A Grammar of Power in Psychotherapy : Exploring the Dynamics of Privilege

This book reveals four common patterns of interaction in the therapy partnership, and explains how social power dynamics influence those patterns. Societal issues based in power and privilege inevitably enter the therapy room. In this book author Malin Fors offers an intersectional grammar to unmask the hidden dynamics. Integrating theory, research, and a wealth of clinical narratives, Fors explores four core situations: when therapist and patient have similar levels of social power, when either therapist or patient has more privilege relative to the other, and when both therapist and patient have similar levels of nonprivilege. This fresh synthesis-for which the author was awarded the 2016 APA Division 39 Johanna K. Tabin Book Proposal Prize-offers new language for understanding power dynamics in psychotherapy, counseling, and all treatment relationships. Clinical topics explored include voluntary and involuntary self-disclosure, visible and invisible similarities between patient and therapist, internalized oppression, and choosing whether or not to address privilege explicitly, among many others. Nancy McWilliams contributed the Foreword to this book, which gives professionals from any therapy orientation a helpful framework for aligning their desire for social justice with healing interactions around race, gender, sexuality, ability, class, age, and other differences. This integrative work will help clinicians address unique challenges that arise when privilege and power differences-often unrecognized-enter the therapy room. It focuses on four core clinical situations: when therapist and patient have similar levels of social power, when either therapist or patient has more privilege relative to the other, and when both therapist and patient have similar levels of non privilege "This book sheds light on how underlying patterns of societal power relations affect the patient-therapist dyad in psychotherapy and psychoanalysis. It is an effort to understand, and ideally to reduce, clinical blindness in psychotherapy. The book systematically addresses unique therapeutic challenges in four different core therapeutic dyads of relative privilege: when therapist and patient share the same social privilege, when privilege favors the therapist, when privilege favors the patient, and when therapist and patient have a similar level of nonprivilege. It explores relevant clinical patterns and dynamics in each of the four core fields of relative privilege and will be helpful in the teaching of issues of diversity, cultural competency, social justice, and awareness of privilege. The book is divided into eight chapters. The first chapter provides an overview of the key concepts discussed in the book. Chapter two introduces readers to the complexities and inconsistencies of privilege and subordination, endeavoring to invite curiosity and self-reflection about one's own privileges and complexities. Each of the subsequent chapters explores, using vignettes, one square from the matrix: Chapter three describes similarity of privilege; Chapters four and five discusses privilege favoring the therapist and privilege favoring the patient; Chapter six explores the situation of similarity of nonprivilege. Chapter seven recounts a longer case that illustrates the complexity of fighting sexism and finding repair in political interpretation. Chapter eight presents a summary and integration of the ideas that have previously arisen with respect to the different relative power situations."--Preface. (PsycINFO Database Record (c) 2018 APA, all rights reserved) This book explores how social power differences influence the therapy partnership. It offers research and clinical examples to help therapists become aware of privilege, and take steps to address power-related issues in therapy. Societal issues based in power and privilege inevitably enter the therapy room. In this book, Malin Fors offers an intersectional grammar to unmask the hidden dynamics. Integrating theory, research, and a wealth of clinical narratives, Fors explores four core situations: when therapist and patient have similar levels of social power, when either therapist or patient has more privilege relative to the other, and when therapist and patient have similar levels of nonprivilege. This fresh synthesis offers new language for understanding power dynamics in psychotherapy, counseling, and all treatment relationships. Clinical topics explored include voluntary and involuntary self-disclosure, visible and invisible similarities between patient and therapist, internalized oppression, and choosing whether or not to address privilege explicitly, among many others. Dedication 6 Contents 8 Foreword • Nancy McWilliams 10 Acknowledgments 14 Prologue 18 1. Our Blind Spots in Therapy 26 2. Dynamics of Power and Privilege 32 3. Similarity of Privilege 62 4. Privilege Favoring the Therapist 80 5. Privilege Favoring the Patient: Confused Subordination in Therapy 120 6. Similarity of Nonprivilege 148 7. Distortions in the Matrix of Relative Privilege 168 8. Afterword: The Unthought Known 180 Appendix: Suggested Themes for Further Reflection 184 References 190 Index 210 About the Author 220 This integrative work will help clinicians address unique challenges that arise when privilege and power differences,often unrecognized, enter the therapy room. It focuses on four core clinical situations: when therapist and patient have similar levels of social power, when either therapist or patient has more privilege relative to the other, and when both therapist and patient have similar levels of non privilege