Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
DSpace
UBCV
Ledgard, Delyse
Master of Arts - MA
University of British Columbia
This study addressed women's experiences of power in the therapeutic relationship. A grounded theory method of investigation was used. Eight women were interviewed who had been, or were, in therapy with a woman therapist. The interviews progressed from a generalized discussion of the therapeutic relationship and concept of power to a more detailed examination of the women's experiences of power within therapy. The results highlight the individualistic nature of the experience of power in therapy and that empowerment is achieved through a woman's self-knowledge. Disempowerment occurred when a woman's self- expression was restricted or when she felt judged and rejected by the therapist. The implications for therapists are summarized by the need for therapist's to respond to the individual needs of the women in the therapeutic process.
7953253 bytes
application/pdf
WOMEN'S EXPERIENCE OF POWER ' IN THERAPY WITH A WOMEN THERAPIST. By Delyse Ledgard C.Q.S.W. Ha t f i e l d Polytechnic, England, 19 THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Department of Counselling Psychology) We accept t h i s thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA _ December 1996 © ^-^ Delyse Ledgard, 1996 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further, agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall, not be allowed without my written permission. Department of 'Cakf4£ \ CA ftj^ fio/yVo The University of British Columbia Vancouver, Canada Date DE-6 (2788) i i Abstract This study addressed women's experiences of power i n the therapeutic re l a t i o n s h i p . A grounded theory method of inv e s t i g a t i o n was used. Eight women were interviewed who had been, or were, i n therapy with a woman therapist. The interviews progressed from a generalized discussion of the therapeutic r e l a t i o n s h i p and concept of power to a more de t a i l e d examination of the women's experiences of power within therapy. The r e s u l t s h i g h l i g h t the i n d i v i d u a l i s t i c nature of the experience of power i n therapy and that empowerment i s achieved through a woman's self-knowledge. Disempowerment occurred when a woman's s e l f -expression was r e s t r i c t e d or when she f e l t judged and rejected by the therapist. The implications f o r therapists are summarized by the need for therapist's to respond to the i n d i v i d u a l needs of the women i n the therapeutic process. l l j , Acknowledgments This t h e s i s would not have been completed without the support and encouragement of the following people. F i r s t , a s p e c i a l thanks goes to my committee members for t h e i r enthusiasm f o r t h i s study. In p a r t i c u l a r , my gratitude to Dr. Bonnie Long and Dr. Barbara Paterson who w i l l i n g l y gave me t h e i r time, and f o r t h e i r feedback which I valued immensely. In addition, the discussions we had stimulated both my research ideas and my c l i n i c a l p r a c t i s e . Second, the support and love of my friends has sustained me throughout t h i s project. I am p a r t i c u l a r l y thankful to Brenda Shaw f o r taking the time to e d i t the f i n a l d r a f t . Third, but not lea s t , I want to thank my father, Michael Ledgard, f o r h i s constant support and b e l i e f i n me, without which t h i s t h e s i s would not have been written. i V Table of Contents Introduction 1 Rational for the Study 1 Li t e r a t u r e Review 5 Therapeutic Relationship 5 Theory/Research: Perspectives on Power 9 Women and Power 15 Power i n Therapy 18 Methodology 24 Research Question 24 Description of participants 25 Grounded Theory Method 26 Procedures 28 Data Sources and Interview Structure 29 Data C o l l e c t i o n and Analysis 30 Theoretical S e n s i t i v i t y 30 Categorization 31 Memoing 32 Theoretical Sampling 33 Writing the Theory 34 Women's P r o f i l e s 34 Results 43 Discussion 124 Overview of the Theory 124 The Therapeutic Relationship 128 V Power D i f f e r e n t i a l 136 Therapist Self-disclosure 146 Power and Awareness 151 Recommendations for Therapy 156 Therapy Practise 156 Future Research 159 Conclusion 161 References 162 1 INTRODUCTION Rational for the Study My i n t e r e s t i n the power dynamics i n the therapeutic r e l a t i o n s h i p comes from both personal and professional experience. As a c l i e n t , the f i r s t therapist I saw acted i n such a way that I now r e a l i s e re-traumatised me around childhood experiences. In addition, a dual rel a t i o n s h i p developed where I was both a c l i e n t and a x f r i e n d ' . My experiences with her occurred both i n a group setting and i n d i v i d u a l therapy and i t took me a couple of years before I r e a l i s e d the extent of her misuse of the power she had as a therapist. Some of the elements of her behaviour involved: (a) a confusion of boundaries, (b) lack of acceptance and persecutory attitude towards c l i e n t s , (c) professional i s o l a t i o n from colleagues except people she had trained, (d) encouraging an i d e a l i z a t i o n of her s e l f by group members, and (e) denial of her power as a therapist. The reactions that I had as a c l i e n t were to doubt my experience and blame myself. I thought that I had to change myself so that I was more Aacceptable' and believed that she must be r i g h t because therapy was suppose to be l i k e t h i s . These c l i e n t reactions and behaviours on the part of the therapist appear to be consistent with the research on unethical behaviour (Nielson, 1988; Strasburger, Jorgenson, & Sutherland, 1992). My motivation to conduct t h i s research involves a desire to understand, from a c l i e n t ' s viewpoint, how power i s experienced and the basis of those experiences of power. 2 As a therapist, I am interested i n the nature of t h i s unique r e l a t i o n s h i p — relationship i n which the c l i e n t exposes t h e i r v u l n e r a b i l i t i e s and i s empowered, yet a r e l a t i o n s h i p that i s f a r from r e c i p r o c a l . Moreover, I have experienced my own needs as a therapist i n the therapeutic relationship, needs that emerge with varying degrees of intensity. I am also aware of how close we come as therapists to abusing our power, and of the importance of personal work to keep our own needs out of the therapeutic r e l a t i o n s h i p . I have experienced my words coming back to me through my c l i e n t s with the status of fact rather than suggestion or an expression of another perspective. The importance of my opinion to my c l i e n t s i s clear as they look to me f o r reassurance, v a l i d i t y of t h e i r experience, guidance and advice, a reason to l i v e , and a sense of t h e i r own worth. From my experiences as a c l i e n t and a therapist, I am very aware of the power d i f f e r e n t i a l that e x i s t s . I have become curious about how i t works i n the relationship, what the benefits are, and how the power of the therapist can be used against the c l i e n t . The l i t e r a t u r e on the therapeutic r e l a t i o n s h i p seems rather piecemeal i n i t s portrayal of the power dynamics, and there i s l i t t l e theory and research i n t h i s area. I have chosen to use a grounded theory research method (Strauss & Corbin, 1990) and address power as a phenomenon that exists within a number of contexts, and examine the relationship between power and various aspects of the therapeutic relationship. The emergent theory that i s generated by t h i s method i s inductively derived from the 3 women's experiences of power i n the therapeutic r e l a t i o n s h i p . Research on power has t r a d i t i o n a l l y used quantitative methods. Moreover, research on power i n therapy has often been l i m i t e d to inves t i g a t i n g power i n r e l a t i o n to components such as the working a l l i a n c e (Luborsky, 1976; Luborsky, Crits- C h r i s t o h , Alexander, Margolis, & Cohen, 1983). A grounded theory study such as t h i s examines the experience of power within the therapeutic process, and the variables connected to power naturally emerge out of the women's experience. In the l i t e r a t u r e review, I examine theories of the therapeutic r e l a t i o n s h i p that p a r t i c u l a r l y explore aspects of power (Claiborn & Strong, 1982; Gelso & Carter, 1985; Jordan, Kaplan, M i l l e r , Stiver, & Surrey, 1991). The experience of power i s examined within the context of the therapeutic r e l a t i o n s h i p . The nature of t h i s r e l a t i o n s h i p i s important i n understanding the experience of power. To date, the research on the therapeutic r e l a t i o n s h i p has concentrated on aspects of the re l a t i o n s h i p and how that may e f f e c t outcome, but very l i t t l e research r e l a t e s to the ef f e c t s of the power d i f f e r e n t i a l . The research and theory r e l a t i n g to women and power has t r a d i t i o n a l l y used quantitative studies that viewed power as influence and control over others, and tested i n d i v i d u a l s ' needs for power experimentally (McClelland, 1975; Winter, 1973). Even Claiborn and Strong's (1992) theory of power i n r e l a t i o n s h i p i s based on the t r a d i t i o n a l view of power as a one way influence. This approach to a d e f i n i t i o n and understanding of power has been 4 c r i t i c i z e d by feminist theorists as only portraying a ^masculine' experience of power (Baker-Miller, 1986; G i l l i g a n , 1982; Lips, 1991). In addition, t h i s small but growing body of l i t e r a t u r e begins to point to women's experiences of power as including an emphasis on interpersonal connectedness that frames the various components of power as influence or having and expressing personal i n t e g r i t y (Wilson, 1991). In doing research of t h i s nature, within the context of c l i e n t ' s experience of the therapeutic r e l a t i o n s h i p , valuable information i s added about the nature of the power dynamics, and begins to give some basis to a theory of power i n the therapeutic r e l a t i o n s h i p . The focus of t h i s study, therefore, i s to gain more insi g h t into our understanding of women's experiences of power within a context that i s t r a d i t i o n a l l y seen as being s t r u c t u r a l l y unequal i n the d i s t r i b u t i o n of power. From the exi s t i n g research i t would seem that there i s l i t t l e information on the experience of power dynamics i n the therapeutic r e l a t i o n s h i p for women c l i e n t s . The r e s u l t s of t h i s study may enrich counsellors understanding of the ways i n which women can be empowered and gain information on how power i s experienced by women i n various therapeutic experiences. Conversely, given that women are more vulnerable to the abuse of power, data regarding the negative experiences of power f o r women contribute to our understanding of therapist's misuse of t h e i r power, and therefore go some way to add to the e x i s t i n g knowledge for the prevention of therapist abuse. 5 Literature Review In the l i t e r a t u r e review, I examine the e x i s t i n g research and theory that relates to the context of the therapeutic r e l a t i o n s h i p and the phenomenon of power. In the f i r s t section an overview of the theories that pertain to our present understanding of the therapeutic r e l a t i o n s h i p i s presented. In the second section, I explore theories of interpersonal power that provide part of the context to examine power within the therapeutic r e l a t i o n s h i p . As I am focusing attention on women's experience of power:, I address some of the theory and research on women and power. In the f i n a l section, I present some of the research and theory relevant to power within the therapeutic r e l a t i o n s h i p . My investigation into these areas of theory and research h i g h l i g h t my th e o r e t i c a l understanding of power i n therapy that informed my analysis of power i n therapy f o r women. The Therapeutic Relationship Therapy happens within a relat i o n s h i p that i s both representative of a l l the relationships i n our l i f e and unique i n i t s structure and purpose. A l l psychological theories espouse the kind of therapeutic relationship that w i l l f a c i l i t a t e t h e i r p a r t i c u l a r brand of therapy. Psychoanalysis proposes that the therapist i s emotionally distant to encourage the transference process; whereas the humanist approaches, including Rogerian, Gestalt, and E x i s t e n t i a l , propose varying degrees of emotional i n t e g r i t y within the relationship i n order to create the conditions whereby the c l i e n t can experience t h e i r own i n t e g r i t y 6 (Corey, 1991). What i s clear from the l i t e r a t u r e i s that there i s widespread acknowledgment that the t h e r a p i s t - c l i e n t r e l a t i o n s h i p i s c e n t r al to the progress of therapy (for a review see Gelso & Carter, 1985). Gelso and Carter (1985) attempt to d i s t i n g u i s h the elements that constitute the therapeutic r e l a t i o n s h i p across a l l of these theories. They have i d e n t i f i e d three main components of the therapeutic relationship: the working a l l i a n c e , the transference relationship, and the r e a l r e l a t i o n s h i p (based on the work by Greenson, 1967). In contrast, Claiborn and Strong (1982) outline t h e i r theory of i n t e r a c t i o n and change based on influence. Here the therapeutic rel a t i o n s h i p i s seen as a means for change i n which the c l i e n t i s influenced by the therapist to change the areas of t h e i r l i f e and behaviour that are problematic. Their theory c l e a r l y sees the therapist i n a higher power p o s i t i o n due to the s o c i a l power inherent i n the therapeutic r e l a t i o n s h i p . They define s o c i a l power as: a person's a b i l i t y to influence another. So c i a l power i s rooted i n the other's dependence and therefore has magnitude. The constructs of dependence and s o c i a l power are operationally t i e d to the observation of one person changing actions as a r e s u l t of another's request ... dependence and power are inferred. Dependence and s o c i a l power can also be inferred from the impact of changing perceptions of needs and resources, (p. 43). 7 This theory i s based on a one-way notion of power that examines how we are influenced i n interactions. The authors define s o c i a l influence as: a t t i t u d e change i n an interpersonal s e t t i n g , where the discrepant information i s communicated, or awareness of i t e l i c i t e d , by another person. The focus of the s o c i a l influence paradigm i s on two sets of variables, the communicator's c h a r a c t e r i s t i c s and the nature of the presentation.... these variables correspond to the therapist's s o c i a l power, or a b i l i t y to influence the c l i e n t , (p. 53). Claiborn and Strong (1982) examine such therapist c h a r a c t e r i s t i c s as c r e d i b i l i t y , trustworthiness, and attractiveness as contributing to the therapist's a b i l i t y to influence. In addition, they apply French and Raven's (1959) sources of s o c i a l power to the therapeutic r e l a t i o n s h i p . The three main sources that they see as relevant are legitimate, referent, and expert power. This theory d i f f e r s from Gelso and Carter (1985) by focusing primarily on how the therapist e f f e c t s change through t h e i r power position, whereas Gelso and Carter do not s p e c i f i c a l l y i d e n t i f y power within the components viewed as f a c i l i t a t i n g change. A feminist view of the therapeutic r e l a t i o n s h i p i s proposed by a c o l l e c t i v e of feminist t h e o r i s t s at the Stone Center (1992). They see the r e l a t i o n s h i p as a dialogue within which there are two active participants with the potential for change through 8 t h e i r i n t e r a c t i o n . This promotes the p o s s i b i l i t y of a more equal r e l a t i o n s h i p . Jordan (1991) emphasizes the way i n which the models of r e l a t i o n s h i p are important i n determining the therapeutic context that w i l l influence i n d i v i d u a l growth. I f the therapist has a perspective of relationship as interdependent, t h i s w i l l both influence her interactions with her c l i e n t s and lead her to encourage supportive relationships i n the c l i e n t ' s l i f e , rather than the ultimate state of s e l f - r e l i a n c e and independence. Within t h i s context the therapeutic r e l a t i o n s h i p has the p o t e n t i a l f o r r e c i p r o c a l caring and a degree of mutuality, respect, emotional a v a i l a b i l i t y , and openness to change. This perspective has been developed largely by therapists based on t h e i r c l i n i c a l experience (Jordan, Kaplan, M i l l e r , Stiver, & Surrey 1991). However, the degree of mutuality i s debatable because the therapist's experience may be very d i f f e r e n t from the c l i e n t ' s experience of mutuality. As a therapist you may be aware that the c l i e n t i s having an impact on you personally and contributing to your own change, but with the focus on the c l i e n t ' s process the c l i e n t may not experience he r s e l f as having an impact on the therapist. I t would seem to be an important part of a mutually empowering relationship to have a sense that you are impacting the other person. Conversely, Jordan (1991) points out that therapists are uncomfortable with the idea that they may grow through t h e i r work, f e e l i n g that t h i s i s ex p l o i t a t i v e . She points out that t h i s 9 discomfort comes out of the t r a d i t i o n a l and h i e r a r c h i c a l models of r e l a t i o n s h i p where only one person can benefit at the expense of the other. Research/Theory: Perspectives on Power The l i t e r a t u r e i n t h i s area examines d e f i n i t i o n s of power, and our understanding of the nature of power within interpersonal r e l a t i o n s h i p s i n p a r t i c u l a r . Psychology has t r a d i t i o n a l l y investigated power along f i v e d i f f e r e n t dimensions: the q u a l i t y of power that i s attributed to a person, a source of motivation to act, a s o c i a l influence process, a t r a i t or state of the in d i v i d u a l , and the s o c i a l structures that support a power hierarchy within society (Lips, 1991). A l l f i v e of these approaches to power i n some way rel a t e to our ximage' of power. These images of power provide a context i n which women learn about power i n t h e i r l i v e s . H i s t o r i c a l l y human beings have been concerned with power i n t h e i r dealings with each other. This represents a desire to have control over t h e i r l i v e s and to prevent others from wielding excessive power over them (Lips, 1991). In r e l a t i o n to t h i s idea i s the concept of locus of control (Rotter, 1966). People e x i s t on a continuum of inter n a l versus external locus of control, and people who have more of an external locus of control tend to f e e l l e s s powerful i n t h e i r l i v e s . In the context of the therapeutic r e l a t i o n s h i p , people tend to enter therapy i n search of answers to an area or areas of t h e i r l i f e that f e e l s out of t h e i r c o n t r o l . Where women c l i e n t s f a l l on the continuum of locus of control may also have some bearing on t h e i r experience of power i n therapy and t h e i r feelings of powerfulness within t h i s experience. The images of power i n society that influence our understanding of our experience are t y p i c a l l y male images and point to the way i n which power i s seen as leadership (e.g. people and groups that make an impact) (Lips, 1991; Winter 1973). Lips (1991) outlines these images as Gods, physical strength, people and groups that control resources, stars and c e l e b r i t i e s , and the perceived experts i n society. The e f f e c t s of these images on women are discussed i n more d e t a i l under women and power. I t i s s u f f i c i e n t to say at t h i s point that these images provide the context for our understanding of d e f i n i t i o n s of power and the psychological theories that have developed i n r e l a t i o n to power. Two main d e f i n i t i o n s of power exi s t i n the l i t e r a t u r e , the more t r a d i t i o n a l d e f i n i t i o n and a feminist d e f i n i t i o n as i t applies s p e c i f i c a l l y to women's experience of power. In considering the power dynamics i n the therapeutic r e l a t i o n s h i p , power i s i n the context of interaction. Johnson (1978) outlines the t r a d i t i o n a l d e f i n i t i o n of interpersonal power as: the a b i l i t y to get another person to think, f e e l , or do something they would not have o r d i n a r i l y done spontaneously. I f one person possesses the means to a f f e c t another, one has power v i s - a v i s that person. I f one uses one's power, i t i s c a l l e d influence, (p. 302). This d e f i n i t i o n sees power as a one-way process within an 11 in t e r a c t i o n at any given time, i n l i n e with the t r a d i t i o n a l view that power i s synonymous with concepts such as force, authority, control, and influence (French & Raven 1959: Winter 1973). This d e f i n i t i o n stems from a s o c i a l exchange theory that sees power as the capacity of one person to influence another; the person who i s l e a s t dependent on some kind of reward i n the r e l a t i o n s h i p w i l l have the most power (Hamans, 1974). While using t h i s general d e f i n i t i o n of power as influence, there are a number of theories that examine both the source of power and the ways i n which power i s exerted i n the relationship. French and Raven (1959) i d e n t i f i e d f i v e sources of power that a person could use to influence another. These are reward power, coercive power, legitimate power, referent power, and expert power. As mentioned e a r l i e r , Claiborn and Strong (1982) apply these sources of power to the therapeutic relationship and see the therapist's power based mainly on legitimate, referent, and expert power. From t h i s perspective the power that the therapist has i n r e l a t i o n to the c l i e n t i s based on the c l i e n t ' s perception that the therapist has the q u a l i t i e s and resources to meet t h e i r needs. The legitimate power of the therapist i s based on her, acknowledged r o l e as helper and i s seen as necessary to f a c i l i t a t e the therapeutic process. As Claiborn and Strong (1982) state: Without legitimacy, aspects of the therapeutic process such as intimate s e l f - d i s c l o s u r e and the outward p e c u l i a r i t i e s of the therapist's techniques would arouse insurmountable threat and 12 resistance. Legitimacy i s r e q u i s i t e for development of t r u s t i n the r e l a t i o n s h i p , (p. 66) . S i m i l a r l y , the therapist's expert power i s produced by the c l i e n t ' s perceptions of the therapist's knowledge and s k i l l s to e f f e c t change i n the c l i e n t ' s d i f f i c u l t i e s . The more expertise the c l i e n t a ttributes to the therapist, the greater the capacity of the therapist to influence the c l i e n t as opposition to the therapist's viewpoint i s diminished. The referent power of the therapist rests on her attractiveness to the c l i e n t based on s i m i l a r i t i e s i n experience and l i k i n g . The degree to which the therapist i s perceived as s i m i l a r , i n conjunction with an elevated p o s i t i o n i n the world, provides an i n s p i r a t i o n for the c l i e n t and gives the therapist the power to influence. Claiborn and Strong (1982) assert that without these basic power attributes the therapist would be i n e f f e c t i v e i n her work. They go on to point out that incongruous s h i f t s between these power bases can disrupt c l i e n t ' s expectations and cause resistance. I t i s also conceivable from t h i s viewpoint that a therapist could misuse these sources of power. For example, a therapist could p o t e n t i a l l y disempower a c l i e n t as opposed to f a c i l i t a t i n g change by using her c l i e n t ' s perception of the therapist's expertise to i n s i s t that she was r i g h t when her c l i e n t challenged her. This i s explored further i n the section on power i n therapy. Two theories of interpersonal power examine how power i s exerted. The f i r s t by Tedeschi, Schlenker, and Bonoma (1973), who 13 make a d i s t i n c t i o n between a dimension of open versus manipulatory types of influence and control or mediation of rewards and punishments. These two dimensions combine to give various types of i n t e r a c t i v e processes that a person can use to influence. This perspective takes into account overt and covert ways of influence. The second, by Johnson (1976), explains the exertion of power along three dimensions: directedness versus indirectedness, competence versus helplessness, and personal versus concrete resources. What i s noteworthy i s that these two perspectives recognize that power can come from a place of "weakness" not o r d i n a r i l y associated with power. For example, someone can either appear incompetent and unable to do something i n order to influence others to take care of them, or d i r e c t l y ask f o r help c i t i n g t h e i r weaknesses. Johnson points out that the i n d i r e c t uses of power that come from a place of weakness, even though the influencer may be successful, do not increase a person's status or self-esteem. These forms of influence can produce resentment and contempt i n those being influenced, r e s u l t i n g i n chronic low self-esteem for the influencer. Feminist t h e o r i s t s have generated questions regarding society's view of power and who has power i n society. The feminist movement i t s e l f grew out of an awareness of differences i n power between men and women. Feminists have promoted the idea that power can e x i s t without dominating others, i n p a r t i c u l a r , interpersonal empowerment and personal power that comes out of a sense of s e l f (Bardwick, 1976). In the Stone Center writings, 14 M i l l e r (1991) defines power from a feminist perspective as: the capacity to produce a change - that i s , to move anything from point A or state A to point B or state B. This can include moving one's own thoughts or emotions sometimes a very powerful act. I t can also include acting to create movement i n an interpersonal f i e l d , as well as acting i n larger realms such as economic, s o c i a l or p o l i t i c a l arenas, (p. 198). This d e f i n i t i o n extends the t r a d i t i o n a l concept of power as "power over" to include influencing oneself to create change. I t i s therefore possible to see power not just as the influence of one person upon another, but as an i n t e r a c t i o n of influence where a person has the power to use the influence of another upon themselves or to r e j e c t i t . The Stone Center model (Surrey, 1991) of i n t e r a c t i o n further states: The a l t e r n a t i v e model of interaction that we are proposing might be termed a "power with" or " power together" or "power emerging from i n t e r a c t i o n " model. I t overrides the active/passive dichotomy by suggesting that a l l p a rticipants i n the relationship i n t e r a c t i n ways that b u i l d connection and enhance everyone's personal power.(p. 165) . This a l t e r n a t i v e model redefines the passive/active dichotomy that t r a d i t i o n a l l y defines power as h i e r a r c h i c a l and competitive and allows for the notion of interdependence and empowerment. Another perspective on power within the interpersonal sphere 15 can be described from a view of inequality based on the difference i n status and power. M i l l e r (1986) i d e n t i f i e s two types of inequality: temporary and permanent. In the temporary inequality relationships, the goal i s to bring the x l e s s e r ' party up to a place of equality with the xsuperior' party and thereby end the re l a t i o n s h i p of inequality. Examples are the parent/child r e l a t i o n s h i p as well as the t h e r a p i s t / c l i e n t r e l a t i o n s h i p . In the therapeutic r e l a t i o n s h i p the ending of the r e l a t i o n s h i p can be seen i n terms of the c l i e n t no longer needing the resources of the therapist (Claiborn & Strong, 1982). This implies that the experience of inequality can change i n the progression of therapy. In the permanent relationship of inequality, some people have power based on t h e i r belonging to a p a r t i c u l a r dominant group which has no goal of equality ( M i l l e r , 1986). In a l l our rela t i o n s h i p s t h i s dimension may be present, including the therapeutic relationship. The dominant groups are defined on the basis of clas s , age, race, sexual orientation, or other c h a r a c t e r i s t i c s ascribed at b i r t h . Therefore, one could assume from t h i s that i f the therapist belonged to several of these dominant groups and the c l i e n t did not, there would be a negative e f f e c t on the poten t i a l for mutuality and empowerment of the c l i e n t . Women and Power Women's relati o n s h i p to power i s complex, and involves a developmental context that shapes women's conceptions and 16 interpersonal experiences of power. In addition, women are influenced by the dictates of society that l e g i t i m i z e power fo r c e r t a i n groups over others. As mentioned e a r l i e r , our images of power i n society are largely male, although t h i s i s slowly changing. For example, i n advertising women are more often portrayed as phy s i c a l l y strong. Despite changes, however, the main portrayals of women's influence and power are s t i l l conveyed through her sex appeal (Lips, 1991). Women's conceptions of power p o t e n t i a l l y a f f e c t both t h e i r experience of themselves as powerful, as well as how women see other women. How women perceive power i n therapy may be greatly influenced by what women have learned about women and power. In t h i s regards, a grounded theory study not only examines the experience of power but, within the analysis and development of the theory, incorporates both the meaning of power and the context of women's l i v e s . Lips (1981, c i t e d i n Lips, 1991) showed i n one study that both women and men tend to see male figures as more powerful than female figures; however, women were able more often than men to i d e n t i f y a woman as powerful i n t h e i r l i v e s . This would imply that women and men are influenced by images of power d i f f e r e n t l y , and furthermore, hold d i f f e r e n t images of power. Research conducted on the d i f f e r e n t uses of power by women and men show, i n general, that women use more personal, helpless, and i n d i r e c t methods of power (Johnson, 1974, 1976, 1978; Lips, 1991). What seems to reinforce these d i f f e r e n t uses i s the 17 portrayal of women who employ more "masculine" uses of power as negative and inappropriate. For example, a women i s l i k e l y to be viewed as aggressive, s e l f i s h , and out of l i n e i f she used d i r e c t , competent, and concrete influence methods. This leaves women i n an ambiguous relationship to power, as Lips (1991) states, "The negative image of the overtly powerful woman l i e s at the heart of many of the gender differences i n power-related behaviour." One study conducted by Carleton Cann (1979) examined the use of power by men and women i n a given s i t u a t i o n . In a rol e play s i t u a t i o n , the women and men were a l l supervisors and asked to influence employees i n another room by writing them messages. They were a l l given permission to use reward and/or coercion to influence. There was no difference between the men and women i n the ways used to influence, but women t r i e d to influence less often and expressed a discomfort with the r o l e of supervisor. These re s u l t s indicate that women are less comfortable with power and expressing power i n d i r e c t ways, and therefore, are more l i k e l y to use i n d i r e c t and helpless ways that do not put women i n a di r e c t experience of power. S i m i l a r l y , sex differences i n regards to locus of control show that men consistently describe themselves as more powerful and stronger than women and g i r l s do (Maccoby & Ja c k l i n , 1974). The experience of power for women i s re l a t e d to t h e i r focus on the importance of relationships and the needs of others (Jordan et a l . , 1991). The Stone Center model sees women's power i n the context of mutual empowerment or psychological 18 empowerment, and i s defined as: the motivation , freedom, and capacity to act purposefully, with the mobilization of the energies, resources, strengths, or powers of each person through a mutual, r e l a t i o n a l process. Personal empowerment can be viewed only through connection ... the establishment of mutually empathic and mutually empowering r e l a t i o n s h i p s , (p. 164). This concurs with Wilson's (1991) findings that women experience power as a dynamic process within a rel a t i o n s h i p , and that connection and interdependence i s an in t e g r a l part of the experience of power. Power i n Therapy The experience of the therapeutic power d i f f e r e n t i a l i s a complicated one containing many factors; most of which may not be i n the c l i e n t ' s awareness. Johnson (1978) points out: "Most power i s not even noticed because i t i s b u i l t into our norms for s o c i a l i n t e r a c t i o n " (p. 302). In addition, f o r women, power i s associated with a xpower over' concept that stems from the t r a d i t i o n a l view of power. Furthermore, because women are concerned with connection to others, they cannot e a s i l y i d e n t i f y themselves or other women as having power (Surrey, 1991). The consequence for the therapeutic rel a t i o n s h i p from these viewpoints i s that the power of the therapist i s not e a s i l y i d e n t i f i e d i n the context of a relationship that i s meeting the needs of the c l i e n t and has the potential to be denied. The 19 denial of power by therapists i s most problematic i n the area of boundary v i o l a t i o n s , p a r t i c u l a r l y i n sexual intimacy with c l i e n t s where there i s often a gradual erosion of boundaries that blurs the d i s t i n c t i o n between therapist and c l i e n t (Neilson, 1988; Simon, 1989; Strasburger, Jorgenson, & Sutherland, 1992). Research on power and therapy has focused on power i n r e l a t i o n to some other aspect of the re l a t i o n s h i p . One study of p a r t i c u l a r i n t e r e s t examined the relat i o n s h i p of power and involvement to the working a l l i a n c e (Reandeau & Wampold, 1991). The authors used a multi-case design to examine examples of high and low a l l i a n c e i n four b r i e f therapy cases. In r e l a t i o n to power, they compared the power of the therapist i n the high and low a l l i a n c e cases and what, i f any, interactions would account fo r the difference i n level s of power and involvement. The r e s u l t s were not very conclusive i n comparing the patterns of in t e r a c t i o n between the high and low a l l i a n c e cases. The low a l l i a n c e cases did not produce any common patterns between the two cases, whereas the high a l l i a n c e cases did. The authors put t h i s down to case s p e c i f i c interactions that i n t e r f e r e d with the patterns found i n the high a l l i a n c e cases. Overall, the pattern highlighted by the authors i n the high-alliance cases was that high power responses encouraged high involvementlow power responses on the part of the c l i e n t and discouraged neutral or low involvement responses. The power and involvement responses of the therapists did not vary a great deal across a l l four cases so that generalizations can not be made from these cases. 20 However, what t h i s may point to i s that the therapist's high power responses and position i n the r e l a t i o n s h i p can be part of a p o s i t i v e i n t e r a c t i o n pattern that supports a good working a l l i a n c e . In addition, t h i s study supports the basic assumption that the therapist's role i s inherently powerful and the c l i e n t i s i n a p o s i t i o n of low power. The fact that the power p o s i t i o n of the therapist did not change across a l l four cases does not give us very much information on the e f f e c t s of the power of the thera p i s t . Some of the research on the working a l l i a n c e has found that the a l l i a n c e i s established early i n treatment characterized by a mutual l i k i n g , t r u s t , and respect that correlates highly with outcome (Horvath & Greenburg, 1986, 1989; Strupp & Hadley, 1979). In conjunction with these c h a r a c t e r i s t i c s , good a l l i a n c e s appear to be reinforced by the c l i e n t perceiving the therapist as h e l p f u l and themselves as receiving help, i n t h i s way they are i n a lower power p o s i t i o n (Luborsky, 1976; Luborsky, C r i t s -Christoph, Alexander, Margolis, & Cohen, 1983). Burman (1992) analyzed the connection between power and involvement through the discourse of the f i r s t and fourth session of a woman's therapy with a woman therapist. Power i n t h i s study was associated with meaning and agenda se t t i n g within the therapeutic process. Burman found that the therapist's power was demonstrated through her interpretations of the c l i e n t ' s behaviour which was incorporated into the c l i e n t ' s own meaning making. The c l i e n t ' s absorbtion of the therapist's terms was seen 21 as control over meaning by the therapist i n the therapeutic process. How the agenda and meaning developed i n the therapy was a process that went back and forth between c l i e n t and therapist and therefore was shared. In t h i s way, power was r e l a t i o n a l and part of the connectedness of the therapist and c l i e n t . The power of the c l i e n t was expressed i n a number of ways including: (a) not accepting reframing u n t i l she had worked i t through, (b) s e l e c t i v e l y drawing on interpretations, and (c) i n i t i a t i n g i n t e r p retations. The conclusions that can be drawn from these r e s u l t s are limited given the analysis was conducted on only two sessions with one p a r t i c u l a r c l i e n t , but i t does indicate that power between women i n therapy can be a mutually shared phenomenon. From a feminist perspective the power of the therapist can be reduced to generate an e g a l i t a r i a n r e l a t i o n s h i p p r i m a r i l y based on s e l f - d i s c l o s u r e by the therapist (Brown & Brodsky, 1992; Laidlow & Maimo, 1990). From another perspective Lander and Nahon (1992) discuss the e f f e c t s of s e l f - d i s c l o s u r e as maintaining a higher power pos i t i o n of the therapist by creating an i l l u s i o n that the therapist "has i t a l l together". They maintain that therapists are reluctant to make themselves t r u l y vulnerable and show t h e i r weaknesses as well as t h e i r successes for fear of l o s i n g c r e d i b i l i t y i n the eyes of t h e i r c l i e n t s . This brings up the question of what does being authentic mean as a therapist, and i n the author's view the need for therapist i n t e g r i t y i n the r e l a t i o n s h i p . Lander and Nahon define i n t e g r i t y as based upon the 22 elements of honesty, r e s p o n s i b i l i t y , and increased emotional closure. The authors discuss aspects of honesty and r e s p o n s i b i l i t y within the therapeutic r e l a t i o n s h i p by maintaining that equality i s created between therapist and c l i e n t when the ther a p i s t i s prepared to be as "open as the c l i e n t about the * secrets' i n his or her past and present" (p. 115). The a r t i c l e outlines various ways t h i s 'openness' can be expressed as a therapist, and ways i n which other approaches do not express t h i s i n t e g r i t y and equality. F i r s t , therapists who express t h e i r values and feelings i n response to the c l i e n t s behaviour promote c l e a r l y defined boundaries that enable the c l i e n t to learn what i s 'me' and what i s 'not me'. Second, the authors question the use of empathy that often becomes sympathy, and reinforces a power imbalance. They question the focus of delving into the c l i e n t ' s pain or suffering as a r e v i c t i m i z a t i o n with the c l i e n t being "forced" into a position of being vulnerable. However, they do not give a clear alternative to t h i s i n terms of working with a person's pain that does not promote t h i s s i t u a t i o n . Third, they discuss the kinds of s e l f - d i s c l o s u r e that maintain a distance i n the therapeutic relationship, as mentioned above, and propose that therapists reveal t h e i r v u l n e r a b i l i t y with c l i e n t s . The a r t i c l e raises important questions about how to be ' r e a l ' with c l i e n t s . There i s no doubt that important moments and changes can occur when the therapist shares an a f f e c t i v e response and shows her v u l n e r a b i l i t y , but I am not convinced that equality i s achieved through t h i s 'openness', when underpinning the 2 3 . therapeutic rel a t i o n s h i p i s the premise that the thera p i s t i s there to meet the c l i e n t ' s needs. In addition, women's pain and discomfort i s the reason that they come to therapy. I t i s doubtful that equality w i l l be achieved by the thera p i s t ' s expression of her v u l n e r a b i l i t y when the c l i e n t ' s v u l n e r a b i l i t y and d i s t r e s s f a r outweighs that of the therapist at any given moment of disclosure. The research on power i n therapy i s not extensive and prim a r i l y focuses on some other component of the therapeutic r e l a t i o n s h i p and i t s relationship to power. Therefore, the decision to use a grounded theory method places power as the cen t r a l phenomenon, and allows the variables i n r e l a t i o n to power to emerge. Furthermore, power has not been examined i n a n a t u r a l i s t i c s e t t i n g such as t h i s study, which addresses the experience of power within the therapeutic r e l a t i o n s h i p for women c l i e n t s . A n a t u r a l i s t i c study assumes that a phenomenon i s constructed i n multiple ways and approaches the question from the ind i v i d u a l s subjective position. I t i s clear from t h i s b r i e f overview of the l i t e r a t u r e that power i s a complex phenomenon and by addressing the question of women's experience of power within a n a t u r a l i s t i c paradigm, the complex connections between the components of the therapeutic relationship, the context of the women's l i v e s , and the experience of power i n therapy can be analyzed. 2 4 METHODOLOGY Research Question My i n t e r e s t i n the power dynamics i n the therapeutic r e l a t i o n s h i p centre on how power i s experienced, p a r t i c u l a r l y from the c l i e n t ' s perspective. The s p e c i f i c question that t h i s study addressed was: What i s the experience of power for women within the context of the therapeutic relationship with a woman therapist? This study examined the basis on which power i s experienced, how power i s experienced i n ways that may f a c i l i t a t e the therapeutic process for c l i e n t s , and i n what ways power may be experienced as problematic. In order to understand the place that power has within the context of therapy, I paid p a r t i c u l a r attention to the context of the therapeutic relationship as experienced by the women. The interplay between the various components of the therapeutic rel a t i o n s h i p and power was analyzed. Because I wanted to examine women's experiences of power within therapy, I explored the kinds of situ a t i o n s and behaviours that involve power. The dynamics of power within the therapeutic r e l a t i o n s h i p emerged through the ways i n which women described t h e i r experiences. How these women experienced power as 'empowering' and 'disempowering' within therapy was addressed within the context of the process of therapy and healing. In asking these questions, i t was important to acknowledge the context of women's l i v e s when addressing questions of power. From the l i t e r a t u r e i t i s clear that the s o c i a l context i n which 25 we l i v e constructs power i n terms of force and authority (Johnson, 1978). Therefore, the word *power' may have had associations that made i t d i f f i c u l t f o r women to describe b e n e f i c i a l experiences of the power dynamics i n the therapeutic r e l a t i o n s h i p . The questions outlined above focused on generating a general overview of the phenomenon. Using a grounded theory analysis e n t a i l e d developing additional questions as the i n i t i a l theory emerged. This study compliments Wilson's (1992) study of women's conceptions of power where she explored the conceptions of power held by women therapists p a r t i c i p a t i n g i n an a l l women work group. Although Wilson's study does not d i r e c t l y examine women therapist's view of power within therapy, t h e i r conceptions of power are important i n framing t h e i r work with women c l i e n t s . Description of participants. The women were r e c r u i t e d through two sources. F i r s t , women were rec r u i t e d through women therapists working i n the Vancouver area. A l e t t e r was sent to therapists to d i s t r i b u t e to t h e i r women c l i e n t e l e o u t l i n i n g the basic purpose of the study (see Appendix A). Second, women were rec r u i t e d through an advertisement i n a l o c a l p u b l i c a t i o n (see Appendix B). From these sources 12 women volunteered f o r the study and eight were interviewed. The c r i t e r i o n f o r women to be included i n the^study were as follows: (a) women who are or have been i n therapy with a woman therapist, (b) women who are 21 years old or over, (c) women who have a command of English that enables them to express t h e i r 26 experience c l e a r l y . The women who were interviewed i n t h i s study had been i n therapy for periods that ranged from 6 months to 3 years. Five of the women were s t i l l i n therapy, whereas three had ended t h e i r therapeutic relationship. Most of the women had been i n therapy for approximately a year. This ensured a c e r t a i n f a m i l i a r i t y with the therapeutic process that enables an ease i n discussing t h e i r experiences of therapy. Furthermore, there was a wider v a r i e t y of experiences within the r e l a t i o n s h i p to draw on the longer the woman had been i n therapy. By keeping the experiences limited to women therapists and women c l i e n t s gender differences i n the experiences of power were not considered. In addition, c l i e n t c h a r a c t e r i s t i c s were important i n determining who to interview and provided a context f o r the therapeutic experience. Women's c h a r a c t e r i s t i c s such as age, employment, reasons for therapy, therapeutic approach, and the length of therapy were important i n providing a cross section of experiences to draw on for the interviews (see Figure 1). Women's c h a r a c t e r i s t i c s are not the focus of investigation but are he l p f u l i n understanding the factors that influence how they describe t h e i r experiences. Grounded theory method. Grounded theory analysis i s a q u a l i t a t i v e method that generates theory of a phenomenon through the inductive examination of data (Rennie, P h i l l i p s , & Quartaro 1988; Strauss & Corbin, 1990). I t involves a constant comparison of the data from each interview with data from previous interviews, looking for new codes, better examples of e x i s t i n g codes and Women's Demographics Age Occupation Time i n Therapy +ve/-ve Experience Anne 54 Managerial 2yrs +ve J u l i e 30 Social Worker 1.5yrs +ve E s t e l l e 42 Therapist 13mths -ve Pam 32 Massage Therapist 2yrs Both Cathy 39 Legal Secretary llmths +ve Dennise 23 Performing A r t i s t 5mths +ve Barb 52 Realtor 2yrs +ve G a i l 46 Community Development Consultant l y r -ve Figure 1. 28 ideas about how various codes may begin to f i t together. Ideally, an examination of the l i t e r a t u r e occurs i n response to the emerging theory, and supports the findings and expands the theory. However, the use of the researcher's knowledge of the phenomenon gained from the l i t e r a t u r e and personal experience i important i n guiding the analysis; t h i s i s c a l l e d t h e o r e t i c a l s e n s i t i v i t y . The stages of the method include: data c o l l e c t i o n , categorizing, memoing and writing of the theory. Procedures. Each interviews took approximately 2 hours. A p r i o r meeting took place that involved recording demographic information and preparation for the main interview. This allowed time f o r the women to f a m i l i a r i z e themselves with me, thereby providing a more comfortable atmosphere f o r the interview. At t h i s time, written consent was obtained (see Appendix C), and questions or concerns about the process were addressed. The interviews were audiotaped and then transcribed f o r analysis. The data from the interviews were analyzed according to the grounded theory method, and then presented to the women who had been interviewed for feedback. The women had the choice to attend a focus group to discuss the theory or to receive a written summary that they could give feedback on. Four of the women attended the focus group and the remaining were sent the written summary. One woman met with me to give her feedback and two women had telephone conversations with me to validate the theory. One woman had moved and could not be reached. From the focus group and these follow up contacts the theory was s l i g h t l y modified. 29 The theory was then written up and discussed i n r e l a t i o n to the e x i s t i n g l i t e r a t u r e . Data sources and interview structure. Data were c o l l e c t e d through a q u a l i t a t i v e interview structure that enabled the women to t e l l t h e i r story and experiences i n r e l a t i o n to the phenomenon of power. As mentioned above, the i n i t i a l interview covered as large an area as possible i n r e l a t i o n to the phenomenon. For t h i s reason the interview included questions regarding the women's experience of the therapeutic relationship i n general, as well as t h e i r d e f i n i t i o n of power. This provided a context i n which t h e i r experiences of power i n therapy could be understood. As the theory began to emerge as the f i r s t couple of women were interviewed, the focus of the questions was modified f o r the remaining interviews to gain more s p e c i f i c information around the ideas that were evolving. In addition, respondents with p a r t i c u l a r c h a r a c t e r i s t i c s were chosen to be interviewed as the evolving theory required that investigation. The interview progressed from a generalized focus to more and more s p e c i f i c d e t a i l s around the experiences of power. The f i r s t questions i n v i t e d the women to describe t h e i r experience of the therapeutic relationship, and to highlight what they consider to be important elements that make t h i s r e l a t i o n s h i p d i f f e r e n t from other relationships. They were also asked to describe t h e i r understanding of power from t h e i r general experience. The interviews used open ended questions and c l a r i f i c a t i o n s from a stance of xnot knowing', to e l i c i t the c l i e n t ' s experiences of these general phenomena. Once the context had been explored the questions moved towards the women's experiences of power. C l a r i f i c a t i o n of these descriptions involved questions about s p e c i f i c behaviours that were involved i n expressing power, who has power, and the e f f e c t on the women's experience and t h e i r therapy. Also women were asked to describe situations, i f any, within therapy that were empowering or disempowering and any s i t u a t i o n that involved power that she would not describe i n either of these ways. F i n a l l y , the women were asked i f they would l i k e to add anything about t h e i r experience they have not been asked. Questions were developed from the i n i t i a l interviews around how they experienced the therapist's s e l f - d i s c l o s u r e , the power d i f f e r e n t i a l , and dependency. Data c o l l e c t i o n . Analysis and Writing. Data c o l l e c t e d from the interviews involved approximately 200 pages of transcribed material and personal notes from 20 hours of audiotaped material. The data were analyzed and the theory was developed from the processes of categorization, memoing, t h e o r e t i c a l sampling and writing up the theory. The i n i t i a l l i t e r a t u r e review, and my previous experiences around the issue of power i n therapy also informed my analysis of the data and development of the theory; t h i s i s referred to as t h e o r e t i c a l s e n s i t i v i t y . Theoretical s e n s i t i v i t y . Strauss and Corbin (1990) define t h e o r e t i c a l s e n s i t i v i t y as the personal q u a l i t y of the researcher 31 that i s seen as valuable to the research process. The components of t h e o r e t i c a l s e n s i t i v i t y w i l l vary from person to person but consist of the researcher's f a m i l i a r i t y with the l i t e r a t u r e , and the professional and personal experience that informs her perspective. The importance of the experience of the researcher i s that i t gives meaning to analysis of the data. My experience i n the f i e l d of psychotherapy, both as a p r a c t i s i n g therapist of 6 years and as a c l i e n t of ongoing personal therapy, gives me a perspective on the data that f a c i l i t a t e s a recognition of what i s important and meaningful to the evolving theory. Theoretical s e n s i t i v i t y i s also relevant to the analysis the more I worked with the data. As ideas emerged i n the i n i t i a l a n a l y s is and I began to make comparisons and ask questions, my perspective again was influenced by my previous experience. I t was important to be aware of the way my experience influenced the process, and to remain open to new ways of looking at the phenomenon and exploring the relationships between concepts. Categorization. The interviews were transcribed and analyzed through various l e v e l s of categorization. The interviews were broken up l i n e by l i n e into detailed 'meaning un i t s ' . These units were coded i n a descriptive manner using codes that r e f l e c t the actual wording used by the woman. The codes were based on the meaning embedded i n the text. As these descriptive codes emerged they were formed into clusters of constructed codes that continue to r e f l e c t the meaning of the descriptive codes. In t h i s way, as the categorizing develops and the theory begins to emerge, i t i s rooted i n the women's description of t h e i r experience. Each meaning unit has the potential to belong to several codes, which i s c a l l e d Aopen categorizing', and provides the basis f o r very r i c h data that r e f l e c t the many level s of meaning embedded within a p a r t i c u l a r description of experience. Saturation occurs when new data does not reveal new categories. In t h i s study, complete saturation d i d not occur. In the l a s t interviews, there were no new major categories that emerged but there were new sub-categories. As the categories were developed, the relationship between categories began to form. A h i e r a r c h i c a l structure of categories emerged when c e n t r a l categories were linked with many of the sub-categories. As t h i s structure developed categories were judged according to the contribution they made. The core categories to emerge were: (a) context, (b) relat i o n s h i p with the therapist, (c) ther a p i s t s e l f -disclosure, (d) power d i f f e r e n t i a l , and (e) experience of power as expanding, limited, and blocked. These core categories formed the basis of the theory. How they related to each other developed into a t h e o r e t i c a l model of the experience of power i n therapy. Memoing. Throughout the data c o l l e c t i o n and analysis of the interviews, I recorded my process of t h e o r e t i c a l ideas through memoing. This involved recording speculation about categories that may have been pre-mature, and the recording of ideas that led to the development of the categories. Memoing was c r u c i a l to the write up of the theory but was not a f i n i s h e d product i n i t s e l f . The ideas expressed i n the memos were formed as I analyzed the categories and, therefore, were inherently t i e d to the emerging theory. Theoretical sampling. In grounded theory analysis decisions around who to sample and what t h e o r e t i c a l concepts to investigate evolves i n response to each interview. The i n i t i a l interviews are focused on generating data that r e f l e c t s as broad an experience of the phenomenon as possible. There i s an indiscriminate s e l e c t i o n of interviewees at t h i s point. These interviews are then analyzed and, as concepts emerge, questions develop for further investigation of comparisons and rel a t i o n s h i p s between concepts. As the interviews progress the investi g a t i o n becomes more s p e c i f i c increasing the depth of the focus. Following the analysis of the i n i t i a l interviews, I began to make preliminary hypotheses about the relat i o n s h i p s between concepts. This was achieved by mapping concepts i n various ways and i d e n t i f y i n g relationships that were unclear or missing. For example, questions about how the context of a woman's l i f e a ffected her experience of power emerged. In addition to an inves t i g a t i o n of s p e c i f i c relationships between concepts, decisions about who to interview were important i n the development of th e o r e t i c a l formations. The women who were i n i t i a l l y interviewed had experience and t r a i n i n g i n the f i e l d of counselling, and therefore, subsequent interviews concentrated on women who did not. In addition, women who had therapy experiences of l e s s than a year were recruited to make comparisons. Theoretical sampling occurs as an in t e g r a l part of the 34 analysis. Analysis and sampling compliment each other to produce a theory that r e f l e c t s the depth of experience surrounding a phenomenon, and data c o l l e c t i o n occurs on the basis of the th e o r e t i c a l relevance to concepts. Writing the theory. The theory evolved both from the structure of the categories and the information within the memos. Memos were sorted and related to the categories that emerged i n the analysis. The theory that emerged i n t h i s study developed in t o a dynamic portrayal of the experience of power. The writing of the theory also involved an integration of e x i s t i n g research and l i t e r a t u r e that supports and expands the ideas that came out of the analysis. According to Rennie, et a l (1988), the theory should i n the f i n a l analysis s a t i s f y four basic requirements: (a) i t i s believable and plausible to the reader;(b) i t present a comprehensive account of the data; (c) i t i s grounded i n the appropriate procedures, and therefore, inductively t i e d to the data; and (d) i t should be applicable and lead to further in v e s t i g a t i o n . Women's P r o f i l e s . Twelve women volunteered for the study and eight were chosen to be interviewed. Factors of age, po s i t i v e and negative therapy experiences, length of time i n therapy, and occupation were taken into consideration when deciding who to interview. In the following p r o f i l e s of the eight woman who were interviewed, a l l names are pseudonyms to maintain c o n f i d e n t i a l i t y . The women's 3 5 ethnic and r e l i g i o u s backgounds included: P h i l i p p i n e , Greek and German, I r i s h , French, European/Canadian and Jewish. Anne Anne i s 5 4 years old. She i s single and l i v e s alone i n Vancouver. She was born i n Canada. At the time of the interview she was unemployed and at a crossroads i n her l i f e , not quite sure what her career goals were. She had mainly worked i n managerial positions i n her l i f e but was wanting to explore more creative options for herself. She l i k e d to teach and spoke with great pride about the public speaking organization she belonged to where she was a tr a i n e r . Anne had 2 previous therapy experiences before her present therapeutic r e l a t i o n s h i p . One of these was with a male therapist and one with a female therapist. She had also been involved i n peer counselling. Anne had been seeing her present therapist for 2 years at the time of the interview and was s t i l l involved i n t h i s r e l a t i o n s h i p . Anne discussed her experiences of her present therapist during the interview, which was a very p o s i t i v e and empowering experience for her. Her therapist was a trained Ericksonian hypnotist with Neurolinguistic Programming (NLP) t r a i n i n g . Anne was also trained i n NLP and i t was important for her to work with someone within t h i s approach. Anne wanted to volunteer for the study to help consolidate her growth and to explore how she developed her power through her therapy. Throughout her interview she highlighted how she experienced her power through knowing her own needs and being able to express 36 them. This was i n the context of growing up i n a family, and society that made i t d i f f i c u l t for her to even be aware of her own needs. Anne described her relationship with her thera p i s t as a p o t e n t i a l friendship. I t was obviously a very important r e l a t i o n s h i p i n her l i f e , more so because she did not have very much support elsewhere. J u l i e J u l i e i s 30 years old and l i v e s with her partner i n Vancouver. She works as a s o c i a l worker i n the mental health f i e l d . J u l i e had a couple of therapy experiences before her present therapeutic re l a t i o n s h i p . When she chose a therapist she had a very c l e a r idea of what she was looking f o r . I t was important that her therapist have a feminist perspective to counter the oppression she experienced i n her l i f e . J u l i e i d e n t i f i e d a power d i f f e r e n t i a l i n the therapeutic relationship, and she experienced her therapist reducing t h i s by f a c i l i t a t i n g her own discoveries. She has been seeing her therapist for 1.5 years and i t i s ongoing. J u l i e volunteered for the study to make a contribution and r e f l e c t on what has worked for her i n therapy. Therapy i s important i n helping her learn about herself and gain the knowledge to make her l i f e more e f f e c t i v e . She has an extensive support system, and therefore, does not experience therapy as a dependency. J u l i e did i d e n t i f y times within therapy where she needed more guidance and f e l t overwhelmed with the things she was 37 discovering. Overall, therapy has been an empowering process that has enabled her to make changes i n her l i f e . E s t e l l e E s t e l l e i s 42 years old. She i s a single mother who l i v e s alone with her daughter. E s t e l l e has been a student f o r a number of years and has recently graduated to begin her career as a counsellor. E s t e l l e had a number of previous therapy experiences before the one under discussion. One experience was with a man which lasted 14 months; she had several more b r i e f experiences, and once saw a p s y c h i a t r i s t whom she did not l i k e . The therapy experience she discussed lasted 13 months. E s t e l l e l e f t t h i s r e l a t i o n s h i p confused and angry about how her the r a p i s t acted. She had a number of d i f f e r e n t relationships with her therapist previous to therapy including supervisor and friendship, which continued to influence her experience of therapy. The reason E s t e l l e wanted to volunteer for the study was to help her process some of the unfinished business she had from t h i s r e l a t i o n s h i p . E s t e l l e brought into therapy her t r a i n i n g and understanding of therapy. Her therapist was a psychodynamically trained therapist. E s t e l l e revealed during the interview that the main issue she was dealing with i n therapy was abandonment, and t h i s i s what she ended up experiencing with her therapist. She was l e f t f e e l i n g powerless i n the relationship because her therapist would not respond to her concerns. 38 Pam Pam i s 32 years old and l i v e s by herself i n a suburb of Vancouver. She has been married twice and i s presently s i n g l e . She works as a massage therapist, and also as a r e s i d e n t i a l worker with a spe c i a l needs population. At the time of interview, Pam was no longer i n therapy. She talked about two therapists that she had been seeing concurrently. One of the therapists had been a p o s i t i v e experience and she had seen her for 2 years, and the other had been a negative experience that had lasted for 18 months. Previous to t h i s , she had a number of b r i e f therapy experiences and many workshops she had attended. Pam's experience i n l i f e had taught her that she had no power, being subjected to both family and marital abuse. Through therapy and connections with women i n her l i f e , she discovered that she had power and that she could t r u s t people enough to be vulnerable with them. She viewed her therapists as being i n a x g o d l i k e ' p o s i t i o n . Her relationship to them i n t h i s way was very p o s i t i v e . Pam did not want to have to deal with her therapist's v u l n e r a b i l i t y because she needed safety i n order to be open about what was going on for her. Her view of power has completely changed from power as control and force, to power as love. She has come to see power as control as a fake kind of power coming from a place of insecurity. Cathy Cathy i s 39 years old and l i v e s with her husband and c h i l d 39 i n a suburb of Vancouver. She works as a l e g a l secretary and night school instructor. She only experienced a couple of sessions for advice regarding her marriage and one session with a p s y c h i a t r i s t before her present therapist whom she has been seeing f o r 11 months. Her therapist described herself as a systemic therapist. Cathy described her relationship with her th e r a p i s t as an equal r e l a t i o n s h i p , although when she talked about her r e l a t i o n s h i p with her therapist i t was s i m i l a r to other women's experiences. Cathy perceived her therapist as having d i f f e r e n t knowledge to her but only saw t h i s as a difference not as something that gave her power. Cathy defined power i n a negative way and as something that i s used against her, where she does not have a choice. She experienced abuse growing up and t h i s informs her d e f i n i t i o n of power. Cathy experienced the therapeutic r e l a t i o n s h i p as po s i t i v e , and therefore, does not contain any power dynamics. Cathy has found therapy to be most b e n e f i c i a l i n providing her with d i f f e r e n t perspectives on things i n her l i f e . Dennise Dennise i s 23 years old and l i v e s outside Vancouver with her mother. She i s single but i n a long term r e l a t i o n s h i p . Dennise works as a performing a r t i s t and c l e r i c a l a s s istant. Dennise's present therapy experience i s the f i r s t one of her choosing; although, she went a couple of times to see someone with her mother when she was 15. She has been seeing her 4 0 therapist for 5 months. She approached a l o c a l agency f o r therapy and had to wait to get i n to see someone. Dennise went into therapy aft e r she l e f t a theatre group she had belonged to for 9 years. I t was very d i f f i c u l t f o r her to leave t h i s group as i t had dominated her l i f e . Dennise came to r e a l i s e that t h i s group had too much control over her, and she did not f e e l that she was allowed to make her own decisions. This group experience influenced how she saw power. Therapy was important for her i n providing a place that was an a l t e r n a t i v e experience to t h i s group and that enabled her to f i n d her own power. Being empowered meant that she could stand up f o r herself and f e e l comfortable with who she i s . Barb Barb i s 52 years old and l i v e s i n Vancouver with her partner. At the time of the interview, she was unemployed and undecided about what d i r e c t i o n to pursue i n her career. She had worked f o r a number of years as a r e a l t o r . Barb was born i n France and had moved to Canada many years ago. Barb has had a number of therapy experiences previous to her present therapeutic relationship. Most of her previous experiences she described as unsatisfactory. She went to see a couple of p s y c h i a t r i s t s at d i f f e r e n t times, both men. These experiences l e f t her f e e l i n g judged and *under a microscope'. She did not f e e l that she could be who she was; and t h i s was very d i f f e r e n t i n her present therapy rel a t i o n s h i p where she f e l t accepted. 41 Barb's childhood was one that involved sexual abuse. She received l i t t l e attention for things that she achieved, and as a r e s u l t , t r i e d to be the 'good g i r l ' . Barb described f e e l i n g t h i s way with the p s y c h i a t r i s t s she saw, always t r y i n g to please them. Through her present therapeutic relationship, she has learned that she i s ok just for who she i s . For most of her l i f e , Barb's power was attached to her sexuality. Her power has changed from sexual power to personal power where her experience and perspective i s important. Barb described how she has come to t r u s t h e r s e l f and her feelings, and how she can now see her p o t e n t i a l . G a i l G a i l i s 46 years old. She i s a single mother l i v i n g on Vancouver Island. Her daughter i s no longer l i v i n g at home. G a i l works as a community development consultant. G a i l did not have any previous therapy experiences to the one discussed, although she had read books and done some group work. She was involved with her therapist for a year and did not f e e l s a t i s f i e d with the way i n which her therapist approached therapy. G a i l i s very focused on community and what power means i n the larger context. She i s p a r t i c u l a r l y interested i n how professionals present themselves and the power they express by t h e i r p o s i t i o n . G a i l experienced her therapist as having power by playing a r o l e and not sharing more of her s e l f . As a r e s u l t of t h i s G a i l f e l t distanced by her therapist and uncomfortable i n 4 2 the r e l a t i o n s h i p . In addition, she f e l t that there were expectations of her to be a certain way as a c l i e n t that did not f i t f o r her. G a i l and her therapist are part of the lesbian community and had come across each other s o c i a l l y . G a i l ' s therapist appeared very distant i n t h i s s i t u a t i o n , to a point that G a i l f e l t was unnecessary and unnatural. As a r e s u l t of t h i s experience, G a i l did not see therapy as a productive means for healing. G a i l did have a view of power that she perceived as healthy. She described t h i s as a mutual exchange of power but did not experience t h i s with her therapist. 4 3 Results Presentation of Categories Context I t became obvious from the interviews that the context of these women's l i v e s had an important influence on t h e i r experience of power i n therapy. The meaning of context i s very i n d i v i d u a l i s t i c , even within the sub-categories that are explained i n the following discussion. Given that the focus was power i n therapy, the categories that emerged are s p e c i f i c a l l y r e l a t e d to power. As women described t h e i r experiences, the context of t h e i r l i v e s would emerge within the therapeutic process. Therefore, i t would seem that those aspects of the context that are i d e n t i f i e d as important are symbolic of a dynamic process. Pam, who had been seeing two therapists at the same time and experienced one as pos i t i v e and one as negative, explained the process as: Pam: I think a l o t of i t was symbolic of what was going on inside of me with a l l the negative I grew up with and a l l the passive voices and a l l the condemnation and a l o t of the t r a n s i t i o n between the therapist who was negative very much a part of my childhood symbolizing my childhood and then going through the t r a n s i t i o n of having the po s i t i v e therapist during a time that was r e a l l y mixed up for me. The r e l a t i o n s h i p between context and the therapeutic process i s a complex one. What i s important about the context of women's l i v e s presents i t s e l f within the therapeutic process as a function of that process. The sub-categories that emerged under context include patriarchy: meaning of power, abuse, work 4 4 s i t u a t i o n , previous group experience, support systems, family r e l a t i o n s , and knowledge about therapy. Two further categories are part of the context but are more s p e c i f i c a l l y focused on seeking therapy. They are: choice to seek therapy, and expectations of therapy. These categories are explained below. Patriarchy. The aspects of patriarchy that were revealed included a number of further sub-categories that h i g h l i g h t the various e f f e c t s that patriarchy has on t h e i r l i v e s . The sub-categories are: differences between men and women's experience, p r i v i l e g e , r e b e l l i n g , and women reclaiming t h e i r power. A number of the women d i r e c t l y used the term patriarchy when they discussed the differences between men's and women's power. The other components of patriarchy, which were p r i v i l e g e , r e b e l l i n g and women reclaiming t h e i r power, seem to be a r e s u l t of men's and women's d i f f e r e n t experiences. In discussing the differences between men and womens' experiences, a number of women referred to the entitlement they saw men as having. As Anne states: Anne: .. men's power i s a given, and i t ' s competitive generally speaking and when i t comes to males and females, men's power has been taken f o r granted, i t has been assumed. One of the ways women experienced gender differences related to the male p r i v i l e g e they saw i n society. Women f e l t that men had more power and control i n society. E s t e l l e expressed t h i s as men having * outer' power and women having * inner' power. She l a t e r expressed t h i s i n the following way. E s t e l l e : ... there's p r i v i l e g e that you have as a man that you don't have as a woman, quite often men have more power than women, not always, but I think that 4 5 women's power i s on an inner l e v e l i n a more profound way than an outer l e v e l . Growing up female i n the context of men's power, l e f t Pam f e e l i n g that i t was 'an absolute curse to be born female'. She expanded on t h i s b e l i e f l a t e r . Pam: I f e l t that men had a l l the power i n the world, they used i t against women, they used t h e i r physical power sexual energy they had a l l the f i n a n c i a l power p o l i t i c a l power I figured they had i t a l l . Most of the women f e l t that patriarchy and t h e i r general experience of power put them at a disadvantage being a woman. As a r e s u l t , they had obstacles to overcome i n fin d i n g t h e i r own way i n the world. Women found ways to overcome t h i s , which can be summed up under the two sub-categories, r e b e l l i n g and women reclaiming t h e i r power. Women reclaiming t h e i r power i s expanded on l a t e r i n r e l a t i o n to the experience of therapy. Anne spoke about r e b e l l i n g i n connection to patriarchy, as a resistance to the expectations of the roles assigned to women. Anne: ... the patriarchy i s so unconscious, I didn't know anything about i t I just behaved as expected ... I see that my power would have been i n being a good wife and mother ... But I did exercise power because I didn't do that I rebelled. When asked how she rebelled, she talked about not marrying or having children. When the interviewer commented on how she did not associate these roles with power, and the only way to have power was to r e s i s t them, she re p l i e d ; Anne: I think I have l i v e d a l o t of my l i f e that way by doing the opposite, r e b e l l i n g p a r t i c u l a r l y against my father's suggestions and advice, he thought we should be more a t h l e t i c be better housekeepers and good cooks and do a l l the rig h t things. 46 The following excerpt i l l u s t r a t e s how one woman went from be l i e v i n g she had no power and that men had a l l the power, to r e a l i s i n g how women's a b i l i t y to nurture i s profoundly powerful. This r e a l i s a t i o n changed her l i f e and can be considered a method of women reclaiming t h e i r power. Pam: ... I remember my therapist had t r i e d to get across to me that women have a power too, they have the power to nurture and I said so what who gives a s h i t , men can just pound the heck out of women what good i s i t , I just r e a l l y couldn't see i t , and then with her and a l o t of other wonderful women around me, had a dream that r e a l l y changed my l i f e , and I worked with her on a l l the d i f f e r e n t parts of i t and the one part of i t near the end had to do with a c h i l d , that had been r e a l l y r e a l l y hurt and I was down on the f l o o r rocking t h i s c h i l d with a l l these broken bones, and when I woke up out of that dream I r e a l i s e d i n s t a n t l y that the only way I could heal that l i t t l e c h i l d i s with nurturance, there's no physical power, f i n a n c i a l power, p o l i t i c a l power, s o c i a l power, that can cure that kind of pain, only nurturance can cure that, holy s h i t i s that ever powerful and that t o t a l l y flawed me ... and that's the way I see things now, and when I see people using power to hurt or overpower others i t doesn't make me scared of them or angry at them or anything I j u s t f e e l sad for them. Meaning of power. For the women i n t h i s study, the meaning of power r e f l e c t s how they perceive power i n t h e i r l i v e s . The women experienced power i n four main ways, as influence, personal power, money and p r i v i l e g e , and control versus choice. However, when Pam was asked what power meant to her, she described i t as being i n everything, i l l u s t r a t i n g how pervasive the experience of power i s . Pam: I t ' s to me everything i n one way or another, i t can be anything from the power of a smile or a tear, to hurting and destroying somebody, and everything i n between i t ' s empowering others or empowering yourself, or disempowering others or yourself or givi n g up your power, I see i t as synonymous with energy, i t can be 4 7 p o s i t i v e or negative or physical or emotional. This excerpt portrays the expansive experience of power, and the varied ways i n which power can influence women's l i v e s . The women's understanding of power can be broken down into those experiences of power between individuals and/or i n s t i t u t i o n s , and personal power that comes from a sense of yourself. Both of these aspects of women's understanding of power are i l l u s t r a t e d i n t h e i r more s p e c i f i c experience of power i n therapy, which i s expanded on l a t e r . A number of women talked about power as influence, which can be power exerted towards someone or, as i n the example above, something that i s a personal experience. J u l i e described the dynamic nature of influence when she talked about the people who have been i n f l u e n t i a l i n her l i f e and gave her a d i f f e r e n t outlook. J u l i e : ... just taking d i f f e r e n t parts of things and incorporating them into your own b e l i e f s , or value system and so i n that respect i t ' s quite i n f l u e n t i a l i f somebody says something that I can r e a l l y r e l a t e to, I think i s r i g h t or true. I: Can you be influenced by somebody where i t doesn't r e l a t e , i s that an important aspect of influence? J u l i e : Yes I think so, because otherwise i f i t wasn't something that made sense to me, or I held as one of my own b e l i e f s I think that I can respect that, but i t i s not necessarily an influence on me because I don't adapt i t to my own b e l i e f s ... i f i t i s an influencing force i t i s something that you take i n , I suppose that not r e a l l y true either, because I'm just thinking about hearing something I may not believe or hold as my b e l i e f , does that influence me i n any way? i t doesn't sway my b e l i e f s because t h e i r f a i r l y i n t a c t , but obviously they change and evolve as well but just by hearing that information i t can have some sort of influence. Control versus choice was an important way i n which women 4 8 had an understanding of power i n t h e i r l i v e s . Money and the p r i v i l e g e of money was also understood i n terms of the control i t gives you i n your l i f e . J u l i e talked about t h i s and r e l a t e d i t to the power to influence. J u l i e : ... just b e l i e f s and values that society holds or court systems or anything that can influence your l i f e , i n that regard forcing you to l i v e a c e r t a i n way and money comes into that ... money i s power and i t allows you to do things, and not be able to do things and l i v e a certain way even to af f o r d to come to therapy. J u l i e : ... just having money i s power, also so you can influence with money also equals power. Power as control emerged i n various ways throughout women's understanding of power, power i n therapy, and empowerment. The meaning of power as control, as part of the context, was an important influence on a woman's experience of power i n therapy. One woman only saw power as control, and having a choice meant there i s no power. Whereas, other women spoke about choice as power i n a p o s i t i v e way. The ways i n which power i s perceived brings into question how t h i s a f f e c t s a woman's experience i n therapy, or at the very least her understanding of her experience i n therapy. In the following excerpt, Cathy i l l u s t r a t e s how her experience of power as control influences how she percieves the re l a t i o n s h i p with her therapist. Cathy: ... she (therapist) seems to be a very equal person and when I thought about power there doesn't seem to be too many d i r e c t things that she did I: What's a d i r e c t power thing? Cathy: Out and out t e l l i n g you you got to do t h i s ... so that to me i s a di r e c t power thing i n my l i n e of thinking, i s t e l l i n g you d i r e c t l y t h i s i s what you have to do and there's no two ways about i t , and you don't have a choice where as to me, she may have, I'm sure there was power i n the therapy suggestions and models she was doing, but I sure didn't f e e l i t inside f e e l the nervousness of a power. I: Is there a power that doesn't t e l l you you should or i s i t always a d i r e c t power? Cathy: Probably i n my mind an in d i r e c t power i s more body language, the shire way somebody looks at you puts t h e i r body and things l i k e that, to me power i s dominance over somebody and they eith e r d i r e c t t e l l i n g you or in d i r e c t by shrugging your shoulders away from somebody because you don't l i k e the topic t h e i r on. The meaning of power as control also r e l a t e s to the context of abuse that a number of the women experienced i n t h e i r l i v e s and i s explored l a t e r . Personal power was another aspect of the meaning of power that each woman spoke about i n some way, even though some women did not define i t as power. Personal power rel a t e d to knowing themselves and being able to express t h e i r needs. Even though t h i s experience of power may be influenced by interactions with others and situations they have dealt with i n t h e i r l i v e s , i t i s pri m a r i l y focused on how the women f e l t about themselves. The following excerpt expresses what a l l the women spoke about around t h i s meaning of power. Anne: ... the main synonym for power i s i n t e g r i t y ... I have t r i e d to define what i t i s and I think i t i s in t e g r i t y , of being grounded and honest about myself. Anne: Integrity to me means congruence and honesty i n representing myself as myself and being able to encourage others to t h e i r own truth. As Anne explored t h i s i n the interview, she talked about how i n most of her l i f e she did not know what she wanted. When asked i f 5 0 t h i s r e l a t e d to her experience of power i n general, she r e p l i e d : Anne: Yes i t i s related very much i f you don't know what you want, you therefore can't ask for i t , and i f you can't ask for i t , you don't get i t and you s t i l l don't know what i t i s you're not getting that you r e a l l y need, there's no power there at a l l . She l a t e r developed the connection between personal power and self-awareness. Anne: ... I think I get a l o t of my power out of the discovery of parts of myself, parts I didn't necessarily know that I had and the r e f l e c t i o n back to me by x i n a very p o s i t i v e way, adds to my power When asked i f awareness i s a big part of power she r e p l i e d : Anne: Awareness goes back to beginning d e f i n i t i o n of power, a l l part of the i n t e g r i t y s e l f awareness, because i f you can say look t h i s i s who I am take i t or leave i t and mean that, then I think that's a r e a l l y good d e f i n i t i o n of power. Abuse. As mentioned above abuse was an experience common to a l o t of the women's l i v e s . Their experience of abuse influenced t h e i r understanding of power, and would often be a part of t h e i r decision to seek therapy. Abuse was talked about as childhood sexual and physical abuse — physical abuse from men i n t h e i r l i v e s as well as boundary v i o l a t i o n s . The following excerpt shows the meaning of abuse for E s t e l l e , who expressed i t i n terms of a lack of respect. E s t e l l e : Yeh I think i t b o i l s down to the lack of respect, i f the person who i s i n a po s i t i o n of power i s not appropriately respecting the person who i s i n a lesser position of power, then there i s an abuse ... t h e i r i n t e g r i t y i s vi o l a t e d . Later she gives an example i n regards to her work supervisor: E s t e l l e : ... I think of my supervisor here, I f e e l l i k e i t ' s an abuse of power i f she comes i n and t e l l s me what the story i s without any kind of consultation ... so 51 i f there i s a place where my own i n t e g r i t y and my own connection gets severed then that f e e l s not r e a l comfortable to me. I t was apparent that the abuse women had suffered was ever present throughout t h e i r therapy, as the following excerpts show. For Cathy, the decision to look for a woman therapist r e l a t e d to the abuse. Cathy: I f e l t comfortable going to a female the r a p i s t because my therapy was abuse rel a t e d i n a family relationship, so I personally f e l t more comfortable dealing with a woman. She also described how abuse related to her d e f i n i t i o n of power. Cathy: Maybe my d e f i n i t i o n i s part of the abuse process. Power was physical power was control and through my l i f e getting away from that. The next excerpt shows how Pam's experiences of physical abuse r e l a t e d to the way she saw herself and to the issue of t r u s t . Pam: When I think of things l i k e when my f i r s t husband use to h i t me and when I was pregnant when I was 16, he took me down to the hooker corner and t r y and make me go and hook and things l i k e that. What I f e l t was a r e a l disempowerment ... I saw him as strong and me as weak. Later on she described how hard i t was to t r u s t following her experiences of abuse. Pam: In the beginning d e f i n i t e l y more a f r a i d of that, I would f i g h t with my ex-husband and he would h i t me, I remember him grabbing my hair l i k e t h i s , and smashing the back of my head against t h i s cement wall, and I didn't f e e l a f r a i d , but when I would t e l l people about my fears of them leaving me that's so much s c a r i e r ... to me the tr u s t i n g being more a f r a i d and being able to be vulnerable and express myself, that's r e a l l y t r u s t i n g that I'm going to get through that fear, that's where the tr u s t i s that in c r e d i b l e extreme hope that they're going to be safe. When asked how t h i s changed her experience of power she r e p l i e d : Pam: Well I quess before to me power was seen as other people being able to hurt me there was no issues of tr u s t because I wouldn't t r u s t anybody ... I ju s t kept everything locked up so t i g h t l y inside that I couldn't see that there were any locks, and then when I started t r u s t i n g that process work was going to make some changes i n my l i f e , then I started f e e l i n g stronger i n myself. The context of abuse for these women seemed to be connected to t h e i r understanding of power, as well as the ways i n which women have learned to re l a t e i n order to protect themselves. Family relationships. Many of the women would t a l k about t h e i r family relationships i n connection to t h e i r experience i n therapy. The relationships that were i d e n t i f i e d were parental r e l a t i o n s h i p s . Women talked about t h e i r unmet needs from childhood, and how therapy provided a re l a t i o n s h i p where they could meet some of those needs. Conversely, women talked about how t h e i r family relationships were being re-created. Both cases show how family relationships are another important influence from the context of t h e i r l i v e s . E s t e l l e , who i s a thera p i s t h e r s e l f , described the therapeutic r e l a t i o n s h i p as a form of 'reparenting'. This r e f l e c t s her th e o r e t i c a l perspective as a therapist ( i . e . , a psychodynamic perspective), as well as her experience as a c l i e n t . E s t e l l e : I would say that's one aspect of therapy for sure, there are other things i n terms of parenting things that didn't get under way when you were growing up ... there's the rebuilding of your own a b i l i t y to take care of yourself, that you normally develop i n relationship with your parent, and the way they treat you, so i f you didn't have a chance to do that when you were growing up, you get to get a chance to do that i n therapy so I think that i s 5 3 p a r t l y what reparenting i s . The q u a l i t y of parental relationships for these women seems to determine aspects of the relationship with the therapis t . In p a r t i c u l a r , the context of parental relationships influences the therapeutic rel a t i o n s h i p by highlighting the unmet needs from childhood. E s t e l l e continues l a t e r i n her interview to discuss parental issues that arose i n her rel a t i o n s h i p with her therapist . E s t e l l e : I'm being t o t a l l y abandoned here, i t f e e l s awful i t ' s l i k e i f any reparenting s t u f f happened, i t ' s l i k e oh great we're just going to go through you know parental abandonment again, i t was the way i t f e l t l i k e my dad died when I was 14 and my mum became psychotic at that point, I had big experience of parental abandonment, f e l t l i k e I was rig h t back i n that. Work s i t u a t i o n . A number of women referred to t h e i r work si t u a t i o n s when discussing power i n t h e i r l i v e s . Work si t u a t i o n s are another example of the context where these women learned about power. As J u l i e expressed: J u l i e : Authority relates to power i n the most basic sense i n a work relationship, i f you have a supervisor that person has authority over you, they are overseeing you, they are overseeing your work and that's power. Conversely, Pam spoke about the work she did and how t h i s was empowering for her. Pam: Now I do massage and I work with people who are mentally and physically handicapped, and I f e e l very powerful I f e e l as big as the universe. For these women there were varied experiences of t h e i r r e l a t i o n s h i p s to work. These experiences, as i n the examples above, were often hinted at as they discussed power i n t h e i r 5 4 l i v e s . G a i l discussed how her work influenced how she saw the re l a t i o n s h i p with her therapist and power. G a i l : The work I do i s n ' t disconnected, so I was there for my own personal reasons, but at the same time I do a l o t of work with community professionals around power relationships, and one of the things that r e a l l y concerns me i s about a r t i f i c i a l boundaries that are put up to protect professional status, to protect professional authority. So t h i s i s something I am pretty aware of i n a whole l o t of d i f f e r e n t contexts, and so one of the things that comes up frequently i s when someone who i s playing a professional r o l e i n the community, whether they're a nurse or a psychologist, no matter what they are, when they r e l y on that r o l e to define who they are, and to determine what t h e i r involvement w i l l be, and one of the things I always t r y to point out to them, i s the degree to which when they are setting that boundary, the degree to which i t ' s consolidating t h e i r power within the community, and within the relationship, and the degree to which i t i s disempowering to other people. This excerpt shows how a woman's values can be inherently t i e d to her work. The women interviewed i n t h i s study expressed varying degrees of s a t i s f a c t i o n with t h e i r work and i t s importance i n t h e i r l i v e s . Five of the women worked with healing i n d i v i d u a l s or groups, and, as the exerpt above shows, a f f e c t s t h e i r understanding of therapy and power. Support systems. Another aspect of context to emerge from the interviews i s the relationship to t h e i r support system and t h e i r r e l a t i o n s h i p with t h e i r therapist. The r e l a t i o n s h i p these women have to the support i n t h e i r l i v e s seems to a f f e c t t h e i r expectations of and relationship to t h e i r therapist. As Anne described her experience of dependence within the therapuetic r e l a t i o n s h i p she made the connection to the support i n her l i f e . Anne: ... I need to work on that part of me that wants to sabotage myself, and that's where we go back to the 5 5 issue of dependence, and a l o t of the dependence i s wrapped up i n the fact that I have very l i t t l e support system outside of x got to do something about that. Dennise began therapy at a time when she was i n c r i s i s . She had l o s t a group s i t u a t i o n that had been the main support i n her l i f e . Dennise: I'd just l e f t my support system and I needed somebody to t a l k about a l l t h i s s t u f f , I could t a l k to my boyfriend about i t and that was great, but I didn't want to lean on him to sort out my l i f e , because he i s my boyfriend and he w i l l agree with whatever or not, but I wanted somebody I respected not so much respected, I just wanted a d i f f e r e n t support system I wanted to b u i l d that up. The re l a t i o n s h i p with the therapist i s a d i f f e r e n t kind of support than friends or family, and the components of t h i s support are explored l a t e r . What emerged from these women's experiences i s how t h e i r perceptions of the r e l a t i o n s h i p with t h e i r therapist may be shaped by t h e i r r e l a t i o n s h i p to the support i n t h e i r l i v e s . Barb: I have some uncomfortable time and where I have been hot i n my seat, and she w i l l need to say look at t h i s t h i s i s what i t i s , and I don't want to look at i t . I do not want to own my problems and i t i s uncomfortable, but I know there i s no malice. There i s no major thing i s she i s not there to control me, she i s not there to have power over me, and I can f i n d a l l of those i n my friends ... they have not had my experiences and t r u l y they do not understand from any angle I come from ... they do not have the understanding or the knowledge to take me to a better place ... I f i n d a l l those are reasons why a counsellor and s p e c i f i c a l l y x, a l l those things she does not do. I: So i t sounds l i k e that with friends there's a l o t of themselves that come into the re l a t i o n s h i p with you. Barb: They bring i n t h e i r own issue with me, x does not. Previous group experience. Dennise had been part of a theatre group. She f e l t that i t had been both a p o s i t i v e and destructive force i n her l i f e . She went for therapy a f t e r she had decided to leave t h i s group and wanted to heal some of the e f f e c t s of the abuse of power she experienced i n t h i s group. Therefore, her group experience was very much a part of the context that she brought into therapy and influenced how she experienced therapy. Throughout her interview she would make reference to t h i s group and the ways in which i t affected her i n her l i f e and with her therapist. The following i s an example of how her experience affected her rel a t i o n s h i p with her therapist. Dennise: I found i t d i f f i c u l t because she (therapist) would get defensive of me when I would describe situations that I would put myself i n , and ways i n which I would give my power away to t h i s woman, the group leader, and she would get defensive f o r me, Oh t h i s woman had no r i g h t to do that, and a f t e r nine years of being with t h i s woman I can't say I love her but I was l o y a l to her and f o r someone to come along who had no clue, I f e l t defensive. Later i n the interview she expanded further. Dennise: I quess that's what made i t d i f f i c u l t , was that t h i s woman didn't have the r i g h t to do that, i t made me f e e l that because I chose to be with her I had made the wrong decision, even though I disagreed with the power t h i s woman had I s t i l l didn't f e e l that my nine years was a mistake. These categories which represent the context, demonstrate the unique nature of every woman's contextual experience. I t i s evident that i n some of the areas the experiences are s i m i l a r , and i n other areas, the experiences are s p e c i f i c i n nature. However, even when t h e i r experiences are s i m i l a r , the way i n which that s i t u a t i o n affects a woman shows the i n d i v i d u a l i s t i c nature of her context. 57 Choice t o seek therapy. When a woman comes t o the p o i n t of see k i n g therapy, two i s s u e s are s a l i e n t : (a) the c h o i c e t o seek therapy, and (b) her e x p e c t a t i o n s of therapy. These components of a woman's r e a d i n e s s f o r therapy, are p a r t of the c o n t e x t , but are more s p e c i f i c a l l y focused on the therapy. The p r e v i o u s a s p e c t s of the c o n t e x t stand a p a r t from therapy, u n t i l t he women a r e i n v o l v e d i n a t h e r a p e u t i c r e l a t i o n s h i p . Women seem t o make the ch o i c e t o seek therapy f o r v e r y d i f f e r e n t reasons t h a t depend on t h e i r c i r c u m s t a n c e s . T h e i r a b i l i t y t o make informed and optimum c h o i c e s of which t h e r a p i s t t o work w i t h may have been l i m i t e d . One of the elements of see k i n g therapy t h a t women eluded t o was the amount of i n f o r m a t i o n they had about therapy. As Barb e x p l a i n s . Barb: Between t h a t time ( r e f e r r i n g t o time from e x p e r i e n c e s w i t h p s y c h i a t r i s t t o present t h e r a p i s t ) I r e a d hundreds of books, and I t h i n k I had a b e t t e r understanding of how the mind works by the time I met x, so I was probably coming a t i t from a d i f f e r e n t p e r s p e c t i v e a s w e l l , I was o l d e r , p r o b a b l y the d e s p a i r a s w e l l , the whole t h i n g from the b e g i n n i n g t o now i s 16 years, t h a t ' s a long time t o be t r y i n g t o f i n d y o u r s e l f . For Barb t h e r e had been an accumulation of ex p e r i e n c e s as w e l l as her own i n v e s t i g a t i o n s t h a t prepared her f o r a more p o s i t i v e t herapy experience. In c o n t r a s t , the f o l l o w i n g e x c e r p t shows how Dennise, even though she had r e s e r v a t i o n s about her t h e r a p i s t was l i m i t e d i n her c h o i c e s . Dennise: I had spent t h r e e months t r y i n g t o get a t h e r a p i s t and I had been through the run around i n the s e r v i c e s ... I had fought so hard t o get where I was, so I thought I had t o go because I had fought so hard t o get ther e , and a l s o a f t e r t h r e e times of going t o my t h e r a p i s t I had j o i n e d a group f o r 5 8 survivors of sexual abuse, and one of the things i n that group was you had to go see a therapist, so I had to i f I was going to be part of that group. Expectations of therapy. In preparing to enter a therapeutic r e l a t i o n s h i p , the women had certain expectations therapy that they brought with them. The expectations seem to be derived from the women's previous experiences of therapy, the contextual experiences talked about previously, and from a t h e o r e t i c a l understanding of therapy. A number of women expressed a desire to seek a woman therapist based on some of these experiences, as one woman conveyed. Pam: I wouldn't t r u s t men i n therapy, I a c t u a l l y did have one male therapist I saw about twelve times ... he was r e a l l y awesome, he t o t a l l y blew me away he was the gentlest man up to that point I had met ... other than him I only checked out women, because I was a f r a i d of men and I didn't t r u s t women. E s t e l l e described how her previous experience of her therapist interfered i n t h e i r therapeutic r e l a t i o n s h i p . E s t e l l e : She was my c l i n i c supervisor when I was i n going through the program, I already had somewhat of a relati o n s h i p established before I asked i f I could go into therapy with her ... i n retrospect I think that was a bad idea because we were already s t a r t i n g off with a r e a l power difference,and also she l e f t c l i n i c half way through and nobody knew she was going to do that ... so because of the difference i n power, I had never addressed that with her, talked about how I was r e a l l y angry and hurt with that, so I went into therapy with her with t h i s unexpressed s t u f f . The expectations that r e s u l t from these previous experiences centre on what i s safe to express to t h e i r therapist. Expectations were also influenced by the t h e o r e t i c a l perspectives that some of the women held. This was highlighted by what they 59 were looking for and the kind of connection they wanted, as J u l i e relays i n the next excerpt. J u l i e : What's important i s not necessarily that my experiences are similar, but that b e l i e f s and methods of therapy are important that mine are quite s i m i l a r to hers, and that was something I was looking for ... how do they practise, what are t h e i r methods of therapy, where are they coming from, what perspective, feminist or whatever. Later i n the interview, J u l i e talked about the power d i f f e r e n t i a l she experienced i n therapy, and how she had expectations of what the therapeutic r e l a t i o n s h i p would be l i k e based on a feminist perspective. J u l i e : ... the understanding comes from because her basis of her practise i s from feminist theory, and so having knowledge of that and knowing that part of feminist theory i s to do exactly that, and break down the hierarchy, t r y and make i t as l e v e l as i t could possibly be, and so knowing that i s what she practises when I came into that, I had that assumption, and being with her for a while now I've found that that was the case ... I assumed that's the way i t would be, the kind of r e l a t i o n s h i p we do have and the way i n which the therapy i s c a r r i e d out and the way she practises. G a i l expressed s i m i l a r sentiments about expectations that come out of a t h e o r e t i c a l base. G a i l : I t was a r e l a t i o n s h i p that for me d i d not g e l , and I think part of that was around expectations, around what would happen i n a r e l a t i o n s h i p between someone who c a l l s themselves a therapist and someone who i s there i n the r o l e of c l i e n t , and I think those expectations are grounded i n probably therapeutic theory, but also very much have elements of power re l a t i o n s that I, from where I come from, didn't f e e l p o s i t i v e or h e l p f u l to me, i n terms of the kind of healing work I was looking to do. Other expectations of the therapist were expressed by a number of women as the kinds of connections they were looking for 60 which i d e n t i f i e d a s i m i l a r i t y between themselves and the therapist, and with t h i s the expectation that the th e r a p i s t would be able to understand them. Cathy: She's an older woman a l i t t l e b i t younger than my mother. I f e l t very comfortable going to a female therapist because my therapy was abuse r e l a t e d i n a family i n a family relationship ... she's family oriented, her youngest i s 13 and my only c h i l d i s 8, and so I f e l t very close i n that, and she's a nice person I just c l i c k e d with her. Cathy expressed the need to connect i n terms of s i m i l a r i t i e s i n l i f e s t y l e and circumstances. Barb expressed the need to connect i n terms of the issues she was dealing with i n her therapy. She begins here by t a l k i n g about previous experiences. Barb: I t was also d i f f e r e n t , she (previous therapist) was i n her 30's, she was not, nor had been, married. She did not have any children. I: How did those things a f f e c t you? Barb: I f e l t maybe she did not have enough experience of l i f e i n general, personal experience wide enough yet and that was af f e c t i n g me, and I had never given i t any thought but x i s the closest i n age, and t h i s probably i s making a difference as well ... there are no s i m i l a r i t i e s except age. I think she (therapist) i s one year younger or two because she i s married and has two children. I have never been, but that f a c t that she had been f i g h t i n g a long time what she was going to do i s a very big issue and a big plus for me, because again t h i s i s another area where she can understand where I come from being at my age and not knowing what I'm going to do when I grow up, but she i s also a great example for me, she started 4 or 5 years ago to go back to school, I don't think I w i l l go to school but at leas t I can see i t ' s possible for me to f i n d something I would l i k e to do. Conversely, Pam had the need to keep her therapist i n a po s i t i o n of perfection, and as a r e s u l t had the expectation that the therapist would not divulge her v u l n e r a b i l i t y or information 61 about her s e l f , and the relationship would remain within the bounds of the o f f i c e . Pam: I wouldn't want i t to continue outside of the o f f i c e , because i t would f e e l unbalanced and u n f a i r and unsafe. To have somebody know things about me that I don't know equal sort of information about them, but i n s i d e the o f f i c e walls there were moments that the t h e r a p i s t t o l d me private things about themselves, that made me f e e l a b i t uncomfortable, I don't think I need to hear that. Pam: I had put them i n the same pos i t i o n as a c h i l d I had put my mum and had put a god figure, i n that, see that person as being strong, and then when you hear weaknesses, i t ' s very uncomfortable. You need that figure to be somehow perfect, to be able to look up to and look for guidance from. The above excerpt i l l u s t r a t e s the kind of connection that t h i s woman wanted with her therapist, and how that included a need fo r protection through the boundaries of the r e l a t i o n s h i p . Cathy expressed her expectation of protection based on the understanding she had that her therapist would behave i n an e t h i c a l manner. Cathy: ... I'm going to define you as a guardian, the rel a t i o n s h i p that we have i s going to be t o t a l l y d i f f e r e n t than anyone else, and because of the ethic she w i l l do me no harm, and these are a l l the things inside me that I have given to her that persona, that she w i l l never ever harm me she's not there for a harmful thing, and so i t i s very d i f f e r e n t from friends because friends can harm you. In summary, there seems to be a number of ways i n which the context influences the women's experience of power and t h e i r r e l a t i o n s h i p with t h e i r therapist. From the women interviewed i n t h i s study, there were a number of contextual experiences that were i d e n t i f i e d : (a) experiences from t h e i r family s i t u a t i o n s , (b) s o c i e t a l experiences such as patriarchy, (c) the structures 62 of t h e i r l i v e s including work and support systems and (d) the th e o r e t i c a l and meaning making experiences that inform how they see power. In addition, the context i s associated with women's needs i n the therapeutic relationship and helps to shape the expectations they bring to therapy. Relationship with the Therapist From the interviews i n t h i s study, the category of re l a t i o n s h i p with the therapist emerged, which comprised three sub-categories: (a) involvement with the therapist, (b) support of the therapist, and (c) power dynamics. These sub-categories are addressed i n the following discussion. Involvement with the therapist. The women's re l a t i o n s h i p s with t h e i r therapists involved varying degrees of personal involvement, depending on the needs of each woman and the kind of connection she was looking for. Personal involvement enta i l e d the amount of friendship they wanted i n the rel a t i o n s h i p , and ranged from no friendship to one woman who had a friendship outside of the therapy rel a t i o n s h i p . The amount of involvement with t h e i r t herapist resulted i n various degrees of s a t i s f a c t i o n and f a c i l i t a t i o n of t h e i r therapeutic process. The following excerpts show how varied these experiences are. Anne: Both of us f e e l that we could have a good friendship, but we wont do i t as long as I'm i n therapy with her. Later i n the interview, as she was discussing how her rel a t i o n s h i p with her therapist was d i f f e r e n t from friends, she says; Anne: The other major difference i s that I don't know very 6 3 much about her ... which with a f r i e n d you do you f i n d out s i m i l a r types of things with fr i e n d s . I: How does not knowing her af f e c t you? Anne: On occasion I would l i k e to know more and there are times when I know she i s going through something d i f f i c u l t , f o r instance I know she recently developed high blood pressure and so we take a l i t t l e time to f i n d out at least where she i s , i t ' s odd when she's a person I know I would l i k e to make a f r i e n d . Anne's experience shows that even though the desire and intension i s towards friendship, the relationship i s d i f f e r e n t from that of frien d s . At the other end of the spectrum Pam did not view a friendship as possible even when therapy had ended. Pam: She did always seem l i k e a fascinating woman, even now a f t e r I haven't seen her for more than a year, I s t i l l have a b i t of a god l i k e image of her, and I f e e l even i f she had never been my therapist I can't imagine having a friendship type r e l a t i o n s h i p with her, because she s t i l l seems so much greater and wiser and more powerful, I don't see an equality between the two of us. Later she explored further the difference between friends and her therapist. Pam: I have two friends that are therapists and I can't imagine them being my therapists because they don't seem god l i k e . I: So i f they weren't godlike, they wouldn't be your therapist, i s that what you're saying? Pam: Kind of seems l i k e they have to go together to me, I have two friends who are therapists who I love very much, and I can't imagine anyone taking them seriously. I have slept with these women, I can't imagine x i n any other setting. She has t o l d me about her private l i f e some, that she doesn't have a t e l e v i s i o n , t o l d me a l i t t l e b i t about the gatherings and things she's gone to and I can't imagine her loose. E s t e l l e described her relationship with her therapist as a 6 4 dual r e l a t i o n s h i p . This involved having an ongoing s o c i a l r e l a t i o n s h i p , and a therapeutic relationship at the same time. The e f f e c t s of t h i s , for E s t e l l e , were to leave her f e e l i n g confused, and ultimately f e e l i n g 'betrayed' by her therap i s t . The consequences of t h i s relationship are addressed further under the core category 'power i n therapy'. From the information gathered from these interviews, involvement i n a dual r e l a t i o n s h i p with a therapist seems to be p o t e n t i a l l y destructive, and a f f e c t s a woman's experience of power i n therapy. The following excerpts from t h i s woman's interview highlights the kind of involvement with her therapist that a dual relationship produces. E s t e l l e : She'd been my supervisor and I'd been at her house a couple of times for dinner and she'd been at my house so there was big fuzzy boundaries. The only place where i t interfered with therapy was the part where I f e l t a friendship happening as well, things l i k e you're part of my people and we'll be s i t t i n g on our porch when we are 80 years old ... E s t e l l e : There was c e r t a i n l y a dichotomy there, i t had more to do with being intimidated, l i k e could I l i v e up to t h i s person who i s r e l a t i n g to me i n a p a r t i c u l a r way, who came from an i n t a c t family where money wasn't a problem and who was professionally together and a l l that kind of s t u f f . That wasn't what my circumstances were at the time I was a single mother r e a l l y t i r e d a f t e r a m i l l i o n years at university, so the times i t would be r e a l l y uncomfortable would be i f I was over at her house, I wouldn't know what to say l i k e oh my god we are i n a d i f f e r e n t r e l a t i o n s h i p I don't know how to r e l a t e to her r i g h t now so that would be confusing, that would be very uncomfortable. I'm not sure i t was uncomfortable i n therapy, but i t would be very uncomfortable i n other s i t u a t i o n s . S e l f - d i s c l o s u r e by the therapist i s a component of the therapeutic rel a t i o n s h i p that helps determine what that involvement w i l l be. I t would appear from the interviews, that 6 5 disclosure i s largely at the therapist's d i s c r e t i o n , and so i s the degree of involvement. I t i s assumed therefore, that s e l f -d i sclosure and involvement with the therapist are important elements of the experience of power, and w i l l be discussed l a t e r i n r e l a t i o n to power i n therapy. The women's experiences of s e l f -d isclosure are as varied as t h e i r experiences of involvement with t h e i r therapist. In addition, women expressed varying needs i n r e l a t i o n to s e l f - d i s c l o s u r e . J u l i e ' s experience a r t i c u l a t e s c l e a r l y the l i n k between s e l f - d i s c l o s u r e and involvement with her therapist. J u l i e : There aren't any emotional attachments to t h i s person, well I don't f e e l anyway i n my re l a t i o n s h i p , so you don't have the st u f f you would have with friends, the day to day problems you don't know a whole l o t about t h i s other person and you don't get involved i n what's going on with them, so you don't have the involvement i n t h e i r l i f e . Involvement with the therapist seems to e n t a i l the amount of emotional and personal connection each woman wants with her therapist. This can be affected by the expression of friendship, the kinds of boundaries that are put i n place, and the therapist's s e l f - d i s c l o s u r e . The involvement with the therapist a f f e c t s the experience of power by contributing to the amount of comfort and safety created i n the relationship, which i s explored i n more d e t a i l l a t e r . Support by therapist. Seven of the eight women interviewed spoke about the kinds of support they received from t h e i r therapists. There seems to be a number of d i f f e r e n t ways t h i s support i s given, which can be broken down into; focus on the 66 c l i e n t , therapist's s k i l l , guidance, empowering, and sharing. The support that the women received was instrumental i n the changes they have made i n t h e i r l i v e s . Many of the women spoke about the focus of therapy being t h e i r agenda, and the following excerpt shows how the process of therapy works when focused on the c l i e n t ' s agenda. J u l i e : I think that b a s i c a l l y what happens i s that a therapist i s there to guide you along and point out things as you go and i n my re l a t i o n s h i p with my therapist, i t has been my agenda, and so what are my issues, what do I want to look at, what have I noticed that i s not necessarily working, or what do I want to work on, and from there having point things out or patterns of behaviour, and making me see the l i g h t . Cathy described how the focus on her agenda enabled things to emerge. Cathy: I have been doing t h i s with her sensing that I needed to s t a r t organising and c o n t r o l l i n g the sessions, f e e l i n g free enough to t e l l her my agenda, l i k e my goals, my ideas, so yeh she did allow that and we got comfortable enough that even personal things that I didn't know came out and there was no fear for me. For Pam, focusing on her agenda meant that anything she brought into therapy could be explored to f i n d the deeper meaning. Pam: She r e a l l y r e a l l y explored things with me and sometimes I'd say something keeps coming into my head, something happened or whatever, i t r e a l l y didn't mean anything to me at a l l , but I can't stop thinking about i t and so she'd get ta l k i n g to me and ask me i s there a time when you f e l t l i k e t h i s as a k i d or something and then I'd f i n d that there was something that r e a l l y came up that I had been so accustomed to shutting down. Later she summed t h i s up with; Pam: ... she just seemed more than w i l l i n g to discuss anything that came up, she was just r e a l l y there f o r me. 6 7 From the data gathered i n t h i s study, the focus of the r e l a t i o n s h i p between a therapist and a c l i e n t i s i n the c l i e n t . This i s , i n many ways, the cornerstone of the r e l a t i o n s h i p where the c l i e n t i s validated by t h i s attention, and able to discover new things about themselves, express repressed aspects of themselves, and f e e l empowered. The main aspect of the therapist's support to emerge from the data was guidance. The following excerpt captures Cathy's need for guidance i n providing her with answers. Cathy: B a s i c a l l y I think because one of my major goals was I needed answers, I have come to a point i n my l i f e where I've h i t the maximums, I've h i t the end of a l l my major goals and I needed answers to what to do with the rest of my l i f e . I was f e e l i n g l o s t and needed these answers, and i f you look back on i t , i t ' s l i k e a shaman you go to them because they are wise and give you some answers, and i t ' s turned out something l i k e that t h i s wisdom, and j u s t what I needed because that's where answers could be found, and i t couldn't be found from just friends because they wouldn't know enough of what was going on personally, and I would not f e e l l i k e divulging i t to them because I would have to face them again. Barb talked about being encouraged by her therapist through d i f f i c u l t times. This could be described as emotional guidance, where she was given a sense of hope. Barb: She helped me through those bad times where I did not believe i n myself because she was giv i n g me f a i t h and support, i f I hang on there i t w i l l happen and I believed her. Now why I believed her, I f e e l she i s honest, she give me more of the time that I was paying for and I just had these gut feelings, r e a l l y she was the only person I could hang onto at t h i s time and i f I wanted to make i t , she was my l i f e l i n e . The guidance and encouragement of the therapist stems from a focus on the c l i e n t ' s agenda. In other words, i t i s the c l i e n t ' s 68 p r o c e s s t h a t i s being guided. The next e x c e r p t shows how t h i s o c c u r r e d f o r J u l i e , and how important the t h e r a p i s t ' s guidance i s i n t h a t p r o c e s s . J u l i e : I went wit h an i s s u e of f e a r , so wanting t o know where does t h i s come from, why do I have f e a r ? So the process was d i s c u s s i n g what the f e a r , b e i n g more s p e c i f i c , her a s k i n g me more s p e c i f i c q u e s t i o n s about what I am f e a r f u l of and then what has been my experiences around t h a t t o p i c . So a l o t of q u e s t i o n i n g and e n q u i r i n g about what i t i s I'm l o o k i n g t o do, so j u s t g e t t i n g more s p e c i f i c w i t h i t , and then l i n k i n g t h i n g s t o g e t h e r and making connections, t h a t b a s i c a l l y i s what I have done i n therapy i s making connections w i t h her p r o b i n g and a s k i n g q u e s t i o n s and b r i n g i n g those t h i n g s out and i t ' s almost l i k e a l i g h t goes off-, l i k e doors open and b e l l s s t a r t r i n g i n g , and I s t a r t making these connections, whereas be f o r e I wouldn't have done t h a t I wouldn't have had the a b i l i t y t o go and f i g u r e these t h i n g s out. The support o f the t h e r a p i s t w i t h i n the r e l a t i o n s h i p w i t h t h e t h e r a p i s t f o r some of the women was d e s c r i b e d as a mutual p r o c e s s . For Cathy t h i s was expressed i n her a p p r e c i a t i o n of the d i f f e r e n t k i n d s of knowledge t h a t she shared w i t h her t h e r a p i s t , and how they both had t h i n g s t o c o n t r i b u t e . J u l i e touched on how the p r o c e s s was mutual i n terms of going back and f o r t h between her and her t h e r a p i s t . J u l i e : ... I'm sure she's d i s c o v e r i n g i t as she goes a l o n g too so i t ' s more of a d i s c u s s i o n i n t h a t sense and connections I'm making and v o i c i n g , and so t h e y ' r e going back and f o r t h and I'm a s k i n g q u e s t i o n s of her as w e l l and throwing t h i n g s out, and so i t ' s a k i n d of a d i s c u s s i o n i n t h a t regard, more than her a s k i n g q u e s t i o n s and me answering them, and a l s o e x p l o r i n g o t h e r areas as w e l l i f she makes some s o r t of connection, goes o f f on another tangent or e x p l o r e s another area, t h a t a l s o happens so a f l o w and a d i s c u s s i o n more than anything i t ' s two way. Another c o n s i d e r a t i o n of the mutual aspect of the r e l a t i o n s h i p , 69 was a sense of interdependence, which E s t e l l e i d e n t i f i e d as working together on things. She l a t e r expanded on t h i s to i d e n t i f y how the therapist and c l i e n t are responsible f o r t h e i r own i n t e r n a l processes, and part i n the therapeutic r e l a t i o n s h i p . E s t e l l e : The most important part of t h i s i s to deal with people i n r e s p o n s i b i l i t y i n a d i f f e r e n t way, and to move on i n a d i f f e r e n t way than you have i n the past. So ok you (the therapist) need to stay open to what's happening and you need to be able to point out i f you see patterns for the other person, but you also need to be able to take r e s p o n s i b i l i t y of anything that's yours, and so i t ' s very disempowering to not do that. When Cathy was asked whether she experienced power when she i s more vulnerable, she made more of a connection with the sharing aspect of the relationship. Cathy: I'm not sure that power i s i n there. No i t ' s r i g h t with that sharing s t u f f , i t ' s not a power i f I am vulnerable. We do have a crying moment I have act u a l l y put her into tears. We've both put each other into tears through what we have discussed and i t wasn't intentional when I shared something and brought her to tears and so to my mind she wasn't doing anything to bring me to tears, so there's no power over either of us, no negative force. I t ' s very p o s i t i v e . One of the central themes that women spoke about was empowerment. For the majority of women that i s what power i n therapy entailed. In the relationship with the therapist, empowerment emerged as an aspect of the therapist's support. Generally speaking, the women defined empowerment as a process where someone enables you to access your own power. This i s explored further when discussing the category power i n therapy. Through the therapist's support of her c l i e n t , the c l i e n t i s empowered. In t h i s regard, a l l of the ways that the therapist 7 0 supports her c l i e n t s w i l l p o t e n t i a l l y lead to empowerment. Dennise: I would say through v a l i d a t i o n because that was my biggest thing, to have somebody, whether I respected her or trusted her almost didn't matter but to just have somebody else who was outside my l i f e say, you're not insane or you're not bad ... I wouldn't say I went out and conquered the world a f t e r that but I f e l t l i k e i t was a good voice to add to a l l the bad voices i n my head, i t was l i k e a way to f i g h t back, someone said t h i s was ok, so I'm going to hold onto that voice, rather than the s t u f f that's t e l l i n g me I'm lazy, so I found that to be the greatest thing of power. From these data one could say that the therapist's s k i l l involves a l l the ways the therapist supports her c l i e n t that have been mentioned above. The therapist's s k i l l s needs to be i d e n t i f i e d as important aspects of the r e l a t i o n s h i p that enable the c l i e n t to t r u s t and f e e l confident i n her therapist, as Anne explains. Anne: Her s k i l l s are a l o t of her power. Her a b i l i t y to be focused for me, to be able to see i t at a p a r t i c u l a r spot that a l i n e of questioning i s n ' t working, and she's f l e x i b l e enough to be able to know to reword or change d i r e c t i o n . She r e a l l y knows how to pay attention to me and d i r e c t my processes to where they need to go, and I think a r e a l l y big part of i t i s that during an entire session she does not get bogged down i n her own problems ... and she i s able to stay up and focused on me without f a l l i n g into the mess. Power dynamics. Within the context of i d e n t i f y i n g experiences of power i n therapy, p a r t i c u l a r aspects of power within the therapeutic relationship became evident. These included; transference, power d i f f e r e n t i a l , dependence, and therapist maintains distance. Although only one woman used the word 'transference,' other women's experiences reinforced t h i s phenomenon. Transference i s a 71 psychoanalytical term that refers to the emotional response to past in d i v i d u a l s i n a person's l i f e , experienced within the present day rela t i o n s h i p . Within the context of the r e l a t i o n s h i p between the therapist and c l i e n t , the therapist often represents parental figures for the c l i e n t . E s t e l l e : I think there was an abuse of power i n that relationship, and i t had to do with severing the connection i n some ways, l i k e putting huge l i m i t s i n there and completely severing any connection and not acknowledging what was happening or being prepared to enter into dialogue either, and I think i t was worse because that wasn't a part of her, there was tons of support* I mean there was huge mummy transference going on ... and i t ' s l i k e ok now I would imagine the mummy transference s t u f f around that was mine and not hers, I don't imagine that she p a r t i c u l a r l y wants to be my mother, I'm quite sure she doesn't, so that's mother transference s t u f f on my part. Pam r e l a t e s how her experience of a negative therapeutic r e l a t i o n s h i p where her therapist did not show any i n t e r e s t i n her, l e f t her f e e l i n g l i k e a 'middle c h i l d ' . Pam: ... and t h i s happened Tuesday, that was two more yawns and half a sandwich, ok t h i s and t h i s happened, oh that got your interest so l e t s s t a r t t a l k i n g . I j u s t f e l t 5 years old and tr y i n g so hard to be good f o r her and get her attention. Some of the women i n t h i s study i d e n t i f i e d a differ e n c e i n the power the therapist had, and the power the c l i e n t had. J u l i e r e f e r r e d to t h i s as a power d i f f e r e n t i a l that was a p o s i t i v e experience, as the following exerpt shows. J u l i e : The power d i f f e r e n t i a l I think you can't get r i d of i t , I mean I am going to somebody to have them provide a service for me, and i n that opening myself up and putting myself i n a vulnerable p o s i t i o n with them, and so I think that i n i t s e l f i s not balanced i f they're not putting themselves i n the same posi t i o n i n that respect. And then of course they're 7 2 i n a position of influence ... how can I change t h i s or why did t h i s happen or whatever i t i s , and t h i s person has the advantage of being able to look i n on that and make that process of change occur or not occur, but influence i t i n some way. Later i n the interview she was asked how the power d i f f e r e n t i a l affected her and her therapy. J u l i e : I t a f f e c t s me i n a p o s i t i v e way, as obviously I think i t i s important, and i t ' s empowering, i t gives me power over the knowledge of how to do things d i f f e r e n t l y , the knowledge of having i n s i g h t and making changes i f I want to make change, seeing things i n a d i f f e r e n t l i g h t comes from that rela t i o n s h i p s p e c i f i c a l l y and the teaching me ways of doing things d i f f e r e n t l y has been very p o s i t i v e . Based on J u l i e ' s experience, there i s a power d i f f e r e n t i a l that r e f l e c t s the difference i n v u l n e r a b i l i t y and influence. As a r e s u l t of these aspects of the relationship, the c l i e n t can be empowered. E s t e l l e experienced the therapist as inaccessible because of her p o s i t i o n of power. E s t e l l e : ... i t would be very uncomfortable i n other situations, there was one time when we had a c l i n i c reunion and I invited her and other people over, and I'm t a l k i n g about my washing machine and d r i e r s , not normally things I would t a l k about, washing machine and d r i e r s . E s t e l l e : Yes, and I remember I had dreams before I started therapy about her and [therapist's partner], r e a l l y dressed up i n multicolored f i n e c l o t h i n g and me having a hard time getting there and not being appropriately dressed, l i k e these guys are up there and I'm somewhere down here and so I do f e e l intimidated f o r sure. Later i n the interview she expressed how she f e l t at the end of the therapeutic relationship, and the e f f e c t the power d i f f e r e n t i a l had on her a b i l i t y to f i n d closure. E s t e l l e : I think i t was an abuse of power i n my r e l a t i o n s h i p 7 3 with x, I think that the v i o l a t i o n of my personal i n t e g r i t y happened i n that r e l a t i o n s h i p , mainly because not being w i l l i n g to acknowledge her own r e s p o n s i b i l i t y i n what had happened, or being prepared to even t a l k about i t , being able to stand up against my anger and process i t . So yeh I think that was l i k e , ok I'm i n a p o s i t i o n of power so you can fuck r i g h t o f f . Connected to the power d i f f e r e n t i a l i s the element of a therapist maintaining her distance. The power d i f f e r e n t i a l provides a structure to the relationship where a therapist can take on the r o l e of a therapist to such an extent they become inaccessible to the c l i e n t . In the following excerpt, i t i s clear that the lack of v u l n e r a b i l i t y of the therapist can create an unnatural distance. G a i l : ... I see i t as a r o l e because I think what t h i s person did was t r y to keep parts of themselves from entering into that relationship, and that's probably appropriate i n l o t s of situations, where your own s t u f f i s not suppose to get i n the way of the other s t u f f , but I actually found when I asked about that, cos one of the things I was aware of was i t was r e a l l y c l e a r to me that st u f f was going on with her, and she didn't have to spend my hour t e l l i n g me about i t , t h i s was my hour and I was paying for i t , but i t was r e a l l y c l e a r to me that i t was a f f e c t i n g her a b i l i t y to be present some of the time. So what I suggested that would be more help f u l for me was i f there was a l i t t l e more exchange with what was going on f o r her ... and the response that I got was that most of my c l i e n t s are so messed up that they need me to be a l l together, now again I'm probably oversimplifying, and I thought I don't think so, I mean I don't want to judge what's going on for other c l i e n t s but i t didn't f e e l l i k e that was what i t was r e a l l y about. I would f e e l r e a l l y patronized i f someone suggested I was not together enough to handle t h i s person as a whole human being, so that's where roles f i t into i t . In addition, i t would seem that t h i s woman's experience shows how a lack of s e l f - d i s c l o s u r e contributes to the therapist maintaining a distance. From the data co l l e c t e d i n t h i s study, the experience of dependence emerged as an aspect of the power dynamics of the therapeutic re l a t i o n s h i p . The following excerpt shows Anne's d e f i n i t i o n of dependence i n the rel a t i o n s h i p . Anne: In that sense being able to continue the process of becoming more aware of my needs, and continue the process of becoming more a c t i v e l y involved i n getting my needs, and am I going back to her dependently counting on her to help me get there? I: Something about counting on her? Anne: Yes yes, no no, i t ' s not, i t ' s more i f we get there f i n e and good but at least i n going to her I'm working at i t , the process i s ongoing instead of j u s t wallowing i n a mire of s h i t I suppose. I: That's what you c a l l dependent? Anne: Dependent to me r e a l l y i s , would I do i t without her? and i f the answer i s no then I'm dependent. E s t e l l e describes similar sentiments and hig h l i g h t s how dependence may be part of a certain stage i n therapy. E s t e l l e : Where you need the other person to f e e l ok, that you haven't quite figured out how to move out of the muck to f e e l ok yourself. Then there are stages to therapy, i t takes time for a person to s t a r t to be able to b u i l d up for themselves, so there's a ce r t a i n period where t h e i r sense of power comes from your r e f l e c t i o n ... From these excerpts, dependence has aspects of the therapist's guidance and encouragement. The focus of r e l y i n g on the therapist seems to be c r u c i a l i n terms of dependence. A l l of the components of the rel a t i o n s h i p with the therapist, which have been outlined above, play a part i n the experience of power i n therapy. Both the context and the r e l a t i o n s h i p with the therapist contribute to each woman's 7 5 experience of power. This i s evident i n the following discussion of the category, power i n therapy. Power i n Therapy From the interviews i n t h i s study, the ce n t r a l category of power i n therapy emerged. The experience of power i n therapy for the c l i e n t f a l l s under three main sub-categories: expanding, limi t e d , and blocked. In addition, the experience of power can be a combination of these three types of experiences depending on the context, the parameters of the relati o n s h i p , and what might be happening at any given time i n the process of therapy. The categories s e l f - d i s c l o s u r e and power d i f f e r e n t i a l are d i s t i n c t from the three categories, expanding, limited, and blocked. However, they a f f e c t the c l i e n t ' s experience of a l l three within the therapeutic process. Self-disclosure and power d i f f e r e n t i a l are addressed f i r s t . Self disclosure. A l l the women i n t h i s study talked about s e l f - d i s c l o s u r e by the therapist. There i s c l e a r l y a d i v e r s i t y i n the experience of s e l f - d i s c l o s u r e and the r e l a t i o n s h i p to power. J u l i e discussed her experience of the difference i n v u l n e r a b i l i t y of her therapist and herself. When she was asked i f t h i s was empowering or disempowering she responded i n the following way. J u l i e : I think at t h i s point i t i s neither, i n i t i a l l y i t was somewhat disempowering i n the sense that that existed and f e e l i n g comfortable with her. At the beginning i t was disempowering to some degree u n t i l you overcome that or r e a l i s e that doesn't play a part i n t h i s , because c e r t a i n l y I know things about her i t ' s not as i f I don't know anything, as well having her reveal things about what she's gone through and what she's done has c e r t a i n l y taken that away and ... i s empowering as knowing that t h i s 76 other person has gone through t h e i r own experiences and they are not t h i s perfect person, and I mean that disintegrates that f e e l i n g of v u l n e r a b i l i t y ... you develop a relationship of t r u s t and you're safe so that v u l n e r a b i l i t y disappears, but that rel a t i o n s h i p of power s t i l l e x i s t s but i t becomes neither. According to J u l i e , s e l f - d i s c l o s u r e can reduce the power imbalance she experienced at the beginning of therapy. J u l i e was able to develop more t r u s t i n her therapist the less she saw her as perfect. Cathy i d e n t i f i e d how s e l f - d i s c l o s u r e enabled her to become more active i n the therapy process and to express her needs. Cathy: I wonder i f there wouldn't be as much t r u s t , I've thought to myself i f I didn't know ju s t a few l i t t l e b i t s and pieces here and there maybe I wouldn't have the courage to go and write on the blackboard, or maybe I wouldn't have thought to bring pictures i n , because we happened to t a l k and she t o l d me she had gone to a c l i e n t s house ... and we were t a l k i n g about perspectives and I didn't say i t to her, but I just thought maybe one S a t u r d a y I w i l l bring some pictures ... and i f she didn't do some of these l i t t l e things I wouldn't be able to open up, or be able to s i t on the f l o o r ... I: On the one hand i t brings up an uncomfortableness and not knowing how to respond, and on the other allowing you to go into c e r t a i n things. Cathy: Yeh we know each other well enough and that gives me an avenue to open up and relax and share some more. Conversely, Pam did not f e e l comfortable with knowing anything personal about her therapist. This kept her therapist i n a p o s i t i o n of being more powerful and wiser than her. I t was important for Pam to maintain an i l l u s i o n that her therapist did not have a l i f e , and i n the following excerpt she explains why. Pam: I t ' s kind of l i k e when your i n grade two and you're imagining your teacher having sex, they don't have a 7 7 l i f e . I: And i t seems important that they remain i n that p o s i t i o n . Pam: Yeh I think i t ' s a l o t harder to f o o l somebody i n that kind of position. I think i f either of my friends who are therapists, i f I was to s i t down with them i n a therapy type s i t u a t i o n I think I would probably f i n d ways of t r y i n g to manipulate them. I expect because there are probably things that I would be r e a l l y a f r a i d of them finding out ... somehow i t just seems so separate. For Pam, not seeing her therapist as a r e a l person enabled her to f e e l safe, and f a c i l i t a t e d her therapeutic process. Whereas for other women, they f e l t safer when they knew more about t h e i r therapist. Some of the women expressed confusion over t h e i r experience of s e l f - d i s c l o s u r e . E s t e l l e : Well those were the things that made me f e e l oh ok, there's a connection here i n a d i f f e r e n t kind of way, i t ' s l i k e ok we have common experiences of having daughters that are growing up, and what's that l i k e . So i t was joining for me to hearing s t o r i e s about what was happening with her kids, and she wouldn't go on and on and on about i t but i t made me f e e l l i k e I was part of her l i f e i n some way, and I think that was part of the problem because i t was confusing whether I was part of her l i f e or wasn't part of her l i f e . Cathy: I've throughout kept thinking how much do I want to know or how much I should allow myself to care ... a couple of times she shared incidences where people i n her family are sick, one of her children i n her twenties i s very sick with a serious i l l n e s s and has been a l l her l i f e and I sometimes want to reprimand myself for not caring enough about another human being having to go through t h i s , and thinking to myself, but I'm here to do a job too, here for one hour to do x because that's our agenda, that's our goal but you s t i l l f e e l . I'm i n a r e a l up and down ... For some of the women se l f - d i s c l o s u r e r e l a t e d d i r e c t l y to 7 8 t h e i r experience of power. Dennise connected her thera p i s t d i s c l o s i n g personal things to her experience of being t o l d how she was suppose to behave. Dennise: ... she hasn't shared herself with me, but i f i t did happen i t would change because i t would become f r i e n d l i e r not that she was my therapist, and she would become inside rather than outside, I know that from being around people or friends when they l e t me i n then we become woven i n a l i t t l e way, I don't f e e l that way with my therapist, I don't regret i t or want i t . I: So that f e e l s fine to you to not have i t at a l l ? Cathy: And I think i t i s more valuable that way, i t ' s not oh she said or she did, i t ' s j u s t ambiguous, a l l the thoughts and the ideas, they're not anybody's, they don't belong to anybody. For example, i n my nine years there were some people's experiences that I would value more than other people's, so because she doesn't say I did t h i s l a s t week with my husband, because i t i s just an ambiguous example, there i s no value on i t , I can just take i t or leave i t , there's no I should do i t . I: Does her sharing or not sharing r e l a t e to power i n anyway? Dennise: I would say i t relates to influence, i t r e l a t e s to my relat i o n s h i p for the past nine years of, well I did t h i s and I don't want you to do t h i s i t screwed up my l i f e . I t makes me more aware of what the person l i k e i n my group shared a personal example of how not to do something. I f you went ahead and did what they said not to do cos t h i s i s what happened to me, you would be seen as r e a l l y stupid. How I f e e l i n that case i s I don't get given the choice ... Even though t h i s woman did not see s e l f - d i s c l o s u r e r e l a t e d to power, she connects i t to being influenced and not having a choice. Both influence and choice have been i d e n t i f i e d by other women as meanings of power. Conversely, G a i l saw se l f - d i s c l o s u r e r e l a t e d to power by 7 9 i t ' s absence. She compares her experience of two d i f f e r e n t therapists, r e l a t i n g equality to s e l f - d i s c l o s u r e through the personal a v a i l a b i l i t y of the therapist. G a i l : ... i t wasn't about what was expected of me i n that process ... so i n answer to the question what I would hope for and expect i s a l o t closer to the second one, where we both acknowledge we are both adults and we both have strengths we bring into t h i s , we both have s t u f f we're working on the reason we are here i s because I'm here to work on t h i s s t u f f , so I don't need you to work on your s t u f f at the same time, so i t ' s more of an equal rel a t i o n s h i p even though the a i r time i s n ' t equal perhaps that sums i t up ... Later i n the interview she referred to her experience of the f i r s t therapist and how that was disempowering. G a i l : In the second s i t u a t i o n , what I experienced was a t r u s t that I was capable of consciously or unconsciously d i r e c t i n g my own process. In the f i r s t s i t u a t i o n , I think the person was r e l y i n g more on what they learned at school and what f i t within a model to advise her about what shape t h i s would take, and the equality f i r s t r elates to whether I as a human being i s recognised as having not i d e n t i c a l s k i l l s , but a reasonable set of s k i l l s that I can contribute to t h i s , my healing process ... i t f e l t to me l i k e there was a hidden agenda i n the f i r s t s i t u a t i o n that's disempowering and i t assumes that we are not equal because I can't possibly know what the game plan i s , i f i t ' s going to be of therapeutic benefit to me ... This woman's experience points to how the therapist's power i s reinforced through the expectations of the r o l e s of therapist and c l i e n t . In p a r t i c u l a r the role of the therapist, that included the therapist withholding information about herself, and being guided by a hidden agenda. The r e l a t i o n s h i p of s e l f - d i s c l o s u r e to power i s a complex one. What i s apparent from these women's experiences, i s that i n d i v i d u a l needs around therapist s e l f - d i s c l o s u r e incorporate 8 0 each woman's context into her expectations of therapy. The kind of r e l a t i o n s h i p that s e l f - d i s c l o s u r e f a c i l i t a t e s depends on who the c l i e n t i s . So for one woman s e l f - d i s c l o s u r e can f e e l l i k e control and influence, whereas to another i t means a connection that allows her to express herself. The only assumption we can make from t h i s , i s that the experience of power w i l l be affected by the therapist's s e l f - d i s c l o s u r e , and how i t a f f e c t s the process w i l l be determined by each c l i e n t . Power d i f f e r e n t i a l . The power d i f f e r e n t i a l i s an expression of the re l a t i o n s h i p between the therapist and c l i e n t that i d e n t i f i e s percieved differences i n power. The women's experiences show the d i v e r s i t y i n t h e i r perceptions of the power d i f f e r e n t i a l , and i n some cases these differences are not viewed as power. When J u l i e was asked what the therapy r e l a t i o n s h i p would be l i k e i f the power d i f f e r e n t i a l was not there, she r e p l i e d as follows. J u l i e : ... i t wouldn't necessarily be as enlightening as pos i t i v e an experience as i t has been. I think that obviously you have people i n your l i f e that have some knowledge or have t h i s , but i t i s a completely d i f f e r e n t s i t u a t i o n because the power d i f f e r e n t i a l i s n ' t there ... The re l a t i o n s h i p would be completely d i f f e r e n t and not what I would consider therapeutic. I: So i t would become a d i f f e r e n t kind of r e l a t i o n s h i p l i k e friendship? What I am tr y i n g to understand i s the nature of the power d i f f e r e n t i a l , and what you are saying i s i f i t wasn't there, i t wouldn't be therapy? J u l i e : No I don't think i t could because the power comes from her having knowledge and insight, and passing that knowledge on to me or giuding me along. I think i f that didn't e x i s t there would be no point having that relationship ... 81 J u l i e ' s experience implies that the power d i f f e r e n t i a l i s i n some way necessary. Although Pam does not use the term power d i f f e r e n t i a l , her description of how she sees her thera p i s t would indicate that her therapist was i n an elevated p o s i t i o n , and that t h i s p o s i t i o n was a condition of the therapeutic r e l a t i o n s h i p . Pam: ... I had put them (therapists) i n the same p o s i t i o n as a c h i l d I had put my mum, and had put a god fi g u r e . I see that person as being strong and then when you hear weaknesses i t ' s very uncomfortable, you need that figure to be somehow perfect, to be able to continue to look up to and look for guidance from. Later i n the interview Pam expressed s i m i l a r sentiments about the re l a t i o n s h i p needing to be t h i s way to be considered as therapy. Pam: ... I can't imagine having a friendship type r e l a t i o n s h i p with her, because she s t i l l seems so much greater and wiser and more powerful. I don't see an equality between the two of us. Not a l l the women wanted t h e i r therapists to be i n a po s i t i o n synonymous with xGod', but a l l the women wanted some kind of guidance from t h e i r therapist. The main outcome of the power d i f f e r e n t i a l seems to be i n terms of influencing or guiding the c l i e n t ' s process. J u l i e expressed how t h i s influence occurs as she discusses her experience of the power d i f f e r e n t i a l . J u l i e : ... I am going to somebody to have them provide a service for me, and i n that opening myself up and putting myself i n a vulnerable p o s i t i o n with them. So I think i n i t s e l f i t i s not balanced i f they're not putting themselves i n the same p o s i t i o n i n that respect. Then they're i n a po s i t i o n of influence ... t h i s person has the advantage of being able to look i n on that, and make that process of change occur or not occur, but influence i t i n some way ... The therapist's knowledge i s an aspect of influence that women talked about i n a number of ways. Although Cathy di d not 8 2 acknowledge a power d i f f e r e n t i a l , she talked about the therapist's knowledge i n the following way. Cathy: There are cer t a i n topics that I can f e e l because of her knowledge of therapy work and what's i n my l i f e , i n order to have me f u l f i l l e d , c e r t a i n things need to happen and she knows i t . She wants to get my husband i n therapy, so there would be a d i f f e r e n t i a l there to me, not quite a difference of opinion but i n order for things to happen, nothing further w i l l happen unless t h i s gets done, bottom l i n e . So to me that's where i t ' s not even a power because there's nothing she can do to make me do anything, because I can't make my husband come so I don't have any power ... there i s a d i f f e r e n t i a l , that word s t r i k e s my mind, there are some things that she knows as d e f i n i t e as far as progress, that I eit h e r wont allow i n or haven't processed things enough for me to acknowledge that those other avenues or ideas are there. In t h i s excerpt, Cathy experiences the therapist awareness influencing the d i r e c t i o n of her therapy. As G a i l explored the concepts of power and influence i n her interview, she highlighted similar sentiments to Cathy's regarding the impact of influence and the connection to power. G a i l : ... I would have some power i f I were influencing but a l l I can do i s influence someone elses decision, the f i n a l authority rests with the person or the i n s t i t u t i o n . G a i l and Cathy a r t i c u l a t e how the power between the therapist and the c l i e n t comes down to who makes the decision on what w i l l occur. Influence i s not seen as power, but i t can be experienced as power within the dynamics of the therapeutic r e l a t i o n s h i p . Dennise talked about influence and power from a d i f f e r e n t perspective when she was asked whether she would define power as influence. Dennise: I wouldn't describe i t that way because I know influence very well, maybe i f I'd not wanted that 8 3 picture she had said, I can't realy say i t was influence because i t wasn't, a you do t h i s and y o u ' l l get whatever. Dennise: ... to be influenced would be l i k e I would be moved to do something because of something I would loose or something I would get. In my 9 years I would say that I was definately influenced because I was moved to do things for what I would loose, that to me i s influence. With my counsellor I didn't f e e l I would loose anything by choosing or not choosing to take i n the information she gave me. For Dennise, influence i s percieved as someone having some kind of hold over her. Her perception i s obviously affected by the context of her previous experience of the theatre group she was i n . She went on to describe the power she sees her therapist having. Dennise: I don't see her as having power over me, but I see i t as she has more power because she seems to me as very open, and for me r i g h t now the d e f i n i t i o n of power i s being able to choose, having opportunities, that openness ... I see her as powerful because she has d i f f e r e n t angles and views of looking at things and information at her f i n g e r t i p s . Because she i s a therapist that enables her i n my mind to have power, not power over, but power i n herself not to be pushed over by anyone else, just to know that what she thought was ok, and i t doesn't matter what anyone else said. Although Dennise does not percieve her therapist as influencing her, the way her therapist expresses who she i s i n s p i r e s Dennise, and therefore, influences her. From these examples, the part that influence plays i n the power d i f f e r e n t i a l of the therapeutic r e l a t i o n s h i p involves an element of choice, and the focus of the r e l a t i o n s h i p on the c l i e n t . The c l i e n t i s choosing to accept or not the influence of the therapist. Because the focus i s on the c l i e n t ' s process and the changes she wishes to make, the therapist's influence i s connected to her r o l e and position, which i s p o t e n t i a l l y experienced as power. Some women had experiences that demonstrate the p o t e n t i a l consequences of the therapist's misuse of t h e i r power. J u l i e talked about the need for the power d i f f e r e n t i a l to be addressed i n order to prevent an abuse of t h i s power, and to provide an a l t e r n a t i v e to the disempowerment that women face i n t h e i r l i v e s . J u l i e : ... I think that she t r i e s to lesson that hierarchy of therapist\patient relationship, where they have a l l the knowledge and you don't have any, and you're just there to provide them with answers and they w i l l figure i t a l l out and relay i t a l l back to you ... When I asked J u l i e i f she had previous experience of the t r a d i t i o n a l therapy she spoke of above, she r e p l i e d : J u l i e : When I say t r a d i t i o n a l i t i s from text books and reading, that sort of thing, so I haven't experienced that. Well that's not true either, I think I have experienced that i n a doctor l i k e p o s i t i o n , patient experience, they hold a l l the knowledge supposedly, and you just l i s t e n to what they have to say, and you do what they say you're suppose to do. The imbalance of power that J u l i e i s describing here can a f f e c t a c l i e n t by the authority she may give her therapist f o r the things she says. E s t e l l e alluded to t h i s as she talked about the advice her therapist gives her. E s t e l l e : ... advice I don't know, i t ' s hard for me to say because x just weaves a magic s p e l l some of the time, and i t would be fun to l i s t e n to i t . Sometimes i t would be advice and i t wouldn't disturb me at the time or disempower me. I think my b e l i e f i s that i t i s disempowering but my experience was more l i k e being mesmorized by a s t o r y t e l l e r ... which i s r e a l l y i n t e r e s t i n g because 99% percent of people i n the world, i f they were to give me advice that's not what I want. I want to be 8 5 able to process ... I want space to process or empathy. I don't l i k e getting advice, I only want advice when I'm r e a l l y asking for advice ... I think I was intimidated and i n awe of t h i s person and a l l that kind of s t u f f . E s t e l l e accepted advice from her therapist that she would normally not accept from people i n her l i f e . What seems to influence E s t e l l e i s the 'intimidation' and 'awe' she f e l t towards her therapist. The therapist's authority i s r e i t e r a t e d by J u l i e as she expresses the importance of addressing the power imbalance i n the therapeutic relationship. J u l i e : Because i t ' s important to bring i t to that l e v e l because I think i f that didn't happen i t would just perpetuate what happens i n society ... i t would just be exactly what I'd been up against and f i g h t i n g against ... i t doesn't mimick what happens i n society and i t means there i s n ' t hierarchy there, i s n ' t a l l that that exists and t r y i n g to break down a l l of that the difference i n power we experience everyday. I: Like providing an alternative to that and g i v i n g a d i f f e r e n t experience to oppression and i n e q u a l i t i e s . J u l i e s : Because that's where I think you gain a l o t of empowerment from i s from not having that e x i s t and i t changes the relationship completely, as apposed to having t r a d i t i o n a l therapy, that there was t h i s definate power d i f f e r e n t i a l between two people that was r e a l l y d i s t i n c t and noticable and authoritarian ... i t wouldn't be therapeutic, i t wouldn't be benefical to perpetuate a l l that h o r r i b l e s t u f f . E s t e l l e ' s r e l a t i o n s h i p with her therapist developed as a dual r e l a t i o n s h i p . The consequences of being involved with her therapist outside of the therapeutic r e l a t i o n s h i p are outlined l a t e r . The following excerpts show the way the power dynamics are experienced for E s t e l l e . In p a r t i c u l a r , when she t r i e d to sort out her confusion over her involvement with her th e r a p i s t . E s t e l l e : ... I was very aware of what an i n c r e d i b l y powerful 86 person she i s , and I think that was one of the things that attracted me to her as a human being, i s that she i s very dynamic, I thought she had an incredible amount of power. I: How would you characterise the power that she had? E s t e l l e : Well she's never tentative about anything that she says, and i t would come out i n r e a l l y strong statement s t u f f , which was i n t e r e s t i n g because at the end of t h i s relationship, a f t e r a l l t h i s happened, my experience of that was that to was quite i r r i t a t i n g , that i t wasn't taking into consideration what was going on f o r the other person ... E s t e l l e highlighted how the therapist's power can be experienced i n a p o s i t i v e or negative way. This appears to depend on whether she f e e l s i t i s being used for or against her. Later i n her interview E s t e l l e expressed how she f e l t disempowered by her thera p i s t . E s t e l l e : I t was tremendously disempowering fo r her not to take r e s p o n s i b i l i t y for her s t u f f around what was going on. Well I gave my power away i n that, so whether i t ' s disempowering for her to do i t , or I did i t by completely buying into that xoh my god t h i s i s me', but then I would say the therapy relat i o n s h i p i s very disempowering to not be w i l l i n g to process what i s going on between the two of you ... What appears to be important here i s that the therapist was unwilling to deal with what happened i n the r e l a t i o n s h i p . Pam's experience shows how the power the therapist has can perpetuate the p a i n f u l experiences she has encountered i n her l i f e , as she describes the kind of attention she received. Pam: ... i n the other one that wasn't so p o s i t i v e she would stare out the window and yawn a l o t and eat her lunch and drink her tea, and I would babble and t e l l her about my week u n t i l something would h i t her, and then she would stop and turn and face me and say oh, and want to explore whatever i t was. In both cases I f e l t 8 7 l i k e child/parent and i n the one i t was desparately t r y i n g to get some kind of attention and i n the other one the attention was always there. As i d e n t i f i e d e a r l i e r , Pam experienced the imbalance i n the therapeutic r e l a t i o n s h i p i n terms of her therapists being godlike. She described the difference i n her experiences of the p o s i t i v e therapist and the negative therapist, and the consequence of t h e i r godlike position. Pam: ... these two that I stuck with for a long time, and there always seems to be a parent/child or even more l i k e a god/mortal sort of thing, and I spent quite a b i t of time t r y i n g to please the therapist and t r y i n g to know what i t was they wanted from me. When asked what she did i n response to t h i s , she r e p l i e d : Pam: Mostly I just think the one therapist, I was constantly t r y i n g to f i n d something to please her ... I was constantly t r y i n g to get some kind of attention or praise. She was a very condeming god, and the other one was a nurturing gentle sort of feminine aspect of a god. Later i n the interview she re i t e r a t e d the difference and the e f f e c t on her. Pam; Well one has been a powerful god-like fig u r e who was very condeming and I was very a f r a i d of her. The other was incredibly wise and power very very gentle and patient, and she r e a l l y helped me to come into my own power. The power d i f f e r e n t i a l , described here as godlike, i s part of the r e l a t i o n s h i p and depending on what happens within the r e l a t i o n s h i p , w i l l determine how the therapist's power i s experienced. Contrary to these women's experiences, some of the women described t h e i r relationship with t h e i r therapist as equal, and did not percieve a difference i n power. 88 Cathy: ... I'm thinking of when we came to a point where I'd acknowledge she was giving me d i f f e r e n t perspectives on things, I never f e l t that she was more powerful than me, or knowledgable even than me, I f e l t we were s t i l l equals... And l a t e r when she was asked i f she experienced knowledge as power. Cathy: No because I have knowledge and she has knowledge, and that makes us pretty equal ... I went i n knowing what I know, and I know what I know very w e l l . And i n my mind she knows, what she knows and she knows i t v"ery well, so that any knowledge she had I took i t for granted that we were going to partake, i t ' s not something she i s going to hold back from me. For Cathy there was a connection between her experience of equality i n the therapeutic relationship and the context of abuse that shaped how she perceived power i n the therapeutic r e l a t i o n s h i p . Equality i s based on acknowledging differences that contribute equally to the healing process. G a i l expanded on equality as she described a 'healthy power exchange'. G a i l : For me that means that i t i s grounded i n a mutual respect, that respect i s something that emerges as you get to know each other. I t ' s not respect f o r a credential, i s n ' t respect for a person's material s i t u a t i o n i n l i f e ... what fe e l s l i k e a healthy power exchange to me i s when I don't f e e l i n the dark, which i s about withholding knowledge and information. When I don't f e e l l i k e I'm percieved to be less healthy than I perceive myself to be. When I f e e l what I have to contribute i s valued ... What appears to be important i n the experience of equality i s the a t t i t u d e of the therapist towards the c l i e n t . I f the a t t i t u d e of condescension i s communicated, which can be expressed i n subtle or obvious ways, the c l i e n t i s p o t e n t i a l l y disempowered. Barb r e i t e r a t e d t h i s sense of equality, within a r e l a t i o n s h i p with her therapist who she sees her as a mentor. Even though she sees her 8 9 therapist i n a po s i t i o n of status (ie. mentor) she experiences t h i s as equality due to the attitude of her therapist. In t h i s next excerpt, Barb was asked whether she experienced any of her therapists as having power. Barb: Oh t o t a l l y yes. Again they had in c r e d i b l e power to me i t was an o f f i c i a l power, i t was t h i s sense I have with men of knowing, for them being on the p e d i s t a l , power which i s i n f a l l i b l e and know i t a l l . I d i d not have t h i s with x, I f i n d so much more equality. This equality I f e l t from day one was as being a very big help for me, to get me where I am. Later she expanded on her experience of equality. Barb: She does not t a l k down to me, she never make me f e e l dumb, she never made me f e e l wrong. Even the worst thing I have done I have said which i s t o t a l l y accepted, I have no shame with her, she never made me f e e l shameful. I have t h i s f e e l i n g she i s there for me, to help me and not judge me, t h i s makes i t for equality. The flow of whatever v i b r a t i o n i s between us i s never cut along the way, ... I have never seen her once as my mother, I did not see her as my father, I saw her as a human being who wanted to help me. When asked about her experience of the power d i f f e r e n t i a l , as described by others, Barb rep l i e d : Barb: Yes power means negative. For me when I think of power there i s one person who i s powerful and i t means automatically I am the one who does not have the power. So power for me i s negative. There are two words, i f I say mentor. A mentor i s someone who passes on t h e i r knowledge to you and wish for you to eventually be equal. They do not work from a point of , power to put you down and to lower you, they want to r a i s e you up. I see the power with x that way, I always saw power with a man the other way ... I do lack the knowledge of course, I would not go to a counsellor who has got less knowledge than I have. I very much appreciate her knowledge and I am there to soak i t up. I w i l l go and see a good counsellor as mentor. In summary, the part that the power d i f f e r e n t i a l plays i n the therapeutic relationship i s dependent on the perspective of 9 0 the c l i e n t and the attitude of the therapist towards the c l i e n t . The power d i f f e r e n t i a l i s f e l t by the c l i e n t when the therapist conveys an attitude that dismisses and judges the c l i e n t i n some way. When these situations occur the power d i f f e r e n t i a l i s illuminated by i t ' s negative e f f e c t . Because the therapeutic r e l a t i o n s h i p i s perceived as a safe and healing place, when these dynamics are present even when they are subtle, the e f f e c t on the c l i e n t i s p o t e n t i a l l y devastating. The context of the women's l i v e s and t h e i r perceptions of power again influence t h e i r experience of power i n therapy. Equality was described i n terms of the therapist's p o s i t i v e attitude towards the c l i e n t . This entailed an att i t u d e of acceptance and acknowledging the c l i e n t ' s knowledge and agenda. These women s t i l l described the therapist i n a p o s i t i o n of influence, guidance, and i n v u l n e r a b i l i t y . This i s not always experienced as power, unless i t comes with an at t i t u d e that disempowers the c l i e n t . Expanding power. In addition to the experiences outlined under s e l f - d i s c l o s u r e and power d i f f e r e n t i a l , women discussed a number of experiences within therapy that expanded t h e i r personal power. The categories that emerged r e f l e c t e d the c l i e n t ' s personal process and the therapist's part i n expanding t h e i r power. The sub-categories are: self-awareness, therapist's personal power, therapist's approach, and p r a c t i c a l issues. Self-awareness produces an expanding sense of power through the increase i n knowledge a woman acquires about h e r s e l f . A l l the 91 women focused on t h i s aspect of power. Anne described how she can become aware of the b e l i e f s she has, and how that r e l a t e d to change. Anne: ... I can come up with something I had no idea that's what I believed, and I can see i t f o r i t ' s falseness. It ' s funny that how can I have believed that and yet I have done, and bringing something l i k e that into the l i g h t of day w i l l more often than not ju s t change i t . Just knowing i t was there, how can we have these s i l l y buried b e l i e f s we operate on. In the next excerpts J u l i e described s i m i l a r sentiments. J u l i e : Biggest sense of power i n therapy would be linked to knowledge of what i s happening i n t e r n a l l y with me, or what has happened and making connections ... figure things out, things that aren't necessarily good parts of my personality, that I can change, that I have that power, that I have that a b i l i t y because I have the knowledge making those connections ... whatever the outcome I am seeking for me, ju s t the knowledge and that s e l f discovery has been the most powerful thing and given me the greatest sense of power. Self awareness for these women gives them a sense of control over t h e i r l i v e s through the a b i l i t y to change. In addition, s e l f awareness expands t h e i r sense of who they are. Pam expressed how becoming aware of herself makes her f e e l good about h e r s e l f . Pam: ... she would give me just enough information i n what she would see i n my words, that I would go oh so I must have f e l t t h i s and I would have revelations of my own that she was somehow supporting and pushing the r i g h t buttons, that I f e l t proud of myself for f i n d i n g something myself... There i s a clea r connection between s e l f awareness and an increase i n comfort with themselves. Cathy r e i t e r a t e d t h i s experience i n the following excerpt. Cathy: ... we got comfortable enough that even personal things that I didn't know came out and there was no fear for me... 9 2 In these excerpts, the women are describing a process within therapy that enables them to become more aware of things about themselves that were previously hidden to them. I t i s important that i n t h i s process they are supported and accepted by t h e i r therapists, i n order to accept the revelations themselves. The importance of discovering things i n t h e i r own time was highlighted by a number of the women. J u l i e explains t h i s process i n the following excerpt. J u l i e : ... there have been occassions where she has thought something about my behaviour or wanted to point something out, and instead of saying t h i s i s what I think i s happening for you, she allows that process where I come across that discovery myself, i t ' s not crammed down my throat and I get defensive, i t ' s a much smoother process i n terms of me discovering i t on my own and acceptance... I: When you say acceptance i s a l o t easier? J u l i e : Yeh acceptance of whatever i t i s , I know that I have c e r t a i n l y not wanted to hear or not wanted to discover some of the things that I have discovered ... she's sort of guided me along u n t i l I have discovered i t myself at whatever point, and kind of said well t h i s i s what I think i s happening and does t h i s r i n g true to you and I think the acceptance i s a l o t easier than having her be confrontational ... Cathy reinforces t h i s aspect of s e l f awareness that requires the c l i e n t to be i n control of her pace. Cathy: From the learning of new perspectives d i f f e r e n t things l i k e that, I can see the influence on that. I t ' s allowing me to grow rather than t e l l i n g me I have to do something, l i k e smarten up instead of damn you wake up and smell the roses. I t ' s more i f we do t h i s y o u ' l l allow yourself time to smell the roses. Women spoke of self-acceptance as an important outcome of self-awareness, and i n t h i s way self-awareness connects the women to themselves. Barb expresses how her connection to h e r s e l f has 9 3 changed. Barb: ... now I f i n d that my foundation i s my own l i f e experience which I accept, which before I d i d not accept, I did not accept my parents, I did not accept where I came from, I did not accept what I did, I accept nothing about myself, the only thing I was accepting was my outside appearance, and now I have trouble with my outside appearance s t i l l but i t does not matter so much. I have had a f u l l r e v e r s a l of my p r i o r i t i e s and what was important to me, that's the source of my power has changed, has switched. I think I have got i t now from the source which can keep on feeding me, instead of physical which diminishes with the years but now for me I can see i t expanding with the years. The women's sense of expanding power rel a t e d to these aspects of self-awareness. Through t h e i r connection to themselves women made changes i n t h e i r l i v e s . Change seems to come through the discoveries they make about themselves. I t was important that the women f e l t they could go at t h e i r own speed. The control they have over how and when they make those changes i s important i n the effectiveness of the discoveries. Through t h i s process the women f e l t an increased sense of self-acceptance that expanded t h e i r power. The therapist's approach i s an important aspect to the expansion of the woman's power. As alluded to under power d i f f e r e n t i a l , the therapist's attitude towards the c l i e n t can a f f e c t the experience of power. Those attitudes and approaches that are expansive emerged as attentive, guiding, accepting, providing alternatives, and containment. Pam's experience with two therapists contrasted p r i m a r i l y around the attention they gave her. In the following excerpt, she ta l k s about the po s i t i v e attention she received and the e f f e c t 9 4 that had on her. Pam: I t was r e a l l y p o s i t i v e because I f e l t l i k e I had her 100% attention a l l the time, and she always remembered everything I'd say ... i t made me f e e l so honoured that she cared enough to remember everything I was saying, and she r e a l l y r e a l l y explored things with me and sometimes I'd say something keeps coming into my head, something happened, i t r e a l l y didn't mean anything to me, but I can't stop thinking about i t , and so she'd get t a l k i n g to me and ask me i s there a time when you f e l t l i k e t h i s as a kid ... The therapist's attention i s important i n providing a sense of acceptance. Through the attention that the therapist gives, the c l i e n t can relax and explore themselves i n a non-judgmental atmosphere. E s t e l l e uses the term unconditional p o s i t i v e regard to describe the connection that expresses the therapist's acceptance. E s t e l l e : The whole thing about unconditional p o s i t i v e regard and joining with the person, knowing that they look at you and think you are a great person, just that they see you i n terms of your strengths ... The q u a l i t y of the therapist's attention communicates a non-judgmental attitude towards the c l i e n t . In addition, the therapist's attention conveys a view that everything about the c l i e n t i s important, which communicates a genuine i n t e r e s t . In conjunction with the c l i e n t ' s development of s e l f acceptance, i t i s important that the therapist has an accepting atti t u d e . In the next excerpt, E s t e l l e expresses the value i n acceptance of a l l feelings that i s empowering. E s t e l l e : There i s such respect i n not trampling on the person's feelings, a l l feelings are welcome. I: Sense of allowing you to be who you are, that's empowering? 95 E s t e l l e : That's r i g h t , so i t ' s not a matter of them seeing some power i n you that you forgot about, but i t ' s more a matter of, you r e a l l y are ok, and whatever your feelings are. From E s t e l l e ' s experience we can see that through acceptance of fee l i n g s the therapist conveys the message that t h i s person i s valued. Cathy goes on to distinguish two components of the therapist's acceptance, the r e f l e c t i o n of the c l i e n t ' s strengths, and being with a l l the c l i e n t ' s feelings. Cathy: They're both empowering, seeing the person i n terms of t h e i r strengths even when they're presenting as not that way. But you also need to be able to stay with whatever feelings are happening ... I think i t ' s empowering to be f u l l y accepted for whatever feelings are happening, but s t i l l the r e f l e c t i o n you get back from the person you don't look i n t h e i r eyes and see yourself as a fuck up or as a problem, even though that might be your personal experience. So both receiving the feelings and receiving the r e f l e c t i o n of strength and support and encouragement. I t i s c l e a r from t h i s excerpt that acceptance means a non-judgmental view of the c l i e n t . In accepting the c l i e n t ' s f e e l i n g s , the therapist i s not necessarily accepting the c l i e n t ' s view of her s e l f . For example, i f the c l i e n t was f e e l i n g overwhelmed and inadequate, these feelings would be responded to by the therapist and acknowledged, but the b e l i e f that she i s incapable would not be reinforced. Barb r e i t e r a t e s t h i s process as she describes how she believed her feelings were wrong. Barb: ... No one before had t o l d me how p a i n f u l the process was going to be. I f e l t drained and exhausted, she understood t h i s and she would say to me, go home and rest , t h i s i s the understanding she had of what I was going through and I never had t h i s before. As a matter of f a c t I use to think I was weak, again I f e l t l i k e every f e e l i n g I had was wrong, I was not doing r i g h t , always t h i s c h i l d i s h f e e l i n g that everything I do i s wrong ... she reaffirmed that i t was ok fo r me to be 96 l i k e t h i s , i t was natural, i t was a normal process for me to f e e l that way, and t h i s made a l l the difference ... just confirmed my feelings were ok that's probably the biggest thing ... was natural and I was not to be blamed for i t Another aspect of acceptance i s the permission f o r the c l i e n t to t a l k about anything they need to. Pam portrays t h i s sentiment i n the next excerpt. Pam: The one that was the positve one, i t was safe for me to express anything that I want i f I wanted to t a l k about something. I f i t seemed unimportant i t never was to her, she would always look for whatever i t was that was deeper ... Guidance emerged as an important feature of the therapist's approach. Guidance and encouragement by the therapist was i d e n t i f i e d under the sub-category 'relationship with the therapist'. In t h i s regard, the therapist's guidance was connected to her knowledge and experience, which she used to f a c i l i t a t e the women's therapeutic process. These aspects of the therapist's guidance are important i n promoting an expanded power experience for women. The therapist's guidance i s focused on f a c i l i t a t i n g the woman's self-awareness. Anne expresses the r o l e of guidance i n empowering someone. Anne: If I were empowering the other person, i t ' s giving them the opportunity to use t h e i r own power to get where they want to be, to answer t h e i r own questions ... guiding and d i r e c t i n g , and that's what empowerment i s to me, and that's what happens i n my sessions. I get guided, and we both knew the process to begin with, so I didn't have to be taught i t . But when you're i n the midst of some pretty awful s t u f f , i t ' s just a whole l o t easier to have someone else ask you the questions than do i t yourself. Along with the therapist's guidance i s the containment of the therapeutic process by the therapist. The therapist i s 9 7 experienced as having a sense of d i r e c t i o n to the therapeutic process that provide boundaries around the woman's process which support her discoveries. Barb also experienced her thera p i s t assuring her of the path ahead of her i n therapy. Barb: ... no one before, except her t o l d me how p a i n f u l the process i s . Most people go and see a counsellor and they go back to work an hour a f t e r . I f e l t drained and exhausted. She understood t h i s and she use to say to me, yes you go home and rest ... t h i s was part of the understanding she had of what I was going through ... She reaffirm that i t was ok to be l i k e t h i s , that i t was natural, i t was a normal process f o r me to f e e l that way and t h i s made a l l the difference. From these data, i t seems that the therapist's containment of the therapeutic process involves a normalizing of the women's experiences that has the e f f e c t of reducing t h e i r d i s t r e s s . In addition, containment involves a c e r t a i n amount of o b j e c t i v i t y by the therapist as J u l i e r e f l e c t s i n the next excerpt. J u l i e : I t ' s an outside perspective, they don't have a l l the other s t u f f . . . I obviously don't have that perspective or a b i l i t y . They have the advantage of seeing things c l e a r l y ... just a better perspective, I don't want ot use the word objective because they're not, I mean as objective as one can be. They don't have the subjective influences l i k e my own that cloud things up for me. As J u l i e discussed the e f f e c t of t h i s o b j e c t i v i t y , she i d e n t i f i e d how t h i s enabled the therapist to xteach me ways of doing things d i f f e r e n t l y ' . Boundaries were another aspect of containment by the therapist. S p e c i f i c a l l y , boundaries were i d e n t i f i e d as the therapist providing l i m i t s . E s t e l l e talked about boundaries i n general and how they provide a sense of safety. When she was 9 8 asked what her safety needs are i n therapy, she r e p l i e d . E s t e l l e : I think i t i s about knowing what the l i m i t s are, where you push up against things. Like I could come back to i t ' s possible to have dual r e l a t i o n s h i p s and make them work, and my experience of having that happen i s that we did: one at a time, processed i t a l o t , and made r e a l l y clear d e f i n i t i o n s of each time things changed, and' that went through doing therapy together, and then doing supervision together, and being friends together. So at each part of that we r e a l l y talked about what i t meant, and i t was r e a l l y clear what the boundaries were. E s t e l l e ' s experience shows how setting l i m i t s and having c l e a r guidelines i d e n t i f y what i s going on i n the therapeutic r e l a t i o n s h i p , and that t h i s c l a r i t y enables her to f e e l safe. Containment as a function of the therapist's approach seems to include, guiding the di r e c t i o n of therapy, normalising the women's experiences within therapy, maintaining o b j e c t i v i t y , and i d e n t i f y i n g boundaries. The containment of the therapeutic process i n these ways enables the woman's process to unfold, and therefore promotes an expanded experience of power. In addition, containment provides safety for the woman by reducing her di s t r e s s , and providing c l a r i t y regarding the therapeutic r e l a t i o n s h i p . The f i n a l aspect of the therapist's approach to emerge was providing a l t e r n a t i v e s . This relates to how the therapeutic r e l a t i o n s h i p o f f e r s an alternative to the negative experiences i n a woman's l i f e . The therapist's approach i s important i n maintaining a pos i t i o n that does not reinforce the re-creation of negative experiences. Dennise explains how her experience with her therapist was d i f f e r e n t from her experience i n the theatre 9 9 group. She begins by explaining how i t was i n the theatre group. Dennise: ... i f I didn't t a l k about something then i t was cast down upon l i k e I was being non-communicative, there was no room to just go that's enough. You had to deal with everything whether you were ready enough, or had the power or the words. So f o r me to be able to go i n a s i t u a t i o n where you could go and t a l k to someone and they wouldn't check up on the r e s t of your l i f e ... [the] s i t u a t i o n with my therapist was very valuable because I learned that just because I didn't t a l k about one of the things that was heavy on my heart, or whatever, that didn't mean I had stopped dealing with my l i f e , or moving ahead ... i t ' s b a s i c a l l y f a c i l i t a t i n g a space that was d i f f e r e n t from the one I grew up i n . That enabled me to discover and use my own choosing c a p a b i l i t i e s that were inside me, that I was never able to use or I did, but I got whipped fo r doing so. In summary, the therapist's approach promotes a woman's expansion of t h e i r power by communicating a sense of well-being. The attitudes of attentiveness, acceptance, and guidance are the ways the therapist communicates to the woman that i t i s her process, and that the therapist i s with her i n that process. A woman develops a sense of well-being by being accepted for who she i s . In addition, containment communicates that the therapist i s confident and a safe person, and the feelings of security with the therapist also contrbute to a woman's sense of well being. In providing alternatives, the therapist communicates that the woman can expand her experience and sense of who she i s . By communicating i n these ways the therapist enables the woman to f e e l good about herself and t h i s contributes to her sense of power. Connected to the therapist's approach i s the therapist's personal power. Through the therapist's personal expression of 100 her own sense of who she i s , she communicates a sense of p o s s i b i l i t i e s . In the previous discussion, Pam was i d e n t i f i e d as viewing her therapist as 'godlike'. This i l l u s t r a t e s an experience of the powerfulness of her therapist. In the next excerpt, E s t e l l e r e f l e c t s on how her own power was r e f l e c t e d back to her.. E s t e l l e : She would t e l l me I was an i n c r e d i b l e person, and i f I'd come in f e e l i n g r e a l l y undone about something she'd say, i t ' s r e a l l y hard f o r me to r e l a t e to that because I think of you as a very powerful person. So I think she was t r y i n g to provide a mirror for me to see my own power i n the rela t i o n s h i p ... and I was very aware of what an incredibly powerful person she i s too, and I think that was one of the things that attracted me to her as a human being i s that she i s very dynamic. I thought she had an incredible amount of power. Later she i s expanding on her experience of her therapist's power. E s t e l l e : ... i t has to do with being f u l l y engaged and being a l i v e . I t ' s almost l i k e you are wired to l i f e , and you have a l l t h i s e l e c t r i c i t y running through. That's power i n a d i f f e r e n t kind of way, not who has power but just being a powerful person, being connected and engaged, and being w i l l i n g to be out there i n the world. So when I think that when we are t a l k i n g about my power, sometimes I'm way out there i n a si m i l a r way. As E s t e l l e r e f l e c t s on the power of her therapist, she makes the connection to her own power. In t h i s way the therapist's power acts as a r o l e model for the woman to see he r s e l f . Dennise expresses t h i s sense of her therapist as a r o l e model. Dennise: ... she i s an example of a way to be powerful that I would want.to learn and include i n my l i f e . So when I see her I f e e l , not free, but l i k e I f e e l I have permission to be however I want to be i n front of her ... the information that she has given me i n our sessions, has enabled me to judge her as a 101 person who u t i l i z e s a l l the things that she's sai d to me, of not being pushed around by other people, and having your own choices and they don't have to be good or bad, they just are. The women i n these excerpts responded to t h e i r experience of the therapists personal power as an i n s p i r a t i o n to t h e i r own personal power. The therapists personal power i s therefore an important element i n the women's process of expanding t h e i r power. The p r a c t i c a l issues that emerged include aspects of the environment i n which therapy took place, and money. A couple of the women spoke about the therapeutic se t t i n g that helped them to f e e l more comfortable. Barb explains how t h i s affected her i n the next excerpts. Barb: ... t a l k i n g about the setting, the si z e of the room makes i t much more interesting, much better because i t ' s a small room, and to t a l k i n a big fancy furnished o f f i c e i s not going to be very condusive to ta l k . I believe i n t h i s case the si m p l i s t s e t t i n g the better. Barb: ... the good eye contact we have i s what makes me want to keep going on, i f she was s l i g h t l y on the side or i n the shadow I would not because I would f e e l l i k e I have l o s t her or she has l o s t me. She also has the l i g h t s quite dim and the quietness i s quiet. Barb's experience demonstrates how important i t i s to be comfortable and relaxed with a therapist. Barb f e l t on a more equal footing with her therapist because of these aspects of the physical surroundings compared to the p s y c h i a t r i s t s she had seen. In t h i s next excerpt, Barb highlights the equality that was engendered by the setting. Barb: ... maybe the sett i n g again was d i f f e r e n t , she's just s i t t i n g across from me, and I did not f e e l overpowered by her. I f e l t I could t a l k to her l i k e I could a 102 f r i e n d ... In the next excerpt Cathy i l l u s t r a t e s how a change i n the s e t t i n g can a f f e c t the therapeutic r e l a t i o n s h i p . Cathy: ... there was one time i n the summer time that we went up to her upper f l o o r and sat outside on her patio, and that was sort of l i k e me going in t o more of her personal world because she had herbs and s t u f f l i k e that, and I f e l t a l i t t l e b i t uncomfortable allowing myself into her personal world rather than her professional world. But she s t i l l made i t comfortable enough for me to s t i l l have the t r u s t there that everything i s ok ... but my thoughts and s t u f f I knew I wanted to make sure she knew I wanted to make she knew i t was s t i l l j u s t me, j u s t as i f we were s t i l l i n her o f f i c e ... Although the rel a t i o n s h i p with her therapist enabled Cathy to t r u s t that the change i n environment did not r a d i c a l l y a l t e r the therapeutic process, she had to assert her boundaries to f e e l safe i n the change of surroundings. These examples reveal the importance of the environment to support the therapeutic process. In addition, the surroundings can a f f e c t the power dynamics between the therapist and c l i e n t , and therefore have an a f f e c t on the c l i e n t ' s experience of her power. Money emerged as an important factor i n the experience of power. Money can produce an expansion of power through giving a woman the motivation to use therapy to her f u l l advantage. Anne i s asked i n the next excerpt what makes i t possible f o r her ther a p i s t to know her better than anyone else? Anne: Two things, one being the fact that's what I'm paying her f o r . So that I go f o r i t , I l e t i t out because I t r u l y want to grow and change, and the other i s there i s no fear of judgement ... J u l i e expresses how money can enable a woman to access therapy i n 103 the f i r s t place. J u l i e : ... anything that can influence your l i f e i n that regard, forcing you to l i v e a c e r t a i n way, and money comes into that. Money allows you, money i s power and i t allows you to do things, and not be able to do things, and l i v e a certain way, even a f f o r d to come to therapy. Money can expand a woman's power i n therapy i n these ways, and i s part of the p r a c t i c a l structures that surround the therapeutic r e l a t i o n s h i p . Money and the environmental surroundings are examples of the p r a c t i c a l structures involved i n therapy that were i d e n t i f i e d by the women i n t h i s study. I t i s conceivable that there may be other p r a c t i c a l considerations involved i n the therapeutic rel a t i o n s h i p that r e l a t e to the experience of power. Limited power. The women i d e n t i f i e d periods within the therapeutic process that were experienced as li m i t e d power. These involved times that they f e l t overwhelmed or stuck, and at these times they experienced themselves as powerless. Women experienced these times as a normal part of the therapeutic process. The sub-categories are: self-awareness, dependence, and therapist's interventions. Self-awareness r e f l e c t e d the new information about s e l f that the women found hard to intergrate or deal with. Anne re l a t e s t h i s primarily to the emotions she experienced as out of cont r o l . Anne: ... when I get mired into emotions, where I'm crying a l o t , r e a l l y crying, I f e e l powerless. I f e e l stuck. This p a r t i c u l a r session I can't remember what the session was about. But I know that I ju s t wanted to quit, I was just exhausted. But again I got guided through i t and back up, and so the disempowerment was my own emotions ... i t ' s my own emotions that are disempowering, or fe e l i n g a lack of con t r o l . Not being able to control i t , of just going into i t . 104 In t h i s excerpt, Anne also refers to the therapist's interventions that are expanded on l a t e r . J u l i e expresses s i m i l a r sentiments i n regard to the discoveries she made i n therapy. J u l i e : Just being overwhelmed, you've opened up t h i s can of worms to your soul, and you're discovering a l l these things, and the more you discover, the more you know, the more you noticed, and so I know at points I've f e l t r e a l l y l i k e , oh my god there's something seriously wrong with me, l i k e there's a constant overwhelmed by everything ... i t didn't f e e l l i k e I had a l o t of control ... I've discovered a l l of t h i s s t u f f , and now what do I do, where the h e l l do I go from here ... I didn't f e e l a sense of power even though I had the knowledge that t h i s was what was going on with me. Self-awareness under limited power i s d i f f e r e n t from the s e l f -awareness under expanded power. In these excerpts i t i s c l e a r that as discoveries were being made during the therapeutic process, they are l i m i t i n g the women rather than expanding t h e i r experience of themselves. What seems to d i s t i n g u i s h these awarenesses i s that the women had not been able to intergrate the discoveries i n a managable way, and t h i s l e f t them f e e l i n g powerless and stuck. Cathy expresses these periods i n therapy as rough times that caused l i f e to be i r r e g u l a r , which her therapist warned her about as they came to some c r i t i c a l stages i n the therapy. Cathy: ... I might be going through something that she knew was going to be inevitable, but she sort of didn't want to t e l l me that l i f e i s not going to be regular r i g h t now ... Cathy's experience eludes to a natural period i n therapy that challenges the f a m i l i a r i t y of her l i f e . When t h i s occurs, women can f e e l disoriented as new information and experiences of 105 themselves cause them to experience diminished personal power. Not expressing the knowledge a women has about her s e l f can cause an experience of limited power, as J u l i e ' s experience shows i n the next excerpt. J u l i e : What I choose to say or not to say, or l i e about, or keep from her i n some way, i s a form of power because i t i s knowledge ... I suppose i t i s disempowering for me i f I'm not going to be honest about i t then. I: How would i t be disempowering? J u l i e : Well i t would take away from r e a l l y getting to the root of the problem, or discovering things ... half the knowledge. So I think that i s more disempowering than anything. The l i m i t e d power through self-awareness covers those experiences that r e s u l t i n the woman being overwhelmed by new information, and temporarily unable to cope e f f e c t i v e l y with her l i f e . In addition, a woman witholding important information can i n h i b i t her therapeutic process. When women are experiencing periods of li m i t e d power, dependency seems to be fostered. Dependency was b r i e f l y i d e n t i f i e d with regards to the therapeutic r e l a t i o n s h i p . Dependency was ar t i c u l a t e d as reliance on the therapis t . This i s an important function during periods of limi t e d power. The experiences of being overwhelmed and stuck require guidance from the therapist that can be experienced as a temporary dependence. The following excerpts highlight women's experience of dependence through these times. Dennise: When I didn't have anybody to t a l k to about the things that were r e a l l y bothering me, and she was the only one, and I definately f e l t dependent. I remember experience that only once when I c a l l e d 106 her a l l upset, and I f e l t dependent because she was the only one i n my environment that I could t a l k to about i t ... I now know that i f I need someone to do something, or to l i s t e n I need to know that I have a l o t of options because i f I have one I f e e l stuck . . . yeh, b a s i c a l l y when I hadn't developed my support network I f e l t dependent on her . . . I wouldn't say I was dependent on her now. Barb describes t h i s dependency as a l i f e l i n e . Barb: . . . I jus t had t h i s gut f e e l i n g , r e a l l y she was the only person I could hang onto at t h i s t ime, and i f I wanted to make i t she was my l i f e l i n e , very much so, and i f I was going to see her obviously I wanted to make i t otherwise I would have. I have had severa l times where I thought I was not going to go back. Then I was going to q u i e t l y k i l l myself here, and that would be the end and my s o l u t i o n . When she was asked how t h i s period of dependency af fected her therapy she r e p l i e d : Barb: I don't think i t can be avoided. This process i s going from one way of th inking to another, t r u s t i n g my own i n s t i n c t and I need the reinforcement. I t ' s a need of someone outside the s i t u a t i o n who's going to give me a very object ive view or correct me when I am not object ive . . . Pam describes dependency as something that i s f a m i l i a r and cons i s tent . She describes a s i m i l a r process of moving from one way of being to another when she was seeing two t h e r a p i s t s . Pam: . . . i f you are get t ing beaten up once a week, you depend on i t , so that the next few days a f t e r are good. I ju s t depended on consistency, and then a f t er seeing her (negative t h e r a p i s t ) , I would depend on (pos i t ive therapst) to re lax me . . . i t was something I needed to get that was f a m i l i a r , i t wasn't p o s i t i v e i t was a f a m i l i a r i t y thing . . . there were times when i t f e l t l i k e I r e a l l y needed to see (pos i t ive t h e r a p i s t ) , and there were times when I would phone her up and say I need an extra session and I would go i n twice a week because I needed somewhere safe to t a l k . . . and then I remember the day I came to see her and t e l l her I d i d n ' t need to see her anymore, and she sa id I know . . . The way she saw i t was there ' s two worlds, and people l i v e i n a world where everything i s cloudy and 107 bad and negative, and every once i n a while they go and v i s i t the sunny place, and then come back to the ho r r i b l e place, and then they spend more and more time i n the sunny place, u n t i l you move there. I t i s c l e a r from these excerpts that the women experience dependency as part of the therapeutic process, p a r t i c u l a r l y during the periods described under the category l i m i t e d power. Dependency comes out of a need to r e l y on someone when everything i s changing and unfamliar. I t i s also c l e a r that t h i s i s a temporary state for the women i n the process of fi n d i n g t h e i r own power. Barb also revealed the need to share her achievements with her therapist as part of dependency. The women experienced t h e i r therapist's interventions as more d i r e c t i v e during t h i s time and talked about being guided through the times where they f e l t overwhelmed and stuck, and needed t h e i r therapists to help them make sense of t h e i r experience. J u l i e ' s experience r e f l e c t s what a number of women talked about. J u l i e : ... she was extremely he l p f u l i n that sense by putting things i n perspective. That was an empowering thing r i g h t there. To be able to c l a r i f y things, and make i t seem not so overwhelming, and s i m p l i f y i t , and p r i o r i t i z e things ... J u l i e : ... as far as the way i n which she was a s s i s t i n g me was d i f f e r e n t . In the sense that before i t was more of a discovery process, whereas i n that period of time i t was more of a teaching experience. She was tr y i n g to get ways i n which to cope ... In addition to the need for the therapists perspective on things, and assistance i n developing ways to manage t h i s period, women expressed the need for someone to give them hope. Barb: ... I went weeks after weeks saying I don't see any 108 change. I could not see my changes, I thought maybe my anti-depressant p i l l s were doing the job and not me. The truth i s she helped me through those bad times where I did not believe i n myself because she was able to make me, she was giving me f a i t h and support, then i f I hang on there i t w i l l happen, and I believed her... Limited power i s experienced within a period i n the therapeutic process where women struggle with new information about themselves, and t h e i r inner resources f e e l inadequate. The therapist's interventions are focused on ways to manage t h i s period, and help women to bui l d on t h e i r own resources. Empowerment. A l l the women spoke about how they experienced being empowered. This involved those experiences within expanded power and limited power, and that both of these were part of the therapeutic process. Empowerment occures as a combination of these two aspects of power i n therapy. The following excerpts show various expressions of that empowerment. J u l i e : ... I went with an issue of fear ... then l i n k i n g things together and making connections ... i t ' s almost l i k e a l i g h t goes o f f , l i k e doors open and b e l l s s t a r t ringing, and I s t a r t making these connections. Whereas before I wouldn't have had the a b i l i t y to go and figure a l l these things out ... i t ' s the whole knowledge thing, just becoming aware. E s t e l l e : ... ultimately i t ' s the working through of i t that allows you to be able to deal with i t i n your l i f e afterwards, not i n that hour together. So that when you're f e e l i n g undone on your own, you don't need to phone somebody up ... y o u ' l l have some process where you can go ok I know what t h i s i s and ju s t work i t through ... Pam: The things that f e l t empowering to me with x would be that she wouldn't t e l l me what to do i n any ways, or use a tone of voice that was at a l l shameful ... she would give me just the ri g h t information ... I would have revelations of my own ... I f e l t proud of myself for finding something myself ... remembering everything 109 made me f e e l r e a l l y special, and a l l the names. Yeh that was r e a l l y empowering, and she would get excited for me ... Denise: I would say I'm discovering my power the same way she i s shining a l i g h t on i t for me, and I'm not sure I would say I have power l i k e her, but I'm just becoming aware of i t i n everyday l i f e from being with her ... These women's experiences show how empowerment r e l a t e s to being able to deal with things i n your l i f e , and f e e l good about yourself as a r e s u l t . Women f e l t supported towards f i n d i n g t h e i r own p o t e n t i a l and solutions. Changes i n concepts of s e l f and others. Women's experiences of empowerment i n therapy resulted i n changes i n t h e i r s e l f -concepts and feelings towards others. The sub-categories that emerged were p o s i t i v e experience of s e l f , new perspectives, r e s p o n s i b i l i t y for s e l f , and relationship to therapy. When therapy f a c i l i t a t e s empowerment women experience a p o s i t i v e view of themselves. For these women t h e i r experience of themselves changed during therapy. A number of women i d e n t i f i e d how t h i s change developed through acceptance of themselves, which i s connected to t h e i r experienced of power. Anne: From point of view of me having the power, gives me more confidence, c l a r i f i e s thinking f o r me ... i t i s making me less c o n f l i c t e d i n presenting with my own c o n f l i c t s or d i f f i c u l t i e s , and working on them ... Much more able to accept a l l the parts of me ... Women expressed a comfort with themselves that developed through therapy. J u l i e also r e i t e r a t e s t h i s sense of acceptance as an expansion of her experience of herself. J u l i e : ... opened up a part of myself that wasn't there 110 before. Just focusing on me and being a l o t more comfortable with myself, and a l o t more comfortable with the way I am ... The women's experiences i l l u s t r a t e how increases i n acceptance can be a r e s u l t of becoming more connected to themselves. In the next excerpts, women express another aspect of a p o s i t i v e experience of themselves. Pam: ... I f e e l more r e a l i n myself than I ever have before, and I f e e l more a l i v e and a part of something ... Cathy: ... t h i s change has happened i n me that I have t h i s perspective that I'm a person I can s i t t a l l , I'm here, I've arrived ... These women express a sense of t h e i r presence i n the world that r e f l e c t s t h e i r experience of power from within. Women i d e n t i f i e d new perspectives r e s u l t i n g from changes that occurred through the therapeutic process. Cathy: ... one of the biggest things she's given me i s di f f e r e n t perspectives on what I'm seeing, and doing, and thinking about, and I quess changing d e f i n i t i o n s i s part of the new perspective ... J u l i e ' s experience concurs with Cathy's as she stated a change i n values that gave her new perspectives. Pam expressed new perspectives on her past experience that affected the experience of herself. Pam: ... i n the l a s t 2 years I've f i n a l l y stopped wishing I was dead. I'm glad to be a l i v e . I use to wish I was dead even i f things would be good for weeks on end. I was stopping and thinking i s t h i s worth i t yet, no s t i l l wish I was dead, s t i l l not worth the memories, and now I'm glad even i f things are r e a l l y bad I can stop and think, and go i t ' s s t i l l worth i t , i t ' s great. And I even see a l l the hu r t f u l things when I was younger as pos i t i v e now ... Pam's experience shows how her perception of the context i s I l l a f fected by her experience of empowerment. In the next excerpt, Barb t a l k s about how she changed from seeing herself only having sexual power to having personal power. Barb: ... my power came from my body, from sexual power, that i s the only one I use to have so f a r , and i t has diminished ... but I f e e l better than I ever f e l t , I f e e l way more. confident x my partner r e a l l y can see that I do l i k e myself. I have f i n d my, l o t s of personal power through the work I have done with x. I have l o s t my sexual power which i s the only power I had before, and I f i n d I have gained t h i s through the work I have done with her about accepting that I am an int e r e s t i n g person, I am an i n t e l l i g e n t person and I have f i n a l l y grown up ... Barb also t a l k s about a change i n what she expects from other people as she ta l k s about her partner. Barb: ... many times I have wanted to break up my rela t i o n s h i p because I could not deal with myself, my anger, the way I am, and somebody next to me who does not have any understanding of what I have gone through ... eventually x has t o l d me i t ' s ok he doesn't have to understand you can accept that. I have come to accept that and I have come to accept, I kind of laugh about i t now. I accept the fa c t that he wont understand i t and he does not want to understand i t , but I don't have to have him understand i t anymore ... I can accept he i s a good man otherwise and he does not have to understand aft e r a l l t h i s i s not something I have to hang onto ... From these excerpts i t seems that a change i n perspective can cover how the women see themselves, as well as how they see the world and others. Becoming more responsible for themselves and t h e i r l i v e s emerged as another aspect of the changes i n the women's experience of themselves. J u l i e highlights what a number of the women spoke of as she r e f l e c t s on the e f f e c t s of therapy. J u l i e : ... just a more active r o l e of where I want to go , and what I want to do, and who I want to be, as 112 apposed to going along with whatever. Like allowing things to happen to me ... I have more control over my l i f e , and who I am, and who I associate with ... In conjunction with a sense of more control over t h e i r l i v e s , the women expressed being able to tr u s t themselves, as Pam re l a t e s i n the next excerpt. Pam: ... being able to be vulnerable and express myself. That's r e a l l y t r u s t i n g that I'm going to get through that fear, that's where the t r u s t i s ... Resp o n s i b i l i t y for s e l f included being able to accept t h e i r f e e l i n g s and know that they could take care of themselves through p a i n f u l times. The women expressed changes i n t h e i r r e l a t i o n s h i p to therapy because they experienced more of t h e i r own power and a diminishing need for therapy. Pam i d e n t i f i e d her process of the end of therapy and how t h i s related to empowerment. Pam: I've no sense of being l o y a l to her, and continue seeing her after I f e l t better and I went back once or twice for a tune up ... the l a s t three months I was seeing her things were getting s t e a d i l y better and better, and there were times when things got bad and I wanted to see her but I got through i t , and oh, I quess I didn't need her after a l l . Barb expressed a change i n the way she experienced herself as an adult within the therapeutic r e l a t i o n s h i p that was empowering. Barb: ... She's probably the only person I f e l t l i k e an adult before too many times I f e l t l i k e a c h i l d ... I: Did the ps y c h i a t r i s t s that you saw, did they do things d i f f e r e n t l y that way? Barb : I don't remember, i f I had to do any work but I do remember constantly having the f e e l i n g I was a c h i l d , yes, and he was a teacher at school and I flunk the te s t a l l the time, and I never f e l t that with x, I 113 never flunked ... It took Barb some time within t h i s therapeutic r e l a t i o n s h i p to f e e l l i k e an adult as opposed to a c h i l d , as she revealed l a t e r i n the interview. Barb: ... when I met x I think the c h i l d was i n a t e r r i b l e shape, and because my mother i s dead there i s a grown up person l i t e r a l l y wanting to come out but did not know how. But my power before was coming only from a c h i l d power. Never had before adult power ... with x I just accepted, you are a c h i l d , and I went as such .. and eventually, the c h i l d i s there I s t i l l have some st u f f to do and work on, but o v e r a l l I can catch myself and r e a l i s e who I am, and where I am, and what can I do now. A number of the women implied that a change occurred i n t h e i r approach to therapy, as well as t h e i r experience of themselves within that process. J u l i e stated that i t was important to her that therapy continue to a s s i s t her. J u l i e a r t i c u l a t e s i n the next excerpt how she sees therapy as part of her ongoing process of growth. J u l i e : Ongoing that I don't think w i l l ever end. Not that I w i l l be i n therapy for the rest of my l i f e , but ce r t a i n l y the process of growth and change, and discovery i s ongoing throughout your l i f e ... This shows how therapy for these women becomes a process within t h e i r own exploration of themselves instead of looking to therapy for the answers. Blocked power. The category blocked power emerged as the ways women experienced the therapeutic process as obstructing t h e i r process. The sub-categories that evolved were, dependence, dual re l a t i o n s h i p , therapist approach, and s t r u c t u r a l l i m i t a t i o n s . 114 Dependency that i s r e f l e c t i v e of blocked power leaves the women with a sense of inadequacy. The women's experiences show how the therapeutic process engenders t h i s sense of inadequacy. Dependency seems to be d i f f e r e n t from the li m i t e d power exeriences, where the therapeutic r e l a t i o n s h i p was experienced as moving them beyond t h i s sense of inadequacy. G a i l expresses her view of how dependency i s negative. G a i l : ... dependency does seem to be a pretty important component of the helping profession, the industry. And that's for a whole l o t of reasons and a l o t of i t ' s economic ... there's definately a work culture within the helping professions that helps to create a dependency, and that's p a r t l y because people want to help so much, and i t ' s r e a l hard not to be needed, and that happens a l o t . There's also an assumption that people don't have the capacity to become as healthy as they can, and so there's some kind of investment i n keeping people poor, and there's a l o t of emphasis on education as apposed to empowerment so i f we just teach people these s k i l l s , i f we could j u s t educate them. So that's a l l about dependency. G a i l describes an unhelpful process that encourages women to look outside themselves for strength and power. E s t e l l e r e i t e r a t e s t h i s when she i s t a l k i n g about dependency. E s t e l l e : Where you need the other person to f e e l ok. That you haven't quite figured out how to move out of the muck to f e e l ok yourself ... Previously dependency was discussed as a function of l i m i t e d power and i t was i d e n t i f i e d as part of the process of therapy. I t i s c l e a r from women's experiences that dependency could be encouraged as a central dynamic within the r e l a t i o n s h i p . Barb highlights the potential dangers that could a r i s e during a period of dependency. Barb: ... the dependency I see as helping. I f I was to see a 115 r e j e c t i o n on her part at that point i t would be, because t h i s dependency, i t ' s not an adult dependent i t ' s got to be back to the c h i l d . I t would be a rej e c t i o n d i r e c t l y , the worse thing that could happen. Again I never f e l t abandoned by x ... Dependency, i n t h i s sense, has the poten t i a l to encourage a woman to remain c h i l d l i k e , and the therapist's responses could have a devastating e f f e c t . E s t e l l e highlighted another way i n which the thera p i s t could encourage dependency. E s t e l l e : ... she moves a l i t t l e quickly into the empowering without necessarily staying with my r e a l i t y at the time ... E s t e l l e : ... I think i t would have been a l o t better to work through that s t u f f . I think i t would have been a l o t more therapeutic to have r e a l l y hung out with a l l of those things, and understand the meaning of where they came from ... i t doesn't necessarily go away, i t maybe changes your experience from the moment but then the other person i s your crutch i n a cert a i n way, or you're dependent on them ... Taking a woman out of her pain by focusing on her strengths can take away a woman's power and create a dependency. Although dependency as a function of li m i t e d power r e f l e c t s s i m i l a r aspects, such as, the women f e e l i n g that they needed extra guidance from t h e i r therapist; i t i s c l e a r that i f the therapist's guidance does not re-route them back to t h e i r own inner resources, they are i n danger of an unhealthy therapeutic process. In addition, dependency that blocks the woman's power can be a r e s u l t of the therapist's resistance to f a c i l i t a t i n g the c l i e n t ' s experience of pain. As discussed e a r l i e r the therapist's approach i s an important factor i n the experience of power. In addition to the 116 therapist's attitude, which i s revealed i n regards to dependency, the therapist's approach can block a woman's power i n a number of ways. Pam talked about one therapist who gave her the impression that she was not interested i n her. Pam: Her power, kind of l i k e her attention, and i t ' s l i k e she would give i t to me only i n very small doses when her inter e s t was tweeked, i t just f e l t so desperate a l l the time ... Apart from f e e l i n g desperate, Pam f e l t a f r a i d to say the wrong thing f o r fear of re j e c t i o n . Pam also i d e n t i f i e d how the atti t u d e of the therapist affected her therapy o v e r a l l . Pam: ... very much a f r a i d of her condeming me, or abandoning me. Never r e a l l y being able to be myself with her at a l l , or express myself, or get down to things that I knew needed to be worked on, but without safety I couldn't. E s t e l l e discussed how she was blocked i n her process by the therapist not addressing her concerns. E s t e l l e : ... I wrote a l e t t e r saying I'm r e a l l y confused here, and r e a l l y hurt and angry. I was getting double messages about our re l a t i o n s h i p being personal and being therapeutic. I don't know where I stand ... she just said t h i s i s a l l your s t u f f , doesn't have anything to do with me, you're on your own with t h i s , and so I f e l t t o t a l l y betrayed ... Later i n the interview E s t e l l e does highlight how i t was an abuse of power fo r the therapist to not acknowledge her part i n the re l a t i o n s h i p . E s t e l l e : ... there was an abuse of power i n my r e l a t i o n s h i p with x ... the v i o l a t i o n of my personal i n t e g r i t y happened i n that relationship, mainly because not being w i l l i n g to acknowledge her own r e s p o n s i b i l i t y i n what happened, or being prepared to even t a l k about i t ... In addition to the therapist not responding to the c l i e n t ' s 117 concerns about what i s happening i n the rel a t i o n s h i p , E s t e l l e highlighted how not acknowledging a l l of her feeli n g s and experiences i s disempowering. The ways i n which the therapist's approach can block the woman's power involve an attitude that i s r e s t r i c t i v e , and f a i l s to give attention to the woman's concerns. These women's experiences show a contrast between the therapist's approach that i s expanding power, and the therapist's approach that blocks power. The attitudes i d e n t i f i e d as blocking power are the reverse of the acceptance and non-judgmental attention that i s i d e n t i f i e d as expansive of the women's power. E s t e l l e experienced her power being blocked due to the dual r e l a t i o n s h i p she had with her therapist. As i d e n t i f i e d under the category r e l a t i o n s h i p with the therapist, the dual r e l a t i o n s h i p involved a therapeutic relationship and a friendship r e l a t i o n s h i p . What seemed to be p a r t i c u l a r l y problematic was how E s t e l l e experienced the friendship r e l a t i o n s h i p . E s t e l l e f e l t intimidated i n s o c i a l situations with her therapist, and t h i s was not something she normally experienced with other people. In addition, the friendship caused E s t e l l e to expect a s p e c i a l connection with her therapist i n group s i t u a t i o n s , and when t h i s did not happen she f e l t very hurt, as the next excerpt shows. E s t e l l e : ... I went to a workshop that her and x were doing l a t e r and I was just fumming. I f e l t no connection from her to me, and I was wondering what i s t h i s , i s t h i s a l l me. Like a l l t h i s s t u f f about your part of my people, your part of my community, was that a l l b u l l s h i t or what? The friendship led E s t e l l e to f e e l a part of her therapist's l i f e 118 and when the therapeutic relationship ended badly, the loss of the friendship resulted i n a great loss. In addition, the transference feelings of parental abandonement i n t e n s i f i e d t h i s lo s s . E s t e l l e : ... i f any reparenting s t u f f happened i t ' s l i k e , oh great we're just going to go through you know parental abandonment again. I t was the way i t f e l t l i k e my dad died when I was 14, and my mum became pychotic at that point. I had bi g experience of parental abandonement f e l t l i k e , and so I was r i g h t back i n that ... From E s t e l l e ' s experience i t i s c l e a r that the dual r e l a t i o n s h i p complicated her experience and l e f t her with more unfinished business to deal with. In addition, how the therapist dealt with these issues, as highlighted under the category therapist's approach, added to E s t e l l e ' s f r u s t r a t i o n and lack of power. Limited growth\Disempowering. When women experienced a therapeutic r e l a t i o n s h i p as blocking t h e i r power they described various outcomes that ranged from limited growth to disempowerment. Women spoke about times they f e l t disempowered as part of the processes i d e n t i f i e d under li m i t e d power. This e n t a i l e d times during the therapy process where the woman f e l t disempowered through being overwhelmed or stuck. Disempowerment was also expressed as a r e s u l t of the t o t a l i t y of the therapeutic process. Under the category therapist's approach, Pam expressed her i n a b i l i t y to be herself, and that the consequence of t h i s was to l i m i t the amount of work she could do i n therapy. Barb also alluded to a lack of growth with some of the p s y c h i a t r i s t s that 119 she had seen. Barb: ... I have f e l t l i k e I have said, I was i n a lab. I am l i k e another of those things under a microscope, l i k e he has seen before and knows what to do, and he's going to put i n t h i s solution, and he's going to get a p a r t i c u l a r r e s u l t , that i s the way I f e l t ... with her (therapist at UBC) I did more of getting r i d of my feelings for my parents ... but I d i d not learn any s k i l l s to l i v e i n my present l i f e ... These women's experiences show how blocking a woman's power can have consequences for t h e i r emotional growth, and t h e i r a b i l i t y to learn how to l i v e more e f f e c t i v e l y . For E s t e l l e the consequences of being blocked f e l t more severe to her. She experienced the dual relationship she had with her th e r a p i s t as being destructive, and disempowering. When she was asked to describe disempowerment she r e p l i e d : E s t e l l e : There's a l o t of things connected to helplessness. You make a person helpless when you disempower them. You stop being i n connection with them ... i t ' s not about the whole thing about saying no, i t ' s more to do with not maintaining that connection with that person when you are saying no to them. I: Something about not acknowledging. E s t e l l e : yeh, not acknowledging who they are, how they might f e e l or t h e i r part i n t h i s ... I think that the other thing that's disempowering i s when you s t a r t pigeon-holing a person, p a r t i c u l a r l y i n terms of pathology, or not seeing t h e i r personhood or t h e i r point of view ... Concepts of s e l f and others. A therapeutic process that l i m i t s or disempowers women resu l t s i n inadequate self-concepts. The sub-categories that emerged were taking r e s p o n s i b i l i t y , f e e l i n g s about themselves, and feelings about therapy. E s t e l l e was l e f t with unresolved feelings about her 120 r e l a t i o n s h i p with her therapist. She was l e f t f e e l i n g responsible fo r what happened. E s t e l l e : ... I had a m i l l i o n d i f f e r e n t r o l e s with t h i s woman, and I keep f e e l i n g that there needs to be a way to figure out how to do t h i s , and I've f a i l e d because I couldn't figure out how to do that ... E s t e l l e described the ending as being a piece of 'unfinished business' when her therapist did not respond to her concerns and take r e s p o n s i b i l i t y for her part i n the r e l a t i o n s h i p . This l e f t E s t e l l e with confused feelings about the r e l a t i o n s h i p . E s t e l l e : ... I'm sure I got my own s t u f f i n that, that I need to work through. But i t ' s hard to work through i t on my own so you get a b i t unclear when I t a l k about i t ... Because E s t e l l e did not have a way of finding closure with her therapist she struggled with taking r e s p o n s i b i l i t y h e r s e l f , as i d e n t i f i e d above, and holding her therapist accountable. E s t e l l e : ... ultimately the only way I had to take some of my own power back, and say wait a second, I think she screwed up here, I think t h i s i s r e a l l y unprofessional of her ... Women talked about various feelings that were associated with a negative therapeutic experience. E s t e l l e had a l o t of anger about the s i t u a t i o n that was connected to the way her therap i s t was unwilling to respond to her when she wrote a l e t t e r . E s t e l l e : ... I wrote a l e t t e r saying I'm r e a l l y confused here and r e a l l y hurt and angry. I was getting double messages about our re l a t i o n s h i p being personal, and being therapeutic. I don't know where I stand ... and I don't f e e l safe with t h i s , and so she just said t h i s i s a l l your s t u f f , doesn't have anything to do with me, you're on you're own with t h i s , and so I f e l t t a t a l l y betrayed, and r e a l l y stung by a l l of t h i s ... 121 As i d e n t i f i e d e a r l i e r , Pam experienced f e e l i n g condemed and i n s i g n i f i c a n t by one of her therapist's. Other women spoke about feel i n g s that came up during periods i n the therapeutic process where they experienced limited power. Even though t h i s was a temporary state i t i l l u s t r a t e s how women can be effected by t h i s kind of experience. Anne: ... when I get mired into emotions where I'm crying a whole l o t , r e a l l y crying, I f e e l powerless. I f e e l stuck ... Anne: ... of f e e l i n g a lack of control. Not being able to control i t , of just going into i t . J u l i e : ... I know at points I've f e l t r e a l l y l i k e oh my god there's something seriously wrong with me. Like there's a constant overwhelmed by everything, and for a b r i e f period that c e r t a i n l y didn't f e e l very good, and i t didn't f e e l l i k e I had a l o t of control because everything was sort of coming at me at once ... f e l t very vulnerable ... For Barb and Pam the negative therapeutic experiences they had d i d not stop them pursuing therapy, although Barb took a number of years before she t r i e d to f i n d her present therapist. E s t e l l e expressed a need to work with someone else but had not attempted to contact anyone at the time of the interview. G a i l expressed mixed feelings about the usefulness of therapy a f t e r her experience. G a i l : ... I've continued to read and proccess and that. I'm also at a place where I don't see therapy as the most useful healing t o o l i n a l o t of si t u a t i o n s as well. I think i t ' s one of many tools and again a much more h o l i s t i c integrated approach to me i s what makes more sense ... There i s some indicati o n from these women's experiences that subsequent therapeutic relationships are impacted by previous 1 2 2 therapeutic relationships. This can leave a woman f e e l i n g apprehensive or re s i s t a n t to further therapy. Direction of therapy. The experience of power i n therapy i s also influenced by a general progression of the therapeutic process. Where i n that process a woman i s , a f f e c t s her experience of her power and that of her therapist's power. Women who had a po s i t i v e experience of therapy expressed various differences i n t h e i r r e l a t i o n s h i p with t h e i r therapist as time progressed. The sub-categories were stages of therapy, increase i n t r u s t , and decline i n dependence. E s t e l l e implied that there were d i f f e r e n t stages that therapy would t y p i c a l l y follow. E s t e l l e : ... there are d i f f e r e n t stages i n therapy because i t takes time for a person to s t a r t to b u i l d up for themselves. So there's a ce r t a i n period where t h e i r sense of power comes from your r e f l e c t i o n ... there's the g r i e f and loss or whatever i t i s people have to go through, where you just stand beside them for a long time sometimes. A number of the women talked about going through periods of dependency on t h e i r therapist under the category l i m i t e d power. This reinforces the idea of stages, that progress from the i n i t i a l b u i l d ing of the relationship to a period where more intense work occurs for the women. In addition, there seems to be a f i n a l stage where the contact with the therapist diminishes, as Pam described under the category changes i n concepts of s e l f through empowerment. Women's experiences described above, and under the category l i m i t e d power, show how there i s a decrease i n the dependency on 123 the therapist. This change occurs as therapy progresses. Another theme to emerge i n the progression of therapy was an increase i n t r u s t that develops through an empowering therapeutic process. Women highlighted d i f f e r e n t aspects of the r e l a t i o n s h i p that they trusted. Pam talked about how she learned to t r u s t that despite her therapist showing anger the r e l a t i o n s h i p was not going to end. Pam: ... she t r i e d calmly to get points across that women have something r e a l l y good, and then i t started to get r e a l l y heated between the two of us, and then she said t h i s i s n ' t working, t h i s conversation i s n ' t working and we are going to have to stop i t , and i t f e l t r e a l l y scary for me. I thought she wasn't going to work with me ... Pam: I was a f r a i d that since she was angry at me she wasn't going to want to be around me or have anything to do with me ... Pam: ... i t took a while for me to r e a l i s e that i t was going to be ok for me to keep seeing her. I think f o r a l i t t l e while I was nervous and ca r e f u l about things I was saying around her ... Cathy explained how tr u s t i n g her therapist affected her. Cathy: ... we got comfortable enough that even personal things that I didn't know came out, and there was no fear for me ... These examples indicate how t r u s t i s developed throughout the therapy. 124 Chapter V: Discussion In t h i s chapter an overview of the theory i s presented f i r s t . Next, the theory i s discussed i n r e l a t i o n s h i p to selected l i t e r a t u r e on power i n therapy. This i s followed by recommendations and implications f o r therapists, and f i n a l l y , concluding remarks are offered at the end of the chapter. Overview of the Theory The focus of t h i s study was to develop an understanding of power i n therapy for women with women therapists. In order to do t h i s , the following questions were addressed. 1. What does power mean to women from t h e i r general experience? 2. What i s women's experience of the therapeutic relationship? 3. How do women experience power i n therapy? 4. How do women distinguish between empowering and disempowering experiences? The analysis of the data col l e c t e d from these interviews formed a theory of power i n therapy for women. The following i s an overview of the main components of the theory. The experience of power i n therapy f o r women e n t a i l s three c e n t r a l aspects: expanding, limited, and blocked power. S e l f -disclosure by the therapist, and the power d i f f e r e n t i a l emerged as important aspects of the therapeutic r e l a t i o n s h i p that influenced the women's experience of these three types of power. Sel f - d i s c l o s u r e could give women a sense of equality within 1 2 5 the r e l a t i o n s h i p , and for others, i t interfered with t h e i r empowerment within the therapeutic r e l a t i o n s h i p by moving the focus away from t h e i r needs or confusing t h e i r sense of themselves. The power d i f f e r e n t i a l was also experienced on an i n d i v i d u a l i s t i c basis. The power d i f f e r e n t i a l i s defined as the difference i n the power of the therapist and c l i e n t based on a difference i n v u l n e r a l i b i t y and knowledge. The women had various experiences of a difference i n power. Some women did not perceive t h e i r therapist as having more power whereas others perceived t h e i r therapist's power as a natural function of the re l a t i o n s h i p . The main influence on the i n d i v i d u a l i s t i c nature of the women's experiences i s the context. The context i s defined as everything i n the women's l i v e s that shapes who they are. The e f f e c t of t h i s s p e c i f i c a l l y on the experience of power i s to inform the issues they are dealing with i n therapy, and the way i n which they come to perceive power. The context becomes evident as the women deal with t h e i r therapeutic issues and experience the r e l a t i o n s h i p with t h e i r therapist. The needs each woman has within the therapeutic relationship are a r e f l e c t i o n of her context. Power i s experienced i n the in t e r a c t i o n between the context and the relationship with the therapist. The women's expanding power e n t a i l s those experiences that expand t h e i r sense of themselves. This expansion of power occurs through both the actions of the therapist and the responses of 1 2 6 the woman by enhancing her self-awareness. The main aspect of expanding t h e i r power i s knowledge of themselves. At times i n the therapeutic process, t h i s awareness can be overwhelming and produces a temporary sense of powerlessness, which i s termed l i m i t e d power. Within the context of a therapeutic process that i s p r i m a r i l y aimed at expanding the woman's power, she moves i n and out of limi t e d power and expanding power towards empowerment. The r e s u l t of an empowering process i s a change i n the woman's concepts of herself. She sees herself as capable and i n charge of her l i f e . A woman's power i s blocked when the therapist's actions and the power dynamics r e s t r i c t her awareness of herself and does not meet her needs. In t h i s s i t u a t i o n , the therapeutic process may contain times that are supportive of the woman and times that she has l i m i t e d power, but the ov e r a l l experience l i m i t s her growth by r e s t r i c t i n g who she i s and who she could be. The outcome i s a negative view of herself and the therapy r e l a t i o n s h i p . Some women become d i s i l l u s i o n e d with therapy and are unwilling to t r y again, and others carry the eff e c t s of these d i f f i c u l t experiences into subsequent therapeutic relationships. The experience of power i n therapy occurs within a dynamic process that i s constantly changing. However, despite the changeable nature of the therapeutic process, there appears to be a general d i r e c t i o n of therapy that has d i f f e r e n t stages and changes within which the experience of power i s encapsulated. The experience of power i s influenced by the context of the woman's 1 2 7 l i f e and the context of the d i r e c t i o n of therapy. At any given time, the factors that influence her experience of power come from these sources. For each woman the context w i l l determine some of the ongoing variables, as well as those aspects of the context that emerge i n the moment and influence the experience of that moment. For example, i f a woman experienced her needs being ignored i n her l i f e , she may not want her therapist to s e l f - d i s c l o s e , and she w i l l be sensi t i v e to any indication that her therapist i s not l i s t e n i n g to her. This i s l i k e l y to remain a constant issue for her throughout therapy and influence how she experiences power. On the other hand, the context can emerge through something that happens between the woman and her therapist that brings a p a r t i c u l a r experience into view at that moment. As the woman's experience of her power changes within therapy, her perception of the context can change. For example, i f she she learned growing up that men had a l l the power, and then through therapy she discovered her own power, her perception of her experience growing up changes. These changes occur within the expanding and empowering therapeutic experiences. When a woman's power i s blocked i n therapy, i t i s more l i k e l y that she w i l l have these r e s t r i c t i v e experiences reinforced, and therefore, l i t t l e w i l l change i n her perceptions of her context. I t i s u n l i k e l y that a woman whose context taught her that she had power would stay very long within a therapeutic r e l a t i o n s h i p that l i m i t e d her. 128 My i n i t i a l review of the l i t e r a t u r e and research on the therapeutic r e l a t i o n s h i p and power dynamics i d e n t i f i e d a number of areas that r e l a t e to women's experience of power i n therapy. F i r s t , I discuss the therapeutic r e l a t i o n s h i p as i t r e l a t e s to the emergent theory, then l i t e r a t u r e and research as i t r e l a t e s to the power d i f f e r e n t i a l , therapist s e l f - d i s c l o s u r e , and power and awareness. The Therapeutic Relationship The r e s u l t s of the present study i d e n t i f i e d the importance of the therapeutic relationship to the experience of power and the ways women are empowered through t h i s r e l a t i o n s h i p . Important elements of the relationship to emerge were: (a) d i f f e r e n t kinds of personal involvement with the therapist, (b) ways i n which the therapist supported the women, and (c) the power dynamics. The three components of the therapeutic r e l a t i o n s h i p outlined by Gelso and Carter (1985) emerged i n t h i s study as aspects of the rel a t i o n s h i p — the working a l l i a n c e , the transference relationship, and the r e a l r e l a t i o n s h i p . This present study addressed the experience of power for women, and therefore, related three components of the r e l a t i o n s h i p to power. In addition, t h i s study highlighted the power dynamics of the therapeutic r e l a t i o n s h i p as an important factor i n the therapeutic process. The working a l l i a n c e i s defined as a contractual connection that the therapist and c l i e n t establish, which forms the foundation for therapy to proceed. Importantly, the working 129 a l l i a n c e i s established early i n the therapeutic r e l a t i o n s h i p . Many of the women described a connection with t h e i r therapist that occured during the i n i t i a l contact. These connections are based on personal s i m i l a r i t i e s , t h e o r e t i c a l perspectives, and l i f e experiences. The women's experience of her therapist's support was often i d e n t i f i e d early as creating an atmosphere that enabled them to t r u s t her enough to proceed with therapy. Gelso and Carter (1985) make the assertion that an i n i t i a l working a l l i a n c e has to be created for therapy to be successful, but i f the therapy requires the woman to reveal more aspects of herself i n order to heal and change segments of her psyche, fe e l i n g s , and behaviour, the working a l l i a n c e needs to be stronger. In t h i s regard, i t i s something that changes and develops as therapy progresses. This study supports t h i s assertion. Women who experienced an unsatisfactory therapeutic r e l a t i o n s h i p i d e n t i f i e d that they were unable to go into deeper issues because the tr u s t they needed had not been developed, and/or they were not i n agreement about the way therapy should proceed. The data from t h i s study suggests that a working a l l i a n c e i s informed by a woman's contextual experience, and therefore, the qu a l i t y and the expectations of the connection are i n part determined by her context. For example, J u l i e c l e a r l y sought out a therapist who i d e n t i f i e d herself as a feminist, and had expectations that the therapist would encourage an e g a l i t a r i a n therapeutic re l a t i o n s h i p . J u l i e ' s perspective originated i n her previous experience, and determined how the therapist and herself 130 were going to work together. This i s an important addition to our understanding of how the working a l l i a n c e i s determined and i t s connection to a woman's experience of power. The working a l l i a n c e i s one of the factors that determines how the rel a t i o n s h i p i s experienced, and how i t can promote an atmosphere of t r u s t building, or simply an agreement to proceed i n therapy. This study shows how important the therapist's response i s to predicting the women's experience of power. An important factor connected to empowerment i s the therapist's non-judgmental attitude, and conversely, how an attitude of r e j e c t i o n or d i s i n t e r e s t contributes to a disempowered experience. A woman's context may influence her to form a working a l l i a n c e that i s rooted i n her own powerlessness i f , for example, her previous experience has informed her that people i n authority are the experts, and that she should defer to them. I f a woman connects with her therapist i n t h i s way, i t i s not possible f o r the woman to access her own power unless the therapist provides an al t e r n a t i v e experience. Thus, the therapist's responses to the woman are c r u c i a l as they provide the d i r e c t i o n of therapy. The working a l l i a n c e i s instrumental i n determining the kind of experience a woman w i l l have of power i n therapy, and i s determined by the interaction between the therapist's a t t i t u d e towards the woman, and the woman's own expectations. The second component of the therapeutic r e l a t i o n s h i p i d e n t i f i e d by Gelso and Carter (1985) i s the transference r e l a t i o n s h i p . Transference i s defined by Gelso and Carter (1985) 131 as: a r e p e t i t i o n of past c o n f l i c t s (usually but not always beginning i n early childhood) with s i g n i f i c a n t others such that feelings, behaviours, and attitudes belonging r i g h t f u l l y i n those early relationships are displaced; i n therapy, the displacement i s onto the therapist, (p.170). The findings from t h i s study support the presence of the transference relationship as outlined by Gelso and Carter (1985). However, transference as defined above was only one aspect of past c o n f l i c t and experience that i s repeated within the therapeutic r e l a t i o n s h i p . This study points to an even broader perspective that includes a l l aspects of a woman's previous experience, and can influence how she re l a t e s to her therapis t . Her early relationships with s i g n i f i c a n t others do create the most intense feelings and needs expressed towards her therapist. In other words, women from t h i s study consciously i d e n t i f i e d experiences from childhood relationships that were r e f l e c t e d i n the r e l a t i o n s h i p with t h e i r therapist. For example, Pam i d e n t i f i e d the ef f e c t s that patriarchy had on her, which l e f t her with fee l i n g s of powerlessness. This part of her context became a c r u c i a l focus for her as she worked with her therapist to access her power. However, t h i s aspect of her context was not recreated within her relat i o n s h i p with her therapist, as her childhood re l a t i o n s h i p s were. This study shows that the transference r e l a t i o n s h i p has implications for women's experience of power i n the therapeutic 132 re l a t i o n s h i p . The transference relationship seems to be the aspect outlined by Gelso and Carter most associated with the power dynamics within the relationship, although they do not discuss power i n t h i s context. Because the transference fe e l i n g s and behaviours often originate i n childhood experiences, women may f e e l powerless i n the same way they were powerless as a c h i l d . The transference may be valuable i n providing a woman with the opportunity to f i n d her power as an adult as she works through the transference, or i t may reinforce her powerlessness i f the therapist's responses are reminiscent of her childhood experiences. At the end of her therapy experience E s t e l l e f e l t abandoned by her therapist, reinfo r c i n g the powerlessness she f e l t as a c h i l d . Conversely, Pam received the attention and in t e r e s t from her therapist that she did not receive as a c h i l d , and experienced t h i s as empowering. In addition, t h i s study expands the concept of the transference r e l a t i o n s h i p to include a l l aspects of a woman's l i f e that she brings into therapy, and t h e i r importance to the experience of the therapeutic r e l a t i o n s h i p and her experience of power i n therapy. The t h i r d component that Gelso and Carter (1985) i d e n t i f y i s the r e a l r e l a t i o n s h i p . They explain t h i s as follows: In a r e a l relationship, one's perceptions and interpretations of another's behaviour are appropriate and r e a l i s t i c , the feelin g s are genuine, and the behaviour i s congruent, (p 186) . The r e a l r e l a t i o n s h i p occurs when the therapist and the c l i e n t 133 responding to each other i n the present, and develop a bond that r e f l e c t s a genuine connection. Geslo and Carter (1985) do not address the e f f e c t that the r e a l relationship has on the c l i e n t ' s experience of power i n therapy, but they do acknowledge that the degree to which the therapist and the c l i e n t can be open and genuine about t h e i r feelings are l i k e l y to be d i f f e r e n t . Data from t h i s study shows that there i s a difference i n the therapist's and c l i e n t ' s v u l n e r a b i l i t y that can be experienced as power. An important aspect of the r e a l r e l a t i o n s h i p to emerge from t h i s study was the degree to which the therapist disclosed personal information. A f u l l e r discussion of the therapist's s e l f - d i s c l o s u r e i s addressed l a t e r . There were a number of important aspects of the r e a l relationship that influenced the women's experience of power. Many of the women described a connection with t h e i r therapist that was based on l i k i n g each other and possible friendship. On the other hand, some women wanted t h e i r therapist to remain unknown to them. For example, Pam perceived her therapist as 'Godlike', and wanted her therap i s t to remain personally inaccessible. This would indicate that there are variations i n the degree to which a r e a l r e l a t i o n s h i p exists for d i f f e r e n t women. Consistently, the therapist's genuine presence was associated with an empowering therapeutic experience. The quality of the therapist's attention and presence r e f l e c t s c h a r a c t e r i s t i c s of a r e a l r e l a t i o n s h i p as outlined by Gelso and Carter (1985). For example, Pam always 134 experienced her therapist as interested i n anything she had to say, and i n t h i s respect, i t was important for her to experience the ' r e a l ' connection with her therapist. The data from t h i s study confirms the importance of a r e a l r e l a t i o n s h i p , and i l l u s t r a t e s how t h i s component i s connected to power. G a i l perceived her therapist as maintaining her distance by not being genuine or open to her as a r e a l person. G a i l viewed t h i s as a negative use of her therapist's power, which resulted i n an unsatisfactory therapeutic experience. I t would appear that the lack of a r e a l relationship can be equated with a disempowering therapeutic experience. The r e a l r e l a t i o n s h i p d i f f e r s from the transference rel a t i o n s h i p by i t s a c c e s s i b i l i t y to the c l i e n t . For example, Dennise experienced her therapist as a r o l e model for accessing power. She experienced her therapist as possessing c h a r a c t e r i s t i c s that i l l u s t r a t e a way to be i n charge of your l i f e . This was an important a t t r i b u t e that Dennise wanted to develop, and because she experienced t h i s i n her therapist i n a r e a l way, i t was attainable. Transference a t t r i b u t e s are less accessible to the women because of t h e i r unreal and i l l u s i o n a r y nature. In t h i s regard, the r e a l r e l a t i o n s h i p i s an important component of the women's a b i l i t y to access t h e i r power. The findings from t h i s study are important because they highlight the importance of the women's context to the therapeutic relationship, and provide information about i t s connection with women's empowerment. Claiborn and Strong's (1982) theory l i n k s therapeutic change 135 to both the power of the therapist to influence and the dependence of the c l i e n t . Claiborn and Strong view the therapeutic rel a t i o n s h i p as an interaction that i s based on the c l i e n t being more dependent on the therapist, which r e s u l t s i n intrapsychic and behavioral changes for the c l i e n t . This study confirms that each woman had needs of her therapist, such as, safety, attention, support, and guidance i n creating an environment that allows changes. The women i n t h i s study d i d not experience a dependence on t h e i r therapist u n t i l they encountered a lack of control i n t h e i r l i v e s , and they were i n c r i s i s . In other words, dependence did not become an issue i n the therapeutic process u n t i l the women f e l t powerless and needed more guidance from t h e i r therapist. Feminist t h e o r i s t s have proposed a model of the therapeutic r e l a t i o n s h i p as an interdependent int e r a c t i o n based on mutuality and equality (Jordan, Kaplan, M i l l e r , Stiver, & Surrey 1991). Mutuality i s defined by Jordan (1991) as a caring i n both d i r e c t i o n s , emotional a v a i l a b i l i t y , and openness to change on both sides. The findings from t h i s study support the emergence of a mutual therapeutic relationship. The women's experiences d i f f e r i n the degree of mutuality that they desired, and the ways i n which they experienced the relationship as mutual. Cathy, for example, experienced her relationship as mutual through the d i f f e r e n t kinds of knowledge that she and her therapist shared. She expressed how i n t h i s way they both had something to contribute to the therapeutic process. J u l i e experienced 136 mutuality i n the way she and her therapist would explore an issue through discussion. This study shows a l i m i t a t i o n i n the degree of mutuality that e x i s t s between therapist and c l i e n t . None of the women revealed a sense that they had an impact on t h e i r t h e r a p i s t or affected her growth. The women's experience of mutuality focused on t h e i r therapeutic process and f a c i l i t a t e d t h e i r s e l f -discoveries. In addition, the degree to which each woman wanted her therapist to be open and reveal herself varied. Anne had a desire to be friends with her therapist, whereas J u l i e and Dennise were clear that they did not want any emotional attachment to t h e i r therapist. According to Jordan (1991), mutuality f a c i l i t a t e s empowerment through f a c i l i t a t i n g connectedness i n relationships. These theories (Claiborn & Strong, 1985; Jordan et a l . , 1991) are explored i n more depth i n the discussion of the power d i f f e r e n t i a l . The data from t h i s study i l l u s t r a t e s the importance of the therapeutic relationship to the experience of power f o r women, and the ways i n which the components of the re l a t i o n s h i p vary as a r e s u l t of the women's context. Power D i f f e r e n t i a l The findings of t h i s study highlight a number of aspects of the power dynamics within the therapeutic r e l a t i o n s h i p . There are three main areas that emerged: the power d i f f e r e n t i a l , dependence, and the transference re l a t i o n s h i p . Dependence and the transference rel a t i o n s h i p are discussed as a function of the 137 power d i f f e r e n t i a l because they occur within the therapeutic r e l a t i o n s h i p which would appear to be constructed on t h i s difference i n power. A number of the women experienced the therapist as having greater power because of her a b i l i t y to influence t h e i r process either i n a po s i t i v e or negative way. The ways i n which the power d i f f e r e n t i a l i s perceived and experienced by the women varied as a r e s u l t of t h e i r context and the attitude of the therapist. The power d i f f e r e n t i a l i n the therapeutic r e l a t i o n s h i p has been i d e n t i f i e d by feminist th e o r i s t s , and i t s e f f e c t s addressed within the context of women's oppression i n society (Douglas, 1985; Greenspan, 1983; Laidlaw & Malmo, 1991; Worell & Remer, 1992) . Lerman and Rigby (1990) i d e n t i f y the way the power d i f f e r e n t i a l has come to be perceived by feminist therap i s t s : As the theory and practise of feminist therapy has matured, most feminist therapists have come to recognize that the goal of eradicating a l l power d i f f e r e n t i a l s between therapist and c l i e n t i s an imp o s s i b i l i t y . We have learned about the power that i s inherently i n the very r o l e of therapist, (p. 52) . Douglas (1985) i d e n t i f i e s the power of the therapist i n terms of French and Raven's (1959) f i v e sources of power, and power that r e s u l t s from the inequality of the sexes. Claiborn and Strong (1982) focus on three of these sources of power: legitimate, expert, and referent (French & Raven, 1959). Lerman and Rigby's (1990) expression of the power of the therapist as contained i n her r o l e can be equated with French and Raven's sources of power. 138 These sources of power were supported by the findings from t h i s study. The legitimate, expert, and referent power of the therapist was expressed by women i n t h e i r descriptions of the ways i n which t h e i r therapist influenced and guided them. For example, Cathy talked about the knowledge that her thera p i s t had about the therapy process, and how her therapist knew what needed to happen for her to progress. When she f i r s t contacted her therapist Cathy decided that t h i s therapist had a l l the necessary requirements to bu i l d a tr u s t i n g relationship, and to embark upon a therapy process. In addition, she very quickly i d e n t i f i e d personal s i m i l a r i t i e s with her therapist that were important to her. Barb p a r t i c u l a r l y stressed that the s i m i l a r i t i e s she experienced with her therapist gave her confidence i n her therapist . This demonstrates the three sources of power as described by French and Raven (1959). However, Cathy did not perceive her therapist as having power because she saw i t as up to her to accept her therapist's suggestions and comments. In other words, her therapist could not make her do anything without her agreement. Cathy's view of power was influenced by her past experience that taught her power was control and force. Cathy would therefore only experience power i n the therapy r e l a t i o n s h i p i f i t f i t her perception of power as a negative force. These findings provide evidence that the power d i f f e r e n t i a l i s present i n the authority that i s inherently i n the therapist's r o l e , but the women only experienced the power d i f f e r e n t i a l i f t h e i r 139 experience f i t t h e i r expectations. J u l i e acknowledged the power d i f f e r e n t i a l and perceived i t as necessary to f a c i l i t a t e her therapy. Her perception was influenced by her understanding of feminist theory. Theoretical understandings of power were important i n determining how power was experienced. The women's t h e o r e t i c a l knowledge i s another example of the influence of t h e i r context i n t h e i r experience of the power d i f f e r e n t i a l . The data from t h i s study also confirmed Claiborn and Strong's (1982) assertion that the therapist's power i s necessary to influence the c l i e n t to change. G a i l did not form a working a l l i a n c e throughout her therapy because she did not have confidence i n her therapist's way of working, which included her t h e o r e t i c a l outlook and her personal presentation. A l l three forms of French and Raven's (1959) sources of power were missing for G a i l , and her therapeutic needs were not met. J u l i e and Pam both i d e n t i f i e d how the therapist's greater power p o s i t i o n was necessary for therapy, and without i t , i t would not be a therapeutic r e l a t i o n s h i p . Claiborn and Strong (1990) highlight important aspects of the therapist's c h a r a c t e r i s t i c s , and how she presents information to the c l i e n t . Those c h a r a c t e r i s t i c s include the a u t h o r i t i v e aspects outlined above, i n addition to the attractiveness of the therapist to the c l i e n t . The nature of the presentation i s a t t r i b u t e d to the therapist's interventions: Many of the therapist's interventions do not seem to the c l i e n t l i k e influence at a l l , because the counsellor may 140 simply help the c l i e n t focus on his or her own behaviour, and the c l i e n t i s led to attribute changes i n intrapsychic rather than interpersonal processes. Attitude change i n counselling and psychotherapy i s seldom the consequence of overt persuasion; i t r e s u l t s from the therapist's creating the conditions for change which, i n turn, appears spontaneous to the c l i e n t , (p. 54). The conditions for change that Claiborn and Strong h i g h l i g h t r e f e r to the therapist a f f e c t i n g attitude changes i n the c l i e n t from the things that the therapist does, such as, suggestions to pursue a topic, or focusing on feelings, and interpretations. This study adds valuable information about the att i t u d e of the therapist towards the c l i e n t that creates conditions f o r change and the women's experience of power. Consistently, the therapist's acceptance and non-judgmental attitude towards the c l i e n t f a c i l i t a t e d an empowering experience, as did the therapist's guidance that focused on the c l i e n t ' s connection to her own inner resources. Claiborn and Strong do not address the d i f f e r e n t kinds of ef f e c t s of the therapist's power, nor how i t can be used against the c l i e n t . Feminist l i t e r a t u r e i s concerned p r i m a r i l y with i d e n t i f i c a t i o n of the power d i f f e r e n t i a l and ways to reduce the inequality to f a c i l i t a t e women's empowerment (Douglas, 1985; Jordan et a l . , 1991; Greenspan, 1983; Laidlaw & Malmo, 1991; Worell & Remer, 1992). The findings from t h i s study support both aspects of the therapeutic experience for women, that i s , a power 141 d i f f e r e n t i a l supports women's empowerment when i t i s used to f a c i l i t a t e t h e i r own awareness and di r e c t i o n , and i t i s important to reduce the negative impact of the therapist's power p o s i t i o n . The context of women's l i v e s has emerged i n t h i s study as important i n determining what happens i n the therapeutic r e l a t i o n s h i p and t h e i r experience of power. The i n i t i a l l i t e r a t u r e review i d e n t i f i e d how women's experience of power i n society contribute to t h e i r perception of women's lack of power, (Johnson, 1994, 1996, 1998; Lips, 1991; Maccoby & J a c k l i n 1974). Women generally experience t h e i r power i n terms of t h e i r sex appeal (Lips, 1991). A number of the women expressed how they had not seen themselves as powerful, or how i t had been l i m i t e d to sexual power and stereotypical r o l e s f o r women p r i o r to therapy. Through an empowering therapeutic process, women were able to see themselves d i f f e r e n t l y , and reframe the negative impact of t h e i r context. Feminist t h e o r i s t s have focused t h e i r approach to therapy on changing a woman's self-concept, which was developed as a r e s u l t of p a t r i a r c h a l oppression (Worell & Remer, 1992). From t h i s point of view, feminist l i t e r a t u r e addresses the issues a woman brings into therapy as a r e s u l t of her context. However, the way i n which a woman's context af f e c t s how she approaches therapy, and what she needs from therapy varies from woman to woman. Feminist therapy advocates an e g a l i t a r i a n r e l a t i o n s h i p , which i s established through the therapist's personal involvement and s e l f - d i s c l o s u r e , and an attitude that views the woman as i n 142 control of her own process (Worell & Remer, 1992). The findings from t h i s study demonstrate the complexity and d i v e r s i t y of how a woman i s empowered through the relationship. For example, Pam expressed her experience of the power d i f f e r e n t i a l by viewing her therapist as 'Godlike'. She wanted her therapist to remain i n t h i s p o s i t i o n to provide her with the confidence to reveal more vulnerable aspects of herself and to f e e l that her thera p i s t was focusing her attention on her. I t could be concluded that on some l e v e l t h i s therapeutic relationship was reproducing the power imbalances women experience i n society. However, Pam went from seeing he r s e l f as having no power to valuing her power as a woman, and f e e l i n g that she was i n charge of her l i f e and capable of achieving a l l that she wanted. This therapeutic r e l a t i o n s h i p show important elements i n creating a re l a t i o n s h i p that reduces the negative e f f e c t s of a power imbalance, such as, focusing on the c l i e n t s agenda, an accepting and non-judgmental attitude, and guidance from the therapist. The findings from t h i s study place importance on the indi v i d u a l needs of the women i n therapy and t h e i r involvement with the therapist, and conversely, the therapist's attitudes i n creating a therapeutic r e l a t i o n s h i p that i s an alt e r n a t i v e to the r e s t r i c t i v e conditions that oppress women. The transference relationship was i d e n t i f i e d as an important element that r e f l e c t s an aspect of the women's context, and i s expressed through the therapeutic r e l a t i o n s h i p . The findings from t h i s study show how transference i s present. Moreover, the women 143 expressed both feelings of admiration, awe, and of intimidation, which r e f l e c t e d a transference relationship. The transference r e l a t i o n s h i p i s an important aspect of the therapeutic r e l a t i o n s h i p . Working through of the transference w i l l lead to a freedom from past pain and unsuccessful r e l a t i o n s h i p s (Kohn, 1992). The data from t h i s study shows that dealing with the transference issues can lead to alternatives that are l i b e r a t i n g and empowering for women, such as Pam's experience of receiving missed attention from childhood. A l t e r n a t i v e l y , confronting the transference i n the therapeutic r e l a t i o n s h i p can be experienced i n a way that blames the woman. For example, E s t e l l e expressed her anger towards her therapist who refused to acknowledge her fee l i n g s and r e f l e c t e d them back as E s t e l l e issues. E s t e l l e acknowledged her part i n the interaction but ended up f e e l i n g powerless because of the lack of a r e a l response to her concerns. I t i s unclear from the findings of t h i s study what the connection i s between transference and the power dynamics i n the therapeutic r e l a t i o n s h i p other than that i t e x i s t s . The focus of t h i s study did not address the transference issues of the women, and therefore, important questions are unanswered about how transference issues were resolved within the r e l a t i o n s h i p , and how they affected t h e i r experience of power. What can be inferr e d from these findings i s that transference feelings were often associated with an elevation of the therapist's p o s i t i o n i n r e l a t i o n to the woman. I t could be speculated that t h i s occurs because the transference feelings originated i n childhood i n 144 r e l a t i o n to adults when the c h i l d was powerless. Therefore, the pot e n t i a l for the therapeutic relationship to reproduce an imbalance of power for women through transference issues i s evident, and w i l l greatly depend on how the transference i s addressed i n therapy. Dependency i s an aspect of the power d i f f e r e n t i a l that Claiborn and Strong (1985) maintain i s inherent i n a l l r e l a t i o n s h i p s to varying degrees. They view the c l i e n t as more dependent on the therapist because of t h e i r needs, and that dependency i s a r e s u l t of needs. They assert that i f t h i s dependency did not exis t the therapist's power to influence would not be e f f e c t i v e , and the relationship i s u n l i k e l y to e x i s t at a l l . The findings from t h i s study reveal a range of needs expressed including a need for safety, involvement, attention, new perspectives, and d i r e c t i o n about ways to cope. Dependency was not a r t i c u l a t e d as something the women experienced u n t i l t h e i r emotional need for the therapist was f e l t . For example, Barb described how her therapist was at one time her l i f e l i n e , and she i d e n t i f i e d her dependency on her therapist at t h i s time. A number of women who spoke about dependency expressed i t as a temporary state during a time of c r i s i s , or when they became overwhelmed with new information about themselves as a r e s u l t of the therapeutic process. Within an empowering process these periods of dependency are temporary states, and the therapist's intervention and support re-directs the women's need fo r environmental support back to self-support. The process described 145 here demonstrates the temporary inequality that M i l l e r (1986) defines as r e f l e c t i n g the power dynamics of the therapeutic r e l a t i o n s h i p . I t i s clear that t h i s state has the p o t e n t i a l to become a central c h a r a c t e r i s t i c of the power r e l a t i o n s between the r a p i s t and c l i e n t . In addition, i t can be i n f e r r e d that dependency rel a t e s to the transference r e l a t i o n s h i p by symbolizing a parent/child interaction. For example, Barb expressed how during t h i s period her feelings of dependency were coming from a c h i l d place, and many of the women talked about needing more guidance and di r e c t i o n during these times. Claiborn and Strong (1985) did not i l l u s t r a t e how the dependency of the c l i e n t could be dangerous. Feminist l i t e r a t u r e c r i t i c i z e s t r a d i t i o n a l therapy for fostering dependency of women c l i e n t s through a lack of choice i n the treatment process, and through the therapist maintaining her expert p o s i t i o n (Lerman & Porter, 1990; Worell & Remer, 1992). The data from t h i s study recognizes dependency as a natural part of the process, and supports the view that at these times the therapist's power can be b e n e f i c i a l to the woman. The findings from t h i s study also show how women f e l t inadequate and powerless at these times; therefore, i t can be inferred that dependency has the po t e n t i a l to be destructive to the woman's self-concept i f i t becomes a permanent feature of the relationship. These findings add to the l i t e r a t u r e by confirming how dependency becomes an issue within the therapeutic process. From the findings i n t h i s study, dependency could be 146 fostered through a lack of attention to the woman's v u l n e r a b i l i t i e s and painful feelings. When the thera p i s t only supports the woman's strengths, the woman could become dependent on the therapist to validate her. In working through the areas i n her l i f e that she has d i f f i c u l t y with, or allowing her to experience feelings of g r i e f and helplessness, women learn that they can manage these feelings and come through them. What seems to be a p a r t i c u l a r l y important process i s that when a woman i s struggling and a therapist intervenes by v a l i d a t i n g her strengths (presumably with the intention of empowering her), the opposite occurs, and the therapist becomes a potential crutch f o r her to f e e l good about herself. This adds important information about empowerment and considerations for the therapist. Worell and Remer (1992) i d e n t i f y the importance of integrating a l l aspects of a woman's personality, and at the same time, emphasize the need to i d e n t i f y a woman's strengths. They stress how patriarchy has devalued feminine c h a r a c t e r i s t i c s , and that i t i s important f o r the therapist to revalue and redefine these i n a p o s i t i v e way. The data from these findings show how i t i s important to illuminate her strengths within the context of her therapeutic process, and to be mindful of her agenda and needs within that process. Therapist Self-disclosure The l i t e r a t u r e regarding therapist s e l f - d i s c l o s u r e has pri m a r i l y focused on pos i t i v e and negative implications. L i t e r a t u r e that focuses on how se l f - d i s c l o s u r e v i o l a t e s the 147 therapeutic r e l a t i o n s h i p and prevents transference issues from being addressed r e f l e c t s the psychodynamic model of therapy (Palombo, 1987; Tansey, 1992). Research that promotes the effectiveness of therapist s e l f - d i s c l o s u r e has suggested that there i s a lessening of the power of the therapist r e s u l t i n g i n greater freedom for the c l i e n t to disclose, and s e l f - d i s c l o s u r e o f f e r s hope and connection to others (Anderson & Mandell, 1989; Pugh, 1990; Simon, 1988). Most research investigates s e l f -d isclosure from the c l i n i c i a n ' s point of view. Wells' (1994) study which does focus on the c l i e n t ' s experience of therapist s e l f - d i s c l o s u r e and the effects on treatment, compliments the findings from t h i s study. The exis t i n g l i t e r a t u r e , however, does not address the relationship between s e l f - d i s c l o s u r e , empowerment, and the influence of a woman's context. The r e s u l t s of the present study add valuable information about the e f f e c t s of s e l f - d i s c l o s u r e on a woman's empowerment. The findings from t h i s study show the d i v e r s i t y of s e l f -disclosure experiences that the women had and how these expeiences affected t h e i r experience of power. Wells (1994) does not discuss the relationship of s e l f - d i s c l o s u r e to power. Some women i n t h i s study i d e n t i f i e d that the power imbalance was reduced when the therapist s e l f - d i s c l o s e d , and others f e l t empowered. Conversely, other women f e l t m i s t r u s t f u l of t h e i r therapist as a r e s u l t of s e l f - d i s c l o s u r e . Wells (1994) described the connection between the degree of t r u s t that had been b u i l t between therapist and c l i e n t before the 148 dis c l o s u r e occurred. She found that the respondents who reported a negative e f f e c t on therapy did not have a very high degree of tr u s t or confidence i n t h e i r therapist p r i o r to the disclosure. These findings support Mathews' (1988) study that emphasized that therapist's tend to disclose more l a t e r on i n the therapeutic process. The findings from the present study do not support these data. For example, G a i l did not have confidence i n her therapist and was unable to pursue her therapeutic issues, because she needed her therapist to disc l o s e more of he r s e l f i n the therapeutic process. Pam was able to develop t r u s t but continued to need her therapist to keep d e t a i l s of her experiences out of the therapeutic r e l a t i o n s h i p . On the other hand, Dennise who had been i n therapy f o r the shortest period of time was s t i l l i n the process of learning to t r u s t her therapist and anticipated f e e l i n g controlled by the therapist's s e l f -d i sclosure. The relationship between the amount of t r u s t b u i l t up and the kind of impact on the therapeutic process i s unclear from t h i s study. The discrepancy between Wells' study and these findings may be explained by the various needs and previous experiences of the women that influence how they experience the therapeutic re l a t i o n s h i p . Wells does not s p e c i f i c a l l y i d e n t i f y the respondent's context as an important factor i n t h e i r various experiences of se l f - d i s c l o s u r e which t h i s study h i g h l i g h t s . A l l of the women i n t h i s study expressed the importance of t h e i r therapist's genuine expression of support and a sense of knowing from her actions that they were accepted. This could be 149 described as s e l f - d i s c l o s u r e that communicates the therapist's f e e l i n g s about the woman and does not produce the confusion of overt s e l f - d i s c l o s u r e s , as Khan (1991) points out: There i s f i r s t of a l l the question of s i n c e r i t y . A c l i e n t could be forgiven f o r wondering i f statements of a f f e c t i o n and esteem are l i t t l e more than what therapist's say to a l l t h e i r c l i e n t s . That problem seems lessened when therapist's communicate p o s i t i v e regard by what they do and how they do i t , rather than by what they say . . . r e a l regard i s communicated by subtle cues and by actual behaviours, (p. 140). This study shows a clear connection between the women's empowerment and the therapist's expression of her acceptance, support, and genuine caring. Some feminist l i t e r a t u r e highlights the importance of responding to the women's individual needs when therapist's d i s c l o s e (Brown, 1994; Greenspan, 1986). When the respondents i n Wells' (1994) study were asked what recommendations they would make, they a l l spoke about the importance of the t h e r a p i s t making disclosures i n response to the c l i e n t ' s needs and knowing the c l i e n t . The findings from t h i s study support the importance of knowing the i n d i v i d u a l needs of the woman i n r e l a t i o n to her context. Related to the importance of the context i s the transference relationship that influences the experience of the therapist's s e l f - d i s c l o s u r e (Greenspan, 1986; Khan, 1991). Wells's study indicates that when the s e l f - d i s c l o s u r e recreates a 150 f a m i l i a r and threatening dynamic, i t can cause disruption i n the c l i e n t ' s therapy. Findings from t h i s study confirm the existence of the transference relationship within the therapeutic interactions around s e l f - d i s c l o s u r e . Pam i d e n t i f i e d how she viewed her therapist i n a similar p o sition to the one she had put her mother i n when she was a c h i l d . Pam saw her mother as strong and needed her to be perfect. Therefore, she did not want her therap i s t to disc l o s e personal information because t h i s altered the perception of her therapist as strong. The findings from t h i s study concur with Wells (1994) i n showing how s e l f - d i s c l o s u r e can produce confusion f o r the c l i e n t . Various ambiguities ar i s e from overt s e l f - d i s c l o s u r e including: uncertainty about how to re l a t e to the therapist, uncertainty about why they are being given t h i s information, and the boundaries of the relationship. Wells's study reveals that despite the i n i t i a l negative feelings that some c l i e n t s had about disclosures, the o v e r a l l impact on the therapeutic r e l a t i o n s h i p was p o s i t i v e . What t h i s points to i s that s e l f - d i s c l o s u r e i s not detrimental to the therapeutic process simply because the c l i e n t f e e l s uncomfortable, and suggests that the way i n which the therapist deals with t h i s issue w i l l add to the therapy. In addition, t h i s study revealed possible implications to the boundaries of the therapeutic relationship that arose from s e l f -d isclosure. For example, Cathy was unsure how to respond to her therapist when she disclosed, even though the o v e r a l l e f f e c t on therapy was a p o s i t i v e one. Cathy revealed that she d i d not want 151 her therapist to s e l f - d i s c l o s e too much information because she did not want to care about her therapist when the r e l a t i o n s h i p had to end at some point. The data from t h i s study did not show any detrimental e f f e c t s of the therapist's disclosures but highlighted the var i a t i o n s i n experience of disclosure and the e f f e c t on the power dynamics. In the cases where disclosure was not welcomed, for example with Pam and Dennise, i t was not clea r that negative e f f e c t s occurred because these women were i n therapeutic re l a t i o n s h i p s that met t h e i r needs. Power and Awareness The discussion to t h i s point has highlighted those factors which influence a woman's experience of power, that i s , aspects of the in t e r a c t i o n i n the therapeutic r e l a t i o n s h i p , and the woman's context of her l i f e ' s experiences that she brings into therapy. In t h i s section, I address what the experience of power i s l i k e f o r these women. The data from t h i s study i d e n t i f i e s the experience of power for these women through awareness. A l l of the women expressed t h i s aspect of t h e i r development of personal power. Some feminist l i t e r a t u r e highlights awareness i n regards to the goals of feminist therapy as f a c i l i t a t i n g a woman's awareness of the ef f e c t s of patriarchy on her l i f e , and awareness of her needs and strengths (Avis, 1991; Smith & Douglas, 1990; Smith & Siegal, 1985; Worrell & Remer, 1992,). The data from the present study supports both of these assertions. 152 Many of the women spoke about changes i n t h e i r concept of themselves that r e f l e c t e d a redefining of how they perceived and f e l t about themselves as a women. For example, Barb i d e n t i f i e d changes i n her perception of power from sexual power to personal power, and through t h i s change she came to value who she i s . Smith and Siegal (1985) capture the connection between empowerment and change i n perception of s e l f : As feminist therapists we are i n a po s i t i o n to empower the woman, that i s , to enable her to reclaim her own power by renaming c e r t a i n aspects of her behaviour, e s p e c i a l l y that c a l l e d manipulative or crazy, as attempts to achieve the goals of control and influence under given s o c i e t a l constraints, (p.14) . And l a t e r : A focus of feminist therapy i s to empower women to become s e l f - d e f i n i n g . As the therapist gives p o s i t i v e acknowledgment of women's needs, needs not approved of by the dominant male culture, women's self-esteem r i s e s and they begin to explore the r i s k s involved i n using power more d i r e c t l y , (p. 16) . Conditions within the process of therapy are important factors i n the f a c i l i t a t i o n of women's awareness. The conditions of p a r t i c u l a r significance were acceptance and containment of the therapeutic process by the therapist. Acceptance r e l a t e s both to the therapist's acceptance of the woman and the woman's acceptance of herself. As i d e n t i f i e d previously, the therapist's caring attention conveys to the woman that she i s valued. 153 Attention to a l l of her feelings and concerns gives another message, that a l l aspects of her are important. Worell and Remer (1992) point to the acknowledgment and valuing of female c h a r a c t e r i s t i c s , such as, empathy, nurturance, and i n t u i t i o n as a redefining process. The appreciation of these c h a r a c t e r i s t i c s h i g h l i g h t s the c o n f l i c t s that often surround them due to the double bind placed on women by patriarchy (Worell & Remer, 1992). The findings from t h i s study substantiate t h i s l i t e r a t u r e . Many of the women spoke about the resolution of i n t e r n a l c o n f l i c t s connected to t h e i r roles i n society. Resolution of these c o n f l i c t s was linked to feelings of empowerment by r e s u l t i n g i n acceptance of themselves. The data from t h i s study contributes to an understanding of the interplay between limited power, empowerment, and awareness. Women i d e n t i f i e d that during the period of l i m i t e d power, they often became overwhelmed with new awareness but f e l t powerless. In p a r t i c u l a r , women often did not f e e l good about themselves and i d e n t i f i e d f e e l i n g out of control of t h e i r l i v e s . This suggests that awareness i n i t s e l f i s not enough for the women to f e e l empowered. What seems to be important i s the integration of t h i s new material into a sense of who they are. Women were able to access t h e i r power through a process of increasing t h e i r knowledge of themselves that expanded t h e i r r e p e rtoire of who they are. By connecting with themselves i n t h i s way, which requires that they resolve i n t e r n a l c o n f l i c t s , they developed self-acceptance. 154 Containment by the therapist i s an important condition that f a c i l i t a t e s empowerment and awareness. The l i t e r a t u r e that addresses containment focuses on bondaries and the v i o l a t i o n s of boundaries (Brown, 1994; Lerman & Rigby, 1990; Margolies, 1990; Peterson, 1992). The l i t e r a t u r e does not make a c l e a r connection between boundaries and awareness or between boundaries and the empowerment of women through f a c i l i t a t i n g t h e i r awareness. The findings from t h i s study i l l u s t r a t e how containment benefits the rel a t i o n s h i p , and thereby f a c i l i t a t e s a woman's,self-awareness. This study portrays a number of aspects of the therapist's containment of the therapeutic process. Containment includes the following elements: (a) communicating the therapist's confidence and providing safety, (b) providing d i r e c t i o n and knowledge of what to expect within the therapeutic process, (c) normalizing the c l i e n t ' s experience, and (d) allowing for insights into the c l i e n t ' s process. These elements, along with the communication of acceptance, provides the safety needed for the women to explore the therapeutic process that can at times be very p a i n f u l and confusing. I t i s through t h i s exploration that women spoke about gaining new information about themselves, which ultimately was empowering. Conversely, data from t h i s study point to the way i n which a woman's power i s r e s t r i c t e d by a lack of acceptance and r e s u l t s i n her awareness being blocked. Some women i n t h i s study talked about experiences i n therapy that were negative or unsatisfactory. The main outcome of t h e i r experiences was that 155 they could not explore what they knew they needed to explore, and were l e f t f e e l i n g bad about themselves. This r e s t r i c t i o n gave them the message that they were not valuable because t h e i r concerns or needs were not valuable. The l i t e r a t u r e on boundaries validates t h i s finding, and highlights how boundary v i o l a t i o n s occur when the focus s h i f t s to the therapist (Brown, 1994; Peterson, 1992; Smith & Douglas, 1990). Smith and Douglas (1990) p o s i t that i t i s unethical to enter into a power struggle with the c l i e n t by i d e n t i f y i n g her concerns as 'resistance'. This was true f o r E s t e l l e who confronted her therapist with her concerns and her therapist dismissed them as transference. Brown (1994) i d e n t i f i e s guidelines for therapists regarding boundary issues. She comments on the importance of the i n d i v i d u a l i t y of each case and how the therapist's understanding about boundaries comes, in part, from the c l i e n t ' s input about who they are and what they need. Brown i d e n t i f i e d three dynamics for the therapist to watch for: (a) o b j e c t i f y i n g the c l i e n t , (b) acting from impulsivity, and (c) the therapist's needs becoming centre stage. These issues i l l u s t r a t e the way therapists may not be attending to c l i e n t s needs and the uniqueness they express. The findings from t h i s study do not s p e c i f i c a l l y support Brown's concerns but do suggest that women's power i s r e s t r i c t e d by a lack of attention to t h e i r needs. For example, Pam's experience of her therapist yawning and looking out of the window u n t i l Pam expressed something that caused her to give her attention, suggests that the therapist had a need for Pam to be i n t e r e s t i n g . 156 The data from t h i s study a l s o h i g h l i g h t s the r e s t r i c t i o n s t o the development of self-awareness t h a t occur when t h e r e i s a l a c k of a t t e n t i o n g i v e n t o the c i e n t . When the woman i s not g i v e n a t t e n t i o n from her t h e r a p i s t , she i s not encouraged t o focus on h e r s e l f . These f i n d i n g s suggest t h a t the road t o self - a w a r e n e s s and s e l f - a c c e p t a n c e f o r these women i n v o l v e s a number of pr o c e s s e s t h a t compliment each other and expand the woman's view and exp e r i e n c e of h e r s e l f . These processes i n v o l v e the dynamics between the t h e r a p i s t and the c l i e n t but are i n f l u e n c e d by the con t e x t o f the woman's l i f e , i n p a r t i c u l a r , the e f f e c t s of p a t r i a r c h y and the t r a n s f e r e n c e i s s u e s she b r i n g s i n t o therapy. Self-awareness b r i n g s the woman i n t o c o n t a c t w i t h h e r s e l f , and i t i s t h i s c o n n e c t i o n w i t h h e r s e l f t h a t g i v e s her acc e s s t o her power. Pam: ... I f e e l more r e a l i n myself than I ever have b e f o r e , and I f e e l more a l i v e and a p a r t of something ... Cathy: ... t h i s change has happened i n me, t h a t I have t h i s p e r s p e c t i v e t h a t I'm a person, I can s i t t a l l , I'm here, I've a r r i v e d ... Recommendations f o r Therapy Based on the c o n c e p t u a l i z a t i o n o f power t h a t has emerged i n t h i s study and the su p p o r t i n g l i t e r a t u r e , recommendations can be made f o r the p r a c t i s i n g t h e r a p i s t and f o r f u t u r e r e s e a r c h . The recommendations f o r t h e r a p i s t s are presented f i r s t . Therapy P r a c t i s e The i m p l i c a t i o n s from t h i s study f o r t h e r a p i s t s , and how they support women i n a c c e s s i n g t h e i r power, cover a number of 157 areas. The f i r s t area to address i s the e f f e c t of a woman's context on her therapeutic process. I t would appear that the context i s important i n determining how a woman perceives and reacts to the therapist. The issues that a r i s e from the context appear to do so as part of the ongoing therapeutic process. Getting background information at the beginning of therapy may be he l p f u l i n the development of a broad picture, but i t w i l l not determine the s p e c i f i c needs of each woman. For example, i f a woman has suffered abuse, she may view power as con t r o l . This could a f f e c t her i n a number of ways; she could be s e n s i t i v e to any sign of control i n her therapist and perceive the therapist as having power, or because the relat i o n s h i p i s so d i f f e r e n t from her experience, she could perceive her therapist as not having power. The ways i n which the context a f f e c t s each woman can not be predicted. I t i s , therefore, important that therapists remain mindful of t h e i r assumptions and stay open to the i n d i v i d u a l i t y of the woman. As part of the context, i t would appear that women are affected by the oppressive power of patriarchy which l i m i t s who they perceive themselves to be. Women are empowered through becoming aware that they have value and through expanding t h e i r sense of who they are. I t i s important for therapists to counter p a t r i a r c h a l oppression. I t may not be important to be 'educative' about t h i s , but a continual valuing of the woman's needs and aspects of herself changes the oppressive messages that she has in t e r n a l i z e d . In p a r t i c u l a r , valuing those aspects of her female 158 c h a r a c t e r i s t i c s that are seen i n a negative l i g h t expands her experience of herself. Self-awareness i s one of the most important requirements for a woman's empowerment. Awareness occurs on two l e v e l s : (a) how she experiences herself, her feelings, needs, desires, and behaviour, and (b) the ways i n which her l i f e and society have affected and limited her. The way i n which a therapist f a c i l i t a t e these awarenesses should be consistent with a woman's pace and agenda. Awareness can not occur without the woman's connection to the information or experience. Without t h i s , i t remains the opinion or insight of the therapist. I t i s , therefore, important for therapists to f a c i l i t a t e s e l f -d iscoveries. In addition, awareness contributes to an integration of new information into the c l i e n t ' s psyche and sense of being. Another aspect to valuing a l l aspects of a woman i s the need for therapists to give attention to a l l of her fe e l i n g s , including feelings that might be judged as negative, such as, depression, helplessness, and inadequacy. I t i s important for women to discover t h e i r power by learning to deal with d i f f i c u l t f e e l i n g s , rather than f e e l i n g they have to r i d themselves of a part of themselves or depend on someone else to make them f e e l better. S e l f - d i s c l o s u r e was experienced very i n d i v i d u a l l y . Therapists need to be mindful of the differences i n women's reactions to s e l f - d i s c l o s u r e . The most important aspect of the therapists use of s e l f i n the therapeutic process appears to be 159 the expression of genuine caring and acceptance. Thus, i t may be less important to focus on overt s e l f - d i s c l o s u r e . This study also implies that the reactions to s e l f - d i s c l o s u r e could be important information about the woman, and possible material f o r therapeutic work. I t i s , therefore, recommended that therapists explore these reactions and feelings about s e l f - d i s c l o s u r e . In addition, i t would seem that s e l f - d i s c l o s u r e may have the most p o s i t i v e e f f e c t i n the context of a good working a l l i a n c e and the development of t r u s t . From these findings, i t i s important that therapists concentrate on ways to be present with the woman and be with her i n her process. Therapists, especially inexperienced therapists, are often too concerned with techniques and rules that t e l l them how to be good therapists. Techniques do not empower women but the acceptance and attention of therapists do. F i n a l l y , t h i s study supports an e t h i c a l code that recommends against undertaking dual relationships of any sort with c l i e n t s . Therapists are encouraged to focus on women's needs and give attention to t h e i r concerns. Therapists are encouraged to reduce the power d i f f e r e n t i a l by f a c i l i t a t i n g the women's control over t h e i r own processes, and at the same time, maintaining r e s p o n s i b i l i t y and containment for the therapeutic process. Future Research The l i m i t a t i o n s of t h i s study centre around the lack of saturation of the categories and the relationships between them. Due to the l i m i t a t i o n of a masters thesis, i t was not possible to 160 continue sampling to increase the depth of the data. In writing the emergent theory, questions arose which required further t h e o r e t i c a l sampling but these were not explored, leaving c e r t a i n areas of the findings incomplete. The f i r s t of these areas was i n regards to s e l f - d i s c l o s u r e . The study d i d not investigate d i f f e r e n t types of s e l f - d i s c l o s u r e s and the d i f f e r e n t e f f e c t s on the women's power. In addition, comparing therapists' overt and covert use of s e l f i n the therapeutic process would give further information about the importance of s e l f - d i s c l o s u r e i n therapy, and i t s importance to the women's experience of power. The transference relationship emerged as an important aspect of the therapeutic relationship, but i t i s s t i l l unclear exactly how t h i s r e l a t e s to the women's experiences of power. Further research i s needed to explore the connection between the context and the transference relationship, and to investigate the difference i n the women's transference context and other areas of the context. Also, the way i n which the transference issues are dealt with i n the therapeutic process, and the e f f e c t t h i s has on a woman's experience of power, would be important to investigate. Although the data supplied information about the ways i n which therapists block women's power, there was a lack of v a r i a t i o n i n types of experiences and therapeutic r e l a t i o n s h i p s . I t would be important for further research to investigate t h i s area with a focus on experience of power rather than boundary v i o l a t i o n s . 161 Further research could also invest igate t h i s phenomenon using d i f f e r e n t populat ions, such as, women c l i e n t s with male t h e r a p i s t s , l e sb ian c l i e n t s , and male c l i e n t s , and the t h e r a p i s t s ' experience. Conclusion. The data from t h i s study have h ighl ighted a number of areas that are important to a woman's experience of power, and the therapeut ic impl icat ions for therap i s t s . The data show the importance of the dynamics of the therapeut ic r e l a t i o n s h i p to the woman's experience of power i n therapy. The t h e r a p i s t ' s acceptance towards her c l i e n t , and her genuine presence are important i n f a c i l i t a t i n g a woman's empowerment by al lowing her to experience and v a l i d a t e h e r s e l f . This study i d e n t i f i e d a power d i f f e r e n t i a l between the therap i s t and c l i e n t that could e i ther promote an empowering therapeut ic process, or l i m i t and disempower women. In add i t i on , the t h e r a p i s t ' s s e l f - d i s c l o s u r e emerged as a fac tor that could have an e f f ec t on the power d i f f e r e n t i a l . In a l l aspects of the data, the context of a woman's l i f e and experiences had an e f fec t on how they experienced and perceived power. The context re la te s to the v a r i a t i o n s i n experiences wi th in the therapeutic process and the i n d i v i d u a l i s t i c nature of the experiences of power. 162 R e f e r e n c e s . Anderson, S.C., & Mandell, D.L. (1989). The use of s e l f -disclosure by professional s o c i a l workers. S o c i a l Casework: The Journal of Contemporv Social Work, 70(5), 259-267. Avis, J.M. (1991) . Power p o l i t i c s i n therapy with women. In T.J. Goodrich (Ed). Women and power (pp. 183-200). New York: W.W. Norton. Bardwick, J.M. (1976). Some notes about power re l a t i o n s h i p s between women. In A. G. Sargent (Ed.), Beyond sex roles (pp. 125-335). St Paul: West Publishing. Brown, L.S. (1994). Boundaries i n feminist therapy: A conceptual formulation. Women and Therapy.15(1). 29-38. Brown, L., & Brodsky, A.M. (1992). The future of feminist therapy. Psychotherapy, 29(1), 51-57. Burman, E. (1992). I d e n t i f i c a t i o n and power i n feminist therapy. Women's Studies Int. Forum, 15(4), 487-498. Claiborn, C., & Strong, S. (1982). Change through i n t e r a c t i o n : S o c i a l psychological processes of counseling & psychotherapy. Corey, G. (1991). Theory and practise of counseling and psychotherapy. P a c i f i c Grove, CA: Brooks/Cole. Douglas, M.F. (1985). The role of power i n feminist therapy: A reformulation. In Rosewater, L.B., & Walker, L.E.A. (Eds.), Handbook of feminist therapy (pp. 241-249). New York: Springer. French, J . , & Raven, B. (1959). The bases of s o c i a l power. In D. Cartwright (Ed.). Studies i n s o c i a l power (pp. 15-167). Ann Arbor: University Of Michigan I n s t i t u t e of Soc i a l Research. Gelso, G.J., & Carter, J.A. (1985). The re l a t i o n s h i p i n counseling and psychotherapy: Components, consequences, and th e o r e t i c a l antecedents. The Counseling Psychologist. 13(2), 155-243. G i l l i g a n , C. (1982). In a d i f f e r e n t voice: Psychological theory and women's development. Cambridge: Harvard University Press. Glaser, B.G., & Strauss, A. (1967). The discovery of grounded theory: Strategies for q u a l i t a t i v e research. Chicago: Aldine. 163 Greenson, R.R. (1967). The technique and pra c t i s e of psychoanalysis (Vol. 1). New York: International University Press. Greenspan, M. (1983). A new approach to women and therapy. New York: McGraw-Hill Books. Horvath, A., & Greenberg, L. S. (1986). The development of the working a l l i a n c e inventory. In L.S. Greenberg & W.M. Pinsoff (Eds.), The psychotherapeutic process: A research handbook (pp.529-556). New York: G u i l f o r d Press. Horvath, A., & Greenberg, L. S. (1989). Development and va l i d a t i o n of the working a l l i a n c e inventory. Journal of Counseling Psychology. 36. 223-233. Homans, G. C. (1974). Social behaviour: The elementary forms. New York: Harcourt Brace Jovanovich. Johnson, P.B. (1976). Women and power: Toward a theory of effectiveness. Journal of Social Issues. 32. 99-110. Johnson, P.B. (1978). Women and interpersonal power. In Frieze, I.H., et a l . Women and sex ro l e s : A s o c i a l psychological perspective. New York: W.W. Norton. Jordan, J.V., Kaplan, A.G., M i l l e r , J.B., Stiver, I.P., & Surrey, J.L. (1991). Women's growth i n connection. New York: Guildford Press. Jordan, J.L. (1991). Empathy, mutuality, and therapeutic change: C l i n i c a l implications of a r e l a t i o n a l model. In Jordan, J.V., et a l . (Eds.), Women's growth i n connection. (pp. 283-289) New York: Guildford Press. Khan, M. (1991). Between therapist and c l i e n t : The new rela t i o n s h i p . New York: W.H. Freeman and Company. Laidlaw, T., & Malmo, C. (1991). Feminist therapy. Canadian Journal of Counseling. 25(4). 392-406. Lander, N.R., & Nahon, D. (1992). Betrayed within the therapeutic relationship. The Psychotherapy Patient. 8(3-4), 113-125. Lerman, H. & Porter, N. (1990). Feminist ethics i n psychotherapy. New York: Springer. Lips, H. M. (1991). Women, men, and power. Mountain View, CA: Mayfield. Luborsky, L: (1976). Helping a l l i a n c e s i n psychotherapy. In 164 J.L. Claghorn (Ed) Successful psychotherapy, (pp. 92-111). New York: Brunner\Mazel. Lubrosky, L., Crits-Christoph, P., Alexander,L., Margolis, M. , & Cohen, M. (1983). Two helpf u l a l l i a n c e methods for pre d i c t i n g outcomes for psychotherapy. Journal of Nervous and Mental Disorders. 171. 480-491. Maccoby, E.E., & Jack l i n , C.N., (1974). Psychology of Sex Differences. Stanford, CA: Stanford University Press. Margolies, L. (1990). Cracks i n the frame: Feminism and the boundaries of therapy. Women & Therapy. 9. 19-36. Mathews, B. (1989). The use of therapist s e l f - d i s c l o s u r e and i t ' s p o t e n t i a l impact on the therapeutic process. Journal of Human Behaviour and learning. 6(2). 25-29. McClelland, D. (1975). Power: The inner experience. New York: Irvington. M i l l e r , J.B. (1986). Toward a new psychology of women. Boston: Beacon Press. M i l l e r , J.B. (1991). Women and power. In Jordan, J.V., et a l . (Eds.), Women's growth i n connection, (pp.197-205) New York: Guildford Press. Neilson, L.A. (1988). Substance abuse, shame and professional boundaries and ethics: Disentangling the issues. Alcoholism Treatment Quarterly. 4(2), 109-137. Palombo, J . (1987). Spontaneous s e l f - d i s c l o s u r e i n psychotherapy. C l i n i c a l Social Work Journal. 15. 107-119. Reandeau, S.G., & Wampold, B.E. (1991). Relationship of power and involvement to the working a l l i a n c e : A multiple-case sequential analysis of br i e f therapy. Journal of Counseling Psychology. 18(2), 107-114. Rennie, D.L., P h i l l i p s , J.R., & Quartaro, G.K. (1988). Grounded theory: A promising approach to conceptualization i n psychology. Canadian Psychology. 29(2) , 139-150. Simon, J.C. (1988). C r i t e r i a for therapist s e l f - d i s c l o s u r e . American Journal of psychotherapy. 3. 404-415. Simon, R.L. (1989). Sexual exploitation of patients: How i t begins before i t happens. Psychiatric Annals. 19. 104-112. Smith, A.J., & Siegal, R.F., Feminist therapy: Redefining power for the powerless. In Rosewater, L.B., & Walker, L.E.A. 165 (Eds), Handbook of feminist therapy (pp. 13-22) . New York: Springer. Strasburger, H.L., Jorgenson, L., & Sutherland, P. (1992). The prevention of psychotherapist sexual misconduct: Avoiding the slippery slope. American Journal of Psychotherapy, 46(4), 544-555. Strauss, A.L., & Corbin, J.M. (1990). Basics of q u a l i t a t i v e research: Grounded theory procedures & techniques. Newbury Park, CA: Sage. Strupp, H.H., & Hadley, S.W. (1979). S p e c i f i c versus nonspecific factors i n psychotherapy. A controlled study of outcome. Archives of General Psychiatry, 36. 1125-1136. Surrey, J.L. (1991). Relationship and empowerment. In Jordan, J.V., et a l . (Eds.), Women"s growth i n connection (pp. 162-180) New York: Guildford Press. Tansey, M.J. (1992). Psychoanalytic expertise. Psychanalytic Dialogues. 2. 305-316. Wells, T.L. (1994). Therapist s e l f - d i s c l o s u r e : I t ' s e f f e c t s on c l i e n t s and the treatment rel a t i o n s h i p . Smith College for Soc i a l Work. 65(1). 23-41. Wilson, C. (1991). Women's conceptions of power. Unpublished master's thesis, University of B r i t i s h Columbia, Vancouver, Canada. Winter, D.G. (1973). The power motive. New York: The Free Press. Worell, J., & Remer, P. (1992). Feminist perspective i n therapy: An empowerment model f o r women. Chichester, New York: Wiley. A P P E N D I X A L A P P E N D I X B ni A P P E N D I X C
Thesis/Dissertation
eng
Counselling Psychology
Vancouver : University of British Columbia Library
For non-commercial purposes only, such as research, private study and education. Additional conditions apply, see Terms of Use https://open.library.ubc.ca/terms_of_use.
Graduate
Women’s experience of power in therapy with a women therapist
Text