Disrupting Identity Through Visible Therapy: A Feminist Post-Structuralist Approach to Working with Women Who Have Experienced Child

Sexual Abuse Author(s): Sam Warner Reviewed work(s): Source: Feminist Review, No. 68, Women and Mental Health (Summer, 2001), pp. 115-139 Published by: Palgrave Macmillan Journals Stable URL: http://www.jstor.org/stable/1395748 . Accessed: 02/12/2011 10:33
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Disrupting Identity Visible Therapy:

Sam Warner

through

A Feminist Post-structuralist Approach to Working with Women Who Have Experienced Child Sexual Abuse

Abstract
This article draws on feminismand post-structuralism theorize a narrative to frameworkfor developingand critiquingtherapeutic practiceswith women who have experienced child sexual abuse.I arguethat both objectivism and relativism providepoor guides for conductingtherapyand that it is only throughsituating our knowledgesprecisely that moreliberatory therapypractices may be developed. This approach,termed'visibletherapy',is used to directlyand explicitlychallenge normative constructions women, child sexual abuseand therapy. arguethat it of I is necessary explicatethe embedded to assumptions producedthroughpracticesof of abuse, and which serveto constructchildren's experiences that abuse, in order to wardagainsttheirreproduction withintherapyrelationships. demonstrate I that it is throughsituatingand explicating operationsof powerthat the authenticity the of experience identitymay be questionedand women'songoingpositioningas and guilty victims may be challenged.Thus, I am concernednot with who women 'reallyare' but with how they come to know and be known throughpracticesof both abuse and therapy.This, then, is about making the tactics of abuse and but therapyvisible.Problemsare not locatedwithin individuals, ratherwithin the which situate both past and currentrelationshipsbut which, through narratives reiteration,obscuretheir own social production.I concludethat it is only when categoricalidentityis no longer assumedthat progressive therapypracticeswith women who have been sexuallyabusedcan be developedand maintained. c
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Keywords
child sexual abuse;women;feminism; post-structuralism therapy; critique;

Introduction
Child sexual abuse is a relatively common experience that many people endure and as such represents a significant area of concern within mental health services (Warner,2000a). Child sexual abuse also represents a key site in which unequal and gendered power relations are played out, and
Feminist Review ISSN 0141-7789 print/ISSN 1466-4380 online ? Feminist Review Collective http://www.tandf.co.uk/journals DOI: 10.1080/01417780110042437

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accordingly has long been of particular concern to feminists. As such, feminists have long been involved in providing contexts in which sexual abuse could be recognized, theorized and its effects on women addressed (Warner,2000d). This article builds on this work to develop a narrative framework for therapeutic interventions with women who have experienced child sexual abuse. This approach, termed visible therapy, utilizes both feminism and post-structuralism (Foucault, 1990; Butler, 1990, 1993; Haraway, 1991) to explicate a socially situated framework for engaging with individualized trajectories of distress. I begin by detailing the epistemological framework that underpins the approach. I argue that it is only through socially situating understanding precisely that the particular discursive mechanisms which operate through abuse and therapy, can be made explicit and, thereby, open to challenge. The authenticity of experience and identity is problematized in order to expose the regulatory constraints of naturalizing the negative effects of child sexual abuse as internalized disorder. The implicit therapeutic assumption that talking (about child sexual abuse) is always beneficial is interrogated and the assumed object of therapeutic concern (aspects of the sexually abusive experience) is examined. I describe the 'tactics' of abuse in order to challenge individualized narratives of women's responsibility for past abuse and present re-enactment. I argue that absolute understandings of trust, honesty and survival militate against progressive therapeutic intervention and demonstrate the benefits of socially located revisions of these terms. Implications for adopting a post-structuralist approach to training and supervision are considered and provisional conclusions are drawn. This article, therefore, deconstructs mainstream practices of therapy in order to reconstruct therapy as a socially situated enterprise.

Disputingand regulating 'the truth':post-structuralistconcerns and feminist politics

Given that feminism and post-structuralism are highly contested terms it is a misnomer to talk about feminist or post-structuralist theory, per se (see Farganis, 1994). Rather, what is presented here are those aspects found within both feminist and post-structuralist theorizing that converge to dispute the notion of a natural social order and which, I argue, can provide a critical framework for therapy. From a post-structuralist perspective, and axiomatic to this article, is the understanding that 'reality' is a socially contested and socially structured term. Reality is understood to be regulated through discourse and the assumed transparency of language is refuted in favour of viewing language as constructive (Foucault, 1990). From such

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perspectives,all knowledge has epistemologicalequivalence,in that all knowledge is socially producedand regulated.Such approachesdirectly challengethe modernistassumptionof an objectiveworld, and with this the implicationof any singularunderstanding or approachto, therapy of, for example,childsexualabuse.Normativevaluesareno longer regarding, hidden (as natural),but exposed (as regulatoryfictions)and, as such, are made open to dispute(see Deleuzeand Guattari,1984). Socialconstructionist to approaches therapy(e.g.Whiteand Epston,1990; 1993; Larner, 1995), which draw on these ideas, are often termed Epston, 'narrative 1992) becauseof theirfocus on discursive therapy'(Parker, practices. They are understoodas progressivepreciselybecausedemocratization is presumed to be promoted through the displacement of an of unproblematized understanding 'truth' (Frosh, 1995). However, the idea that democratizationis necessarilyachieved by refusing absolute is understanding naive. Therapistsoccupy a very differentsocial location to their clients and the notion that one can 'give up' power by refusing absolutetruthis a sleightof handwhichdeniesits own productive relation1995). Therapyis, after all, a deliberateintership with change (Larner, vention in the life of someoneelse. From some feminist perspectives(e.g. Hartsock, 1990; Jackson, 1992; Weissen,1993; Benhabib,1995) refusingabsolutetruthwas neverunderstood to be a progressivestrategy.Rather, relativist approacheswere viewed as regressivebecause they invalidate women's knowledge and frameworksseeminglyunderexperience.In particular, post-structuralist minea principled with the 'realproblem'of abuse (seeReavey engagement in and Warner, press).The concernis that if all knowledgeis sociallyconstructedand, therefore,has epistemologicalequivalence,how is perspechow can a feminist tive to be theorized as having value? Specifically, that the sexual exploitation of childrenis wrong be susunderstanding tained?Yet admittingall knowledgehas epistemological equivalencedoes not necessarilyprecludeoperatinga practicalmorality.And the assumption that principlescan only ever be rooted in absolutevalues reinstates the hierarchy insightandtruth(seeFrosh,1995) and, de facto, promotes of ratherthan liberation.While all social practicesregulate,it is regulation the unacknowledged regulationof social space that can act to reproduce dominantvaluesand militateagainsta partialliberationfrom those social that bind us preciselybecausewe cannot see them. structures over others The aim of visibletherapyis to privilegesome understandings without arrivingat an absoluteposition, or at an ultimateunderstanding. cannot exist in a pure state, outside of disand understanding Experience course. As such, the aim is to examine how experiencebecomes known

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and knowledge is experienced,through situated discursiveaction. As Grosz (1995) suggests,we need to ask: 'how does this knowledge,this method,this technique,constituteits object?'- in this case, therapywith women regarding experiencesof child sexual abuse.This cannot be theorized when knowledge is assumed to be perspectiveless,as objective accountsof the world would suggest.Nor can particular be perspectives valorizedwhen all knowledgeis assumedto be of equal value, as some readingsof relativistaccountsof the world would suggest. and As such, I rejectboth a positivistnotion of transcendental objectivity a relativizingof actualizedconcerns. As Haraway (1991) argues both objectivismand relativismare 'god-tricks'which promise, respectively, and vision fromnowhereand everywhere therebydenytheirresponsibility for the things they surveyand construct.Yet, it is only when we specify that we are able to fully theorizethe effectsof our perspective perspective and make visible the obscured assumptionsembeddedtherein. taking Specifyingperspectiveallows greateraccess to the process(es)whereby and interpretations analysesare made, and henceforcesthe therapistto a for greaterresponsibility her actionsthroughattendingto 'both the forms in by which [therapy]is produced,and the relationships which it is produced' (Banister al., 1994: 4). As such, the gaze I cast is neitherinnoet cent nor naive,but is rootedin selectiveconcerns.It is necessary, therefore, to provide a frameworkfor theorizingthe privilegingof particularperspectives.

Situating visible therapy:provisionalperspectives and provisionalpractices

An attempt,termed'feministstandpointtheory',was made by Hartsock The (1983) to theorize the value of drawingon particularperspectives. underlyingassumptionwithin this theory is that structural privilegeprecludesclarityof thoughtbecausethereis no impetusto theorize'thenorm'. increases By contraststructural marginalization clarityof thoughtbecause such personsnot only have access to dominantunderstandings also but have access to 'abnormal'or subjugated Hence, the reasonperspectives.
ing is that: [I]nsocietiesstratified race,ethnicity, by class, gender,sexuality,or some other suchpoliticsshapingthe verystructure a society,the activitiesof those at the of top both organiseand set limits on what personswho performsuch activities can understand about themselvesand the world aroundthem ... In contrast, the activitiesof those at the bottomof suchsocialhierarchies providestartcan research scholarship. and ing points for thought- for everyone's
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(Harding, 1993: 54)

Such an approach,it can be argued, 'directlyunderminesthe point-of- > viewlessnessof objectivism while refusingthe relativismof interpretationism' (Harding, 1990: 97). A post-structuralist revision of standpoint | does not invest understanding within actual persons, but rather theory focuseson situatedknowledgesthat drawon subjugated This ? perspectives. non-materialist revisionof standpointtheoryis crucialbecausewhen iden- z tity and experienceare understoodas provisional,then the ways in which c withinrelationships, identityand experienceare producedand maintained of abuse and/or therapy,can be examined. Hence, a simplisticcall for 'inclusion'of others' experiencesis rejected.The aim is to problematize experienceand identity- to theorizehow differentexperiencesand identhem tities areconstructed constrained and not simplyreappropriate and (see Spivak,1993). Thus, I am less concernedwith who others are (or who I am) than with how 'they' (or I) come to know and be known (throughpracticesof child of sexual abuseand therapy).It is only when we questionthe authenticity identityand experiencewe can begin to explore how particularversions of realityare produced,promotedand maintained.The modernistdesire to interpret what 'thispersonreallymeant'is resistedand, it can be argued, attendant difficultiescircumvented.Hence, while I do not presume to speak for others, I do speak about the social productionof (myselfand) is the others.The aim of visibletherapy, therefore, to problematize assumption of categoricalidentityin orderto make obvious the tactics of taking a This represents concernwith and strategicidentifications. up particular concern for ratherthanbeingand is an argument an epistemological doing, with identificatory ratherthan a searchfor ontologicalstatusor practices, meaning.This, then, is therapyas epistemology. A post-structuralist framework, therefore, allows us to challenge the unproblematicacceptance of any identity and a feminist standpoint enablesus to recognizethe need to privilegeparticular per(marginalized) spectivesin some situationsand on some occasions.Hence, given the cultural validationof professionalexpertiseover everydayexperienceit has at beenimportant, times,to valorizewomen'srightsto claima sharedidentity and to speak for themselves(see also Plumb,1993). However,from a
post-structuralist perspective, this represents a political strategy, rather <

than an ontologicalreality:otherwisefalse and absolutedualismscontinue to (re)create fictivelyand mobilize the division between 'experience'and and 'expertise'; clients and therapists.
The perspective adopted in this article, therefore, is informed by feminism, yet remains provisional. I situate my view from somewhere within marginalized perspectives, rather than within my essentialized ontological state

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etc.) whichalwaysalready (be that as a therapist, woman, and/orsurvivor, mutesdissent.Hence, authorityis locatedwithin realmsof understanding catratherthanclaimsto locationwithinsociallyvalorized(or subjugated) Like Bola et al. (1998: 106) I do not acceptthat all that egoricalgroups. is neededis to state my: 'social location in orderto renderit unproblematic: as if taking differences seriouslysimplymeanslisting one's memberI ship of broadsocial structural categories'. do not want any identification within the text that I can musterto affordme status that is unwarranted of this articleor, indeed,my therapypractice.Nor do I want my concern over women/sexualabuse to be renderedanodyne through representational practiceswhich conflateconcernwith identityto personalizesuch concernas being 'my problem'(see Charles,1992; Reavey,1997). Rather, the value of the perspectives drawn on to developvisible therapyrelates to their abilityto promotecriticalreflectionand to theorizea principled, Thus,whethertherapyoccursin any yet provisional,approachto therapy. servicecontext is a decisionwhich must remainopen (Warner, particular 2000a). As Kitzingerand Perkins(1993) argue,we should not only consider how therapyis conducted(the approachand perspectiveadopted), but also whethertherapyshould happenat all. The first step, then, is to interrogatethe assumption that speaking out generally, and therapy is from specifically, alwaysa good thing, and, in this, integralto 'recovery' child sexual abuse.

and (not)to speak:childsexualabuseas a provisional Deciding partialobjectof concern

The lure of the confessional(see Foucault,1992), and the assumptionof the catharticeffects of speaking,is writteninto the West'scurrentinfatuation with self-disclosure child sexual abuse (Plummer, and 1995). It has also been part of a feminist strategyfor political action (Entwisleand Warner,1989). The benefitsof speaking (about child sexual abuse) are predicatedon the assumptionthat silence equates with passivity (and ongoing abuse) and speaking out brings relief, provides a context for enlightenment and thereby promotes change and emancipation. Yet women are not disinvestedof their sexual abuse simply throughverbal rehearsal.Froma post-structuralist sexual abuse is not someperspective that can simplybe addedand then subtracted orderto revealthe in thing essence of a pure and prediscursive woman underneath.Rather,sexual abuseis productiveof feminineidentity,not somethingthat simplysits on top of that which alreadyexists (Warner, 1996a).
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the Moreover, implicationthat it is only throughthe specialconversations that occur in therapythat women gain insightsituateswomen as passive

containers. According to such a model, women must pour out the to 'badness-which-is-abuse' be filledup with morebeneficial messagesprovided by the therapist.This divests women of agency and obscures the women have interactiveprocessof therapyand the multiplerelationships with the narrativesof their lives. It may also be that an emphasison the productive capacities of therapy subjugatesother, 'ordinary',relationIndeed,the assertionthat peopleneed friends,not theraships/friendships. has also been made by some feminist writers (see Kitzingerand pists, is Perkins,1993). However,'friendship' an idealizedterm which requires as is Friendship no problematization muchas any othergivenrelationship. more a panaceafor mentalhealththan therapyis. a Additionally, feministconflationof political action with privatizedpersonal needs may be premature,as speakingdoes not always provide the is practicewhich can groundsfor emancipation. Speaking an identificatory increasedregulationand more punitive responses,particularly engender for already marginalizedsocial groups (Warner,1996b, 1996c, 2000c; Horn and Warner, 2000), for example,throughdenial,misrepresentation and re-enactment(McFarlane,1989). Moreover,poor and inadequately resourcedmental health servicesreproduceneglect, and women continue to be physicallyand sexually assaultedwithin them (Daly, 1997). Speaka engender positiveor progressive responseand ing out may not, therefore, the negative emotional sequelea of past present practicesmay amplify silencecan be an experiences(see Sedgwickand Frank,1995). Conversely, extremelypowerfultactic when other meansof agencyare closed down this is evidentwhen workingwith so-calledelectivemuteswhose silenceis fails to specifythe situanythingbut passive.As such, binaryreductionism ated and variousidentifications opened up by such moves. I argue,therefore,that the assumptionthat it is always beneficialto talk aboutabuseshouldbe resisted.Womenwill havedifferentlevelsof engagement with their abuse at differenttimes and in differentsituations and Indeed,issuesconcerning may be far presentlife experiences relationships. more pressingthan past concerns.Nevertheless,it may be importantto privilegesexualabuseby askingafterit, as has beensuggestedby a number of authors (e.g. Brown and Anderson,1991; Lobel, 1992; Palmeret al., 1993). This situates women's distressin relation to the productiveconratherthan simplyunsitustraintsof previous(andcurrent)relationships, ated mentalpathology.However,we cannot simply ask the questions (as if thereis one absoluteset whichwill revealall that is important),but state the our reasonsfor doing so. This both demystifies process,and meansthat are clear about their own purposes:be they voyeuristic, 'interrogators' Thus, while sexual abuserepdiagnosticand/ortherapeutic. investigative, and resentsan intelligible readilyimaginable concern, objectof therapeutic

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it should not be raisedas the objectof concern.Otherwise,this provokes a drift towards diagnosis and specification, realized as dogmatic to Thus, it is not enoughthat sexual abuseis asked approaches treatment. after,but it is crucialto note who does the speaking,what form the quesand tions take and what institutionsand personsareprivileged subjugated what it is throughthis process(see Foucault,1990). This meansclarifying and that requiresarticulation examinabout sexuallyabusiveexperiences concern.In ation and the meansthroughwhichwe managethis actualized order to clarify the therapeuticfocus of concern regardingwomen and child sexual abuse, it is necessaryto returnto the originalabuse.

Constructingnegative versions of experience and identity:child sexual abuse, popularcultureand normative prescription
From a post-structuralist perspectiveidentity is understoodas a social realized in relationships,rather than as an internaland stable practice we propertyof individuals.Hence, the experiences have, and the ways in our whichwe understand experiences, riseto particular formsof idengive the tity. At the same time our sense of self will shapehow we understand world and our experiences within it. Reality,therefore,is a functionof the relationshipsbetween understanding, experienceand identity (Warner, 2000b). Identitycan be understoodas a social performance (Butler, 1990) that is given the gloss of stabilitythroughreiteration.Child sexual abuse is one context in which negativeversionsof identityand experienceare the performed, producedand maintained. Explicating embeddedassumptions producedthroughabuse can enablewomen to work out how their own particular sense of self may have been shapedby such relationships. Abusersset up particular versionsof identityand experience that construct themselvesas blameless,position children as guilty and also dissuade othersfrom askingquestionsand recognizing harm.It is throughthe reitof these 'mind-fucks' the 'body-fuck' maintained that that is and terability is stabilized.Hence, the focus in visible therapyis on (gendered) identity the tacticsof abuse,ratherthan the physicalact itself.This is becauseit is the 'mind-fuck', ratherthan the 'body-fuck', which enduresand continues to constitutewomen. The detailsthat are important,then, are those that connectcurrent tactics feelingsaboutself andotherswith the psychological of abuse. Problemsare not located within individuals,but ratherwithin the narratives whichsituateboth past and current but relationships which, obscuretheirown social production.Thus, I am conthroughreiteration, cernednot with who women 'reallyare' but with how they come to know and be known throughpracticesof both abuseand therapy. This, then, is about makingthe tacticsof abuse and therapyvisible.

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The aim of visible therapyis to explore how women might invest in particularversionsof their past abuse and presentadulthood.The task is to contextualizewomen'sidentifications bad, guilty,etc.) in wider social (as discourseswhich enablea personalstory to be exploredin a situatedway (Reavey and Warner,1998). This requires detailing and exploring the and social silencingtacticsthat support rangeof psychological,structural abusivebehaviourand which are implicatedin the regulationof sexually individuallife narratives.For example, black women and white women have differentculturalconstraintsoperatingthroughtheirmultipleexperiences of child sexual abuse.My aim is not to obscurethe dynamicaspects of women's experiencesand identifications,but to recognize the wider social narratives that framethese. It is necessary, therefore,to look beyondthe specifictacticsof child sexual abuseto more generalaccountsof childhood,sex and genderthat provide the narrativecontext in which children,and particularly femalechildren, are interpellatedas passive, yet guilty. A common cultural belief is that childhood is a distinct social state imbuedwith innocence.The assumption is that 'childhood' is a knowable and definable condition which rendersits 'sufferers' dependentand immatureand, therefore,inherently innocent and sex-less. Any sexual content must, therefore,be traumatic. Sex, in this frameis the route out of the 'Gardenof Eden'(whichis childhood) throughknowledgeinto terribleawareness(whichis adulthood).A is differentiation effectedbetweenthe agenticsubjectof adulthoodand the child (Lee,1998). Yet,chil(socially)incomplete,and therefore,objectified dren have complex and varyingrelationshipsaround sex, and a blanket avowal that childhood necessarilyprecludes(agentic)consent may have the aim of protectingchildren,but ultimatelyfails. Innocenceis a powerwhich servesas warrantto deny childreninformation,which ful narrative (Dominelli,1989). might offset (some)vulnerability Moreover,the assumptionof innocencebringsguilt into being. Not only is a differentiation instigatedbetweenso-calledinnocentand guiltyvictims but, throughpopularaccountsof romanticlove, (feminine)innocenceand passivity is installed as always already corrupting. Drawing on the metaphor of 'SleepingBeauty' all girls, like Sleeping Beauty, de facto, cannot consent becausethey are somnolentin their innocence.They, like her,can only be wakenedby the violationof imposedsexualization.Their innocenceis destroyedand their maturationcomplete.But the innocence lost was always guilty.It was the beauty,not yet awakened,that enslaved the prince (abusers)and forced the kiss (abuse).Innocenceis, therefore, always alreadycorruptedby incipient (but unknowing)sexuality which precedes and dictates the subsequent violation. Such stories reify the while at the same time denying notion of femalepassivityand culpability,

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men simply act on invitation and instinct (Warner, male responsibility: of 2000b). It is only when individualtrajectories guilt are sociallysituatthat normativeunderstandings responsibility of ing may be disrupted.

The limits of innocence:socially situating individualtrajectories of responsibility

Guilt is naturalized an individualqualitythroughthe repetitionof disas cursive practices which obscure their own social production. Unless specific trajectoriesof responsibilityare socially located, guilt becomes obscured within, and internalizedto, women. They are both globally passive(unableto change),yet globallytoxic (inthe sensethat theycorrupt all they come into contact with). The aim of visibletherapyis to disrupt the operations of power which, through repetition, immobilize such identifications internalizedpersonalitystructureor pathology.Visible as therapy,therefore,locates women'sbeliefsand feelingsin termsof externalizedtacticsof abuseratherthan viewingthemas symptomsof internalized disorder.The aim is to enable women to understandhow guilt is produced and maintainedthrough practicesof abuse and to challenge implicit assumptionswhich individualizechoice and autonomy.Liberal humanistreadingsof selfhood,which have a centralplace within western psychology,view the autonomous and detachedindividualas the most mature'(Pollack,1997). Women'ssocialityrendersthem 'psychologically de facto immature.Narrativesof individualism deny social responsibility, reinforcemarginalityand promote victim-blaming becausethey assume we are equal autonomoussubjectslivingundernon-oppressive conditions (Pollack,1997). A tacticof visibletherapy, is therefore, activelyto informwomenhow childrenare silencedand producedas powerlessand how 'choice'is a loaded termthat cannotbe fullyachieved.'Choice'is no longerindividualized but is situated within structural(social, economic and cultural)inequalities Women(and regarding,for example, abuse, povertyand discrimination. children)may 'know' what they want but are marginalized throughcultural and structuraloppression and only the socially advantagedhave readyaccessto 'self' determination. Indeed,as Pollack(1997) argues,the valorizationof 'personalchoice' over communalvalues is dangerousfor marginalized groups- isolatingoneselfdoes not createboundaries against harm, rather connection does. Indeed, isolation within families, from are friends,relationsandlargercommunities the conditionsin whichabuse may operate.

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individualistic narratives 'choice'and autonomydisrupt of Problematizing normative therapeuticstories of responsibilityand re-enactment.For

derivedtheoriesarguethat example,both cognitiveand psychoanalytically othersand situationsarelearnt themselves, regarding people'sassumptions childhood experiences(Briere,1992). Such theories imply that through people recreatepast (unresolved) relationshipsand hence, can be used to in of women'sactiveparticipation the re-enactment abuse.Traemphasize of responsibility the (re)production pathologicalrelationfor of jectories ships may then be primarilylocated within women rather than being understoodas a dynamicinterplayof all those concerned,which even a parsimonious readingof psychodynamic theorywould suggest(seevan der Kolk et al., 1994). The constructionof the compulsion to repeat past to experiencesis then internalized women, throughthe fictions of 'faulty desires'(e.g. Clarkand Llewelyn,1994). While cognitions'or 'unconscious 'the mind' and 'the unconscious'may be useful metaphorsin which to narrativize historiesand expectations,they becomeregulatory relationship when the fictionsthey avow elide their own culturalproductionand productivecapacities.When 'the social' is separatedfrom 'the personal'the unconscious/mind then be deployedto accountfor the propulsionof can to women into abusiverelationships, without reference any other issue or interaction. While I would agree that women'sexperiencesof abuse may well imbue I theirexpectationof relationships, would argueagainstconstitutingthem as necessarilyhaving a desire, conscious or otherwise, to re-enact that abuse. Indeed,such stories serve to subjugateother relevantknowledges. This drawsattentionaway from the social productionof abusiverelationobscuresthe role of abuserswho may targetvulnerships and, specifically, able women (Warner,1997a). Such fictions, then, become additional and betrayal. Further,it can be argued that strands of subjectification a goal of treatmentthe aim of changingsuch expectationsand having as beliefswould be dangerousfor those women who do meet abusivemen, and need to adopt protectivestrategiesaccordingly. However,while the guilt installedthrough practicesof abuse should be it interrogated, is not enoughfor therapistssimplyto say, 'it was not your fault', as this offers no means through which adults may find ways to renegotiateabusive relationshipsin the future. Situated understandings cannotsimplybe repeddledin termsof 'correct'ways of thinking,as these will be 'right' only in specific contexts. The aim should be to situate otherwisewomen are condemnedto absolutepassivityever responsibility, after.So, as Deleuzeand Guattari(1984: 65) ask: 'How can we ward off, in the practiceof the cure,this abjectdesirethat makesus bend our knees, lays us on the couch, and makesus remainthere?' 'Guilt'is a productivefictionthat cannot simplybe installedby nefarious
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Not only does this further abusersand removedby benevolenttherapists. situate women as empty vessels, it also paradoxicallyconfirms their 'badness' by positioning them as 'wrong'. Women remain guilty - for attempts gettingit wrong and, worse than that, resistingtheir therapists' to enlightenthem. Negative versionsof identity and experiencemay be foundationalizedin the past, yet their ongoing relevanceis maintained throughdiscursivepracticesthat reproducesuch feelings in the present. mustresisttheirown desiresto providesingularand unsituated Therapists truths, always owned by the knowing therapist,which determineabsolutely what is defined as 'adaptive'.The therapeuticrelationshipis productiveof, and should functionas, a place in which we situateourselves and our clients.This can only be achievedthroughculturally situatingthe knowledgesthat are producedwithin therapy. Hence, we need to understandthe tactics of abuse to make sense of of women'sresidualfeelingsand to challengethe reinstallation these fictions/tacticsin therapyrelationships. example,we mightsay, 'I do not For think children(or women) choose to be abused, but I do know children (andwomen) often feel very guilty becauseguilty feelingsensurechildren do not tell'. The aim is to enable women to make specificconnections between their beliefs and feelingsand the tactics utilizedto ensuretheir within both past and presentabusive particularsilence and acquiescence and exploringthe contradictions within theseperrelationships. Detailing of narratives responsibility diffuses sonal, yet widely available,(gendered) the reitterability the 'mind-fuck' of throughsituatingits operations. and is Verbalizing examiningsuch narratives one way of disrupting negative versionsof identity.The negativeeffectsof past relationships may also be addressedwithout making any direct referenceto the abuse. Rather, which are rooted in negotiationoffer a lived experitherapyrelationships ence of relatingwhich is not predicated someone beingthe victimand on someonebeingthe abuser, indeedthe rescuer(seeCarr,1989). However, or it may still be necessary problematize explicateour practices.Good to and therapistsand effectiveabusersdraw on the sameskills to encouragechildren (and adults) to trust them (Warner, 2000a). Hence, we should be mindfulthat apparently benevolentbehaviouron the part of the therapist may be read by the client as a preludeto abuse.As such, it is also important to explicatenot simplythe contentof therapeutic but intervention, the invokedin that intervention. (psychological) processes

Socially situating trust and honesty: rethinkingthe 'quality'of relationshipbetween therapist and client
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The ultimateactive ingredientin therapeutic _~~~~~aloutcome is often storied as

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an unsituatedand unspecified While 'quality' 'quality'of the relationship. remainsa slipperyterm, it is frequentlyoperationalized terms of trust. in A relationshipbuilt around trust is seen as the central plank on which alliancesare built and therapeutic therapeutic changeis instigated.Hence, it is often assertedthat women need to find someonethey can trustto talk to and that betrayalis a central mechanismfor the negative effects of abuse.By implicationhonestyis presumed be the context in which trustto It may be self-evidentthat relationships ing relationshipsmay develop. built on trust and honesty are betterthan relationshipsbuilt on mistrust and deceit. Yet, from a post-structuralist perspectiveneither trust nor are absolute once and for all achievements,but are social prachonesty tices.In orderto havea meaningful with thesetermsboth need engagement situating. Clients cannot simply 'trust'their therapists,as they can only ever trust to local and specificthings.Therefore, shouldbe prepared make therapists that which can be trusted operant (i.e. explicit and actualized). Such 'things' may include time, location and the physical boundariesaround therapy.More than this, therapistsshould be able to explain how they makesense of what they do and why. This is therapy'long-handed' where the process is describedalongsidethe content and can be understoodas 'situatedhonesty'.The tactics of therapyare made visible, in contrastto the tactics of abuse which conceal their own production.Therapistsmay then sharewith clientsepistemological, ratherthan ontologicalnarratives of (them)selves. women may 'know me' from how I make sense of, and So describethe world, ratherthan through'self-disclosure personaldetails of of my experience'.Again, as argued, there is no direct access to some unconstructed notion of experienceanyway. of Normative assumptionsregardingthe absolute requirement clients to honest and truthfulaccountsof theirpast abuse and presentlives provide are also disrupted.From a post-structuralist perspective,making links betweenthe past and the presentis always about integratingtwo current fictions:past acts can only ever be constitutedthroughcurrentconcerns. Yet disclosing 'accurate'memoriesis often seen as being central to the therapeuticprocess. While 'accurate'details may have relevancewithin investigations,the function of therapyis not prosecutionand hence, the in 'rulesof evidence'do not apply.Despitethis, thereis a privileging, both of fictions of accuracy.Memory,or specificallythe limits of this systems, active (and thereforeuntrustworthy process)becomeanothernarrativein which to story women as bad/madand ultimatelyuntrustworthythemselves (e.g. Bagley,1995). Womenare guilty,unable as they are simplyto reflectthe past, they must always (andwilfully?)constructit. Womenare, with detailedfictions thus, penalizedfor theirinabilityto furnishtherapists

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of their lives. 'Recovered'memories(and their opposition 'false' memo1999). ries) then becomesomethingto be fought over (Warner, when honestyand trust are situatedthen 'belief'ceasesto be Conversely, an undifferentiated move of all acceptanceor non-acceptance.'Belief' becomesa multiplicityof narratives that one may, at times, remainvariand ously agnostic over. Yet, when woman remainsundifferentiated the partialobjectswhich constituteher are conflatedto representthe whole, it becomesinvidiousto queryany part of her story,as this also becomes of synonymouswith attackingthe authenticity that (whole)person.Trust is naturalized the groundson which therapyproceeds,ratherthan trust as encounter. Understanding beingunderstoodas an effectof the therapeutic as provisionaland located implies a mutuallyconstitutiverelationtrust ship that is groundedin shared,but variable,levels of allianceand connectedness.This more accuratelydescribesthe processesinvolvedin any (therapeutic) relationship. Whentrustand honestyare understood global and stablequalitiesthey as intervenremainthe foundationfor,and the goal of, normative therapeutic tionswith people,sexuallyabusedin childhood.Womenwho 'cannottrust' are condemnedand met with 'therapeutic pessimism'.Learningto trust others (usuallymen) is seen as the main functionof therapy. Yet, this is a spuriousgoal of therapy(Dominelli,1989) when we can only ever 'trust' local and specificthings.Moreover, while women may be condemnedfor theirrefusalto engage,they may also be condemned when they engagetoo readily.Visibletherapydirectlychallengesthe negativeeffects of making absolutejudgements which otherwisetrap women within a double bind. which is partialand specificis all and the best that can be hopedfor, Trust is Women's alignedwith a healthy,andpartialscepticism. challenge to trust themselvesto make sense of that which they feel able to rely on. Women shouldbe validatedfor meetingsome situationswith suspicionand taking activemeasuresto protectthemselves. are Yet, when absolutejudgements made regardingthe way women feel and the things that women do, women's strategiesof self-protection and survivalare frequentlyundermined. The negativeversionsof identityfoundationalized past abusive in relationshipsare then reinforcedthrough successiveinterventions.It is to how women'smeansof survival. crucial,therefore, reconsider we theorize

Deliberate self-preservation:using coping strategies to make sense of past and present concerns
Whenchildrenare abusedthey must findways of surviving simplythe not act of abuse, but the continualemotionalassaultson their sense physical of self. If people respond negativelyto the ways childrensurvive they

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furtherinvalidatewho those childrenare. When women's survivalstratwomen'sactual egies are pathologizedas beinginherentlyself-destructive, at self-preservation discredited are and their need to utilize such attempts strategies is paradoxicallyreinforced.Yet 'risk' is located within individualsratherthan the relationships, both past and present,that give rise to such behaviourand such strategiesmay be as indicative of current abusive)ones. (therapeutic) relationshipsas they are of past (deliberately As such, ratherthan simply attemptto stop women doing what they do re-enactsthe conditionsof constraintin which such (whichparadoxically actions arise) we should enable women to make specific connections aroundtheiractionsand emotions(seeWaller,1996). Hence,we must ask not questionsand make links regarding just what women survivebut how survive.By attendingto these strategieswe invoke agentic subjects they in who can activelyparticipate their own lives. Dissociation and self-harm(includingself-injury,drug and alcohol use, over-eatingand starvation) are common methods of coping with the extremelydifficultfeelingsof powerlessness, guilt and angeroften associated with experiences of child sexual abuse (Warner,1998, 2000b). Becauseof widely availableculturalrepresentations femininepassivity, of women may be particularly primedto turn their hurt and anger inwards and self-harm. Traditional readings of dissociation and self-harm, however,fail to recognizethem as meaningfulcoping strategies,located within social structural space. Ratherdissociationand self-harmare often as disembodied perceived symptomsof an underlying personalitydisorder or mentalillness.By bracketing such behaviouras mentaldisorderits out social productionis erased.In such a frame the 'effects'of abuse constitute all that women do, as being all that women are, and ever can be. Narrativesof women'spasts, then, foreclosetheir futures. Collapsingdifferentstrategiesof coping into extant and separabledisordersmilitatesagainst a useful therapeuticengagementwith such strategies. The feelings that underliesuch strategiesmay also be ignored, as engagement stops as diagnosisbegins.Women'slegitimateanger,hurt and ambivalence may then be translatedinto, for example,a decontextualized notion of 'emotionalliability'which reiteratespreciselythose aspects of genderin the first place. Such gendered femininitywhich foundationalize referentsin the conthen be used as the unacknowledged discoursesmay struction of psychiatricclassifications.Such labelling further confirms women as essentiallywrong or flawedand thus compromisesappropriate therapeuticaction. This has led Hamilton (1993: 157) to conclude:'It is probablethat women with a history of childhood sexual abuse are both overserved(handicapped an inappropriate label) and underserved by by mentalhealth deliverysystems.'

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Yet such feelings and actions are not incomprehensible symptoms of mental illness, but rather meaningfulcoping strategies(Romme, 1998) as locatedin socialspace.Whensuch 'symptoms' understood meaningare ful, then women may be helped to understandtheir 'symptoms'not in termsof evocationsof madness,but in termsof comprehensible strategies of survival.For example,when dissociationis understoodas a strategyof survival during abuse, it can be used to explain the non-formationof detailedmemorieslater.This providesa relevantsite for intervention not to 'recover'memoriesbut to offer a story for why some memorieswill remain 'lost'/incomplete.There are practical reasons, therefore, why women may haveveryfew memoriesof the past and, have a limitednarrative for detailingthe ways in which theirlife experiences sense of self and have beenstructured. Women's then,can act as an 'intercopingstrategies, that connectspast and presentversions 1996) mediarylanguage'(LeFerve, of self. When professionalstry to stop self-harmor refuseto engagewith people'svoices they deny the intermediary languagewhich can delay the to findinga new languageand differentversionsof self. More progression than this they recreatethe psychologicalconditionsthat give rise to the need for self-protection preservation. and The key issue is to stop placingabsolutevalues on women'sfeelingsand actions, and remainopen to exploringthe rangeof meaningsthey might have. Self-harm dissociationare neitherthe solutionnor the problem. and work and sometimesthey do not, and self-harm Sometimes and strategies dissociationcan be simultaneously solutionand a problem.Botharesola utions to the problemof limited choices (Warner, 2000b). From a poststructuralistperspectivesuch strategies of survival are given meaning throughsituatingtheir operations.It is important,therefore,to validate that it is OK to care for oneself and that havinga coping strategymeans that this processis takingplace.Validating women'srightto carefor themselves,does not precludemy rightto remainconcernedabout the methods women sometimesuse. I also remainmindfulthat individualcopingstrategies are regulatedwithin social structuralspace and that issues such as race, class, culture,genderand abilitycan also constrainthe options and salienceof particularstrategies.For example,women'suse of alcohol, as a coping strategy,has increasedin Britainsince women'suse of alcohol, Also, in responseto sexuallyabusive socially,has becomemoreacceptable. women may disfiguretheir bodies in multiple ways, for experiences, example, through excessive cleaningrituals. However,becauseof widespreadracismblackwomen have additionalinvitationsto view theirskin and bodies as being pathologicaland, hence, black women may be more likely to scrapeoff their skin and/oruse bleach on their bodies than are white women.

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While women may have developedtheir strategiesin isolation it is still of important,therefore,to locate socially our understanding this, as no is universalbut is sociallyspecific.For example,'dissociacoping strategy tion' is a specificallymodernistproject.In order to be able to dissociate and split partsoff (for example,hearvoices) therehas to be a sedimented social understanding the humanistsubject.If thereis no 'I' therecan be of no 'other' (see Boyle, 1990), concomitantlywithout the 'individual' there can be no 'psy-complex'(Rose, 1990). It is unsurprising, therefore,that the growth of self-regulatory of governmentwithin western technologies societies and the attendantelevation of psy-expertsis paralleledin the twentiethcentury'sobsessionwith pathologizing(and diagnosingas variously dementiapraecox, schizophrenia, psychosis,borderlinepersonality the those behaviourswhich directlyproblematize humanist etc.) disorder, Dissociation can only function, therefore,as a coping strategy subject. within societies that rely on a humanist reading of self-hood. Hence, are copingstrategies moreusefullyunderstoodas sociallylocatedpractices ratherthan ontologicalnarratives disorderand distress. of While it is crucial to engage with the multiple ways in which women sursurvivetheirlives, it is necessaryto resistthe desireto over-determine vival as a primaryconstructof identity.When identityis collapsedaround are being a survivor(or a victim) other identifications necessarilysubjugated and whether survivoror victim such women are definedprimarily and by thatwhichhurtsthem (Kitzinger Perkins,1993). Froma post-structuralistperspectiveany identificatory reductionis unhelpful,particularly Yet from a feministperspective theremay still those which privatizehurt. of be an argument locatingwomen within a narrative survivalbecause for survivalinvokes agency.Once the productivecapacityof these discourses with is madevisiblewomen can then make a more deliberateengagement them. Tracingthe discursivemechanisms throughwhich survivaland vicaffordsthe possibilityof engagingwith timhoodareconstructed, therefore, Womenmay identify versionsof self and experience. new, morepreferred, with both survival and victimization. Neither is a once and for all nor accomplishment, does theirco-existencecancel each other out. However, traditionally,women are often constituted as being either a as victim or a survivor:but not both. Identification, victims or survivors, or is predicatedon the presenceor absence of signifyingcharacteristics symptomatologies(Reaveyand Warner,1998). Such symptomatologies, associated with child sexual abuse, serve to regulate gendered subjects becausethey are often imbuedwith unacknowledged assumptionsregarding the normative limits of femininity (O'Dell, 1997). They act as boundarymarkersbetweennormativeand pathologicalwomen, who are raised as discrete and separable beings. The stigma of abuse signifies

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inclusion (as victim or survivor),while disenfranchising other identifications. When formulaiccheck-listsare raised,we assumewomen are all the same becauseindividualidentifications sexuallyabusedwomen are as obscuredby repeatedabstractions from the specificcontext of their production. Nevertheless,abused women may recognizethemselvesin such check-listsbecausesuch lists becomepart of what we know (ratherthan what we propose)to be the effectsof child sexual abuse,and hencefunction as 'the real'.Womenmay then assumethe 'abusedidentity'.However, shouldnot, themselves, assumethatwomenwill readilyposition therapists themselvesin such a place. Asking whether someone has been sexually abusedinvitesthat personto positionthemselves abused.It may be that as women may not recognizethemselvesin such an identity(andall it seemingly implies), but would recognizethemselvesas having been hurt or manipulated.Hence, questions which imply absolute identities are less useful than questions which situate specific actions and relationships (Warner, 2000b). Onlywhen we fullyengagewith identityas a socialpractice can we promote competing versions of reality which provide the context in which more positive versionsof self may emergeand be sustained.

Supportingtherapists:situated strategies for trainingand supervision

Therapists,like their clients,have multipleand provisionalidentitiesthat are stabilizedthroughreiteration. Therapistsand clientsmay sharesome identifications while having others that are different.Whethersimilaror different,the identificationsthat therapistsmake should be examined, ratherthan simply assumed.For example, the assumptionof similarity betweentherapistand client sharingthe identification 'woman'can act of to obscurepower differences therapybetweenthe two and hence,miliin tate againstthis reflexivity. This may be one timewhen otherness provokes a healthy reaction. Conversely, when therapistsview their clients as so differentfromthemselves they may feel unableto engage,unableto understand and hence, unable to take responsibility the interventions for they make.The traumathat surrounds abusemay,then, be compounded the by effectsof the client's,and the therapist's, different similar and contributory life narratives clashingand melding. What, then, do therapistsdo with the traumathey may bringfrom their own lives and which they experiencein therapy relationships?Sexual abuse confounds efficacy and fracturesgood relationships.Hence, the mutualdanceof therapyis aboutwardingoff those feelingswhichconfirm our senseof incompetence, clientsand as therapists. is no wonderthat as It

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is the lure of containmentthroughdiagnosisand categorization so strong or that strategiesof dissociationand splittingmay be utilized by mental of health workersas well. The institutionalization such coping strategies can lead to inter-professional conflictsand punitiveinterventionsincludand ing sectioning,medicating,scapegoating avoidanceof change(Davenport, 1997). When this happens,therapymay not functionat all. Clear boundariesaround therapy relationshipsare not simply for the benefit of clients but are also there to protect therapists'sense of self. Therapistsrequirea permanentspace for reflectionthat permitsthem to explorethe benefits,to themselvesand theirclients,of takingup theirown If and within therapyrelationships. this particular strategicidentifications is not enteredinto then therapiststhemselveswill act without reflexivity understandingto protect their own fragile fictions of self. And while women may well have survivedworse, they will nevertheless continueto be victimized.The aim of trainingand supervision, within visibletherapy, is to enabletherapiststo developstrategiesfor questioningtheir,and their services', contributoryrelationshipswith their clients' distress and the maintenanceof behaviourthey ostensiblywish to change. Trainingand framework, supervision, conceived within a feminist post-structuralist does not pathologizetherapists,any more than therapy,conceivedwithin a feminist post-structuralist framework,pathologizesclients. Therapists are no more inherentlypathologicalthan theirclients are. Fromthis perspective, beliefsand understandings individual the that therapists hold are socially situatedwhich militatesagainst positioningtherapists as beyond change and development.Socially situating therapists' as understandings discursive practicespromoteschangebecausechanging one's understanding longer equateswith rejectingone's whole being. no Additionally, because absolute versions of identity are rejected, then 'expert' as a category is also fractured.This means that therapistscan engage with training and supervisionwithout necessarilywriting thema selvesinto a story of absoluteineptitudeand naivety.Additionally, poststructuralistapproach would (as some forms of psychotherapy)also accordequal status to processas well as content issues and therebymilitates against the concretization, not just of persons, but also treatment strategies. The narrative framework of visible therapy provides a critical means of deconstructing objects of therapeutic concern, while admitting the value of situated knowledges which actively construct those same objects. Training, therefore, is not about defining pre-determined approaches, but about promoting a reflexive climate that provides a framework for questioning dominant versions of reality through engaging with marginalized perspectives.

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Provisionalreflections on visible therapy

The aim of this articlehas been to demonstrate applicability nonthe of foundationalistfeministpolitics to transforming mentalhealth practices. Post-structuralist feministtheorizinghave been drawnon to develop and a practicaland accessibleframework reconstructing for intertherapeutic child sexual abuse (Warner, ventionswith women who have experienced that it is throughsituatingand explicating 2000b). I have demonstrated the tactics of abuse and therapythat the authenticityof experienceand identity may be questionedand more positive versions of identity and
experience imagined.

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when identityis assumedto be foundationalratherthan proConversely, and visional,prescription replacesdescription acts as the groundon which Whentherapyindividualizes normative valuescan be reinstalled. selfhood, it renders and obscurestheirsocialproduction. Whenthe problemsprivate can social is veiled the assumptionof heterosexuality be reinstated, the as assumed, but unspecifiedgoal of normative therapy (see Maltz and Holman, 1987). This is self-evidentin those (traditional)approachesto with men and therapywhich privilegethe need to trust and reintegrate which, therefore, pathologize those women who exist outside of the heterosexual ideal. Moreover, such therapies are also saturated with westernideals of personhood.Recoveryfrom abuse, then, is a processof inculcationinto a racializedsex/gendermatrixwhich is achievedthrough of 'technologies the self' (Rose, 1990). As McNay argues,applyinga Foucauldiananalysis: Under illusion leading greater the of to the of self-knowledge, disclosure one's inner andunconscious self desires leadsto a moreefficient andnorregulation malisation sexuality of the of ... through production self-policing subjects The is boththeinstrument effectof domination. and confessing subject (1992:87) The fictive separationbetween personal and social serves to concretize women as self-disciplining 'recovered' subjectsset in oppositionto 'unrecovered'women - who are out there, dangerousand unpredictable. The recoveredwoman is 'open about her problems'and has 'insight'.This
woman is no longer 'out of control'. 'Control', in this sense, refers to selfcontrol, rather than ability to control the environment (Plumb, 1993). And personal change is valorized over political transformation (Plummer, 1995). This is why it is crucial to understand identity as a social construal. To do otherwise is to obscure, and shore up, the gendered (re)production of normative femininity and dominant, and singular, versions of reality.
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The challenge of developing and maintaining 'good' practices around experiences of child sexual abuse is, therefore, in creating a context in

which relationships (both past and present)are continuallyreassessedand articulated. The reorientation 'the problem'of sexual abuse as socially of constitutedand constitutiveof genderedidentifications providesa means of throughwhich the maintenance women as (inherently) pathologicalcan be challengedby disrupting conflationof beingwith behaviour. the Reorithe problemof child sexual abuse in this way providesalternative enting trajectories throughwhich socially situatedand accountablepracticesof research,trainingand therapymay be developed.This articleprovidesa particularstory for making the practicesof abuse and therapy visible. Local conversationsare narrativesof culture and while therapy alone cannottransform, local is the context in which alliancesare structured, the articulatedand enacted.Problemsare not located within individuals,but ratherwithin the narratives which situateboth past and currentrelationobscuretheirown social production. ships but which, throughreiteration, Suchan approachprovidesthe groundsfor progressive practicebecauseit militatesagainstthe instillationof naturalized subjectsand, hence, absolute and invarianttrajectoriesof recovery.Disrupting identity through visibletherapyoffers a meansthroughwhich narratives women'spasts of no longer foreclosetheir futures,as women'sstories of self refutefinality and embracepossibility.

Notes
is fellow at Manchester SamWarner a clinicalpsychologistand half-timeresearch in She specializes child sexual abuseand works freelance University. Metropolitan as a consultant,trainer, researcher, expertwitness and therapist.Sam has written Child numerousarticlesand book chaptersand is the author of Understanding with RebeccaHorn, SexualAbuse:Makingthe TacticsVisible(2000) andco-editor, Issuesin Criminologiof PositiveDirectionsfor Womenin SecureEnvironments: cal and Legal Psychology(2000). Sam'sfuturepublicationsincludea workbook the on child sexual abuse (Handsell)and with PaulaReavey(editors)Challenging Tyrannyof Truth:New Feminist Stories of Child Sexual Abuse (Taylor and Francis). Gill I thankEricaBurman, Aitkinand PaulaReaveyfor theirhelpfulcommentson who haveshared earlierdraftsof this article.I thankthe manywomenand children their stories of sexual abuse with me. I also thank the researchdepartmentat AshworthHospital for supportingthe researchout of which this article (partly) arose.

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