Case Study: Self Role As A Counselor For Feminist Therapy
- Understand the application of feminist therapy concepts to counseling.
- Identify techniques commonly used in feminist therapy practice.
Directions: Assume the perspective of a feminist therapist, and show how you would proceed with Marina by answering the questions that follow the case description.
Marina: “Searching for Identity”
By Mary M. Read, PhD, Director of Clinical Training in the Counseling Department at California State University, Fullerton
Marina is a 38-year-old single woman who came into therapy to better understand her emerging racial and sexual identities, as well as to cope with some issues surfacing from her traumatic childhood. She is having trouble keeping her job due to excessive tardiness. She links this to her “head feeling scattered” from new information she just received about her ethnic background and a budding attraction to women, when she had previously expressed herself as heterosexual. She admits to feeling “extremely down” at times, and she is struggling to incorporate conflicting views of herself on her own.
Feminist Therapy Approach from Dr. Read
Marina was referred to me by a coworker, specifically because of my feminist orientation to therapy. “I don’t want anyone to tell me what to do or how to be—I just want to get a handle on who I am so I can get on with my life,” Marina tells me in our first meeting. I assure her that we will explore her issues together, focusing on her strengths, and that she will be responsible for making the choices for her own life. She will be the expert on who she is and wants to become, and I will work to provide hope, encouragement, and support as she moves through this process. We discuss what feminism means in the context of therapy, and I leave plenty of time for Marina to ask me questions about my background, training, and therapy process, leveling the power differential between us somewhat.
Significantly, until recently Marina had been unaware that her father is African American. He left the family before she was 3 years old. Her mother’s family, of northern European descent, never shared with Marina why she did not have blonde hair and blue eyes like the rest of her family. Her brown hair, eyes, and café au lait skin tone matched others in her primarily Latino neighborhood, and she had assumed that her father was Hispanic. She has now met him once and finds that “a piece of the puzzle of who I am just fell into place,” yet some of the information he imparted is also very upsetting. Her father confirmed some of the memories Marina has about being verbally and physically abused by her mother and maternal aunt when she was very young, which progressed to sexual abuse when she reached puberty. Being sexually victimized by female relatives has made it very hard for Marina to explore her own sexuality, especially her developing realization of bisexual attractions.
Marina’s job is on the line, so we focus first on what it would take to please her boss (a woman) enough to successfully complete the remediation plan at work to salvage her job, then earn a better employee evaluation for the next period. This brings up Marina’s lack of sleep from frequent nightmares, resulting in missing her alarm once she finally returns to sleep. As well, Marina’s mood at work has been “grumpy and distracted” by her own admission. I ask if Marina has shared with her boss any of the extenuating circumstances that have caused a drop in her work performance, and she hasn’t. This brings up a choice point, where Marina could go along one path or another, disclosing personal information to her boss or not. Marina and I explore different avenues (mainly by role play and visualization) before she makes her selection, as part of informed consent. Understanding the risk-to-benefit ratio of her choices is part of what gives Marina the empowerment to make changes in her life.
I also encourage Marina to get a good physical from a medical doctor because she has been ignoring her health for some time. There are several female physicians to whom I routinely refer, and Marina agrees to make an appointment with one. The whole person is a focus of feminist therapy, and self-care is a vital tool of empowerment. We also discuss the possibility of seeing a psychiatrist if her depression worsens, or if her posttraumatic symptoms continue to interrupt her sleep. She is hesitant to follow through with this referral because, as she says, “I don’t want to be called crazy for what I remember.” I assure Marina that I do not see her as crazy, and that it is very common for children in abusive situations to develop coping skills that in the moment help them survive, yet in the long run also cause some problems.
Apparently, this has happened for Marina, who admits at our third meeting that she had seen a psychologist previously for a few sessions. “He gave me some tests, then said I was ‘Borderline,’ which sounded pretty hopeless, so I didn’t go back.” I explained to Marina that sometimes children who experience very early trust wounds, usually with their primary caregivers, later have difficulty figuring out who they are relative to others, and go back and forth on whether others are trustworthy or not. Given Marina’s complicated history with multiple losses and traumas, this pattern of development made sense. I encourage her to read books on the subject of surviving trauma in childhood, including John Briere’s Child Abuse and Trauma (Sage Publications, 1992), which talks about psychological symptoms as coping strategies that fit within the context of abuse. This feminist view of the diagnostic process allows for the development of better coping skills over time, emphasizing choice and empowerment versus abnormality and deficit. A strengths-based perspective, essential in feminist therapy, is thus preserved in the context of diagnosis.
Rather than see Marina through the lens of her diagnosis, she and I discuss how she is feeling about our relationship in each session. We make room for her to feel positively and negatively toward me, the therapy process, and the therapeutic relationship, not taking the feelings of the moment as the last word, but simply another layer of information to guide our work together. When she is angry with me, we explore what she might have wanted to be different, and whether that can be arranged, within the boundaries of therapy. For example, when I looked at the clock near the end of one session to be sure we ended on time, Marina came in the following session accusing me of being uncaring and wanting to be rid of her. Now, if I wonder about the time, I ask her where she thinks we are in the session, and we look at the clock together to gauge how to process where she is and where she’d like to be by session’s end. We both approach the end of the session differently now, and are learning from that shift.
To explore her emerging identities, I encourage Marina to participate in cultural events that provide a systemic context for her unique ways of being. She is becoming active in an African American singing and drumming group, wearing traditional African garb for performances. The rich cultural inheritance she now embraces helps her move from feeling “different” to “special,” which is increasing her self-esteem. I also encourage her to participate in events like Pride Festivals for the LGBT (Lesbian, Gay, Bisexual, and Transgender) communities, where many participants experience and express a sense of sexuality alternative to society’s hetero-normative views.
Embracing two identities that have been heavily stigmatized and oppressed over the years is a challenge for Marina because of society’s injustice rather than because of a deficit in Marina. She now realizes that her differences can be causes for celebration rather than discrimination, that social justice demands equality for all races and sexualities, and that finding her way in these alternative identities will take some navigating over time and in different contexts. Marina continues to use the support of feminist counseling to help her embrace her emerging identities and to explore ways to work for a more inclusive, tolerant society.
You Continue as the Therapist
(1) Marina decides to talk to her boss about why she has had issues being tardy (interrupted sleep), but she only discloses learning of her father’s ethnicity, not her child abuse history or shifting sense of sexuality. Marina reports that her boss responded by making a derogatory comment about African Americans. How would you process this with Marina? What are your responsibilities as a feminist counselor?
(2) Given that therapy is an intimate context, Marina begins to indicate she is experiencing feelings of attraction to you. How do you process this from a feminist perspective? How do you balance power-sharing with keeping appropriate therapeutic boundaries?
(3) Marina eventually loses her job, and with it the insurance coverage that paid for her therapy with you. As a feminist, how do you negotiate a new arrangement with Marina, ensuring she continues to receive needed support
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