Feminism and couple therapy

Abstract

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.