Psychotherapy with Women: Exploring Diverse Contexts and Identities


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Thought–provoking guide offers look at multiple identities
(March 2007 Issue)

“Psychotherapy with Women: Exploring Diverse Contexts and Identities”
Edited by Marsha Pravder Mirkin,
Karen L. Suyemoto, and Barbara F. Okun
Guilford Press New York, N.Y., 2005

By Paul Efthim, Ph.D.

Written largely by Boston-area psychologists, "Psychotherapy with Women" is a follow-up to Marsha Pravder Mirkin's 1994 book, "Women in Context." Mirkin, of Brandeis University, together with fellow feminist scholars Karen Suyemoto (University of Massachusetts Boston) and Barbara Okun (Northeastern University), edited this collection of papers exploring how women's multiple identities interact with each other. The result is a readable, practical and thought-provoking guide for clinical practice and the teaching of psychotherapy.

This well-written book is divided into five sections. Part I, Foundational Contexts, introduces conceptual material on identity, the intersection of multiple identities within and among women and how privilege and oppressive social forces can be worked with in therapy.

Part II focuses on women in relationships, with chapters examining intercultural and interracial intimate relationships, immigration-related family dynamics and class differences within families.

The third section consists of four chapters looking at women in the workplace. Part IV explores self-care issues, such as spirituality, health, resiliency among Native American women and playfulness in therapy. The final section lays out dilemmas that the authors could not resolve and directions for further work.

In a refreshing departure from the norm, each author begins by placing herself in context, providing some personal history regarding race, class, ethnicity, sexual orientation and other important aspects of her own history and identity. This approach sets the stage for a discussion of other women's lives in which the authors strive to understand how their own biases may impact how they relate to patients. Numerous case examples and references to the literature help rigorously ground the discussion in what we know from research and clinical practice.

Several chapters struck this white male reviewer as especially engaging. "Class Tensions Within Families" by Sandra Jones examines social class-related phenomena in families.

Jones gives special attention to the notion of "upward mobility" and helps readers consider some of the unspoken assumptions and attitudes about class that lead to relational gaps within families. For example, a woman who grew up in a working-class family may experience vague but unrelenting feelings of being a "class traitor" if she enters a career in academia or the white-collar professional world. Jones presents her interviews in poetic excerpts that lyrically show how individuals struggle with class-related problems within their families.

Our own graduate training may have had seminars and readings on "multicultural competence," but what about competence in dealing with issues of social class? As Jones and other contributors cogently assert, class-conscious practice requires that we examine how we, as therapists and teachers, may give off vibes of superiority which contribute to social distances and estrangements within our working relationships.

Other contributors offer valuable practical guidance on working with low-wage-earning women (Vanessa Jackson), Asian American and Asian immigrant women (Mizuho Arai), immigrant women (Ester Shapiro and Eileen Santa), among others. A chapter by Gretchen Schmelzer and Lise Motherwell offers a rare and stimulating look at play and playfulness in therapy with adult women.

Perhaps the greatest strength of this edited volume is its commitment to incorporating political matters - issues of power, privilege, and oppression - into the dominant apolitical discourse about psychotherapy. On occasion, the text veers briefly into overheated rhetoric, but for the most part it stays close to the facts at hand, which are sobering. Accordingly, the authors close with a hope that their work inspires colleagues and trainees to advocate for social justice as an integral part of their professional practice of psychology.

Timely and challenging, this book is highly recommended for practitioners at all levels and for graduate-level courses in psychotherapy.

Paul Efthim, Ph.D. is a licensed psychologist in full-time practice in Brookline, Mass. He holds a faculty appointment at the Massachusetts School of Professional Psychology.