One question that I get asked frequently is what it means to be a feminist therapy practice. Does it mean we only treat “women’s issues”? That we’re focused on “empowerment”?
It’s a great question! Feminism is a political word. And even among people who identify themselves as feminists, we don’t all agree on the meaning. Your cool Boomer aunt would probably describe feminism very differently from your ethnic studies major cousin.
Stella Nova was built from the ground up very intentionally as a feminist clinic — it’s written into our core values. So I want to share a little bit about what it means to us. I’m writing from the perspective of a psychologist, but I think many of these topics are relevant to other disciplines as well.
Putting Mental Health In Context
I always say that our mental health doesn’t exist in a vacuum.
Being a feminist clinic means recognizing that the systems we live in are inextricably linked to our mental health. That includes how our gender impacts our experiences in the world. It shows up in big and small ways, from the unequal distribution of labor at home, to experiences of sexual and domestic violence, to attacks on bodily autonomy.
It also goes beyond gender. Most modern feminists recognize that we can’t talk about gender without considering its intersections with race, class, culture, and other important facets of our identity. Experiences of sexism, racism, ableism, transphobia and homophobia all have a profound impact on our mental health.
At Stella Nova, we openly talk about these systems with our clients — side-by-side with the individual and family-level factors we’re trained to focus on as clinicians. It’s not about pushing an agenda, but it is about highlighting these very relevant facets of our experience, which are often ignored in a mental health context.
Depathologizing How We Survive
As a feminist therapist, I often find myself working to help my clients recognize the ways they’ve adapted to survive these systems. Our survival strategies can look like pathology to an outside observer.
A small but classic example is how women in corporate settings are often criticized for being overly apologetic or deferential. This can look like lack of confidence or weakness — perhaps even seen as proof that most women aren’t cut out for this line of work.
But the reality is that women are also regularly punished for violating gender norms by presenting themselves as authoritative. They may be labeled a bitch, seen as unapproachable, or find their performance reviews suffer as a result of “not being a team player”.
Without a feminist lens, normal reactions can look pathological
In therapy, that can show up as anxiety as women try to walk a tightrope between too pushy and not pushy enough. It shows up as “imposter syndrome”, or as struggles with self-trust or self-esteem. It can show up as depression, when they lose their sense of agency and hope.
Working with clients to recognize and validate their skills at navigating an unjust situation can help to depathologize their reactions. This can be an enormous relief in itself.
But unfortunately, it doesn’t fix the problem — clients still go back to their workplaces and face the same scenario. There’s no point in our healing at which sexism ceases to be harmful. Creating a mentally healthy world will take more than therapy can offer.
What it does though, is open up new options for how we respond. Ideally, ones that feel aligned with our bigger picture goals and values. Recognizing that we’re not broken, we’re just hitting a glass ceiling, for example, might mean deciding to quit the corporate world and go freelance for one person. For another, it might mean shoring up their support system and working on being more self-compassionate around the barriers they face.
This is one reason that Stella Nova doesn’t assign diagnoses as a matter of routine. We do believe there’s a time and a place for them! Often, for us, that’s to give clients what they need to navigate the world of insurance reimbursement. At other times, they can be useful to clients in understanding themselves better, and informing how we treat them. We’re more than happy to offer that. But the medical model is limited — we treat it as a tool, rather than a dogma.
Respect for Autonomy and Self-Determination
Respect for autonomy and self-determination is imperative in a feminist model of practice.
Women, LGBTQ+ folks, people of color, and other minoritized groups often find their autonomy under attack. We see this, for instance, in the ongoing attacks on reproductive freedoms in the US. Or in the surge of legislation preventing trans people from accessing medical care.
As feminist clinicians, we honor clients’ choices and respect that they’re the number one expert on themselves and their needs. We know that healing can’t be coerced or forced.
In practice, this comes into play in several ways. We strive to be aware of the power dynamics inherent in a therapist-client relationship (and the ways both of our identities impact that dynamic). And we use that awareness to work toward an egalitarian relationship.
We also let our clients guide us on what they want to get out of therapy and what they’re comfortable discussing. Ongoing consent is a cornerstone of feminist practice, whether that’s in creating goals together, making decisions about our approach, or choosing to delve into particular topics (or not!)
Embracing Imperfection, Accountability, & Community
Embodying feminist values in clinical work is aspirational. Even as we strive to approach our work through this lens, we expect that there will be misses and failures. We’re human, and subject to all the personal blind spots and biases that entails. We can be defensive, and get caught up in shame that gets in the way of showing up.
Being a feminist clinician doesn’t require perfection. It couldn’t — we’re swimming in the same murky waters as everyone else. But it does require that we are continuously striving to learn, grow, and do better than we did last week. It requires being brave and honest about our failings. It also means holding ourselves accountable to make right any harm that we cause.
I believe that one of the best ways to keep growing is by doing it within a trusted community that supports a shared set of values. These are the people who will check you and challenge you, while coming from a place of generosity and the assumption of good intent. One of my favorite things about having a group practice is being able to create that space together!
It’s also a reason that I’m excited to continue building community among other feminist clinicians here in California. (If you’re interested in joining us, let me know!) And to be clear: Feminist clinicians can be people of all genders! Everyone has a role to play in dismantling patriarchal and oppressive structures for our collective liberation.
Bringing Our Values To The Workplace
When I say that we’ve worked to build feminist values into our practice from the ground up, that means that we apply them to our organization as well. These principles are a foundation that things like our hiring decisions, communication practices, and decision making processes come back to.
If you’re a healthcare professional, I’m sure you’ve experienced work settings where boundaries aren’t respected, microaggressions are common, and inclusiveness is barely given lip service. But if we expect our teams to show up for clients grounded in our values, we have to be living them with each other. Independent of that, employees deserve to be treated with the same inclusiveness and respect that we try to bring to our clinical work.
Some of the ways that we operationalize our values at Stella Nova include:
- Being up front about our core values in the hiring process from the job posting onward
- Evaluating candidates on their commitment to these values on par with considering their skills and experience
- Committing to transparency and fairness in compensation
- Prioritizing a manageable workload and time for rest and self-care
- Donating to organizations and initiatives supporting our communities
- Working to navigate conflict from a place of collaboration
- Committing to the hiring and development of employees from underrepresented and marginalized groups
I don’t claim that we do any of this perfectly (see above), and I know that we still have a long way to grow. But we’re committed to the journey, and I’m so grateful to be building a team that wants to be on this journey together.
What Does Being a Feminist Clinician Mean To You?
As I said at the outset, there’s no one way to be a feminist clinician. I’m sharing my thoughts as a practitioner and a work-in-progress, not an expert.
So I’d love to know — if you identify as a feminist clinician, what does it mean to you and your work? I’d especially love to learn from feminist clinicians in other disciplines! If you’re curious about bringing a more feminist perspective to your work, what do you want to learn more about?
Drop us a line, or join us at an upcoming Feminist Clinician event for dialogue and connection.
About the Author
Maya Borgueta, PsyD, is a clinical psychologist and the founder of Stella Nova Psychology, a San Francisco based practice that offers online and in-person therapy with an intersectional, feminist lens. She specializes in working with women of color, adult children of immigrants, and business and tech professionals. She is currently leading a support group for women in tech who have experienced a recent layoff.
Connect with a Feminst Therapist Today
Stella Nova’s team of psychologists and therapists offers high quality therapy with a feminist lens. We welcome women, nonbinary folks, and people of all genders seeking a feminist healing space. Our team supports individuals and couples online throughout California, with services for individuals also available in person in San Francisco.
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