I
Making Meaning
There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy. -Shakespeare Hamlet, I, v
Many of the systems for understanding ourselves and our worlds are currently balanced precariously on the edge of a paradigm shift. This shift involves acknowledging the interconnectedness and reciprocalinfluence of the observer and the observed, mind and nature, and the impossibility of objectivity or control of all variables deemed irrelevant in an experiment. The Heisenberg Uncertainty Principle and the sciences of complexity represent this perspective in the field of physics, as does psychoneuroimmunology in the fields of psychology, neurology, and immunology.
Feminist thought has been a crucial part of this intellectual revolution. In the last two decades, feminist thought and analysis have been able to breathe new life into many traditional academic and professional disciplines, from the humanities to the sciences to the social sciences, to name them in the ways that they are currently and artificially divided. Many feminist writers have demonstrated and documented the patriarchal nature of our society and the variety of ways in which patriarchal values serve masculine needs (de Beauvoir I968; Friedan I963; Millett I970), even in such arenas as science (Bleier I984; Keller I985) and the clinical practice of psychology (Broverman, l. K., et al. I970; Chesler I972; Miller I976; lrigaray I985), previously believed to ,be, or at least presented as, evaluatively neutral and apolitical. In the most seemingly diverse fields, women's per- spectives and ideas have been shown to be absent or buried or credited to men. It is always difficult, if not paradoxical, to take note of what is invisible, but it is precisely this paradoxical quest-to make the invisible female perspective visible--that has been undertaken by feminist scholarship.
A FEMINIST CRITIQUE OF MASCULINIST EPISTEMOLOGY
Scrutiny with a feminist eye has led to the development of a psychology that, for the first time, includes women's experiences and women's perspectives. The various prefeminist psychologies have spoken eloquently about how men socially construct and experience a unidimensional category named "woman," but have said little, if anything, about women's diverse experiences, about how women perceive themselves or others, about who women are, and especially about who and what women can be. While many of these theorists and practitioners have simply assumed that what they knew about men and mankind extended to women, others have filled volumes discussing and analyzing the construct "woman," but have failed to explain how they developed that construct or to acknowledge that it ís a construct rather than an absolute reality, which would not need further explanation.
Epistemology is formally defined as the study of how knowledge is possible and how knowing is done (Bateson and Bateson I987, p. 20). Prefeminist epistemologies were not only not objective or value-free but were based upon the world views and experiences of men, which appeared to them to be objective, evaluatively neutral, and universally applicable. Included among these so-called objective observations were men's experiences of women, along with a variety of androcentric psychological stan- dards against which women were, and all too often still are, measured. Such biases could perhaps have been challenged sooner had the perspectives upon which they are based been explicitly acknowledged, that is, made visible. But the epistemology of a dominant group can be made to appear neutral, and its value base invisible, since it coincides perfectly with what appears to be society in some generic, universal form. Justas many sensory experiences depend upon the perception of contrast-so that, for example, a visual image that is made to move in unison with the eye's scanning movement cannot be seen by that eye--masculinist epistemology in a patriarchal society may seem to define epistemology itself. A contrast had to develop first in the mind's eye of a few women, and then of many, before they could collectively make their perspectives visible. In this way, the feminist critique began.
Thus feminist psychology had, as its first task, to expose this masculinist epistemology and challenge its use as the foundation of traditional psychological thought. By masculinist epistemology, I mean systems of knowledge that take the masculine perspective unself-consciously, as if it were truly universal and objective. Despite claims to the contrary, masculinist epistemologies are built upon values that promote masculine needs and desires, making all others invisible. It is important to note that feminist thought sees its task not as promoting the needs and experiences of women as normative or universal but as making visible the varying experiences and perspectives that masculinist thought denies. Many examples of this distinction will be considered in this and subsequent chapters.
PREFEMINIST CLINICAL THEORIES AND METHODS
Over the last two decades, feminist psychology has moved through various stages of development. During its first decade, feminist scholars carefully considered and criticized clinical psychology and other related psy- chotherapeutic practices. Rather than undertaking a comprehensive review of the substantial body of feminist criticism in this area, I will consider some of the most basic and glaring epistemological blind spots of prefeminist thought and their impact on the psychological and psychiatric professions.
The roots of many seemingly discrepant schools of thought and practice are deeply embedded in the soil of masculinist thought, including those schools that have most influenced clinical psychology and psycho-therapeutic practice in the United States: behavior therapy, psychoanalytic or psychodynamic therapy, and family therapy. I will consider each of these approaches from the perspective of their shared epistemological assumptions.
Behaviorisrn
Behaviorism has been presented as a scientifically based approach to an objective psychology. Derived from the logical positivist school of philosophy, it was translated into a uniquely American (pragmatic, control-oriented) form of empiricism originally by John Watson and B. P. Skinner, and eventually by a multitude of researchers and practitioners. lt makes direct application of the same principles originally developed in controlled laboratory settings with animal subjects. Skinner's best-known work was conducted with pigeons and rats, Watson's with a white rat in the famous classical conditioning case of Albert, which he conducted with a little-known female co- investigator (Raynor and Watson I92I). The classical conditioning paradigm associated with Watson, involving the pairing of mutually exclusive responses, has been applied by Wolpe (I958) and other practitioners of behavior therapy or desensitization, in particular for the treatment of phobias (Wolpe I970; Podor I974). For example, an individual who is afraid of open spaces will first be taught relaxation techniques and will then be asked to visualize an increasingly fearful series of situations involving open spaces. Each treatment will continue only as long as the client is able to remain relaxed. As soon as she signals that she is becoming anxious, the session is terminated. Eventually the individual passes through all the imaginary situations in a relaxed state and is ready to confront the actual feared situation.
The paradigm based upon the work of Skinner and many others with operant conditioning is known as behavior modification and has been applied extensively to work with children in school settings and with severely disturbed hospitalized or institutionalized patients. In these situations, contingent reinforcement is applied to increase or decrease the frequency· of a desired or target behavior. For example, a child who does ten minutes of homework may immediately be rewarded with a period of play or may accrue tokens that can be exchanged for a desired activity or other reward. In its simplest form, this is a quid pro quo arrangement.
Most applications of these methods involve a mixture of both the classical and operant models. For example, an approach that grew directly from the early feminist therapy movement, assertiveness training, is based upon desensitization followed by active modification of behavior in the actual feared situation. That is, the individual may begin by visualizing a series of imagined situations in which she is able to behave assertively. The second step may involve rehearsal of these behaviors in the artificial setting of the therapy or training, followed by performing the desired behaviors in the actual settings that had previously been problematic for her. Epistemologically, behaviorism is based upon the premise that every valid and interesting bit of information about persons is and must be, at least in principle, empirically knowable or verifiable. Universal behavioral principles, which apply not only to all people but across species, are sought and considered discoverable by controlled, objective, scientific observation, by identifying and manipulating the smallest possible separate or linked units of behavior. From this perspective, complex human psychology can be reduced to a set of fully knowable and determinate behavioral principles. Change occurs through the identification and manipulation of the smallest possible separate or linked units of behavior according to the same principles. Who and what is changed is considered a decision outside the boundaries of this method.
The feminist scholar Evelyn Fox Keller (I985) has noted that objectivity, control, individuality, and the advancement of science through competing and rising above ordinary life are the hallmarks of Western masculinity and Western masculinist science. The philosophical school of logical positivism translated to scientific empiricism within psychology falls squarely within this tradition. Adherents have claimed that this method defines both objectivity and the science of human behavior itself, by means of which one can learn to "understand, predict and control behavior" (Hassett I984)
The method of this sort of science involves drawing rigid boundaries around minutiae, which can then be carefully controlled, observed, and manipulated, presumably without any undesired influence from the controller, observer, and manipulator or from the larger environment. This approach is obviously reductionist. It purports to be absent of values but in fact has its foundation in the value-based principles of objectivity, dispassionate and uninvolved rationality, control and manipulation, and separation of fact from value, experimenter from subject, and context from subject and experimenter. The psychological world, from this perspective, is both knowable and conquerable as an aspect of the material world.
Yet one achieves objectivity by ignoring a multiplicity of important, if not crucial, influences on the experiment that lie outside its narrow boundary as drawn. These include aspects of the physical context such as the experimental design and the setting in which it occurs, the time of day, the state of readiness of the subject, and whether participation is required for credit in an undergraduate psychology course. Additionally, aspects of the social context such as the effect of various qualities of the experimenter/ behavior modifier (RosenthalI968, including race, gender, and even disposition, are "controlled for" or ignored. Not only are results in laboratories generalized to the natural environment but laboratory subjects are considered to be under the influence only of those variables the experimenter wishes to study, the rest being "controlled." The gender, class, race, and personal history of the subject, along with the very effect of being an experimental or a therapeutic subject, are all too often considered extraneous variables unless they are the object of study.
The behavioral approach tends to be individually or, at best, dyadically focused. For example, in working with a child who is having problems, the reinforcement contingent upon the child's behavior and applied by the mother or teacher may be altered. Contingencies maintaining the mother's or teacher's behavior are rarely considered. Mothers are given responsibility for their children's contingencies much more often in this so-called value-free literature than are children for their mothers' or are fathers for anyone's. Yet implicit in the very principle of reinforcement is its universality. The behaviorist model considers it possible, both in principle and certainly in practice, to ascertain, manipulate, and control the multiplicity of influences that affect a child at any given time.
Imagine a female child who perceives her father's hostile feelings toward his own mother. Additionally, she is aware of her mother's despair over a difficult marriage and an interrupted career at a time when women are gaining access to better jobs. Do these complex experiences affect the child only in observable and manipulable ways? What if we then add to the picture the meanings that the child attributes to these factors, in particular, her own diminished sense of self-worth? Are these aspects reducible to fragments of observable behavior whose combination is only quantitative and does not create a qualitatively different psychological constellation? Indeed, new, complex, and subjectively organized meanings will come to permeate this child's psychological experiences in an untold variety of situations.
The psychoanalytic approach has already been the subject of serious criticism (Millett I970; Chesler I972; Koedt I976; Lerman I986) as well as attempts at revision (Mitchell I974; Alpert I986; Bernay and Cantor I986) by feminist scholars. Its development has not proceeded according to the tenets of logical positivism; rather, this approach is based upon introspection and the analysis of intrapsychic events, such as transference and countertransference, manifested interpersonally in the therapeutic relationship. Nevertheless, Freud and various psychoanalytic theorists who have followed him have sought to discover natural psychological laws that are objective and universal. Psychological phenomena are divided into two realms of experience, the conscious and the unconscious, movement from the latter to the former being a primary goal within the process of analytic therapy, along with the recapitulation of early experience in the therapeutic relationship. The approach is reductionist in that it traces all human behav ior to a few basic drives and/or early childhood experiences. It is deterministic in believing that all mental functioning is caused by identifiable factors already in existence. It is materialist in that it explains "higher" levels of functioning in terms of "lower" ones.
Inherent in the analytic perspective is a gender analysis based upon unalterable anatomical and biological differences between the sexes. As the behaviorists' approach has been judged as too narrow, so the Freudian approach has been criticized by feminists for being phallocentric. lts epistemology takes male experience as the universal norm, considering possession or lack of a penis the central element in the psychological makeup of all people (Cixous I980; Kristeva I982; Irigaray I985). Those without penises are forever relegated, by definition, to inferior status and are unable fully to resolve important developmental tasks. Even women's essential role in childbirth is viewed, in part or fully, as a consolation prize, a substitute for the coveted first prize. Psychological makeup is determined by biology and by early childhood experience in the oedipal triangle formed by the child and parents. Woman is considered an homme manqué to be understood primarily and throughout her psychological development (or lack thereof by her lack of a penis.* Unlike the behaviorist approach, the psychoanalytic clearly distinguishes between two types of people, the haves and the have-nots, the latter being forever doomed to second-class status.
According to the Freudian psychoanalytic perspective, all individuals pass through predictable and definable stages of psychosexual development, which must be successfully negotiated to become mature adults. All human experience is reducible to and explained by these stages of development, which are all completed in childhood and early adolescence and in relation primarily to the parents.
The same client I mentioned in the behavioral example, the woman afraid of open spaces, would be approached very differently by the analytically oriented therapist. The etiology of this fear, diagnosed as agoraphobia, would be sought in early childhood memories, dreams, associations, and transference in the therapeutic relationship. Undoubtedly it would be A male student once explained to me that he thought it is men who have penis envy: he admitted that he himself certainly envied his penis. This comment speaks of some men's relationship with their sexual organ, which they apparently believe has a life of its own sought in the psychosexual history in general and the oedipal or family drama in particular. Undoubtedly penis envy and castration anxiety would figure prominently. Only through uncovering the memory of the early traumatic event(s) that led to this fear, along with the accompanying affects, can a catharsis be accomplished and the anxiety discharged: that is, the underlying intrapsychic conflict must come to awareness and be resolved in the therapeutic relationship.
The analyst is viewed not as a particular person of a particular gender, class, or race with its concomitant values and perspectives but as a relatively dispassionate, neutral figure upon whom projection can occur. The analyst thereby becomes the current representation of the parent(s) of early child-hood and is, in this sense, both decontextualized and disembodied. Although more modern approaches, such as that of Harold Searles (I979), make explicit use of countertransference, it is still considered to be uniquely developed in response to the analysand. This takes place, most importantly, through the defense of projective identification, whereby the analyst is included in the picture but as a finely tuned instrument for receiving and interpreting the patient's projections and distortions and, second, through intrusion of the analyst's unresolved intrapsychic and familial conflicts stripped of any cultural meanings.
I will not, at this point, undertake a criticism from a feminist perspective of all the latter-day revisions, adaptations, and schools of psychotherapy derived from the original Freudian school, which can be broadly subsumed under the aegis of analytically oriented approaches, those emphasizing ego functioning being most prominent. Some of this work has already been begun (Westkott I986), as have attempts to revise or adapt the original Freudian approach 'in a manner relevant to women's psychology (Miller I973; Alpert I986; Bernay and Cantor I986). The object- relations approach, adapted to feminist psychology by Nancy Chodorow (I978) and others, will be considered at length in later chapters.
Family Therapy
The third school of therapy to be considered, the family systems approach, also reflects masculinist perspective and values in its inception and outlook. Introduced as an objective, meta mathematical approach (WatzlawickI967) that closely approximates technological systems thinking, it deals with observable behavior or communication based on a presumably neutral cybernetic model-that is, families function according to the same principles as do computers. Yet the major theorists have clearly interjected their own world views. Of the founders of famíly systems therapy, all but Virginia Satir were men, and they have typically approached families as regulated, rule- governed systems, like computers, or as hierarchical, executive-run systems, like businesses. Satir neither endorsed nor made use of either of these models.
The male theorists have also viewed parenting by mothers and fathers as necessaríly differing, just as the culture at large does, without questioning this assumption. They trace the source of problems all too frequently to the overinvolvement, or enmeshment, of the mother with her children, neither acknowledging the bias inherent in the use of these terms nor understanding the patriarchal basis for this circumstance, but locating the problem within individual women (Hare-Mustin I978, I987). They blame women for being just what the culture prescribes: intensely involved with their families and children. The family systems approach was introduced in the I950s, the decade that saw the rise of the modero, white, middle-class, nuclear family, and took the familia!configuration of the father in the executive role and the mother in the affective role as the norm and the normal--objectively, of course. In fact, these families were "more nuclear, more socially isolated, and more gender dichotomized than any in previous hístory" (Goldner I985, p. 44). Although Jay Haley (I969) and others have recognized power maneuvers as a factor in developing symptoms, the basic power inequity of gender difference and the influence of larger social systems such as gender arrangements have been deemed irrelevant and thus steadfastly ignored by mainstream family systems theorists.
The systems approach, as a result, turns out to be a closed system that does not provide a means to assess differential power orto attribute responsibility to different parts of a system or to allow for external influences. For example, if a woman is being battered by her husband, the systems theorist is required to look at how this behavior is both serving and being maintained equally by both partners. Far from being value-free, this approach ís misogynist and victim blaming (Bograd I984). lt also values the family more highly than any of its individual members and, in practice, often sacrifices the welfare of the individual to that of the group. For example, in a well-known, typical intervention by Salvador Minuchin, a family member, usually the adolescent daughter, is anorectic. Minuchin's strategy involves introducing the distant father into parenting as an expert who can teach the "overly enmeshed" mother a few things about parenting an adolescent. An outcome is considered successful when the anorectíc symptoms are removed. I have yet to hear what happens to the mothers, who have implicitly been informed by an expert not only that they have not done their jobs correctly but that their relatively uninvolved husbands have the necessary expertise to correct the situation. How many of these mothers wind up quietly depressed after this "successful" family outcome?
The client fearful of open spaces would be approached with her partner or spouse and perhaps her whole family. Were she not currently in a partner or family relationship, her family of origin would be the focus of the therapy. The function of her symptom would be sought within these relationships. A typical analysis would consider her fear as a means to exercise power in a primary relationship, for example, to keep her husband or partner by her side. The couple relationship would be more 6nely calibrated so that closeness could be achieved more openly and the symptom would no longer need to serve the function of creating closeness. This might occur through open negotiation or by manipulating the situation so that the woman would back off and her husband or partner would then presumably come forward in a well-calibrated dance. She would see that she had actually been participating in preventing closeness by the very act of seeking it. The work of the therapist is to recalibrate the cybernetic system, all parts being assumed to exercise equal power. As in behavioral therapy, removal of the symptom would be the goal and an indication of a successful out- come. The meaning or sources of this fear in other spheres of her life as a woman would not be considered, nor would its relationship to other fears, feelings, or experiences.
Ironically, this approach was developed in order to consider the larger system in which an individual functions, namely, the family. However, the leaders in the field, as well as the multitude of other nonfeminist practitioners, have, by and large, chosen to ignore both the historical roots of the patriarchal family and its relationship with larger social systems, and in-stead to focus narrowly on the current organization of the family as the best and only means of understanding it. Feminist critics have insisted that competent and consistent application of systems theory must necessarily include formulations about the effect of larger systems such as class, race, ethnicity, and gender on the family and its members (Goldner I985; Luep-nitz I988; Kaschak I990). lt rtlust also include acknowledgment of the values, perspective, and gender of the theorist or therapist. Only after the development of a feminist critique of the 6eld have feminist critics been able to begin to develop a perspective that is consistent with and explicit about feminist principles (McGoldrick, Anderson, and Walsh I989; Walters et al.I988; Luepnitz I988). These are certainly not widely accepted among more traditional family therapists; they are passionately repudiated by some and dispassionately ignored by others who persist in applying misogynist and ethnocentric principles to their work with families.