Trauma-informed Feminist Therapy
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In psychology, Trauma-informed feminist therapy is a model of trauma for both men and women that incorporates the client's
sociopolitical Political sociology is an Interdisciplinarity, interdisciplinary field of study concerned with exploring how governance and society interact and influence one another at the micro to macro Level of analysis, levels of analysis. Interested in the ...
context. In
feminist therapy Feminist therapy is a set of related therapies arising from what proponents see as a disparity between the origin of most psychological theories and the majority of people seeking counseling being female. It focuses on societal, cultural, and p ...
, the therapist views the client's trauma experience through a sociopolitical lens. In other words, the therapist must consider how the client's social and political environment could have contributed to their trauma or perpetuated it. Feminist theory argues that certain traumas are produced and maintained by
institutionalized discrimination Institutional discrimination is discriminatory treatment of an individual or group of individuals by society or institutions, through unequal consideration of members of subordinate groups. These unfair and indirect methods of discrimination are o ...
and
social hierarchies A hierarchy (from Greek: , from , 'president of sacred rites') is an arrangement of items (objects, names, values, categories, etc.) that are represented as being "above", "below", or "at the same level as" one another. Hierarchy is an important ...
.


Background

The diagnosis of
Post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
, or PTSD, was first recognized in 1980 and published in the third edition of the ''
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
''. The original PTSD diagnosis was formulated to fit the
symptomology Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
of veterans returning home from combat. Feminist psychologists modified the diagnosis when treating patients with exposure to childhood sexual assault, chronic
abuse Abuse is the improper usage or treatment of a thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other t ...
, and gender-based trauma. Trauma-informed feminist therapy challenged both the traditional conceptualization of the PTSD diagnosis, as well as the overall standard approach to trauma treatment, by proposing new models of trauma that incorporate sociopolitical context. Feminist therapy began in the 1960s during the
second wave of feminism Second-wave feminism was a period of feminist activity that began in the early 1960s and lasted roughly two decades. It took place throughout the Western world, and aimed to increase equality for women by building on previous feminist gains. W ...
. According to its proponents, a
sexist Sexism is prejudice or discrimination based on one's sex or gender. Sexism can affect anyone, but it primarily affects women and girls.There is a clear and broad consensus among academic scholars in multiple fields that sexism refers primaril ...
power structure in American psychotherapy was harmful to women suffering trauma. Initially, groups of women began to meet at leader-less "
consciousness-raising Consciousness raising (also called awareness raising) is a form of activism popularized by United States feminists in the late 1960s. It often takes the form of a group of people attempting to focus the attention of a wider group on some cause or ...
," meetings where women shared their experiences with sexism in therapy. Many women evoked opinions that oppressive
cultural norms Social norms are shared standards of acceptable behavior by groups. Social norms can both be informal understandings that govern the behavior of members of a society, as well as be codified into rules and laws. Social normative influences or soc ...
affect mental health. To them, the groups acted as a way to both draw attention to the oppression within the mental health system, as well as a way to empower women. The original consciousness-raising meetings evolved into an integrated set of principles to be applied in therapy. Today, feminist therapy has expanded to reflect the ideas of the
third wave of feminism Third-wave feminism is an iteration of the feminist movement that began in the early 1990s, prominent in the decades prior to the fourth wave. Grounded in the civil-rights advances of the second wave, Gen X and early Gen Y generations third-wav ...
, that the patriarchy is harmful to both men and women. Another part of feminist therapy is a focus on social justice issues for people, regardless of their gender, culture,
sexuality Human sexuality is the way people experience and express themselves sexually. This involves biological, psychological, physical, erotic, emotional, social, or spiritual feelings and behaviors. Because it is a broad term, which has varied ...
, social class,
phenotype In genetics, the phenotype () is the set of observable characteristics or traits of an organism. The term covers the organism's morphology or physical form and structure, its developmental processes, its biochemical and physiological proper ...
, or national origin.


Feminist models of trauma

Feminist theory argues that certain traumas are produced and maintained by institutionalized discrimination and social hierarchies Root (1992) coined the term "insidious traumatization," to describe the distress that builds when one is the member of a
marginalized group Social exclusion or social marginalisation is the social disadvantage and relegation to the fringe of society. It is a term that has been used widely in Europe and was first used in France in the late 20th century. It is used across discipline ...
and subjected to constant threat of
discrimination Discrimination is the act of making unjustified distinctions between people based on the groups, classes, or other categories to which they belong or are perceived to belong. People may be discriminated on the basis of race, gender, age, relig ...
. Exposure to insidious trauma is thought to creates both unique vulnerabilities and unique strengths. Feminist theory argues that insidious traumatization can lead to full blown PTSD symptoms. Freyd (1996) expanded the idea of insidious traumatization to include the term "betrayal trauma," to describe the specific kind of trauma that occurs when a child is abused by their
caregiver A caregiver or carer is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commo ...
s; Feminist theory argues that betrayal trauma is inherently different from single-incident trauma, mainly because betrayal trauma tends to manifest specifically as interpersonal difficulties and dissociative symptoms, while traditional intrusive symptoms are usually not present.


Trauma diagnosis within feminist therapy framework

Overall, feminist theory argues against the use of diagnoses, except in instances where a
diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
would assist the service user in gaining access to
mental health care A mental health professional is a health care practitioner or social and human services provider who offers services for the purpose of improving an individual's mental health or to treat mental disorders. This broad category was developed as a ...
. Feminist therapy aims to move away from pathologizing responses to trauma in favor of framing responses as "survival techniques." For example, in regard to diagnoses that relate to trauma, feminist theory takes issue with the diagnosis
Borderline Personality Disorder Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong ...
(BPD), a disorder that is often linked to severe
childhood trauma Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and ...
. Feminist theory posits that a diagnosis of BPD, unnecessarily pathologizes
normative Normative generally means relating to an evaluative standard. Normativity is the phenomenon in human societies of designating some actions or outcomes as good, desirable, or permissible, and others as bad, undesirable, or impermissible. A norm in ...
and adaptive responses to betrayal trauma. In addition, feminist theory argues that chronic exposure to inescapable trauma, such as childhood abuse, is better captured by the diagnosis of
Complex Post-Traumatic Stress Disorder Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma disorder) is a psychological disorder that is theorized to develop in response to exposure to a series of traumatic events in a context in which the individual perceive ...
(CPTSD); CPTSD has been proposed as an alternative diagnosis for those responding to sever trauma with BPD-like symptoms, in an attempt to view symptoms as a survival response as opposed to a
personality disorder Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture ...
.


Trauma treatment with feminist therapy framework

Trauma-informed feminist therapy encourages therapists to take an eclectic approach to trauma treatment, allowing the service user to be the expert of their own experience. Feminist therapy seeks to break down what it terms the inherent power differential between
clinician A clinician is a health care professional typically employed at a skilled nursing facility or clinic. Clinicians work directly with patients rather than in a laboratory or as a researcher. A clinician may diagnose, treat, and otherwise care for pa ...
and client, by actively constructing an egalitarian relationship. In addition, feminist therapists strive to understand their client's experience with trauma by acknowledging and exploring how
social structure In the social sciences, social structure is the aggregate of patterned social arrangements in society that are both emergent from and determinant of the actions of individuals. Likewise, society is believed to be grouped into structurally rel ...
influenced the trauma. Trauma-informed feminist therapy argues that successful treatment is not about creating an absence of symptoms; instead feminist therapy aims to assist trauma survivors in creating a non-blaming view of their traumatic experience from which they can gain a sense of
empowerment Empowerment is the degree of autonomy and self-determination in people and in communities. This enables them to represent their interests in a responsible and self-determined way, acting on their own authority. It is the process of becoming strong ...
.


References

{{DEFAULTSORT:Trauma-informed feminist therapy Traumatology Feminism Post-traumatic stress disorder