Empowering Women Through Therapy

By Marianne DeVries, A.C.S.W.

Women have often been called the "weaker sex." In therapy, however, I am struck by the strengths of my female clients. When family or relationship conflicts arise, often it is women who first seek help, showing a willingness to make changes in themselves. To take that first step requires courage and determination.

Those people who do take that first step find that therapy often helps them lead more emotionally healthy and fulfilling lives. This is true for women, men, couples, and families. Since this Today focuses on women's issues, this article addresses some of the ways that therapy specifically helps women. If you're a female reader, read this for yourself. If you're a male reader, read this for the mother, wife, daughter, and friend you care about.

While it's true that women often show strength by seeking help first, sometimes they make the mistake of carrying too much of the burden. More than once I have remarked, "what you want as the focus for therapy sounds like a marital problem," or "what seems to be depressing you appears to be your son's behavioral problems." It often takes a professional who is not emotionally involved to separate the issues.

Women may have to free themselves from "false guilt" or the excessive guilt they may carry for others' temperament or behavior. Since wives and mothers often feel responsible for creating a positive emotional climate in their homes, they frequently take on blame for its failure. A therapist can help make sure wives, mothers, or daughters don't carry too much of that burden and don't feel responsibility for what is happening. Therapy can thus have a supportive, liberating effect.

Women possess an uncanny ability to cultivate emotional supports amongst themselves. This also can happen in successful therapy. Because they have "walked the walk," female therapists can empathize with the role struggles and conflicts women face today. The relational and empathic capabilities of women may make a woman therapist especially suited to empower female clients to cope with the issues and fabric of their everyday life.

Some women need reminding that they are strong and competent. One way women display their competence is how well they cope with losses in their lives such as divorce or a spouse's death. Faced with the financial difficulties these losses usually cause, women are able to carry on and continue to sustain their families. Independently, they also often cultivate meaningful activities that they might not have before their loss. Many suddenly find talents and skills they had not formerly developed. For example, one widow became an entrepreneur by opening her own craft shop and art gallery and another decided to finish her education, which she had chosen to interrupt for marriage and family. I marvel at the "single again" mothers who carry the burden of being father and mother to their children and at the older women who have become their aging spouses's eyes, ears, wheels, and-eventually-caregivers.

Women's resilience is seen in those women who return to an often fiercely competitive job market after years of raising their families. Today, mothers live many years after their last child leaves home. It takes strength and self-definition to decide what one wants to accomplish in that next stage of life. Many women need the support of therapy to sort out their priorities. They need encouragement to believe in their own competence as they overcome their fear of failure.

In The Cost of Competence, B. Silverstein and Deb Perlich point out that competent women often pay a price in our competitive western society in sexism, ageism, and even "fattism." Self-doubt plagues even the highest achieving women at times. The authors point out that women receive much less encouragement in choosing non-domestic roles. Such gender bias, the authors stress, leads to depression, anxiety, disordered eating, headaches, and somatic symptoms. Family and society prejudices contribute to these maladies. We need to create greater awareness of how easily we devalue each other's choices. Therapy can help a woman evaluate her choices and feel confident in the good choices she makes.

While returning to the workforce or feeling good about life choices are issues that adults face, challenges facing women start long before adulthood. One of the saddest consequences of societal pressures on females is the toll it takes in the form of disordered eating. It is hard to escape the media image of female "attractiveness." Many an adolescent female finds her way into the therapy room when she has started a destructive pattern of self-starvation, which gets her into conflict with her family and the community. These young women engage in severe deprivation and/or painful purging rituals, hoping to express themselves and gain social acceptability. They have lost their ability to recognize normal bodily sensations of being hungry or full. They live with tremendous guilt and self-loathing, all for the sake of thinness and conformity. They may have forgotten-or never realized-that God likes variety, and that's why people were created in different shades and shapes!

One young woman I worked with for an eating disorder was fifteen-year-old Katie.* She expressed her discontent being female and the limitations she felt it placed on her by saying, "My brother doesn't get watched nearly as close as I am....He has many more freedoms. I'm told I may never go in a car alone with a boy, not even a friend who offers me a ride home after school. My brother never was told he couldn't ride with a girl! My parents are much stricter with me, just because I'm a girl. It's not fair!" Katie had already been hospitalized for depression. She resented the way her parents treated her differently from how they treated her brother. Her parents agreed they treat Katie differently, but hesitated to change this rule because they see girls as more vulnerable than boys. In Katie's case and others like her's, family therapy often helps parents redistribute the responsibilities and make changes that are more fair and more emotionally healthy for girls and boys.

Katie's hospitalization for depression as a teen isn't unusual. Silverstein and Perlich view depression in women as gradually developing over the life span. In childhood, girls generally don't sense discrimination as strongly as they do in adolescence. As the young woman's body develops, she more strongly identifies with the female gender-a gender that can feel restrictive to her. The dreamed-of career of becoming an engineer, an astronaut, or a medical doctor may seem unattainable if she also wants to be married and have children.

Silverstein and Perlich feel that this starts the disillusionment that may return at mid-life as feeling empty, trapped, hopeless, and helpless and can result in major depression. Twice as many women are likely to suffer from depression than men. It is thought that much of this may stem from forgoing personal pursuits. For many women, once they become mothers, often expectations are that they will sacrifice or postpone their own personal dreams.

Some depression is due to environmental stressors such as feeling oppressed. This may be particularly true for women in abusive relationships. They often need support in therapy to overcome their victimization.

Janice*, 23, is the mother of a four-year-old son. She came in depressed, anxious, and feeling hopeless. Her live-in, abusive boyfriend told her if she left him, he'd ruin her financially and gain custody of their son. His anger so completely intimidated her that she didn't dare tell him she was coming in for therapy. Through therapy, she realized she had listened to his verbal abuse for so long that she had lost all confidence in herself. She had really believed she couldn't make it on her own, though for years she had been the one who held a steady job, paid the bills, and organized the household. For too long, her mate had shamed her into staying with him. Janice learned to conquer her fear and to take control of her own life by overcoming the passivity and helplessness that made her feel petrified.

When women remain victimized in bad relationships, it demeans their own personhood. Both individual and couple therapy may be necessary. If the abusive husband comes in, he often responds well to firm limits set in therapy. Men who abuse their wives usually have been allowed to bully while growing up. More than likely in their parental home, they were themselves victimized and/or watched parent abuse. "In his aggression," says Dr. Nate Floyd, a New York psychologist who has studied bullies, "he is desperately trying to get the victim to say 'no' so he himself will feel less threatened."

If the abused wife (or child) continues to cower and doesn't stand up for herself, this inter-generational pattern of abuse continues. It has been my experience that when the female therapist models assertiveness without aggression for her client, it gains the abusive spouse's respect. This can be the start of breaking the couple's intimidation/fear response.

Abused women need to overcome their fear of anger-both in themselves and the people around them. This requires adequate self-esteem and an ability to tolerate disapproval.

Unfortunately, many women have been raised to believe that we need always to please others to feel good about ourselves. Facing the displeasure of family and friends has been difficult for many of us.

Sally*, 44, came to my office looking calm and well-groomed. However, she was depressed to the point that she had a hard time going through the motions of her daily chores. It soon became clear that she had stifled her anger for many years because she thought expressing it would end her marriage. She had learned that each time she expressed resentment, her husband, John, backed off emotionally and physically. She felt shut out, devalued, and lonely. In therapy, Sally learned to express herself in ways John could "hear" and respond to. He learned that avoiding problems led to more problems and is beginning to see confrontation as a way of problem-solving.

Our society generally views anger expressed by females negatively. Women learn to ignore and suppress anger. Because one of women's most common fears is that of losing relationships, they internalize their resentments rather than risk severing the ties. This is never more evident than in the teenagers I see who succumb to their boyfriends' pressure to become sexually involved. The fear of loss is greater than the fear of consequences.

We must teach our daughters that being overly compliant and denying their own needs, feelings, and opinions is unhealthy. In fact, it is likely to set them up for victimization. Many women who come for therapy find they spend a lot of time "unlearning" what they've been taught and discovering the truth about their abilities, relationships, and potential.

Any discussion of empowering women would be incomplete without acknowledging the therapist's own empowerment. Where does it come from? Not from mere human enlightenment, I would suggest. As a Christian therapist, I draw strength from a living faith, that generates hope that my clients can change and grow to become all that God has meant for them to be.

In therapy, counselors not only become confidants, but also serve as mentors, advisors, or role models. The famous German theologian Dorothee Soelle suggests in one of her writings that only those who themselves have suffered can fully recognize and respond to those around them who are hurting. While not every therapist has to struggle with depression, an eating disorder, or divorce to help others with these problems, effective ones have accepted their own life story with its inherent suffering, which is part of living in a broken and imperfect world.

Whereas suffering makes some people bitter, cynical, and defeated, good therapists are "wounded healers" (term coined by the Catholic theologian Henri Nouwen). They have moved-or are in the process of moving-beyond bitterness, despair, and hopelessness to become "strong in the broken places." They need to have or to be developing a mature sense of judgment and the desire to learn from their clients as well as teach them to find their path in life.

If you are thinking of entering therapy, find a therapist with whom you feel comfortable, where you feel that you are treated with respect and confidentiality. You will gain a sense of relief when you can share all your feelings, the negatives as well as the positive ones. A good match between therapist and client is usually one in which you come from a similar value and belief system so you will feel heard, understood, and validated. You may want to interview several therapists to find that match.

Therapy provides hope for greater self-definition, improved self-reliance, personal competence, and mastery. Despite the messages society often sends, being born female need not be a drawback if we work toward overcoming gender-bias at home, in our schools, churches, and the workplace. We need to overcome rigid gender roles, especially for women raised in families where dominance rather than dialogue was the norm. Most women want to break the cycle of dysfunction-for themselves and their children. They courageously come to therapy to sort out their issues so they can be positive forces of change in their own lives and in our world.

* names and identifying information were changed to maintain confidentiality