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Carmen Knudson-Martin
Montana State University
This article addresses political questions associated with gender in the practice of mari-
tal and family therapy. In this paper, “political” refers to those processes maintaining or
changing power relations within any social or interpersonal system. To examine the politi-
cal aspects of an issue is to ask whose interests are served by a particular set of social
relationships and practices, how our assumptions, beliefs, and values reflect and support
particular social structures, and how our theories and processes for scientific inquiry are
embedded within or are part of political processes. It is also to examine how professional
decisions and interventions affect political processes. Until recently it has been unfashion-
able, perhaps even unethical, to openly acknowledge political agendas within our clinical
practices. Yet, what we do as marriage and family therapists is not separate from the ongo-
ing power relations between social groups (e.g., races, classes, genders, etc.).
Because politics are part of ongoing personal and social relationships they are often
difficult to see. For example, though gender, a social category ascribed at birth (Lindsey,
1997), affects nearly every aspect of our lives and results in different expectations, roles,
behaviors, and status for women and men, the politics associated with gender statuses are
often beneath the surface and not openly addressed. This is true for therapists as well as
their clients. The purpose of this paper is to make visible the political implications of vari-
ous approaches to gender within family therapy and to examine the ethical issues raised by
them. As agents unavoidably engaged in the political arena of social change we must con-
sider how our theories and strategies support one agenda or social structure or another and
we must make conscious decisions about them. Basic ethical principles such as neutrality
and client welfare also require re-examination and redefinition.
Portions of this paper were presented at the 1996 annual meeting of the National Council on Family
Relations, Kansas City, MO.
Carmen Knudson-Martin, PhD, is an Associate Professor and Program Leader of Marriage and Fam-
ily Therapy, Department of Health and Human Development, Herrick Hall, Montana State Uni-
versity, Bozeman, MT 59717.
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GENDER STUDY AS POLITICAL ENTERPRISE
The recognition of gender as a key component ordering family life has had a major
political impact on the field of family therapy. It has increased attention to the experiences
of women, raised areas for study that had previously been ignored or deemed unimportant,
and challenged many established clinical practices. It has caused us to examine ways that
our practices and theories, developed within an androcentric context, have been biased
against women, and it has stimulated the development of new theories and practices that do
not disadvantage women. Yet, a recent study (Leslie & Clossick, 1996) found that training
in gender did not necessarily result in practices that discriminated less against women; that
is, not all approaches to gender had the same political impact.
One of the most debated and potentially political topics within gender studies is how to
define the nature and extent of gender differences. While most scholars agree that there is
a large overlap between the traits, skills, and abilities of men and women and that variations
within each gender are considerable (Lindsey, 1997; Lips, 1997), the explanatory models
used to guide research questions and interpret the findings have different political conse-
quences. For example, models that emphasize the biological elements differentiating the
sexes without also taking into account institutionalized power differences between the gen-
ders almost inevitably transform male-female differences into female disadvantage (Bem,
1993). Similarly, “gender-neutral” models that minimize, discount, or individualize gender
differences also support the status quo by ignoring the power of the social order to affect
individual experience according to gender. In contrast, models that critically examine the
social context tend to promote social change by emphasizing gender inequalities and the
limitations accompanying culturally reinforced gender stereotypes.
Conclusions about appropriate clinical responses to the research and discourse regarding
gender differences differ according to which literature one reads and which political agenda
one supports. To help marital and family therapists sort through this dilemma, the first part of
this paper examines how contradictory forces within the social context affect gender and
power relations in ways that both support and inhibit change toward gender equality. The
second part looks at how approaches to gender and power issues differ within the clinical
literature and have different political implications. The third part outlines ethical issues asso-
ciated with the political dimensions of practice and suggests ways to respond to them.
There are three ways the social context of gender relationships is important to the poli-
tics of gender in therapy. (1) Most clients are unaware of the ways social conditions and
collective images of appropriate behavior for men and women influence the patterns of
their lives. They experience themselves and their partners as making their own unique and
personal decisions and creating their own successes and failures, joys and disappointments.
(2) The social influences on gender patterns and relationships are contradictory and confus-
ing. There are social factors that encourage gender equality and social factors that inhibit it,
resulting in hidden gender dilemmas, which women and men must in some way resolve.
(3) Clinical symptoms and relationship issues may be related to the tension stemming from
contradictory social forces, yet therapists may be reluctant to raise political issues that cli-
ents themselves do not see or consider a problem.
The political dimensions of approaches to gender in the literature vary primarily ac-
cording to whether existing gender differences are reinforced or challenged. Some ap-
Gender as Process
For many years theorists and practitioners whose focus and interest was on the relation-
ship system tended to ignore the influence of gender. Within the last decade awareness re-
garding the centrality of gender to family processes has been increasingly recognized, yet
often remains not well-integrated into ongoing research and systemic theory (Ferree, 1990;
Thompson &Walker, 1995). Within family therapy much of this awareness was made vis-
ible by Walters, Carter, Papp, and Silverstein (1988) and by McGoldrick, Anderson, and Walsh
(1989). Helpful to the integration of gender within family theory is a process view of gender,
emphasizing both the institutional and interactional levels of analysis, which explains how
gender is created in the day-to-day social relations between women and men (Ferree, 1990;
Risman & Schwartz, 1989). Such a view allows a therapist to validate clients’ experiences by
recognizing and understanding developmental differences between males and females, yet to
also acknowledge the social context in which such differences occur.
The gender as process perspective defines gender as a part of interpersonal processes.
It focuses on the interactional context in which people experience being male or female and
how existing, ongoing relationship patterns construct and maintain gender (Knudson-Mar-
tin, 1995). Since the experience of gender always occurs in relation to others, the psycho-
logical and power aspects of gender roles and identities are not merely properties of the
individual, but are integral to their overall system of relating. Since they exist reciprocally,
masculinity and femininity cannot be understood apart from each other or the power struc-
ture within which they are embedded.
Viewing gender as a process lends itself well to working within a family systems frame-
work, but requires making the gender construction processes visible. While family systems
therapists are used to considering individual traits and identities to be maintained or changed
within ongoing, day-to-day relationship patterns, many do not automatically think of these
processes as also created by and maintaining existing gender patterns. Yet, internalized
constructions of gender identities and social structures that accord more power to men typi-
cally serve as “metarules”defining behavior within the relationship (Knudson-Martin, 1995).
When rules such as “Mary notices John’s stress and tries to attend to him” or “John re-
sponds to Mary’s attention with irritation and distance” are made visible and understood
within their gender context, constructing new gender patterns is more possible.
A process view of gender would see John and Mary struggling within relationship
patterns that were influenced by, yet reinforce and contribute to, gendered individual iden-
tity constructions and societal power differences between men and women. The therapist
would believe that it was important to understand the clients’ issues within both the cultural
differences framework and the power differences framework, but would be most interested
in the unique way Mary and John construct gender between them and would expect that
their established gender patterns be somewhat flexible and open to change. Thus, Mary’s
anger would be seen as reflecting her disappointment that the relationship is not satisfying
her needs for connection and as a reaction to established relationship patterns in which
Mary has shaped her life around John’s and he has expected such accommodation.
To understand the political implications of this therapy, however, the therapist must
also consider how Mary and John’s responses to each other are part of larger social patterns.
If we accept Goldner’s (1985) suggestion that family therapists view gender as a cen-
tral, organizing force shaping family life, gender is not merely one of many potential “out-
side influences” on a particular situation or problem but is intrinsic to the very nature of the
relationship. Just as one cannot not communicate, one also cannot not do gender. To not
place the symptom or problem in its gender context is as incomplete as not placing it within
its systemic, relational context. The meaning of the client’s behavior and experience does
not make sense unless understood within its gender framework. Therapists who accept this
premise, therefore, find themselves in the position of having no choice but to think about
and respond to clinical problems in relation to gender. The question is not whether to
address gender, but how.
CONCLUSION
Discussions about gender in therapy can stir strong passions and disagreements. While
there is usually consensus regarding issues such as the value of clear communication or the
harmfulness of child abuse, the issues relating to the politics of gender in therapy are still
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