TAKING IT PERSONALLY: ISSUES OF PERSONAL AUTHORITY AND COMPETENCE FOR THE FEMALE IN FAMILY THERAPY...

Journal of Marital and Family Therapy 1987, Vol. 13, NO. 2, 157-165

TAKING IT PERSONALLY: ISSUES OF PERSONAL AUTHORITY AND

COMPETENCE FOR THE FEMALE IN FAMILY THERAPY TRAINING*

Elizabeth Reid Susan McDaniel Rehabilitation Support Services School of Medicine and Dentistry

Albany, NY University of Rochester

Constance Donaldson Martha Tollers Private Practice, Rochester, NY

The supervision and training of women requires thinking and planning about how to address issues women bring to the training process as a result of sex-role typing. Dependent behavior and attitudes are interactional problems that need to be overcome in a training process that leads to competency and creativity for therapists. Strategic Supervision can benefit women by increasing their self- reliance, sense of personal authority, and competence.

In the past 5 years, the family therapy field has increased its focus on the supervisory process. Of particular concern have been issues regarding live supervision (Berger & Dammann, 1982; Beroza, 1983; Gershenson & Cohen, 1978; Roberts, 1983a, Roberts 1983b; Whiffen & Bying-Hall, 1982), theoretical orientation and supervision (Colapinto, 1983; Keeney & Ross, 1983; Landau & Stanton, 1983; Liddle & Saba, 1983; McDaniel, Weber, & McKeever, 1983; Reamy-Stephenson, 1983; Simon & Brewster, 1983), and the training of supervisors (Heath & Storm, 1983; Wright & Imber Coppersmith, 1983).

One issue that has not been addressed adequately is how a trainee’s gender affects the family therapy training process. In the past 20 years, the women’s movement has increased our awareness of the differing experiences of men and women in our culture. These varying experiences need to influence our approach to training men and women in acquiring the skills necessary to becoming a family therapist. Recently, increasing attention has been focused on the impact of the women’s movement on family therapy

*We would like to acknowledge the helpful comments and issues raised by Lyman Wynne, MD, PhD, and Adele Wynne, MSW, in their reviews of this paper.

Elizabeth Reid, MDiv, is Director, Treatment Program, Rehabilitation Support Services, 306 Central Avenue, Albany, NY 12206

Susan McDaniel, PhD, is Associate Director, Family Therapy Training Program, Department of Psychiatry, and Co-coordinator of Training in Psychosocial Medicine, Division of Family Medi- cine, University of Rochester School of Medicine and Dentistry, 885 South Avenue, Rochester, NY 14620.

Constance Donaldson, MSW, is in private practice, 100 White Spruce Boulevard, Rochester, NY 14623

Martha Tbllers, MSW, is in private practice, 1576 Long Pond Road, Rochester, NY 14626. Requests for reprints may be sent to Elizabeth Reid.

April 1987 JOURNAL OF MARITAL AND FAMILY THERAPY 157

(Goldner, 1985; Hare-Mustin, 1978,1980; ‘paggart, 1989, but there is more that needs to be researched and explored regarding the effect of gender on the training process.

This paper explores the issues of gender for the female in family therapy training. These issues also influence training for women in all forms of psychotherapy. While the issues discussed are certainly not limited to women, the focus here is on the woman’s experience. Throughout the paper we use many statements of women’s experiences that are generalized and may seem to reinforce already existing sexist attitudes and stereotypes. Our intent is to expand the ways women can choose to behave during the training process, by delineating problems encouraged by our socialization and encountered by us and other women we know. The research on sex differences, such as that summarized by Maccoby and Jacklin (1974) is relevant to a discussion of gender issues in training. However, we restrict ourselves in this paper to the training experience, a context waiting to be researched.

We have found that many women trainees experience major difficulties in developing a sense of personal authority and competence. Women with this problem often “take things personally,” allowing their feelings to be hurt, and questioning their own judgments. By “taking it personally in training,” we refer to a therapist’s tendency to react to the interpersonal process of therapy without conceptualizing its meaning, as if the emotional expressions of a family or a supervisor were only personalized comments on the therapist. A combination of cultural expectations, interpersonal struggles, and intrapersonal conflicts undermines the role of women as experts. This paper will discuss the tendency of many women to take it personally, by exploring what commonly undermines women in training and the supervisory techniques we developed to deal with these issues.

COMMON ISSUES WOMEN BRING TO TRAINING IN FAMILY THERAPY

Because of society’s present structure, women in psychotherapy training bring struggles with sex-role expectations, dependent behavior, and the development of personal and professional identities. Exploration and recognition of these issues as part of supervision can facilitate the growth and skill development of the trainee. As systems therapists, we believe that one level of the system affects another level. The relationship of supervisor to trainee, traineeltherapist to family in treatment, and individual to personal family and society are frequently isomorphic relationships. We are interested in the implications of interactions being worked out on numerous levels, simultaneously.

Sex Role Expectations While recognizing that we risk perpetuating sex-role expectations, we have iden-

tified several expectations commonly held, which we feel affect many women in training. These expectations are: (a) Women are dependent and accede to male authority; (b) women are expected not to be competent; (c ) women’s gratification comes from being primary nurturers; (d) women are nice, polite, socially proper; (e) women’s careers are second to the spouse’s career and family caretaking; (0 women are experiential, feeling and intuitive, rather than cognitive and intellectual; (g) women use their sexuality to get their needs met.

Until very recently, basic sex-role expectations in this society encouraged women to have both greater dependency on others and lesser expectations for achievement. We believe men and women need to work to change these attitudes and assumptions. In training, past and present attitudes must be recognized and managed, thoughtfully and planfully. Following, are examples of ways in which we have found the above assumptions affect the training situation. We offer some playful suggestions on the positive

158 JOURNAL OF MARITAL AND FAMILY THERAPY April 1987

aspects of the stereotypes, and some possible reframes for thoughtful supervision when these effects are noticed:

1. An expectation by a supervisor and trainee that a female will be dependent, pliable, and accede to authority can result in a lessening of a power struggle between the two, thus freeing the trainee to use more of her energies for learning. Diminishing early power struggles and confrontations before a supervisory relationship is solid can benefit a cooperative working relationship. However, it may also result in the trainee remaining dependent upon the supervisor far too long. She may stop short of realizing her potential, failing to take the risks necessary to become a grown-up therapist and professional. The female trainee may underestimate what she knows and question her own authority and expertise for considerably longer than her male counterpart. The thoughtful supervisor would watch for this tendency in the trainee and monitor his or her own need to be depended upon.

2. An expectation that a female will not be competent can allow for maximum use of the one-down position. Both families and colleagues may be less guarded, less defen- sive. Thoughtful supervision can help a woman utilize the advantage of unexpected competence. The power of the one-down position is demonstrated clearly by Peter Falk’s effective Columbo routine and Angela Lansbury’s often unexpected competence in Mur- der, She Wrote. Fisch, Weakland, and Segal (1982) emphasize that it is easier to shift from one-down to one-up, than the converse.

3. An expectation that a female will be nurturant can be one of the primary advantages of being a woman therapist. Often, she can smoothly join and establish rapport because the family may already expect that she cares. The potential difficulty in training a woman who expects, or is expected, to get gratification from being nurturing and supportive occurs when treatment requires confrontation or neutrality in order for a family to get therapeutic benefit.

4. An expectation that a female will be nice and polite can grease the wheel of many interactions. Clients may feel less threatened by an initial meeting. Early in training, a woman must learn to distinguish between being nice and being in charge. For example, a female therapist may have a male patient expect her to go into the treatment room ahead of him so he can be the last one in, closing the door, and observing the social amenities. In not allowing this, the therapist has an early opportunity to establish her role as the provider of structure in treatment.

5. The frequent expectation that a female will put her career second to her family, allows the woman to choose more freely among options for her work schedule, i.e., she may have the luxury of working part-time while her male counterpart may feel he does not have this option. She may also feel more positively about her accomplishments, salary, etc., because less is expected of her. As Sheeley (1983) pointed out, the “model of male and female family roles impacts the manner in which men and women exercise their personal and delegated authority in the work setting” (page 288). The effect on the training process may be that the woman sets a ceiling, or underestimates what it is possible for her to accomplish in her career development.

6. An assumption that a female will be experiential, empathic and intuitive, can be advantageous in relationship and can facilitate a natural ability to think systemically. A woman can be less resistant to a systemic view of problem if she has grown up learning to be sensitive to multiple dimensions and multiple perspectives of a situation. However, both the trainer and trainee need to be cautioned against expecting any trainee’s intuitive skills to cover for weakness in other areas. Good intuition without a strong conceptual base can lead to many difficulties, including overfunctioning by the therapist in the treatment session.

7. An expectation that a female will use her sexuality in her interpersonal trans- actions can be operating in treatmentltraining environment, sometimes out of the


awareness of both supervisor and trainee. Supervisors need to watch for this and need to teach the trainee to use her sexuality carefully and appropriately. We believe the use of sexuality ought to be an overt choice, not covertly expressed out of coyness, seduc- tiveness or dependence. One’s sexuality, smile, eyes, voice, etc., should be used when the decision has been made that it makes sense, therapeutically. Supervisors need to notice if a trainee’s behavior reflects society’s old belief that sexuality is women’s main means to power and credibility.

Dependent Behavior Given sex-role expectations, it is easy to see how dependent behavior can be encour-

aged in women. We believe that dependent behavior in women reflects society’s attitude toward women and interpersonal struggles between men and women. We do not find it useful to view dependency as a personality trait. Rather, we view dependent behavior as a reflection of a woman’s taking all relational exchanges personally, anxiously attempting to meet societal expectations. We will term this constellation of attitudes and behaviors “Dependent Mind Set” (DMS).

DMS is an attitude that can foster self-sabotage. It is an attitude of seeing oneself, and women in general, as dependent, passive, and servile. Aspects of DMS in the woman trainee include the feeling that doing the right thing, looking the right way, and being pleasing are essential to professional existence. This leads to such behavior as being a good girl or being overly responsible. The DMS woman trainee can experience indepen- dent ideas and/or feelings as aggressive and to be avoided. These attitudes or feelings lead to behaviors such as not speaking up in meetings, using a soft voice, and main- taining conformity. Other signs of this passive attitude are the trainee’s need to be kind at all costs and to avoid hurting anyone’s feelings.

In the context of training, a Dependent Mind Set is a distinct disadvantage. A dependent, passive, servile attitude in which one has to experience oneself as pleasing, continually undermines personal authority and competence. The woman whose basic goal is to please and do the right thing has a large repertoire of interactional behavior with which to take things personally (e.g., criticism means she is not liked, so she will not take the criticism as a suggestion leading toward increased mastery). It takes a major shift in attitude and thinking, as well as behavior, to move from this dependent role into more masterful areas of competence.

Caust, Libow and Raskin (1981) draw b distinction between “the referent” and “the expert.” Therapists operating as referents use self as a major resource and are most a t ease with closeness and intimacy at a peer level. Experts use knowledge and skill as resources and may maintain a distant authority position. Competent therapists must have the flexibility of both referent and expert styles. If the woman with DMS has low self-esteem, she likely feels like a servant, while a DMS woman with higher self-esteem can be a referent. The ability to use both referent and expert styles requires overcoming DMS and an even higher level of self-esteem.

Personal and Professional Differentiation The challenge for all trainees is to shift from exclusive caretaking and dependency

to individuation, mastery, and goal setting. Women who have been taught to value others more highly than themselves can lack a sense of personal identity. Without such a sense of identity and self-worth, there can be no sense of personal authority because the woman has no central core of her own, no ability to take a differentiated position- a t home, or a t work.

To develop this central core, women can try listening to their own inner voices, which may require attending less to the voices of others while discovering what is centrally important to them. With this discovery, often comes acceptance of responsi-


bility for personal actions and behavior. But for the female trainee it is not enough to stop with the development of this personal identity. She must also develop professional skills and a professional identity, from which she can assess her own strengths and weaknesses and stand on her own as a therapist. Professional skills include relational skills, perceptual skills to discern patterns of relationships, theoretical and conceptual skills, and a range of executive skills. For the female trainee, it is also important to find credible, competent, female role models, and to explore women’s issues in her culture. The woman who has developed such a professional identity will acquire the expertise and confidence to choose her own style of therapy.

FAMILY THERAPY TRAINING FOR WOMEN: STRATEGIES FOR DEVELOPING PERSONAL AUTHORITY AND COMPETENCE

Strategic Supervision Family therapy training offers a therapist, male or female, opportunities to define

oneself and to establish a sense of competence and authority. All the varying models of family therapy and family therapy training encourage this growth. Of the types of training available in family therapy, problem-oriented strategic supervision offers specific opportunities to deal with sex-role expectations and to escape the trap of DMS, because the supervision fosters self-reliance. By strategic supervision, we mean that supervision guided by the principles of problem-focused, systems-oriented treatment (e.g., Haley, 1976; Madanes, 1982; Watzlawick, Weakland & Fisch, 1974; and others).

In strategic supervision, the focus is on the behavior of the supervisee. The supervisor intervenes only if the supervisee is stuck, leaving ample opportunity for the trainee to use her own skills rather than remain dependent on the expertise of the supervisor. The goal of strategic training is for the trainee to become an effective therapist, with the quest being to find an intervention that has therapeutic benefit, not the right or pleasing answer for the supervisor. With this lessened opportunity for dependence, trainees can develop a greater sense of competence with support from an outside authority.

In the following discussion we explore two areas of supervision, skill development and career development, and propose strategies that may be useful in training women to increase their sense of personal authority and competence. We recognize that this discussion runs the risk of encouraging sexist, stereotyped thinking. However, we think it is important to openly discuss these issues with a view towards encouraging growth.

Skill Development In addition to Tomm’s (1979) division of therapist skills into perceptual, conceptual,

and executive categories, we believe a fourth category of relationship skills needs emphasis.

Relationship skills. Women often come to training with well developed relationship skills. Parenthetically, a larger percentage of male trainees need focused work in this area. While socialization gives most females the edge in this area, all students need training in adapting these skills to the therapeutic context. They need to understand how their own relationship skills influence, and become a part of, the therapeutic system, as well as how to choose among those skills to facilitate treatment.

A relational area that frequently seems to be difficult for women involves differ- entiating maintenance and support from caretaking and overfunctioning. Strategies for dealing with this problem with any trainee might include prescribing silence for the trainee, suggesting the trainee sit at right angles to the patient and reduce eye contact, and reframing support to include the trainee actively allowing patients to make mis- takes and learn from them. Another important aspect of developing relationship skills


includes the maintenance of appropriate boundaries, i.e., defining one’s role as therapist, not family member or friend.

Problems with relationship skills in therapy may also emerge isomorphically in supervision as dependent or counterdependent behavior in trainees. While some dependent behavior is appropriate in training, some women are particularly vulnerable to becoming dependent on the supervisory process. A basic strategy for dealing with this area is to encourage a student’s autonomy in areas of proven skill. It is important to encourage the trainee’s own sense of responsibility for her work, asking, “What is it that you want to do in this situation?“ Another strategy is to use the least amount of intervention possible to accomplish a goal with a trainee. For example, when it is clinically appropriate, a prearranged signal to tap on the window may be less intrusive than calling into a session.

With intermediate and advanced trainees, a supervisor may support autonomy and decrease dependent behavior by encouraging trainees to have the first chance to comment and make suggestions on their colleagues’ cases. The supervisor can then support appropriate suggestions and comment on what has been overlooked. As in therapy, a supervisor must focus, from the beginning, on the trainee’s eventual independence from supervision. While a trainee may need a great deal of guidance early on, the supervisor must find ways to gradually reduce this until supervision ends.

Some trainees respond to supervision with more of a counterdependent style. In these cases, it is important to support the trainee’s autonomy and areas of competence, while not allowing the trainee to avoid areas of difficulty. The supervisor must confront the counterdependent behavior in areas in which training is needed. Early on, counterdependent behavior may show itself as disagreement with systems theory. In these situations, it might be useful for a supervisor to genuinely support the critical thinking of the woman trainee involved in disagreeing by conveying the message: “Be sure not to accept this view prematurely. Think it over critically and carefully, and take only what is useful and meaningful to you.”

Perceptual skills. As with relationship skills, women also, frequently, come into training having already developed many perceptual skills, being well trained to discern others’ desires, feelings, and thoughts. It is important to utilize intuition by training the student to overcome blind spots, broadening her skills to include recognition of the behavioral sequences and patterns important to systemic assessment. Major obstacles to the development of sharp perceptual skills are personal distortions, projections, and countertransference issues. One can offer correction of skewed, or limited, perceptions by introducing more information into the supervisory system through checking out the perceptions of the group behind the mirror. Also, it may be helpful a t times for the supervisor to model how she handles ongoing countertransference issues and confronts her own perceptual distortions.

Conceptual skills. Conceptual skills, the theory and formulation of clinical problems, are an extremely important group of skills with which some women need special help and encouragement through reading, didactic presentations, and critical discussions of theory. Some women struggle with a sense of the clinical problem that is too vague for clear presentation. Women trainees may need to be encouraged to present and explore how they think through a case on a theoretical level. Viewing videotaped sessions, detailed analysis of behavioral sequences and step-by-step planning of potential inter- ventions based on their anticipated effects are all strategies that can enhance the trainee’s ability to make conceptual assessments. Being able to clearly articulate a formulation for a clinical problem that includes a behavioral assessment of the therapist’s impact on the therapeutic system can diminish the problem of taking things personally for the trainee, because she can learn to recognize the interaction between her own behavior and that of the family.


Executive skills. Among advanced trainees, much of training may focus on the development of executive skills. While the active, orchestrating role of family therapist is attractive to many women (Caust et al., 1981), it is also an area of skills that can be underdeveloped for women. In working on executive skills, the issue of defining oneself as an authority and using authoritative behavior may be a problem for the woman trainee. Sometimes a role-play, or a prescription to pretend to be an authority, can be helpful, asking the woman trainee: “How would you act if you were comfortable with being in charge?’ It may also be helpful to deal with specific behaviors of the trainee, such as firm handshakes, ways of dressing that communicate authority, or a matter-of- fact tone of voice.

Another problem that can exist when developing executive skills in women is that many women have been socialized to avoid confrontation; instead, they have been trained to use covert means to express their expectations and to get their needs met. To sharpen skills in this area, it is useful to have trainees identify behavioral sequences in sessions, including their own behavior in this analysis, to begin to clarify any conflict avoidance. The supervisor can prescribe direct interaction between family members in order to get the trainee out of the mediating, confrontation-avoiding position. It is also important to model confrontation directly with the trainee when appropriate.

Career Development Choices about career advancement, career planning, and family needs must be

managed well in order to maintain personal authority and competence. In the area of career advancement, some women set an artificially low ceiling on career goals and do not do any long-term planning. On the surface these women may appear happy to settle for less. Supervision can counteract this with appropriate assessment of skills and questions about long-term plans and professional contributions women wish to make. For example, specific advice and information on how to become an Approved Supervisor often receive a positive reaction from trainees who underestimate their own skills and are not accustomed to planning for their own advancement.

CONCLUSION

We believe in the importance of being aware of gender issues as a supervisor of family therapists. We recommend that more research be done on the impact of gender on the training process. We believe that both men and women can provide credible supervision to the female trainee but that it is often easier for a woman to identify immediately with a woman supervisor. The female trainee’s development of a professional identity can be enhanced by a competent female role model.

It is a complex process for both male and female supervisors to develop authority and competence in the female trainee. Bardwick (undated) describes the female supervisor as mentor, friend, sister, and mother. As such, the complexity of training for a female supervisor may involve a trainee who fluctuates between distancing, enthusiasm and ambivalence. The female trainee may overidentify with, or idealize, the supervisor. This can be a set-up for disappointment. Female supervisors may need to express their ignorance honestly, and generally set appropriate expectations. The position of supervisor is like parenting, in that one can expect a healthy amount of rebellion, especially from women who need to work through cultural expectations. We believe that it is important for the supervisor, female or male, not to take this personally, but to support the trainee’s struggle and eventual differentiation.

The issues that are explored here are applicable to both sexes, as humankind is certainly more alike than it is different. The differences are in emphasis; we believe that highlighting women’s experiences gives us more awareness of the complex whole.


We think both male and female supervisors may experience more effectiveness if they openly discuss gender issues with their trainees. We also encourage all supervisors to be thoughtful and plan for the possibility that women trainees are taking things personally, struggling with DMS, and displaying dependent behavior beyond the time their skill level dictates dependence. We believe it is an ongoing, challenging process for a supervisor to understand the impact of gender issues on the training process and to experiment with ways to change our own behavior to facilitate trainees’ increased authority and competence.

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TAKING IT PERSONALLY: ISSUES OF PERSONAL AUTHORITY AND COMPETENCE FOR THE FEMALE IN FAMILY THERAPY...

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