Gender Bias in Psychotherapy
Updated: Sep 28, 2019
I chose to analyze Salvador’s Minuchin structural family therapy session “Agitated depression in an adult woman.” (Minuchin, Nichols, & Lee, 2007). I want to preface by saying that I have a deep respect for Dr. Minuchin’s work, especially after watching videos of his live sessions. He seems to be a very attentive and attuned therapist, and that is why it is, even more important, to see if he might be subjected to gender bias in his work. If someone, as experienced as Dr. Minuchin, can be at least partially blind to gender bias in the way he works with his clients, it should serve as a warning bell for the rest of the therapists and mental health practitioners.
The main presenting problem in this family of four is that the mother, Elena, is anxious and yells at the children. Everyone in the family seems to agree with that. It reminds me of Freud’s ideas about hysteria in women. These ideas are still covertly alive in today’s western society; A woman who is expressing anger is a problem: Elena is not allowed to be nervous or agitated. Even though Dr. Minuchin’s therapeutic work is pushing the family to step outside of their narrative that the mother is the problem, he never validates her experience but tries to change her behavior instead. Men seem to be allowed in the eyes of the western society to express anger; however, if a woman (or anyone who does not identify as a man for that matter) vocalizes anger a lot, the stereotype is that something is not ok with them. Even Dr. Minuchin says to Elena when he gives her homework: “On the following day she is free to be as crazy as she wants.” (Minuchin, Nichols, & Lee, 2007, p. 101).
It seems like the husband holds power in this family that is organized in a patriarchal structure: “Given the importance of physical strength in resource competition and territorial defense, and given the division of labor between the sexes in reproduction, including child-rearing, especially during the child’s early years, most traditional societies tend to favor male offspring over female offspring and accord more power to males than to females.” (Meyer-Bahlburg, 2017, p. 2). This unequal distribution of power might have led Dr. Minuchin to be overprotective of Elena during the first session. Dr. Minchin admits that he was overly confrontational when asking the husband to let the mother and the son figure things on their own. He says he did it because he felt it was a challenge to his therapeutic goals. There might also be an element of sexism there: He might have been protecting her because she was a woman and he was a man, as a result of the unfair socialization around the sexist concept that women are weaker than men and need their protection. Would he have done the same if it was the father instead?
During the sessions, Elena is viewed as by Dr. Minuchin as someone who needs to learn to be a better caretaker of her family: “I focus on Elena as a caretaker, paying attention to positives. The family made these moments of competence invisible while highlighting Elena’s agitation.” (Minuchin, Nichols, & Lee, 2007, p. 99). What is possibly implied, is that woman’s competence equals being a good caretaker. Furthermore, at the end of the first session, the mother is given independent homework, to work on self-control. When at the second session the father is given homework, it is on the Elena to help him. Once again, the woman is expected and being put in a situation where she needs to be the caretaker.
The homework is partially given by Dr. Minuchin to allow Luis (the father) to let go of control and let Elena help him, but I cannot but wonder about the possibility of Dr. Minuchin falling into the trap of gender bias. Even though the therapeutic work is targeted to minimize the caretaking and controlling of the husband to give more power to Elena, there is a possibility that Luis might be seen as caretaking too much because he is a man, and the gender bias that might be in play here is that caretaking is a “woman’s job.” Dr. Minuchin might also be trying to use the strengths of women as they are thought of in the western culture: “the naturally more relational, empathic, and inclusive style of women makes them better at working with others and fostering a more cooperative atmosphere.” However, this approach can also be dangerous since it puts all of the responsibility of nurturing on women, and minimizes them to merely mothers and wives, forever in service of the patriarchy.
Sasha Raskin, MA, is an international #1 bestselling co-author , the founder and CEO of Go New , a transformational education program, a life, and business coach and a psychotherapist in Boulder, CO. He is working on a P.h.D in Counseling Education and Supervision and is an adjunct faculty at the Contemplative Counseling master’s program at Naropa University, from which he also graduated. Sasha has been in the mental health field for more than 10 years, worked with youth at risk, recovery, mental health hospitals, and coached individuals, couples, families, startups, and groups. He has created mindfulness stress reduction and music therapy programs within different organizations. Whether it’s in person or via phone/video calls, Sasha uses cutting-edge, research-based techniques to help his clients around the world to thrive.
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Meyer-Bahlburg, H. L. (2017). Introduction to the special section on culture and variants of sex/gender: Bias and stigma. Archives Of Sexual Behavior, 46(2), 337-339. doi:10.1007/s10508-016-0871-7
Minuchin, S., Nichols, M. P., & Lee, W. (2007). Assessing families and couples: From symptom to system. Boston: Pearson/Allyn and Bacon.
Kaiser, R. B., & Wallace, W. T. (2016). Gender bias and substantive differences in ratings of leadership behavior: Toward a new narrative. Consulting Psychology Journal: Practice And Research, 68(1), 72-98. doi:10.1037/cpb0000059