAPY At the same time that these documents were published, women therapists began to gather at conferences and professional meetings to discuss their feminist concerns, moving out of their CR groups and into action within their disciplines. Several veteran feminist therapists have described these encounters with other women at national conferences, including the groundswell of anger that led to a feminist takeover of the American Psychological Association (APA) Council of n  9 Representatives meeting in August 1969, an action that set the stage for the founding of the Association for Women in Psychology (AWP) and the Society for the Psychology of Women (SPW; Division 35 of the APA). The Womenʼs Institute of the Orthopsychiatric Association, organized in 1978 by feminist psychiatrist Jean Baker Miller (who went on to found the relationa –cultural school of feminist therapy), became a home to feminists in social work and psychiatry, the disciplines that then constituted the majority of the parent groupʼs membership. In 1981, AWP member —under the leadership of Adrienne Smith, one of the first openly lesbian feminist psychologists, and Lenore Walker, who developed the construct of battered womenʼs syndrom —proposed a meeting for experienced feminist therapists, which grew into the Feminist Therapy Institute (FTI), an interdisciplinary group that met for intensive institutes between 1982 and the second decade of this century, when the organization dissolved. The bulk of feminist psychology scholarship in the 20th century emerged from the meetings and publications of these three organizations, with a largely clinical and qualitative body of knowledge being created by feminist therapists in the context of discussions and paper sessions by practitioners who were calling themselves feminist therapists. The peer-reviewed journal Women & Therapy, founded in 1983, has been the publication home for much of this clinically oriented and more qualitative and heuristic work. A clinical science of feminist therapy has been slow to develop, although the clinical science of the psychology of women and gender has grown exponentially since the early 1970s, with such journals as Psychology of Women Quarterly, Feminism and Psychology, and Sex Roles laying the foundation for a robust research literature. This slow growth of feminist clinical science appears to reflect several trends both inside feminist psychology and in hiring and promotion patterns in academic psychology departments. Because so-called science had been misused to oppress women in prefeminist psychotherapies, there was an initial hostility and resistance to putting feminist therapy under a microscope, with fears expressed that information about womenʼs (and other marginalized peoplesʼ) experiences of distress would be misused against them, as “proof” of womenʼs incapacity to do one role or another. Although feminist psychological scientists were studying girls and women, little of their work was on therapy process and outcome. Feminist psychologists with interests in developing an evidence base of practice were often marginalized in the academy and actively discouraged from identifying themselves as feminists to protect the possibility of tenure, making it more difficult to develop the sort of long-term work needed to establish information about effectiveness and efficacy of an s e l  10 approach to treatment. A result has been a practice with an evidence base that remains largely in the realm of clinical and qualitative materials and via extrapolation from knowledge about those common factors of good psychotherapy that are prominent and central to the feminist therapy paradigm. In the past 2 decades, however, feminist psychological science has generated a stronger body of research on some aspects of feminist practice, particularly psychotherapy supervision (Brown, 2016). STAGES OF CONCEPTUAL DEVELOPMENT IN FEMINIST THERAPY I have somewhat arbitrarily divided the development of feminist therapy into five stages or periods, each described by the theoretical and political theme informing its practitioners. Within each era is a range and diversity of practice that a volume such as this cannot capture; readers are encouraged to seek out the primary sources cited for more in-depth understanding of the full range of feminist therapy practices. These stages, which each lasted roughly a decade, reflected both the Zeitgeist of research and practice in psychology in general and of feminism as propounded primarily in the United States. I define these stages as follows: ▪ No-difference feminism (1960 –early 1980s) ▪ Reformist feminist ▪ Radical feminist ▪ Difference/cultural feminism (mid-1980 –mid-1990s) ▪ Difference with equal values feminism (mid-1990 –present) ▪ Multicultural, global, and postmodern feminisms (the early 21st century) ▪ Feminism of the globally connected world (200 –present) No-Difference Feminism and Feminist Therapy No-difference feminism asserts that there are no actual differences between women and men and that any apparent differences either are due to learned and unlearnable processes or represent artifacts of unequal treatment. It asserts that women should not be excluded from any profession or occupation simply because of their sex because talents and capacities are equally distributed between females and males with differences being individual rather than sex- based. This feminism predated an understanding of gender as performative and tended to conflate sex assigned at birth with gender. It was one direct feminist s s 8 s  11 psychology response to the obvious cultural manifestations of sexism of the era, which justified differential and lesser treatment of women on the grounds of allegedly inherent sex differences. The feminist psychological scholarship of this period is marked by many studies that attempted to challenge the concept of essential differences between the sexes or that identified what few differences did exist and then downplayed their meanings for peopleʼs capacities to function day to day. The initial body of research on womenʼs psychology was done during this period, which can be seen as encompassing the years from 1969, when feminists in psychology first coalesced as a group, into the early 1980s. During this time the first journals addressing empirical research on women and gender were founded: Psychology of Women Quarterly and Sex Roles. Within the psychotherapy realm this strand of thought was initially represented politically by a reformist feminist model (for in-depth reviews of the different schools of feminist political theory, see Enns, 1992, 2004). Reformist feminism, then and today, has a vital interest in increasing womenʼs numerical representation throughout all aspects of society and in legally guaranteeing equal rights and access. However, reformist feminists have not historically engaged in critiques of systemic sexism, misogyny, and other linked forms of oppression, although this has begun to change in the second decade of the 21st century; nor do they generally call for radical social changes in cultural institutions beyond increasing the numbers of women within them. In psychotherapy practice, this politic manifested as getting more women to practice as psychotherapists and making more information about womenʼs lives and experiences available in the training of psychotherapists. No-difference feminist psychology also eventually became a home to radical feminist psychological thinkers, of whom Weisstein was only one. Radical feminism of this period in the late 1960s and 1970s argued that although women and men were indeed not different in their skills and capacities, simply placing female bodies in great numbers in institutions that were inherently oppressive would do nothing to transform the dominant U.S. culture into anything more just and nonsexist. Radical feminists thus worked for tota —that is, “radical — transformation of all institutions of society. The initial emergence of a radical feminist critique in feminist therapy can be seen in early discussions of creating an egalitarian relationship in therapy (Smith & Siegel, 1985). These discussions, which have evolved into one of the cornerstones of feminist therapy in theory and practice, asserted that a woman doing therapy with a woman in the authoritarian, power-over mode typical of therapies as then practiced would not constitute feminist therapy, even if the l ”  12 therapist in question self-identified as feminist. This radical critique of the core structure of psychotherapy argued that for therapy to be feminist, the power dynamics of the relationship need to be interrogated and revised to create equality of power. (A detailed discussion of the egalitarian or liberatory relationship will follow later in this volume.) The majority of currently practicing feminist therapists, no matter how else they define their practice, have integrated this radical feminist critique of therapyʼs power structure into their definitions of feminist practice, along with radical feminismʼs vision that institutions of society must be transformed to accomplish the feminist project of social change. Feminist therapy practice during this period focused on identifying what were seen as womenʼs unique and special treatment needs as well as on the person of the woman therapist. There was not yet a defined theory of feminist practice separate from the political feminist notion that “the personal is political” and that all experiences consequently could be parsed in terms of womenʼs oppression. Some early feminist therapists rejected the notion of a theory as itself too reflective of patriarchal norms and as likely to delay womenʼs progress toward self-determination. Defining itself against the therapy-as-usual of its day, feminist therapy was construed as a short-term process, focused on raising womenʼs consciousness (Brodsky, 1973) and teaching women specific skills for better negotiating their world, such as assertiveness or sexual awareness. Womenʼs distress was seen as arising solely or largely as a result of large-scale and systemic oppression, and feminist therapists of the day posited that once women became aware of that oppression and learned how to respond differently, they would no longer experience that distress. A classic book of the era titled Feminism as Therapy (Mander & Rush, 1974) reflects the hopeful stance that feminist revolution per se could be curative. Therapy was postulated as a sort of “consciousness raising group of two” (Kravetz, 1978, p. 169) in which a relationship of near-equals would obtain. An excellent example of the scholarship of this stage is Miriam Greenspanʼs (1983) A New Approach to Women and Therapy. This work integrates and synthesizes the development of that initial stage of feminist practice and begins to move toward theory development. Some of the very early areas of emphasis of feminist therapy included womenʼs depression, assertiveness training, female sexuality, and, increasingly, violence against women (Brodsky & Hare-Mustin, 1980; Herman, 1981; Rosewater & Walker, 1985; Walker, 1979). Hare-Mustin and Marecek, in their critical analysis of schools of feminist psychological thought (1990), referred to the stance of no-difference feminism as  13 beta bias. They noted that one of the risks inherent in beta bias is that it ignores the realities that even though sex differences may be small, gender as a socially constructed variable does lead to disparate life experiences arising from the gendering of society. Given the extremely early point in life at which gender roles begin to be assigned and linked (sometimes incorrectly, in the case of gender-nonconforming persons) to biological sex and the persistence of this gendering of infants well after feminism began to challenge the gendering of behaviors (Karraker, Vogel, & Lake, 1995), beta bias had the potential to obscure the outcomes of gender as socially constructed. Difference Feminism and Feminist Therapy Toward the end of the 1970s and into the 1980s, a trend emerged in political feminism that adopted an essentialist view of womenʼs psychology. This view proposed that womenʼs behaviors in the interpersonal sphere arose from their inherent biological capacity to mother. This stance was called alpha bias by Hare-Mustin and Marecek (1990), and it embraced and reimagined many of womenʼs allegedly instinctive behaviors, the gendering of which had been rejected by the radical feminists of the first period. Importantly, it reframed those paradigms of instinctive femininity by valorizing previously denigrated qualities traditionally ascribed in Western patriarchies to women, such as nurturance, peacemaking, and a focus on relationships over rules in calculating what constituted morality. This “difference” feminism argued that although women and men were different in essential ways that were embedded in biology, those differences simply meant different distribution of skills and talents that perhaps suited women better for certain tasks. The work of scholars such as Nancy Chodorow (1978, 1989), Dorothy Dinnerstein (1976), and Carol Gilligan (1981) yielded both theoretical and empirical bases for this strain of feminist psychology, frequently alluded to as the different voice model of womenʼs development, playing off the title of Gilliganʼs well-known book on gender differences in moral development. During this time Jean Baker Miller, a feminist psychiatrist who had proposed a different voice model of womenʼs psychology (1976), cofounded the Stone Center group of feminist therapy theorists at Wellesley College. Stone Center theory blended feminist analysis with psychodynamic formulations to propose a relational model of womenʼs development founded in the mothe –daughter bond and a relationally focused paradigm of feminist therapy practice that is currently known as the relationa –cultural school (Jordan, 1997, 2010, 2018). l r  14 Inherent in the difference stance was the risk of re-creating a gendered vision of socially separate spheres for women and men. While the alpha-bias paradigm valorized womenʼs gendered experiences, the rooting of those experiences in biology implied, in concert with prefeminist writings, that gender was less mutable and more fixed in biology and that social arrangements that differentially assigned roles and capacities based on sex were fair as long as equal value was given to those roles and capacities. This paradigm also made invisible the experiences of transgender and other gender-variant individuals, whose gender differed from sex assigned at birth and, in fact, could not accurately describe the experiences of people misgendered due to the sex assigned at birth. Thus, for instance, if nurturing children were paid as well as driving trucks, then alpha bias would not be problematic because it would function to equalize the value of gendered tasks. However, alpha bias could be, and was, used to reassert that women had a rightful place in the world in the domestic rather than the public sphere (for a discussion of the social construction of motherhood in response to alpha-bias narratives, see Warner, 2006). During the same time frame, Hannah Lerman (1983, 1986), a radical feminist psychologist whose work was grounded in radical feminist politics and humanistic psychotherapeutic traditions, made the initial proposal of criteria for a theory of feminist therapy. Lermanʼs proposal was the first to attempt to differentiate feminist therapy from psychotherapy with women by outlining the parameters of a theoretical model instead of describing clinical practice with a specific problem common to women. Her criteria for a theory to be feminist were as follows: ▪ The theory is clinically useful. ▪ The theory arises from and reflects the diversity and complexity of human experience (no normative dominant group). ▪ It views women (the “other”) centrally and positively rather than as deviant. ▪ It arises from the experience of women and other groups on the margins. ▪ It remains close to the data of experience; in other words, it reflects the real world as people know it. ▪ It theorizes behavior as arising from an interplay of internal and external worlds (the biopsychosocial model). ▪ It avoids using particularistic terminology (no mystical and mystifying language). ▪ It supports feminist modes of practice (e.g., automatically leads toward egalitarian and empowering strategies for practice).  15 Another activity differentiating feminist therapy from other theories was the creation of a feminist ethics code for psychotherapists, and the centrality of ethical thinking in the development of paradigms for psychotherapy practice. For therapy to be feminist, it must reflect a feminist ethic of social justice. Because extant professional codes were seen as deficient in addressing social justice ethics, the FTI membership developed its own code (FTI, 1990, 1999), an aspirational model for feminist therapists. Concepts from this model have been integrated into the codes of mainstream mental health groups in succeeding years. Several books about ethics in feminist therapy practice were developed under the aegis of the FTIʼs Ethics and Accountability Committee (Lerman & Porter, 1990; Rave & Larsen, 1995). Ethics was seen, then and now, as central to feminist theory and practice, with feminist practice itself being construed as an ethical stance (Brabeck, 2000; Brown, 1991) due to the close attention given to nonabuse of the power of psychotherapy as well as to the aspiration that feminist therapy would serve social justice goals. This next phase of feminist therapy development was also marked by challenges from within the ranks of feminist therapists. Feminist therapists of color, poor and working-class therapists, therapists with disabilities, lesbian therapists, immigrant and refugee therapists, and others who were not themselves members of the dominant European American, heterosexual, middle class critiqued feminist therapy and its practitioners for being inattentive to the realities of the diversity and complexity of womenʼs experiences. These criticisms arose in part because of the Eurocentric quality of the different voice feminist theorists whose work had begun to predominate feminist therapy discourse. The emergence of womanist, class-conscious, and other diversity- aware feminisms signaled a move away from the difference model because a focus on the diversity of womenʼs experiences made transparent the absence of a female universal. Brown and Rootʼs (1990) Diversity and Complexity in Feminist Therapy, Adleman and Enguidanosʼs (1995) Racism in the Lives of Women, Comas-Díaz and Greeneʼs (1994) Women of Color, and Hill and Rothblumʼs (1996) Classism and Feminist Therapy: Counting Costs are examples of the wave of scholarship in that period reflecting this change from a monolithic view of women as a sex to a more nuanced perspective on womenʼs intersectional identities and life experiences. It was around this time that more feminist therapists began to conceptualize women in the context not simply of generic patriarchy but of specific cultures and milieus and to ask how feminist models of responding to distress could be informed by the experiences of women from the margins of  16 dominant society. The construct that later came to be named intersectionality (Crenshaw, 1989) became important in feminist therapy theory. Over time, feminist therapeutic scholarship reflecting womanist and mujerista perspectives (Bryant-Davis & Comas-Díaz, 2016) has emerged as a continuing strong thread of feminist therapeutic thought, with the emphasis once again on the wisdom of the margins informing the center of feminist practice. Difference/Equal Value Feminism and Feminist Therapy The political strategies of feminism transformed as research from feminist psychological science began to provide a more nuanced view of differences and similarities between women and men and as within-sex differences related to culture, social class, and other forms of experience emerged as more salient for understanding difference. No longer did political feminists argue that women and men should receive equal treatment because they were the same. Instead, the argument was one of basic fairness, that people should be accorded equal treatment and opportunity because that was the right thing to do and that each personʼs particular skills and capacities should inform access to opportunity. This changing politic of feminism is reflected in the third phase of feminist therapyʼs heritage. As feminist therapists began to see women in a more complex manner, gender, too, began to be more closely interrogated, given the diminished influence of essentialist constructs. Some feminist psychologists and therapists had begun to question whether feminist therapy was for women only. Some of these feminist therapists were already working with men, such as Ganley (1991) who developed treatment programs for men who beat their women partners. Early feminist family therapists, such as Hare-Mustin (1978), Luepnitz (1988), Bograd (1991), and Nutt (1991), were working with men in the context of assisting heterosexual couples. They made compelling arguments for the application of feminist therapy to the intrapsychic effects of sexism and patriarchy that were oppressive to men. These writers and others asserted that even though womenʼs and menʼs concerns might be superficially different in content, given how culture socially constructs gender, at the root patriarchy could still be identified as a causal factor in distress for men as well as women. Levant (1992) theorized a feminist paradigm of menʼs psychology, attending to the manners in which sexism and misogyny specifically distorted menʼs experiences.  17 This third phase in the development of feminist therapy is best marked by a 1993 consensus conference on education and training in feminist practice held under the auspices of SPW and the APA Education Directorate. Findings of this conference were described in Worell and Johnson (1997). More than 200 feminist psychologists and psychology graduate students attended and met in weekend-long working groups, developing conceptual paradigms and defining parameters for feminist practice touching on supervision, assessment, and the integration of diversity into feminist theory. This gathering included some of the most powerful and influential writers, thinkers, and practitioners in feminist therapy, including many of the living founding mothers of AWP, SPW, and FTI. Several other important contributions to the development of theory emerged around this time. In Subversive Dialogues: Theory in Feminist Therapy, Brown (1994) developed a paradigm for defining radical feminist practice that offered feminist models for assessment and diagnosis and that more deeply explored what was meant by the egalitarian relationship. Kaschak (1992), in Engendered Lives, proposed a feminist model for understanding identity development through the lens of gender in the social context. This “self-in-context” model of personality development extended past the self-in-relation construct of the Stone Center authors to a vision of self in relationship to the larger world as well as the more intimate sphere of close connections. Worell and Remer (1996, 2003) proposed the empowerment feminist therapy model (initially empowerment therapy for women) during this period of time. It represents one of the first attempts to systematize the types of specific interventions that would constitute a feminist approach to psychotherapy. Although this model focuses primarily on womenʼs experiences, the authors take the perspective that feminist practice is not simply psychotherapy with women but rather contains elements of empowerment, the analysis of power, and the evocation of feminist consciousness as its core constructs. These authors and groups of feminist therapists achieved a full differentiation of feminist therapyʼs theories of practice and personality during the third period of the paradigmʼs development, so that by the end of the 20th century, it had become clearly defined and distinguished from other approaches to therapy. Multicultural, Global, and Postmodern Feminisms and Feminist Therapy As the 21st century dawned, feminist therapyʼs growing edges continued to reflect transformations in the larger feminist political sphere. As feminists from the formerly colonized nations of the Global South begin to have impact on the  18 practice and theory of U.S. and other North American feminist therapists working in collaboration with their colleagues from those parts of the world (Enns, 2004; Kaschak, 2007; Khuankaew & Norsworthy, 2005; Norsworthy, 2007), feminist therapy was also transforming to become more multicultural and global in its analyses (Enns & Williams, 2013; Morrow & Hawxhurst, 2013; Morrow, Hawxhurst, Montes de Vegas, Abousleman, & Castañeda, 2006). The concept of psychological colonization as a means of understanding the effects of patriarchies on experience has deepened feminist therapistsʼ comprehension of how and why some patterns of problematic behaviors, thoughts, and feelings may persist in clients, especially those whose experiences resemble those of a colonized nation. The importance of including the spiritual dimension as a component of understanding human experience, asserted initially by feminists of color self-described as womanists (Comas-Díaz, 2008), has begun to gain wide acceptance and visibility in the work of feminist therapy theorists (Brown, 2007). The notion of a cisgender man as feminist therapist became more fully accepted (Brown, 2006b; Levant & Silverstein, 2005). Many of the problems addressed by feminist therapists remain familiar from previous eras, such as violence against no –dominant-group people, discrimination in the form of aversive bias, and denigration of women in the larger social sphere. However, the specific intervention strategies used by feminist therapists continued to transform, partially in response to new information about ways of supporting healing and partly as the understanding of how patriarchy manifests itself became increasingly sophisticated. EMERGING FEMINISMS AND FEMINIST THERAPY At this writing, toward the end of the second decade of the 21st century, new visions of what constitutes feminism are emerging rapidly and continuously. The voices of gender-nonconforming people have broken open previous conceptualizations of gender as binary, and the voices of people who are transgender, agender, gender nonbinary, and other iterations of other-than- cisgender have raised questions about the interactions of biology and gendered experiences. At the same time, the near-ubiquitous presence of technologies for communication, such as e-mail and social media, as well as technologies that allow for synchronous no-cost video communication between people at disparate locations, have raised questions about settings and modalitie —not simply for feminist practitioners, but for all psychotherapists. Because feminist therapy practice is guided by the ethic of empowering clients and creating liberatory n s  19 milieux for personal change, some of the leaders in developing integration of these new technologies into psychotherapy have been feminist psychologists (Maheu & Pulier, 2013); as, 50 years ago, feminist therapists asked why it was necessary to define women as less moral or intellectually capable than men, feminist therapists in the 21st century ask why therapy must occur in an office, or for a particular set period of time, or face to face rather than through text messaging, tweets, or other as-yet-to-be-developed forms of electronic communication that feel comfortable and empowering to new generations of both therapists and clients. The reinvigoration of social justice movements in response to the greater visibility of many forms of social injustice, and the apparently spontaneous emergence of groups working for liberatory aims and goals after the 2016 U.S. presidential election testify to the reality that feminism on the global social stage has entered a new phase of growth, spurred in part by capacities for communication that could not have been imagined in the 1960s. The Black Lives Matter movement, the increased visibility of openly transgender people, and the rise of violent right-wing reactionary “alt-right” movements attempting to suppress progressive gains have all energized new forms of feminist activism, which in turn raise questions about the integration of therapy into feminist politics. Feminists of this period have taken the concepts of speak-outs and CR to new technological heights; an example of this is the #shoutyourabortion movement, started by feminists wishing to make visible through the social media hashtag the sheer numbers of women who have had abortions while deshaming and desilencing the experience. In late 2017 this was followed by #metoo, from women (and some men) coming out about having been sexually harassed or assaulted by powerful men in their lives in the wake of several well-publicized outings of repeat sexual harassers in the entertainment industry. Similarly, the Black Lives Matter movement, which arose in response to extrajudicial murders of African American women and men by law enforcement, or the Womenʼs Marches held throughout the United States and elsewhere on January 21, 2017, reflected grassroots, nearly leaderless, collective progressive, feminist, and antiracist responses to political events that were entirely enabled by new communications technologies. Yet simultaneous with these social movements has been the commodification and commercialization of many of the constructs of earlier versions of feminism. Corporations attempt to sell products by conveying, directly or otherwise, that a woman or girl will be empowered by using their makeup, driving their car, or drinking their alcohol. While on the one hand feminist psychologists have  20 studied and deplored the sexualization of girls and women (American Psychological Association Task Force on the Sexualization of Girls, 2007), some other girls and women (e.g., the performer Miley Cyrus) have publicly celebrated their power over their bodies by self-commodifying and identifying that behavior as an expression of their feminist values; the message of such women, many of them in the performing arts, has been that when the woman herself decides how she will present herself to the world, then sexualizing those images is a celebration of self and of female sexuality and of the range of female bodie —fat, pregnant, scarred by surgery, old, missing limb —that were previously ignored, devalued, desexualized, or shamed into invisibility (Gay, 2014, 2017; Solnit, 2015; West, 2016). Female celebrities write op-ed pieces about their experiences of postpartum depression, talk about their struggles with bulimia and body shame during performances, claim their experiences of psychological distress as normative rather than pathological, all framed as feminist messages of self-empowerment and shame reduction. Political feminismʼs rapid transformations during this phase have meant that earlier feminist authorities have been subjected to critique, their assertions challenged for inattention to dynamics of power in manners that parallel the ways in which those same earlier feminists critiqued patriarchal culture. This development is an exciting one, testament to the vibrancy and viability of feminist critique. Feminism that embraces radical understandings of gender and intersectionality, that addresses the pervasive colonization of indigenous and other marginalized peoples, that attends to the disenfranchisement of members of working classes and the ways in which xenophobic memes have arisen to create sharper divides between groups to the benefit only of the top 1% of the population is emerging continuously and cannot be adequately characterized in this volume. These developments within the larger political realm of feminism nonetheless challenge feminist therapists to remain alive and open to changes in feminist politics and principles and continuously interrogate how to integrate those emerging constructs into the specifics of practice of psychotherapy. Because feminist therapy is primarily theory driven and technically integrative, the next chapter, which addresses theory, constitutes the major focus of this volume. Therapists practice feminist therapy because of their epistemology of therapy, not because of what specific behaviors that theoretical model elicits with a given individual sitting across the room. Feminist therapy does not constitute a collection of interventions; it is a theory of how to use the range of psychological and psychotherapeutic interventions in a liberatory manner. Consequently, everything done by a feminist therapist should reflect and s s  21 embody that theory and epistemology of power and empowerment within the larger social and political milieu. How those goals are expressed will, however, vary from therapist to therapist, client to client, and even within the course of work with a given individual. Feminist therapy promoted tailoring the therapy to the client well before such an individualized approach became accepted within mainstream psychotherapy practice (Norcross, 2011). This apparently protean character of feminist therapy is, in fact, evidence of the centrality of theory and client-centered values over attention to any specific application. The feminist model proposes that one can harness many applications in service of the superordinate liberatory goals of the process when the therapy is designed to respect the unique capacities, strengths, and needs of the person seeking psychotherapy.