Conversations with the Founders of the Women's Project on the Integration of Gender and Culture in Family Therapy Training

Marianne Walters Shelley

As you look back over the past twenty years as the field began to grapple with integrating the organizing principles of gender, culture, and power in its training programs, what are your reflections on this process?

Marianne

I think that there has been a sensitization-in the field and in the larger culture-to the issues of gender, culture, ethnicity, race, sexual orientation, and power. But, it is a mistake to think that we have integrated these concepts in our practice or training programs. In general, the field has treated these issues quite separately. There have been special classes, workshops, and conferences, particularly intended to sensitize people to the issues of gender, sexual orientation, 124race, and class. There also have been parts of curriculum specific to these issues in training programs. The topics have been raised, but not yet really integrated into everything that we do. But, we have come a long way in terms of recognizing that there are issues of gender, race, ethnicity, class, and sexual orientation; earlier, we only looked at the intra-dynamics of a family.

Shelley

Do you have other reflections or comments on the field’s development with regard to training?

Marianne

As far as I can see, we are training people primarily in techniques. Depending upon the particular banner under which you received your training–whether it is called solution-focused, cognitive-behavioral, structural, integrative, or narrative–you learn some specific and concrete techniques. There has been more and more of an effort to add more techniques. There seems to me to be “the flavor of the week”–one new technique after another, EMDR, Imago. We learn this and then we learn that. I find that the techniques are devoid of ideology. What ideology underlies them? For instance, do the techniques have anything to do with how we understand the impact of homophobia or racism on families, on people? I worry about this proliferation of a technological way of thinking in our field. I understand that it certainly reflects our culture–where life is increasingly more technologically dependent–but I think it reduces the power of relationships and the artistry of therapy to a series of techniques. This is my general concern at this point.

Shelley

What would you like to see instead?

Marianne

I would like to see more critical thinking. I have been amazed to find that I will speak to an audience that seems to be very much “in tune” with and like what I am saying and the tapes that I show. Then, they listen to the next person who is diametrically different from me–who thinks differently, who has a different ideology, who has a different way of working, or who in fact can be quite 125sexist–and they love that, too. I have seen huge audiences look at work either of mine or someone else’s and not be critical of what is being presented in terms of gender, culture, homophobia–power relationships. They focus on the technique, but there is not much critical thinking.

Shelley

Are you saying that the focus is on the presumed out-come–on what supposedly worked–rather than the process? Or, that the focus is on solving the presenting problem rather than on the messages that are given to the clients?

Marianne

Yes. Very well put. We need to consider at whose expense was the problem supposedly solved. As therapists, we need to develop an ideology that guides our work-one that integrates gender and culture. One of few places that integrates gender and culture is my Center–the Family Therapy Practice Center. We do not raise these issues as special or hold a special class on them. Rather, these issues are part of everything we say and do–integrated into every case, every situation, every presentation, and every conference. All of our supervision and training incorporates this ideology–an ideology that the field as a whole has not yet developed.

Shelley

I would like to hear more about specifically how you train at your Institute–is that what you called it?

Marianne

The Family Therapy Practice Center. We call it The Center–as in “the Center of the Universe” (chuckle).

Shelley

Are you the “center” of the Center?

Marianne

The sun.

Shelley

Could you describe how you train at your Center?

Marianne

My training is all case based. My faculty and I do only one full-day didactic presentation to orient new trainees to our way of working and thinking. We move quickly to 126seeing families using live supervision and reviewing videotapes. We work from “inside out”–from the case to the thinking. Even when we train in welfare departments, or foster care and child protective service agencies, we do some orientation, but mostly we develop the thinking out of the work. By this I mean that we talk with our trainees to elicit their attitudes and assumptions–their belief systems–about what constructs behavior and what constructs change. For instance, if we are going to see a single, twice-divorced mom with a sexually acting out daughter–a daughter that she conceived when she was sixteen–we ask what the therapists are thinking. What are their assumptions? Do they think that the child is repeating family patterns by sexually acting out like her mother did when she was sixteen? Is that what they think? And, if so, why? Then, we begin to challenge this thinking. Our thinking is not about repeated patterns of family behavior. We think in terms of culture and a society that pushes young women–particularly those who are in a financially deprived situation or who are members of an at-risk family lacking social supports and so on–to engage in sexual behavior. We also are looking at the fact that this child could not be sexually active if boys were not encouraging that kind of behavior. Ninety percent of our trainees would initially say that this daughter is repeating her mother’s pattern. It is this kind of thinking that we would begin to challenge.

Shelley

Where does this thinking about repeating family patterns come from–our training programs?

Marianne

Not necessarily; these kind of assumptions are not just in our training programs or our field. If you read the current or past issues of Harper’s, Good Housekeeping, or any popular magazine, you can see that the current common wisdom is that children repeat the patterns of their parents. For instance, we believe that children who are abused frequently abuse their own children. It is far more complex.

127Shelley

What you do in your training, then, is to help trainees articulate these cultural assumptions or beliefs as they pertain to a particular case, and then challenge these beliefs. Is that correct?

Marianne

Yes. This is what I mean by ideology–what are your priorities? What are your concerns? How do you understand socialized roles and rules? Where do you help a family to look at the possibilities and the options for change–within or without, or both? It is not that we cannot work with what is going on in the family–obviously we must and we do–but we have to enter that kind of work in a non-linear way; in other words, rather than the family as the locus of problems, let us look at the gendered, ethnic, or economic construction of relationships and how these operate within a family.

The whole notion of dysfunction has been so trivialized that dysfunctional can be anything from benign neglect of children to a beating. We do not know what dysfunctional means anymore. For instance, I am finding out that an awful lot of young women–unmarried women who are in their late thirties who are high-powered professionals, attractive, wonderful, lots of friends–who are miserable because they are not married and their biological clock is running out. When you ask them why don’t they have a kid if they want a family, the idea has not even occurred to them. It seems so impossible because in our culture, you do not have children without marriage. Well, why don’t you? If you want a child and you are financially able, healthy, and a loving person, then have a child. If we are not critical thinkers and have not developed an ideology, we start working with this kind of woman in terms of what kind of family did she come from, why is she having trouble with relationships, what are her boundary issues, or God knows what. Let us, at least, consider cultural inhibitors; the social messages that construct behavior.

Shelley

So, you are saying that as therapists, we should not accept 128these cultural “myths” about how we should lead our lives. We should become critical thinkers–even about issues that many would argue are accepted traditions of our culture, such as “marriage comes before babies.”

Marianne

Yes. And it is important to remember that these traditions are very much a part of professional lives. Many of the people who read this journal belong to an organization called the American Association of Marriage and Family Therapy. The title indicates that “marriage” and “family” are attached, and does not recognize that marriage is not allowed to 10% of our population. So, it is a discriminatory institution. We would never belong to an organization that was called “marital and family therapy” if only those who could marry were white. This is what I mean by critical thinking.

Shelley

How do you teach this kind of critical thinking at the Center?

Marianne

We are always talking and thinking about these issues. As we talk about marriage, we ask: Why marriage? What about divorce, and is it a problem? Why is it a problem? When is it a success? When does it show intelligence, thoughtfulness, and a taking care of one another in life? Do children need two parents? Why? What do we expect of our children? Do we have different expectations of boys and girls? Why? We challenge all the assumptions that our culture and therapists have about the families that we see.

Shelley

How do you teach trainees to take what they have learned from these conversations into the room with clients?

Marianne

We talk a lot about the use of self–about using your wisdom and experiences as a grown-up person. We use a lot of coaching or scripting. We might say, “Here is something you might say,” or “Here is one way you could approach this guy.” We offer a lot of scripts; we do not ask trainees what they think they should do with the 129client, unless we think they have a real answer. We never ask them the question that we do not want them to ask their clients, which is, “What do you think you should do?” Clients come to therapy not knowing how to do something or what to do next. So, for therapists to ask them, “How could you control your daughter?” seems to be a foolish question. If they knew, they would not be here. That is how we begin to apply notions of competence.

We also do not teach trainees to discuss these issues–society, or culture, or homophobia–with their clients. Instead, we teach them to enact them, and we offer specific ideas about how to enact them. We teach them to talk with people about how they are reacting to or dealing with various issues that come up within their lives. You are working with the family; you are not working on society.

Shelley

How might you teach a trainee to enact these issues with the previous case you were describing–the one with the mother and the daughter who was sexually active?

Marianne

The first thing that we would do is to talk about how alike these two are in wonderful ways. For instance, we would look at the way they interact with each other and find the first time when the mother and daughter laugh at the same things or share an idea about a film that they saw recently. We would begin to point out where this mother and daughter have really good connections and good values. Then, we would begin talking with the mother about how she can help her daughter to negotiate the minefield that is out there for any young, beautiful, attractive girl. The mother has survived this minefield; we ask her to help her daughter to cope with a minefield that says that to be attractive, you have to have a boyfriend and have sex with him.

We first talk about their connectedness. We would not focus on being sexually dysfunctional, but about the 130wonderful things that they have in common–maybe they share a dimple, beautiful black hair, or a smile. You first establish the connectedness on something other than the sexuality, and then you go for the mother’s capacity as a survivor, and her strengths.

Shelley

Do you ever experience resistance to this ideology in training? And, if so, how do you handle it?

Marianne

Yes, I love resistance. I worry if there isn’t any resistance because it means that the ideology isn’t being integrated or taken in. But, when there is resistance, we discuss it. As people often do when you have any ideology, they bring up the exceptions–well, that isn’t true in this situation or the people that I have met are not like that. We talk about it; I might agree that there are exceptions, but I am adamant about how I think. We have differences that we discuss, and we end the discussion by saying, “I am right, and you are wrong” (chuckle). And, we do a lot of laughing and eating, and people get very connected with one another.

Shelley

Previously, you mentioned that you focus on the use of self in your training. How do you work with trainees in this regard?

Marianne

I always ask my trainees these questions: “What about you turns other people on? How do you turn people on? When you enter a crowded room at a party, how do you attract people? How do you get people to trust you, think you’re smart, think you are funny, attractive, or interesting? What do you do?” I have them talk about their answers because it is a stunner. No one wants to say, “Well, I do this and that” But, all of that has to go into the room with you–that is your technique. Most people do not want to think that they do something to attract other people or make themselves attractive or engaging to other people. That is one of the first things I say to people when we talk about use of self-how do you get 131noticed, how do you convince someone that you know something, how do you present your ideas.

Shelley

What a thought-provoking question! Unfortunately, it is time to close. What closing message or comments would you like to say to trainers or trainees who are committed to continuing this work in their training programs?

Marianne

Do not make race, class, gender, sexual orientation separate issues. Find ways to make these a part of your every day living, your every day work, your every day thinking. Then, think of new kinds of ways of working that fit within this ideology. Do not do it the opposite way; that is, think of new techniques and then think of how they fit. Always have a context from which you figure your interventions rather than just thinking up techniques.

Shelley

Thank you, Marianne, for your many significant contributions to our field over the years. It is my hope that we can follow in your footsteps, finding ways to truly integrate gender and culture in every case, conversation, and interaction.