As a feminist psychotherapist, one of my central preoccupations is with the development and application of models of psychotherapy which are neither overly-medicalized nor deterministic, and which are in harmony with feminist aims for women's mental health. I will set the stage with a quote from an earlier pro-feminist theorist and psychotherapist whose ideas I shall return to later:
. . . from childhood a girl encounters a myth that is very likely to shake her belief in her own value, her self-confidence, and to undermine her hope of ever performing competently. . . It is not easy for a girl in our culture to have self-confidence and courage . . . The primacy of men has brought a serious disturbance into the psychological development of women . . . (Adler, in Ansbacher & Ansbacher, 1978, p. 13)
These words describe the general problems in women's psychological development which can be thought of as `the normal pathology' of growing up with the myth of female inferiority. However, when we conceptualize emotional disturbance or mental illness, we obviously mean more than this; we recognize the further presence of distressing or disabling emotional and cognitive processes which in turn affect behavior. For theorists and practitioners in the mental health field, such dysfunctional processes produce pathological mental states, and these must be defined, explained and treated.
The enterprise of classification or diagnosis of psychological distress is inherently problematic in terms of epistemology. How do we know what we think we know about subjective states of mind? What is the effect of the knower upon that which is known? What social factors distinguish the knowers from the known? To what social uses is the knowledge put? And, who benefits?