Critiquing the "Psychiatric Paradigm" Revisited: Reflections on Feminist Interventions in Mental Health

I still remember my first meeting with Jeri Wine. It was the fall of 1986 and I was visiting Toronto from the west coast. The notion of going to graduate school had just begun to take form in my mind and I was in Toronto to investigate what was reputed to be a fabulous feminist program in Community Psychology at the Ontario Institute for Studies in Education. In Vancouver I had recently completed a degree in Psychology and simultaneously had become involved in feminist anti-violence activism working for the WAVAW Rape Crisis Centre. The gap between what I was learning in my classes at the university and the stories I heard from women at the other end of the crisis line about their experiences of violence disturbed and troubled me. So many of these women had stories about how they had been disbelieved by mental health professionals when they had disclosed experiences of sexual and physical abuse. Others, who were clearly having reactions to the trauma they had experienced, appeared to have been misdiagnosed as mentally ill. On occasion, women had mental health problems that pre-existed experiences of violence or which made them more vulnerable to abuse. Violence was not the only thing that marked many of these women's lives - poverty and experiences of racism and homophobia were also evident. I asked myself, how could the material I was learning in my upper level psychology classes be so far removed from the actual lives and experiences of women? More specifically how could the discipline of psychology proceed as though social differences like gender, race, sexual orientation and class were inconsequential variables only mentioned occasionally or relegated to small separate sections in one or two of our psychology texts? Several distinct memories come to mind: a social psychology class where we are told that men experience more violence and crime than women and where the subject of intimate violence is never broached; a class on clinical psychology where sex and race differences related to psychiatric diagnosis are never mentioned much less interrogated for their meanings; a class on the history of psychology where Freud's sexist ideas about women's bodies and sexuality are presented as quaint and outmoded but never discussed in relation to the unwitting legacy he left regarding the massive denial of the role that childhood sexual abuse plays in the lives of women. One welcome departure from this was the lone course on the psychology of sex differences where those of us who suspected that gender, race, sexuality and social positioning were relevant to one's psychological development and one's experience of illness gathered. It was in this class that I began to suspect more ominously that the disciplines of psychiatry and psychology were not always the concerned helping professions they purported to be and were not based on objective science but rather contained deeply held biases that often led them to function in ways that perpetuated social inequity. This deepening realization caused me to abandon my original plans to become a clinical psychologist and I might well have become a full time activist and advocate for women, except for the nagging sense that crisis work, however grounded in women's experiences, would never allow the reflection required to more fully understand the complex social issues I was now grappling with. I was left searching for a graduate program that might allow for a critical discussion of the ways in which women and men's lives are not just biologically and psychologically, but also socially, determined. It was this that led me to Jeri Wine's office on that crisp fall day and it was in her office that I began to realize that there were individuals who had dedicated their lives and careers to critically appraising the ways in which the psychological professions have pathologized women. Jeri, I soon discovered, was one of those unique individuals. The first gift she gave me was to validate my disquiet concerning the disjuncture between what I had been taught in psychology at university and the experiences of women that I witnessed during my time as a rape crisis worker. …

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