Psychiatric Annals

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The Evolution of a Professional Support System for Women Physicians

Maj-Britt T Rosenbaum, MD

Abstract

Women psychiatrists in Westchester County, N. Y., aware of their isolation and minimal participation in both the American Psychiatric Association and the American Medical Association, successfully organized a support system for women within both of these organizations. Seven years ago, nine women members of the Westchester Psychiatric Society (the district branch of the A. P.A.) met informally to discuss common interests and problems. Today there are two committees on women, one in the local A. P. A. and one in the A. M. A. Each group has two main goals: issues confronting female physicians (e.g., mother-role/work-role, wife/ professional, sexism within medicine) and issues concerning women (e.g., abortion, female development, sexual behavior, menopause, and role models). The committees have provided a forum for discussion of common issues, put out position papers, and organized scientific meetings. Nevertheless, these formal functions have not been as important to the women physicians as the opportunity to discuss problems in informal groups.

In 1971 the women psychiatrists petitioned to become an official committee of the A.P.A. district branch. The local psychiatric newsletter reported that "a goal will be to stimulate increased interest and participation on the part of women in their profession and in the society. . . . Membership is open, men invited."

During the next three years, 23 meetings were held at the homes of members. The topics discussed in the first year included gender role development, female adolescence, and the roles and problems of women in society. Although this was an official district branch committee of the A.P.A. on women and not of women, no male psychiatrist attended a meeting during the first two years. The first male colleague attended a meeting that was addressed by women from the Westchester Women's Coalition Group on consciousness-raising groups. It should be noted that initially some women members were hostile to men's joining. However, the Committee officially decided not only to permit men to join but also to actively seek their participation. Perhaps the bonds of a professional women's committee were so extraordinary and positive that there was a strong sentiment to keep the club exclusive. This viewpoint reflected the "consciousness-raising aspects" of a group of successful professional women whose stock in trade was the unconscious. The Committee (we hesitate to use its acronym, COW) currently has five men and 17 women members. Approximately half of the female members of the local A.P.A. branch are on the Committee.

The meetings held in members' homes have encouraged a social informality. Furthermore, they have permitted the women to see how their colleagues live and cope with problems common to all professional medical women. In addition, annual picnics - complete with spouses, lovers, and children - furthered the important social-support aspects of the group.

The Committee has been an effective force within the local A.P.A. society on issues of direct concern to women. For example, an editorial in the Westchester Bulletin of the A.P.A., entitled "Abortion Reform," the general thrust of which was strongly endorsed by the Committee, unfortunately also stated: "Unless a woman is psychopathic, she feels guilt and depression over having an abortion. It takes a long time to recover from this. " The Committee wrote to the editor strongly objecting to his blanket statement. The rebuttal contained a review of the literature, which sharply refuted this editorial conclusion.

In another situation, the Committee was a strong source of support for district branch action. The district branch of the A. P. A. had supported the reform of the New York State abortion law. When the law was under attack, the Committee urged the district A. P. A.…

Women psychiatrists in Westchester County, N. Y., aware of their isolation and minimal participation in both the American Psychiatric Association and the American Medical Association, successfully organized a support system for women within both of these organizations. Seven years ago, nine women members of the Westchester Psychiatric Society (the district branch of the A. P.A.) met informally to discuss common interests and problems. Today there are two committees on women, one in the local A. P. A. and one in the A. M. A. Each group has two main goals: issues confronting female physicians (e.g., mother-role/work-role, wife/ professional, sexism within medicine) and issues concerning women (e.g., abortion, female development, sexual behavior, menopause, and role models). The committees have provided a forum for discussion of common issues, put out position papers, and organized scientific meetings. Nevertheless, these formal functions have not been as important to the women physicians as the opportunity to discuss problems in informal groups.

In 1971 the women psychiatrists petitioned to become an official committee of the A.P.A. district branch. The local psychiatric newsletter reported that "a goal will be to stimulate increased interest and participation on the part of women in their profession and in the society. . . . Membership is open, men invited."

During the next three years, 23 meetings were held at the homes of members. The topics discussed in the first year included gender role development, female adolescence, and the roles and problems of women in society. Although this was an official district branch committee of the A.P.A. on women and not of women, no male psychiatrist attended a meeting during the first two years. The first male colleague attended a meeting that was addressed by women from the Westchester Women's Coalition Group on consciousness-raising groups. It should be noted that initially some women members were hostile to men's joining. However, the Committee officially decided not only to permit men to join but also to actively seek their participation. Perhaps the bonds of a professional women's committee were so extraordinary and positive that there was a strong sentiment to keep the club exclusive. This viewpoint reflected the "consciousness-raising aspects" of a group of successful professional women whose stock in trade was the unconscious. The Committee (we hesitate to use its acronym, COW) currently has five men and 17 women members. Approximately half of the female members of the local A.P.A. branch are on the Committee.

The meetings held in members' homes have encouraged a social informality. Furthermore, they have permitted the women to see how their colleagues live and cope with problems common to all professional medical women. In addition, annual picnics - complete with spouses, lovers, and children - furthered the important social-support aspects of the group.

The Committee has been an effective force within the local A.P.A. society on issues of direct concern to women. For example, an editorial in the Westchester Bulletin of the A.P.A., entitled "Abortion Reform," the general thrust of which was strongly endorsed by the Committee, unfortunately also stated: "Unless a woman is psychopathic, she feels guilt and depression over having an abortion. It takes a long time to recover from this. " The Committee wrote to the editor strongly objecting to his blanket statement. The rebuttal contained a review of the literature, which sharply refuted this editorial conclusion.

In another situation, the Committee was a strong source of support for district branch action. The district branch of the A. P. A. had supported the reform of the New York State abortion law. When the law was under attack, the Committee urged the district A. P. A. branch to oppose repeal, which they voted to do. The local A.P.A. Committee on Social Issues took a similar stand.

By the end of 1973, the Committee had also adopted and printed (as an official position paper of the district branch) its statement on "Sexism and Psychiatry."

We have noted with concern some views in the women's liberation movement that express sentiment against psychiatry. Psychiatrists have been criticized as attempting to adjust women to a passive, "traditional," dependent role. We suggest that it is relevant for our Society to examine issues of sexism, and we submit the following as a possible basis for consensus among our members.

1. There is a wide and overlapping range of abilities and personality traits in both men and women. Specifically, neither activity nor passivity is exclusive to either sex. Mental health is not promoted by trying to fit people into molds based on sexual stereotypes.

2. The mental health of both men and women is aided by the fullest development of each individual's potential. An increase in the number of options society permits for the development and use of talent without regard to sex would be in the interest of all.

3. Therapists should inform themselves of the extent of the discrimination against women. Attitudes and practices which devalue women have many of the irrational foundations that rada! prejudice has, and are so deeply imbedded in our culture that both men and women therapists often accept them unquestioningly. Awareness of and eradication of these attitudes and practices would benefit the mental health of both sexes.

4. In the women's liberation movement, some have taken the position that only women should treat female patients. The sex of the therapist seems to us less important than the ability to accept and apply the philosophy behind points 1, 2, and 3 of this paper.

The statement brought forth criticism from the A.P.A. Psychiatric News, which reported in February, 1974, that the statement was an effort to "quell" criticism that psychiatrists attempt to adjust women to a "passive, traditional, dependent role." Polemics and letters to the editors are the staff of life to any new organization. The Committee drafted a sharply worded reply, noting that it sought not to silence criticism but, rather, to make colleagues examine themselves as therapists - to reflect on "the extent to which sexism enters into the treatment of patients."

The Committee's paper on "Sexism and Psychiatry" was supplemented by a meeting sponsored by the Committee on Continuing Education entitled: "Sexism: Does It Occur in Psychotherapy?" The panel comprised four speakers, two men and two women, all committee members.

The Committee, having clearly established itself within the local A.P.A. structure and supported by the national A.P.A.'s directives, felt confident enough by the start of 1975 to reach out to the 400 women physicians living in Westchester County. All the female physicians in Westchester were invited to an initial meeting, to be addressed by the past president of the Westchester County Medical Society. She gave a brief talk on her experiences as a woman in general practice and within the more formal structures of organized medicine. After her presentation, the women broke up into small groups for informal discussions. The women's medical involvement encompassed a broad range of specialties from cardiology to rehabilitation. These women voiced sentiments strikingly similar to the comments of their psychiatric colleagues when they had formed their committee five years earlier. The women expressed an eagerness to share ideas, deal with problems of isolation, and discuss conflicts between career and family. In addition, there were concerns about sexism within the medical community itself, as well as a feeling that women should more actively participate within their respective professional societies.

A steering committee of the local society of the A. M. A. was formed, and it conducted a telephone survey of all the women physicians in the county. Although this venture proved to be a time-consuming and, at times, frustrating experience, especially as many women were unlisted or listed under other names, a third of the women were reached. The main intention was to find out if the women physicians belonged to a professional society and if they would be interested in meeting with female colleagues on a professional/social basis. Although only about one-third of those interviewed were members of the A. M. A., two-thirds replied that they did want professional/social relations with their female colleagues.

Clearly, existing organizations were not meeting strongly perceived needs. These needs ranged from the theoretical to the pragmatic, from "I am interested in issues related to female assertiveness" to "I need referrals!" Accordingly, the steering committee, composed of 20 women (12 members of the Westchester County A. M. A.) petitioned the Westchester County Medical Society in July, 1976 (a historic date?), to form a committee on women. The established medical bureaucracy responded in a somewhat less than enthusiastic manner.

It would appear from your letter that what you really have in mind is a committee of all women physicians residing in Westchester County where they might have a forum to express and discuss specific problems in which they might have a special interest. Such a committee would be outside the auspices of the society. . . .

After a series of discussions, letters, and perhaps a little male consciousness raising, the County Medical Society consented to the formation of a committee on women. The senior author of this article was appointed chairperson.

In December, 1976, a second open meeting for all women physicians was held. One of the Committee's members spoke on "Career Goals Among Female and Male Psychiatrists." After the talk, a lively discussion ensued. The tone of the meeting was somewhat different from that of the initial meeting the previous year, the women physicians more assertively expressing their wish to participate in the medical community.

In summary, a few comments should be made about the group process that took place in the formation of these two committees on women. The first group was born out of the feelings of isolation and minimal participation of the women psychiatrists in Westchester County. The group was task oriented. It focused on solving problems, yet it was flexible in its attitudes toward leadership. The leadership role was a shared one, with the group giving much support and encouragement to the person in charge of the project. There has always been excellent group spirit, as evidenced by the common purpose to study the problems of women and communicate them to responsible people, the capacity to accept and lose members without fear of losing the group individuality, the lack of internal subgroups, and the value placed on each member's contributions. We anticipate that the second committee can accomplish the same tasks as the first one. We are well aware that the obstacles will be greater as we move from the more supportive climate of the local psychiatric community into the larger context and less receptive atmosphere of the general medical community.

10.3928/0048-5713-19770401-10

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