Abstract
This article reports on a study that used qualitative interviews with 10 social workers about their therapeutic practice with women who were sexually abused as children. It explores two dominant discursive themes that were identified in the analysis: normalizing the effects of childhood sexual abuse and gender power in practice. The analysis found that while engagement with narrative therapy brings a strong emancipatory orientation, normalizing the effects of abuse by distinguishing them from “real” mental illness comes at the cost of restigmatizing other groups of clients, and dualistic understandings of feminism and post-structuralism narrow engagement with the complex ways in which gender power operates in women’s lives.
Child sexual abuse is a widespread social problem that negatively affects many individuals who are subjected to it, as well as their families and society more generally (Wurtele, 2009). Second-wave feminists placed it on the political agenda in the 1960s and 1970s, challenging a long history of silencing and repression (Breckenridge, 1999) and making visible the connection between male privilege and the abuse of women and children (Reavey & Warner, 2003). Feminists were also instrumental in highlighting sexual abuse as a social and political problem, rather than a personal experience confined to a few unfortunate individuals (Breckenridge, 1992, 1999; Carmody, 1997). As a result, Western societies have only relatively recently begun to engage in conversations about child sexual abuse (Southwell, 2003; Tomison, 1995), including a growing awareness of the often-significant impact of abuse on mental health and the need for appropriate therapeutic services (Sachs-Ericsson et al., 2010). These shifts have had major implications for the helping professions that are involved in responding to child sexual abuse, including the ways in which they respond to the ongoing effects of past child sexual abuse in women. Given the profession’s historical role in child protection, social workers continue to play a key role in this area.
Although there is no one feminist theory, all feminist perspectives are concerned with the oppression of women (Orme, 2002; Payne, 2005), and feminists have been able to offer a solid explanation for child sexual abuse and its gendered asymmetry. As Rush (1974, p. 73) argued, “the sexual abuse of children who are overwhelmingly female, by sexual offenders, who are overwhelmingly male adults, is part and parcel of the male dominated society which overtly and covertly subjugates women.” Feminist work with women in this context has therefore located child sexual abuse in a political and societal context in which gender privilege is played out (Astbury, 2006; Seymour, 1998). Feminist social work approaches to working with abused women that have been historically associated with these feminist insights include consciousness-raising and group work in which women’s own voices are privileged over those of social workers and incorporate values of mutuality, respect, and collaboration, while also seeking to highlight the commonality of women’s experiences and situate them in their social context (Dietz, 2000).
Although it was successful in placing child sexual abuse on the political agenda, structural, or second-wave, feminism has nevertheless been criticized for offering an oversimplified, universalist account of the issue (Crinall, 1999; Scott, 2001) that does not address differences related to class, race, and sexuality (Reavey & Warner, 2003). It has also been criticized for its inability to explain why only some men take advantage of their privilege (Seymour, 1998). These tendencies have led many women within and outside Western cultures to feel misunderstood, marginalized, and ultimately excluded from the very movement that was supposed to represent them (Reavey & Warner, 2003). It was this exclusion that encouraged some feminists to turn to post-structuralism for different ways of theorizing diversity and commonality, including those concerned with understanding and intervening in abuse (Reavey & Warner, 2003). Post-structural feminists argue that child sexual abuse takes place in a sociocultural setting in which “truth” is subject to a wide range of interpretations (Hacking, 1995, cited in Reavey & Warner, 2003, p. 1), language is central to the production of social reality (Weedon, 1997), and meaning is fluid and changing rather than fixed (Reavey, 2003). Gender and power are also understood in this way and are not estranged from questions of class, race, and sexuality (Reavey & Warner, 2003). These shifts in feminist theorizations of abuse are also reflected in shifts in the ways in which the helping professions respond to child sexual abuse and its effects.
Child Sexual Abuse and the Helping Professions
A diversity of helping professions in addition to social work are involved in providing counseling and support to women who were sexually abused as children, resulting in a wide range of different interventions and services and a growing literature on clients' experiences of them (see, e.g., Agar & Read, 2002; Fergus & Keel, 2005). Although research has suggested that many interventions are helpful, clients have reported that some interactions with professionals can contribute to retraumatization (Hooper & Warwick, 2006), which has the potential to reinforce their original subjugation through abuse (Hooper & Koprowska, 2000). Indeed, while there has been growing awareness of the potentially far-reaching effects of child sexual abuse for some, individuals who speak about their experiences often “find themselves positioned as other, damaged and different” (Profitt, 2000 cited in Hooper & Warwick, 2006, p.471). Psychiatric and psychological approaches in particular often focus on diagnosing individuals with a variety of mental disorders, such that they are individually pathologized and their life stories are regulated in particular ways (O’Dell, 2003; Reavey & Gough, 2000), while treatment becomes focused on the management of symptoms through various psychological therapies (see, e.g., Chard, 2005; Hetzel-Riggin, Brausch, & Montgomery, 2007; Hund & Espelage, 2005).
Feminist researchers and practitioners have been critical of approaches to working with women who have been abused that pathologize women, drawing attention to the ways in which helping professionals have at times (perhaps inadvertently) colluded in silencing women and producing skepticism about their claims (Breckenridge, 1999), potentially reinscribing abusive power relations. More specifically, post-structural feminists have argued for a move toward approaches that enable the opening of other versions of reality in which women who have been abused are no longer discursively and actually imprisoned by their abusive histories (see, e.g., Warner, 2009; Warner & Wilkins, 2003). Alternative approaches to working with women who have been abused include using women’s stories to develop theory and professional practice that are empowering and critiquing other theories that deny and discount women’s experiences (Scott, 2001).
Narrative therapy, specifically Foucauldian notions of the social construction of subjectivity in language (Foucault, 1972) and the links between power and knowledge (Foucault, 1977), is one of the most well-known therapeutic approaches that is used in this area, based as it is on post-structural concepts (White & Epston, 1989). Social workers and other counselors who work with survivors of sexual abuse have used this approach over the past two decades (Fook, 2002; Healy, 2000). Narrative principles allow therapists to listen to survivors' accounts without interference from professional theories, personal beliefs, or other expectations or reactions (Anderson & Hiersteiner, 2007; Clandinin & Connelly, 2000) and to help women to develop new stories as survivors rather than as victims (Anderson & Hiersteiner, 2007; Phillips & Daniluk, 2004). In recognizing that subjectivity is produced through language, such approaches also aim to contextualize women’s subjectivity in wider social discourses and encourage investigation of the variety of “psychological, structural, and social silencing tactics” that allow sexually abusive behavior and control individual life narratives (Warner, 2003, p.233).
In Adelaide, the Australian city in which the study reported here was conducted, narrative therapy has become the dominant model for working with individuals who have been sexually abused, and most of the therapists in this area are professional social workers. However, to date, there has been no exploration of how these workers use narrative ideas to understand child sexual abuse and its effects, how these understandings may guide their work in practice, or the tensions and dilemmas they may face in trying to bring an emancipatory approach to their work in the face of other powerful discourses, such as the medical discourse of mental illness, with its associated institutional links (Rogers & Pilgrim, 2005). Moreover, both of us are professional social workers who have worked with women who have experienced abuse, and one of us (DH) continues to practice in this field. As such, we, too, have struggled with the challenge of bringing a feminist emancipatory approach to our therapeutic work with survivors of child sexual abuse and therefore share many of the dilemmas faced by social workers in this area.
Research on Child Sexual Abuse
Although there has been a great deal of research on child sexual abuse, most has been quantitative and concerned with measuring the prevalence, causes, and effects (see, e.g., Fergusson & Mullen, 1999; Purvis & Joyce, 2005) and with linking child sexual abuse with psychiatric conditions (see, e.g., Banyard, Williams, & Siegal, 2001; Putnam, 2003). A reasonably substantial body of qualitative feminist research, based on interview methods, case studies, focus groups, and life-history approaches, has explored such constructs as resilience (Anderson, 2006), disclosure and survivors' discourses (Alcoff & Gray, 1993; Naples, 2003), women’s experiences in accessing services (Fergus & Keel, 2005), the gendered nature of child sexual abuse (Breckenridge, 1992; Scott, 2001), the strength and resilience of survivors (Hyman & Williams, 2001), and the importance of survivor-led interventions (Mittenberg & Singer, 2000).
Most of the foregoing studies have been conducted with abused individuals. In contrast, the research on which this article reports focused on professional discourses in the context of practice and was the first study to do so. More specifically, it explored the likely implications for clients' subjectivities of a particular therapeutic model that has become increasingly popular in the field of sexual abuse work, narrative therapy, and was particularly concerned with its potential for challenging some of the powerful, pathologizing discourses about the effects of child sexual abuse that clients face in this area. The ways in which professionals approach such work is critical because the discourses they draw on will shape the subjectivities of their clients to some extent. As O’Dell (2003) suggested, it is essential to examine the production of professional knowledge in this context and the subjectivities that are produced as a result. We hope that examining the discourses through which workers respond to child sexual abuse will contribute to the development of practice that is sensitive to both the gendered nature of these experiences and the differences among women.
Method
We chose a qualitative method because we were interested in the situational context of research and with gaining an in-depth understanding of social workers' approaches (Neuman, 2006). The research design involved in-depth face-to-face interviews with 10 social workers who provide counseling to individuals who have been sexually abused (8 were trained in social work and 2 were not). The social workers were sampled from the three main sectors that provide counseling services in this area: governmental and nongovernmental women’s health services, and private practice counseling services. Seven workers were interviewed individually, and three workers requested a group interview because they wanted to be able to gain insights into the professional experiences of their colleagues. This group interview allowed for a dialogue, shared understandings (Ackerly & True, 2010), and learning (Walter, 2006). The group method was also time efficient, although it required close attention to group dynamics to ensure that all the participants were heard (Walter, 2006). It also allowed us to capture the views of those who might otherwise not have participated. The individual interviews ranged from 60 to 90 min, and the group interview took 120 min. The interviews were conducted by the first author (DH) and were recorded and fully transcribed.
Because the interviewer continues to work in this specific field and the participants are colleagues, the interviews were based on notions of equal relationships, allowing for a dialogue, rather than a question-and-answer approach, in which the participants could ask the interviewer any questions they had. The professionals who participated in this study are considered experts in this field in South Australia and were acknowledged as such by the interviewer before the interviews began. Since this was feminist research, we were also guided by the principles of mutuality and reflexivity (Crinall, 1999), which required us to examine our own positions and their influence on the research (Gergen, 2008). Before she began the interviews, the interviewer discussed the reason for the research in terms of her wanting to understand more about the ways we social workers work with women who have experienced sexual abuse and the ways we can improve this work. She also shared her feminist commitments to understanding and reflecting on her own practice in this area and her research.
Because we are “insiders” in this professional community, we did not aim to set up an us (academic) versus them (professionals) dichotomy. Rather, we wanted to explore alongside the participants the challenges of using therapeutic approaches that are informed by post-structural concepts to support women in overcoming the effects of abuse. In line with this view, we reflected on the questions we asked and our interpretation of the responses in terms of our own constructing capacities (Gergen, 2008). This was particularly the case when workers discussed gender in ways that conflicted with our own commitments to maintaining a gendered perspective on abuse. The interviewer explored with the participants about how they conceptualized child sexual abuse and its effects on women, which therapeutic responses (both theoretical and practical) they preferred and used, the strengths and limitations of their approaches, and the dilemmas they faced while working in this area. The participants were also invited to introduce other topics that are associated with their work in this area.
Data from the interviews were analyzed using discourse analysis. This method was chosen because we were specifically interested in the ways in which the workers constructed their understandings and approach to practice through language and the potential effects of power for clients. We were guided by Parker (1992) in identifying the discourses at work in the data. Parker drew attention to the way in which the objects (child sexual abuse and professional intervention) and subjects (survivors of child sexual abuse) are constructed in texts, with particular attention to the operation of professional power. After several readings of the texts, we were able to group sets of statements belonging to a particular theme. After the sets of statements were rearranged into themes, repeated readings allowed for the discourses to emerge. We specifically attended to contradictions in the discourses on which the workers drew. For example, we examined how the participants rejected the medical discourse in favor of normalizing discourses of the effects of child sexual abuse, but also reproduced the medical discourse for other groups of clients. We were also particularly interested in the ways in which discourses reinforce certain institutional arrangements (Reavey & Warner, 2003) and the ideological effects of the discourses. For example, we explored how the problematization of structural feminist discourses could result in gender-neutral approaches that center only the power relations between adults and children and exclude gender.
While data analysis revealed numerous themes, we chose to focus on two here: normalizing the effects of child sexual abuse and gender power in practice. We chose these themes because they demonstrate two of the most significant challenges faced by the participants in their work, that is, how to challenge the dominance of powerful medical discourses of mental illness in helping women reframe the effects of abuse, and how to retain a feminist perspective that acknowledges the material reality of gender power relations alongside a post-structural concern with the diversity of experience and the constructive effects of language (see McNay, 2004). We show how the related discourses that emerged under these themes and the tensions and contradictions among them have particular implications for workers' approaches to practice and for women as the subjects of these discursive practices. Key excerpts from the participants' interviews are presented and examined to elaborate these implications for both workers and women, and we refer to relevant literature to elaborate our insights. Pseudonyms are used to protect the anonymity of the participants.
Normalizing the Effects of Childhood Sexual Abuse
When asked how they conceptualized child sexual abuse and its effects, the workers talked at some length about their understandings of the connection between abuse and the mental health of clients and their approach to therapeutic intervention in relation to this connection. Much of this talk was concerned with normalizing the effects of abuse and resisting the medical discourse. There were a number of ways workers did so, and we show how, together, these ways worked to construct a normalizing discourse of the effects of abuse that, although wholly emancipatory in its intent, also had some unintended consequences.
One discursive strategy that the workers used to normalize the effects of abuse was a highly provisional use of psychiatric terminology and language to describe their clients' mental health experiences. Thus, while six of the workers identified certain mental illnesses as common among survivors, they used specific rhetorical devices (Potter, 1996) to diminish the pathologizing connotations of the medical discourse. Jaime referred to the “behavioral aspects” of child sexual abuse, rather than directly to mental illnesses, and then listed the common conditions that are associated with abuse: “The behavioral aspects that can show up are addictions, you know, substance abuse, alcohol, drugs, eating disorders, mental health issues, ranging from depression, anxiety right through to psychosis, schizophrenia, [and] borderline personality disorder.” Similarly, Charlie talked about her clients having “relational issues,” rather than mental illness, and Taylor mentioned “the effects of sexual abuse.” In addition, Jordan referred to “a whole range of issues that come with experience of childhood sexual abuse … depression, anxieties, self-harming behaviors, addictions, eating disorders. There is a huge correlation between the impact of child abuse and attracting a diagnosis of personality disorder.”
Jordan emphasized the act of diagnosis, which renders personality disorder only as a diagnostic category, rather than a real clinical condition. Thus, the participants carefully and purposefully chose language to avoid pathologizing clients. Related to how the participants used language to avoid pathologizing clients, Charlie stated, “We use their mental health assessment only to indicate that they have a problem, that they are not the problem … to help people see that they’re dealing with the depression, rather than that they are depressed.”
Separating the person from the problem is known as externalization and is characteristic of a narrative therapy approach (White, 2007; White & Epston, 1989). In her comment, Charlie objectified the problem—depression—rather than the depressed person, allowing for a more critical engagement with the effects of depression in the individual’s life. Jaime also used the language of narrative therapy when she talked about getting a “problem-near definition of the problem”: “I am interested in identifying what’s the problem from the client’s perspective and so getting a kind of what’s called a problem-near definition of the problem, rather than a pathologizing label, and really naming the effects on [the client’s] life.”
This determination to normalize the effects of abuse places metaphorical parentheses around medical and other terms so that their use becomes highly provisional and their status as “truth” is unsettled. It also privileges the individual’s view of the problem, rather than externally derived ones. This cautious, provisional, and critical use of language in regard to mental health is consistent with the post-structural assumptions of narrative therapy that center the construction of subjectivity in language: All these workers used a narrative therapy approach in their therapeutic work with women who have been abused. In addition to careful use of language related to mental health, some of the workers went further and questioned whether their clients were suffering from mental conditions at all. Charlie questioned the status of her clients' issues as “mental health problems,” and Taylor distinguished the effects of abuse from mental health problems: Some of those particular issues that they have with relational issues and emotional regulation and emotional knowledge are actually effects of childhood sexual abuse, … so whether or not they’re mental health problems is another thing. (Charlie) I think that the effects of sexual abuse are often labeled as a mental health problem. … There are genetic things, there are clinical depressions, … so that that’s a separate thing, but for people who have been sexually abused. … it can be very similar to what might be seen as a mental illness. (Taylor)
So, for Taylor, the effects of abuse masquerade as mental illnesses, but because they arise from abuse, they are understood to be fundamentally different in spite of appearances to the contrary. Moreover, real mental illnesses originate in “genetic things” internal to the person or are more severe, such as in “clinical depressions.” Jordan made a similar attempt to separate the effects of abuse from mental illness by suggesting that child sexual abuse “is not a syndrome; it’s not a disorder.” Sasha took a slightly different approach: “I guess the effects aren’t as alien as you might think. It’s, you know, pretty much people having normal reactions to an abnormal situation.” According to Sasha, the individual’s reaction is normal, rather than pathological or strange; instead, it is the child sexual abuse that is abnormal.
Another way that the workers normalized the effects of abuse was through overt criticism of medical discourses and the way they fail to contextualize individual experience. Along these lines, Jordan argued that diagnoses, such as “depression or anxiety,” are “ahistorical,” and Camryn emphasized individual histories through the idea that “multiple childhood trauma” could replace a host of diagnostic categories in the Often in some of those diagnoses like depression or anxiety, they’re what is called, um, they’re sort of ahistorical diagnoses; they don’t take into account the impact of the person’s history and life experiences as well. (Jordan) The psychiatrist who was presenting it [a conference] said he thought if there was a category in the DSM-IV that said. … multiple childhood trauma, they could eliminate a number of psychiatric categories and name the context of people’s experience.” (Camryn)
Underscoring her argument by referencing the view of a psychiatrist helped lend authority to Camryn’s idea of emphasizing the context rather than mental conditions. The workers also normalized the effects of abuse by challenging the idea that child sexual abuse is a life sentence and that abused individuals are permanently “damaged.” This has been referred to as the “harm story” of sexual abuse and positions individuals as different from nonabused people and as permanent victims of their child sexual abuse (O’Dell, 2003). Many of the workers specifically talked about challenging this story during their practice by encouraging clients to question their sense of themselves as “somehow damaged” (Charlie), “damaged goods” (Jordan), or “dirty or soiled goods” (Jaime). Other ways they described doing so included helping women see that their lives could be “good again” (Taylor) and that they do not need “counseling for the rest of their lives” (Lee).
Social work has a long and robust tradition of critiquing the medical model of mental illness for its individualistic, pathologizing, and decontextualized approach (Bland, Renouf, & Tullgren, 2009), and these accounts represent a continuation of this tradition with their emphasis on normalizing and contextualizing clients' experiences. However, we were particularly interested in how this critique may influence workers' practice with clients. Along these lines, the workers provided some specific examples of how they bring a normalizing discourse to their actual therapeutic practice through techniques of externalization and separating the person from the problem, seeking problem-near definitions, and challenging the harm story of abuse with their clients.
One of the main normalizing devices that these workers used involved drawing a distinction between the effects of abuse and real mental illness. Although we identify with the workers' desire to protect their clients from the pathologizing effects of medical discourse, an unintended effect is that the medical discourse of mental illness is actually left relatively untroubled, so that abused individuals are removed from its ambit while other groups of clients remain “truly” mentally ill. Thus, to some extent, normalizing the effects of abuse comes at the cost of repathologizing other groups. While this view may not play out in a problematic way during therapy for these particular clients, it is probably more consistent with the post-structural assumptions of narrative therapy to take a critical approach to “mental illness” more generally. Thus, rather than separating abused individuals from others with “anxiety” or “depression,” sexual abuse becomes one specific type of experience that not uncommonly leads to this type of distress. Clients' mental health problems are still normalized, but not at the cost of restigmatizing other groups, and there is more scope for challenging the way the medical discourse is often blind to context and history for all those who experience mental health problems.
In addition to the complex challenge of normalizing the effects of abuse in their therapeutic work, the workers also described bringing a gender perspective both conceptually and in practice. We now turn to this part of their interviews, identifying the chief discourses at work and continuing our focus on the challenges that these social workers faced in applying post-structural ideas in practice.
Discourses of Gender and Power in Practice
Most of the workers were explicit in arguing that their work is informed by a feminist perspective, while, for two, feminism was more implicit to their accounts. Sasha introduced the idea that gender is relevant to abuse by focusing on the fact that perpetrators are usually male and the abused are more commonly female: “Often the perpetrator is male, and in lots of cases the survivor of the abuse might be female, so that might introduce conversations about … the difference in gender and … the ideas that our society has about who has more rights.” Sasha also referred to “differences in gender” when she posed the question to women of “who has more rights,” implying that she understands that women in general have less than men. Kym talked about how “women start to realize that child sexual abuse is a broader societal thing” evidenced by the large number of women who are abused, with this realization understood to raise consciousness about the social nature of abuse: “When women start to realize that child sexual abuse is a broader societal thing, and when you start to talk about it and really appreciate the one in three statistic, what that actually means for women.”Lee more explicitly emphasized that she talked about “patriarchal society” with clients and the unequal position of women relative to men: “You talk about the patriarchal society we live in [with clients], women’s position within society, just the fact that you’re a woman and what that means.” Thus, like Sasha and Kym, Lee’s aim was to raise consciousness about how abuse is linked to wider gender power relations. Other examples included Amy asking women during support groups, “What’s happening here that all of us have these experiences?” and Kym’s belief that the women “draw tremendous strength from hearing that other people have had the same experience.” Similarly, Lee, Sandy, and Charlie suggested that for women to gain that political understanding, it is necessary for them to realize that they are not the only ones to have experienced child sexual abuse in line with a feminist consciousness-raising approach (Payne, 2005). Lee, Charlie, and Kym also mentioned that “women’s position in society” is relevant to child sexual abuse and their work with women, and most of the workers explicitly emphasized the importance of having a political understanding of abuse and of making the links between the personal and the political in their practice (Dietz, 2000). These workers' emphasis on unequal power relations, patriarchy, and consciousness-raising in practice drew on a structural feminist discourse of child sexual abuse (McNay, 1992).
The way these workers used feminist discourse to explain sexual abuse and their approach to intervention is little different from the way feminist social workers used it some 25 years ago (see, e.g., Marchant & Wearing, 1986), demonstrating how enduring and powerful these feminist insights have been for those who work with violence and abuse against women. However, some workers also pointed out the limitations of feminism for their practice. Sandy criticized feminism for ignoring other oppressions: “Feminism frequently leaves out class; … it left out race until recently; feminism was basically white middle class, Western.” As we noted earlier, Western feminism has been widely criticized for its universalist and singular focus on patriarchy (Featherstone, 2001; McNay, 1992; Scott, 2001), especially prior to the emergence of black feminisms and post-structural and postmodern critiques of feminist metadiscourses over the past two decades. Jordan more specifically criticized feminism for its essentialist tendencies in relation to gender and power: We need to acknowledge where the work and the effort and the heartache [of second-wave feminism] came from, but then you have layers of complexity. It’s about needing to incorporate men’s experience of sexual violence within that …, and then there are other things that sort of come up: “Oh well some women do perpetrate sexual violence, but we don’t want to think about that because that doesn’t fit with our theory.”
In Taylor’s account, the idea that women also perpetrate child sexual abuse leads to an emphasis on power relations between adults and children, rather than between men and girls. While post-structural feminists have drawn attention to weaknesses in structural feminist theorizations of sexual abuse, gender nevertheless remains central because most abuse continues to be perpetrated by men against women and children (Strickland, 2008). The perpetration of sexual abuse by women is extremely uncommon (Strickland, 2008), and when women are involved, it is often with (and at the behest of) male counterparts (Motz, 2001). However, as post-structural feminists have developed a more nuanced account of sexual abuse over the past two decades, so men’s and other conservative groups have also been active (and successful) in arguing that men are also victims and women are perpetrators (Berns, 2001). Of course, acknowledging this point does not mean accepting that gender is no longer relevant to sexual abuse work and, when this is the result, we should be alerted to the unintended “conservatizing” effects of post-structuralism in the field (Dixon, 1993), particularly in the context of other powerful interests and agendas.
A structural feature of the workers' accounts that may play into this contradiction is a relatively clear-cut dualism in the way in which feminism and post-structuralism are understood and applied and is also present in accounts in which a gender analysis is retained. Hence, the workers talked about narrative therapy and its post-structural emphasis on language, multiple subjectivities, and difference on one hand, and structural feminism and its emphasis on gender power inequalities, commonality of experience, and consciousness-raising (as well as essentialism and universalism) on the other hand. Contradiction is not necessarily a problem in and of itself, and these workers are not alone in grappling with the challenge of drawing on post-structural ideas without losing sight of real differences in power and a social justice agenda (see, e.g., Healy, 2000; McNay, 2004, 2008).
Like many feminist social workers, we continue to struggle with this challenge, in both our practice and our research. However, more recent feminist theorizing, including that concerned with violence and abuse, has attempted to move beyond dichotomous thinking about structure versus culture and the material versus the symbolic or discursive aspects of gender oppression (see, e.g., McNay, 2004, 2008; Reavey & Warner, 2003). Contemporary feminism rarely explains sexual abuse or other forms of gendered violence in universal or singular terms any longer. As Reavey and Warner (2003) argued, patriarchy can be no longer considered the main social oppressor of women and is therefore an inadequate explanation for child sexual abuse. Instead, power is understood to operate in more complex ways and, as feminist practitioners and researchers, we can use frameworks that we believe will be helpful for women, but we do not know if they will be helpful for a particular woman at a particular time because all women are different (Gavey, 2003). Hence, the challenge is to find ways for women to speak about the commonality of their experiences of abuse without shutting down the possibility of also speaking about the differences (Reavey & Warner, 2003). This kind of theorizing avoids dualism or hierarchical thinking when power is raised above gender in importance. Rather, power and gender are understood as intrinsically tied together, as are power and race, power and class, and power and sexuality. Feminism and post-structuralism can therefore be used together within a critical practice approach (Warner, 2009), which explores the intersections of power, gender, class, race, and sexuality (Gavey, 1989; Weedon, 1997) and involves a continuous evaluation of practice with awareness of various forms of oppression, including the imbalance in power between an adult and a child (Crinall, 1999). Such an approach does not need to write out gender to foreground other abuses of power and fits more neatly with post-structural assumptions about the discursive production of subjectivity underlying politically motivated empowerment approaches like narrative therapy.
Conclusion
In this article, we have explored the ways in which social workers grapple with the application of post-structural ideas in their work, specifically the use of narrative therapy with adult survivors of child sexual abuse. Although the workers demonstrated a commitment to emancipatory ways of working and offered many examples of strategies for challenging the depowering subjectivities experienced by abused women, there were also some unintended effects of post-structuralism in practice. First, we demonstrated how normalizing the effects of abuse by discursively separating abused clients from other groups of clients with “real” mental illness comes at the cost of restigmatizing these groups and actually leaves the medical discourse of mental illness relatively untroubled. Instead, we argued that it may be more useful to work to destigmatize mental illness more generally during therapy, as well as to continue to focus on the gendered social discourses and power relations associated with abuse that produce mental health problems for many women. Second, social workers' engagements with feminist discourses revealed that while most still place gender at the center of their work conceptually and in practice, the adoption of post-structural critiques of feminism sometimes result in minimizing the relevance of gender or, more commonly, a dualistic approach in which feminism and post-structuralism exist in a somewhat uneasy alliance. This is a common dilemma for feminist social workers. However, we argue that more recent post-structural feminist theorizations of sexual abuse transcend this dualism and fit more comprehensively with politically motivated empowerment therapies such as narrative therapy that center on the discursive production of subjectivity. Finally, child sexual abuse and its effects continue to be a significant area of intervention for social workers, and the need to engage in reflexive inquiry about the discipline’s responses and to be vigilant about the centrality of gender, as well as other power imbalances, remains as important as ever.
Footnotes
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The first author received a vacation scholarship from the University of South Australia to assist in the writing of this article.