Feminism and couple therapy

Abstract

I began this paper as a fairly innocuous statement of gender issues in couple therapy, from the point of view of a psychiatrist/family therapist working in private practice. Two factors began to influence the writing. Firstly, much of the material I felt to be appropriate to the subject has already been written well by others e.g. Hare-Mustin (1978), Goldner (1985) James and Mclntire (1983). Secondly, I realised I was drawn to write on areas which many feminist writers have largely left untouched, namely the part played by gender issues in die conceptualization and treatment of major psychiatric disorders, especially the psychoses.

Treacher & Baruch (1980), Scull (1977) and Szasz (1961) notwithstanding, mainstream psychiatry still treats major disorders as if they are physical illnesses. We have the public perpetuation of the myth that schizophrenia is an illness “just like diabetes or Alzheimer's disease” (Fuller-Torrey and Deveson) and the inculcation in both patients and their families of the belief that usually a young adult, suffers from an incurable brain disease. Psychoeducational programmes add insult to injury by teaching families about excess dopamine in the synapses causing (“perhaps”) the conviction that FBI agents are following the patient. The synapse is like “a space capsule and a space station with a docking port”.

What has this to do with women or couple therapy? It occurred to me that the cases in which I had seen the most blatant sexism, eiUier in the family itself or in the treatment teams, were those in which a member of the family had a serious mental illness. Just as the police in the Yorkshire Ripper case were hampered in their pursuit and apprehension of the culprit by their stereotypic view of what kind of man would commit these crimes (“someone mad, not like us, but who hates prostitutes”) (Smith 1989), so psychiatrists trained in patriarchial systems are blinded to gender-related issues which are of prime importance to proper diagnosis and intervention. As this point of view is not stressed by most critics of traditional psychiatry, I decided to use it as the focus of this paper.     

WHAT IF FAMILY THERAPY WERE A KIND OF PSYCHOTHERAPY? A READING OF THE HANDBOOK OF PSYCHOTHERAPY AND BEHAVIOR CHANGE*

Editor's Note. This piece by Grunebaum is not an “original article,” although his approach to presenting Garfield and Bergin's Handbook to a family therapy audience is certainly original; it does not meet the usual requirements as apiece for the “Connections” section of the Journal, although it certainly does forge such connections with the mental health world beyond family therapy; and it is not a typical “book review,” and thus, is appropriately described in its subtitle as a “reading,” rather than a review. It is a most creative demonstration of the fact that family therapists can learn a good deal of practical value from their colleagues who are “outside” our field.     

Family Therapy … What's in a Name?*

The 2nd Australian and New Zealand Family Therapy Conference, held in Melbourne in July 1992, invited those making presentations to address the Conference theme Family Therapy … what's in a name? In a closing address to a plenary session of the Conference, I used the metaphor of first names (family) and surnames (therapy) to suggest that names are central to issues of identity. Our first name of “family” differentiates us within the larger group who share the surname “therapy”; but what does it mean to belong to the larger group sharing the name “therapy”? Historically, much of family therapy's energy has gone into issues concerned with establishing difference — difference within family therapy in terms of models and approaches, and difference from other approaches to therapy. Yet now perhaps family therapy would benefit from exploring what it shares in common with others who hold the same surname of “therapy”, with the possibility such dialogue could lead to mutual enrichment.     

Why Are So Many (If Not Really All) People and Families Disturbed?*

Many personal and family problems grow out of our not knowing how to process an intricate network of dualities, contradictions, dilemmas, paradoxes, and momentums that are intrinsic to the human condition rather than resulting from “disturbance” or pathology. What we have been learning in family therapy is that the processing of both “right” and “wrong” ways, or “good” and “bad” behaviors, is more likely to yield health and growth, whereas failures to process these dualities are far more the culprit of emotional disorders than bad or wrong behaviors as such. What really becomes important in family life is not the ability to stay out of trouble, but to get out of trouble, that is the ability to process conflicts and dilemmas and unfairness constructively. This way of looking at families helps us to account for and integrate many of the hard empirical findings that have been gathering now for twenty years in family therapy.     

Mental health and the media: From illness to wellbeing

The media are a main source of information about mental health for many people, and an ever‐growing body of literature is evaluating their coverage of the topic. To help keep track of such research, several comprehensive but now dated literature reviews have been published. We assess more recent studies (2007–2017) and suggest future directions by integrating (a) the “circuit of mass communication” model from media and communication studies which posits that production, content, and reception need to be analysed for an in‐depth understanding of the media, (b) the holistic view of mental health as comprising both illness and wellbeing, and (3) the critical psychiatry literature questioning the assumptions underlying psychiatric knowledge and practice. We find that recent studies have focused on content and “the illness side” of mental health by examining the representation of particular mental disorders and events involving individuals with specific diagnoses. We identify as a promising development the growing interest in “the wellbeing side” of mental health whereby authors have started to analyse recovery messages. We invite more production and reception research and more critical content studies which use diagnostic labels cautiously and analyse the representation of people with mental health problems as the victims of violence.     

Single Mothers “Do” Family

This paper explores how single mothers both incorporate others into family life (e.g., when they ask others to care for their children) and simultaneously “do families” in a manner that holds out a vision of a “traditional” family structure. Drawing on research with White, rural single mothers, the author explores the manner in which these women both endorse their children’s attachment to other caregivers and maintain boundaries around issues of discipline and attachment vis‐à‐vis these others. The author demonstrates that single mothers are willing to share this protected realm of family life with a new man (a fiancé or cohabiting boyfriend) as they pursue the goal of what has been called the “Standard North American Family.”     

"In search of a tale they can live with": about loss, family secrets, and selective disclosure

Several authors have written about family secrets in the family therapy literature in interesting ways. According to these authors, the questions “who knows the secret?” and “who does not know the secret?” are central. In the present study, we have qualitatively analyzed the documentary film Familiegeheim (Family Secret) by the Dutch director Jaap van Hoewijk. The film shows van Hoewijk’s investigation into the death of his father in 1974 and tells the story of a family in which the suicide of the father is kept secret from the three children. Our analysis of the film highlights the complex ways in which families deal with sensitive issues like loss, grief, and suicide. The concept of family secrets seems to poorly capture this complexity, focusing one‐sidedly on the destructive effects of withholding delicate information. The concept of selective disclosure is proposed as an alternative. Selective disclosure refers to the complex processes involved in dealing with the dialectic tension between sharing information and keeping it secret. The concept is not only focused on the destructiveness of secrecy but, in addition, also makes room for an appreciation of the caution with which family members deal with sensitive family issues.     

Interview With Michael Kerr

The following article was written by Dr Michael Kerr in response to questions put to him by Barbara Fraser; Linda Mackay and Lu Pease when he visited Australia two years ago. These three family therapists took it upon themselves to prepare this interview in recognition of Dr Kerr's unique vantage point on Bowen Theory and family therapy. Michael Kerr was trained by Murray Bowen in the 1970s and subsequently went on to work as faculty at the Georgetown Family centre. He succeeded Bowen as director of the centre where he has devoted his professional life to the understanding, application and extension of theory. He is the co‐author with Dr Bowen of Family Evaluation: An Approach Based on Bowen Theory (Kerr & Bowen, 1988), which remains the most esteemed text on this theory. He is also the editor of Family Systems: A Journal of Natural Systems Thinking in Psychiatry and The Sciences. Bowen's Family Systems Theory grew out of years of research from the 1950s‐1970s, which included observations of inpatient families with a schizophrenic member and using data from Bowen's own interactions with his family of origin (Bowen, 1978). The theory continues to be influential in family therapy with its most well‐known contributions being the process of triangling, the intergenerational transmission of family patterns and the concept of differentiation of self. (Brown, 1999). The following discussion from Dr Kerr brings a fresh perspective on the current applications and developments of this systems theory     

Vital Connections: Using Literature to Illustrate Social Work Issues

Abstract

This paper introduces a four stage teaching model which encourages students to use fiction as a source of mental imagery and insight into social work issues. Teachers can use the stages flexibly for different courses and levels of student expertise. The model has been developed by the authors during three years of formally implementing it in a range of undergraduate and graduate syllabi. The authors present this approach following detailed observation of the quality of written assignments, classroom interaction and student feedback. This is an exciting way of teaching traditional courses which generates a lively atmosphere for learning.

“We shall not cease from exploration And the end of our exploring Will be to arrive where we started And know the place for the first time.”

T.S. Eliot

(“Little Gidding,” The Four Quartets)     

Whatever happened to “bureaucracy”: Empirical studies of the 1970s

Problems with defining the structure of the organization are the topic of this research. At the beginning of the seventies Hage and Aiken wrote: “Characteristics of organizations do not occur randomly; they are found together in definite patterns.” The purpose of this paper is to begin to make these non‐random patterns explicit. Such a task involves three steps: (1) defining “the” characteristics of organizations, (2) examining the empirical relationships of these characteristics, and (3) summarizing the findings. This paper focuses on step one. The structural elements of organizations as they appeared in the empirical studies of the 1970s as published in the American Sociological Review, American Journal of Sociology, Social Forces, Pacific Sociological Review, Administrative Science Quarterly, and The Academy of Management Journal are presented. Based upon these findings implications for steps two and three above are suggested.     

Time in the Therapeutic Domain

This paper sets out to examine theoretically the role that “time” plays in therapy. It proceeds by investigating the appearance of “time” in the therapeutic literature: specifically, research regarding the efficacy of brief therapy and attendance of clients in therapy, psychoanalytic concepts of “time”, family therapy's recent emphasis on the future and conceptualisations available about “time” and its role in problem formation and resolution. A summary of these findings precedes a discussion emphasising the problems of crisis, irreversibility and chronicity. The conclusion re-emphasises the need for a multi-modal approach to any future theorising on “time” in the therapeutic domain.     

“Changing the world”: epistemic communities,and the democratizing power of science

This paper puts forward the argument that science can not only “save the world” but also “change the world.” While much has been written about the evident power of science to bring politicians to change their policies in order to “save the world,” e.g. the environment, less attention has been drawn on the hidden power of science to “change the world,” i.e. to frame and shape political orders and constituencies so that they get more democratic in the deliberative sense of the term, both at international and domestic scales. The paper sheds light on how science can induce democratizing effects in domestic constituencies. It can do that by the intermediary of three distinct enumerative mechanisms: “teaching,” “empowering,” and “taming.” These mechanisms, it is argued, are especially likely to become effective in those transnational institutional settings linking scientists and technical experts on the one side, with political and societal actors, on the other side, or in what Haas calls “epistemic communities.”     

Social Justice

The nature of the connection between family therapy and issues of social justice is explored, using various metaphors from Salman Rushdie's novel Midnight's Children. The author cautions against the affirmative use of a phrase like “social justice” in the context of family therapy, arguing instead for the potential of its critical, negative employment. This may allow a productive disruption of the currently dominating theoretical perspectives.     

Theories of Family Treatment

“Theory” in the social sciences may be defined as “Systematically organized, lawlike propositions about society and social life leading to hypotheses that produce a high rate of positive affirmation.”¹ No such theory exists in the subject area of “family”, generally much less in “family therapy”.     

Migrant Assimilation in Europe: A Transnational Family Affair1

The paper advances our empirical and theoretical understanding of migrant assimilation. It does so by focusing on a very particular group of individuals who appear more likely than other migrant types to “go native.” We call these individuals “mixed nationality relationship migrants” (i.e., migrants who have committed to a life outside their home country because of the presence of a foreign partner). The paper argues that the transnational family milieus that emerge from this form of international migration are critical to the assimilation process. Empirical material from 11 in‐depth interviews with female migrants in Britain (Sheffield) and France (Paris) supports our argument. We also suggest that such “extreme” assimilation is more likely within a regional migratory system – like the EU – where the “identity frontiers” crossed in the formation of a transnational family are relatively shallow.     

Paternal domination and the mafia state under post-communism

This review essay discusses Bálint Magyar’s most recent book, Stubborn Structures: Conceptualizing Post-communist Regimes (Budapest: CEU Press 2019). Bálint Magyar first published in Hungarian in 2015 (published in English by CEU Press in 2016) a path-breaking book on The Post-Communist Mafia State: The Case of Hungary. This was the first major attempt to move beyond political controversies and offer a systematic critique of post-communist states. The book also went beyond the usual accusation of “corruption.” Magyar’s key point is that—at least in Hungary—a mafia style of “upper-world” was created, with a “godfather” at the top of it and an “adopted family” below it. This fascinating idea was followed by edited books that included contribution by other scholars. The latest such book is Magyar’s Stubborn Structures: Conceptualizing Post-communist Regimes (CEU Press 2019), which includes articles applying the “mafia state theory” to a great variety of post-communist countries.

     

THE LIMIT OF THE DISCURSIVE: A Critique of the Radical Constructionist Approach to Family Experience

To date, the postmodernist approach to family experience which considers the actor's use of discourse rather than external sociocultural forces as primordial in constituting domestic reality has become an intellectual stream which sociologists can hardly ignore. Using the Gubrium–Holstein model as an exemplar for a “more sophisticated” postmodernist approach to constructing family experience, this article attempts to outline a critique of radical constructionism which overemphasizes the discourse of actors as artfully producing reality as featured in the notions of “doing things with words” and “talking reality into being.” The critique is mainly based on the works of Schutz and Garfinkel, of which Gubrium and Holstein claim their own model share “abiding concern,” and is further supplemented by the work of Bourdieu. This article carries a commitment to rebuking the postmodernist emphasis on the discursive by highlighting that the prepredicative structure of the lifeworld—which is nondiscursive in nature—constitutes the primordial, albeit insufficient, basis of the nomos pertaining to experience as constituted.