Understanding Power

Foreword by Monica McGoldrick
Preface

Chapter 1: Conceptualization of How Power Operates in Human Functioning
Elaine Pinderhughes

Chapter 2: Legacy and Aftermath: The Mechanisms of Power in the Multigenerational Transmission of Trauma
David Anderson Hooker

Chapter 3: Racial Shaming and Humiliation: Tools of Oppressive Power
Vanessa McAdams-Mahmoud

Chapter 4: Power-Based Therapy: Transforming Powerlessness into Power
Vanessa Jackson

Chapter 5: Tsalagi Spiral Conjurations in Ghost Country: Exploring Emergent Power Differentials with a Native American Client
Rockey Robbins, Scott Drabenstot, and Mollie Rischard

Chapter 6: The Power to Recover: Psychosocial Competence Interventions with Black Women
Lani V. Jones

Chapter 7: Culture, Power, and Resistance: Testimonies of Hope and Dignity
Makungu Akinyela

Chapter 8: Decolonizing Social Work Practice with Immigrants: The Power to (Re)define
Hye-Kyung Kang

Chapter 9: The Power to Create Equity and Justice
Patricia Romney

Chapter 10: The Joy of Sharing Power and Fostering Well-Being in Community Networks
Ramon Rojano

Chapter 11: Cash & Counseling: Empowering Elders and People with Disabilities to Make Personal Care Decisions
Kevin J. Mahoney and Erin E. McGaffigan

Chapter 12: Teaching Power beyond Black and White: Recognizing and Working with Student Resistance in Diverse Classrooms
John Tawa and Jesse J. Tauriac

Chapter 13: Discovering and Building RESPECT: A Relational Model Addressing Power and Difference in Medical Training
Carol Mostow

Chapter 14: Deconstructing Power to Build Connection: The Importance of Dialogue
Boston Institute for Culturally Affirming Practice (BICAP)

Chapter 15: Power and Research
Sarita Kaya Davis

Chapter 16: Re-methodologizing Research: Queer Considerations for Just Inquiry
Julie Tilsen

Chapter 17: Conclusion and Syllabus
Vanessa Jackson, Elaine Pinderhughes, and Patricia Romney

Index

Elaine Pinderhughes, MSW, is professor emeritus at Boston College, having joined the faculty in 1975. Her 1989 textbook, Understanding Race, Ethnicity and Power: The Key to Efficiency in Clinical Practice, substantially changed the language of multiculturalism and human behavior in the practice arena and provided the rubric of culturally compe­tent practice across human services disciplines.

Vanessa Jackson, MSW, is a licensed clinical social worker, Soul Doula, and owner of Healing Circles, Inc., a healing practice based in Atlanta, Georgia. Ms. Jackson earned a master’s degree from Washington University, George Warren Brown School of Social Work. She is a nationally recognized speaker on mental health issues, with a focus on culturally conscious therapy and therapy with marginalized populations.

Patricia Romney, PhD, received her doctorate degree from the City University of New York, where she won the Bernard R. Ackerman Award for Outstanding Scholarship in Graduate Psychology. She completed her internship in consultation and education at the Yale University School of Medicine and did postgraduate study at the College of Execu­tive Coaching. Her current work is focused on consulting and coaching for excellence and equity in higher education.

The pernicious potential of power to destroy human lives – as still happens for all those groups oppressed by race, poverty, gender, and so on – is the reason we need a clear analysis of how power operates in our world. The editors and authors of this crucial and timely book have done us a great benefit in laying out a roadmap for our consideration on how to understand power in clinical practice.

Monica McGoldrick, PhD, MSW, LCSW
Director, Multicultural Family Institute
Highland Park, NJ

Understanding Power was reviewed by Nicole Marcum for the journal Social Work.

Power operates as a dynamic force that leaves no area of life untouched, influencing individuals, families, communities, and institutions. Despite its great influence on society, professionals working in human services are often oblivious to their own power and privilege, their impact on the therapeutic relationship, and how the lack of acknowledgment and dialogue contributes to the marginalization of certain individuals and groups. “Power matters for those who have it and for those who lack it. Power matters because it affects one’s ability to secure desired outcomes (including the satisfaction of basic human needs to control and to belong)” (p. 8).

The editors to Understanding Power: An Imperative for Human Services begin the book with a thorough overview of power dynamics and theories of power relations, targeted toward human services practitioners across disciplines (that is, social workers, psychologists, counselors, occupational and physical therapists, and medical professionals). The book then elaborates further on the various ways that power relations manifest and present in clients seeking care across human services settings. After establishing exigency for creating an understanding of power, the editors point out that “few social workers have been trained to analyze power dynamics, and even fewer have been given the space to struggle with power. . . as part of their professional training” (p. xiii). This book attempts to provide curriculum and pertinent information to create opportunities for human services professionals to grow and learn in a variety of settings, such as continuing education units, job trainings, supervision, and undergraduate and graduate classrooms.

Read the full review. Available to subscribers of Social Work.

I have been waiting for this book for many years! The editors have far exceeded their hopes to provide helpful examples of how power operates and to share some novel ways clinicians, researchers, and consultants are thinking about power and working toward emancipatory practice. This is an amazing book in its exploration of how power operates in clinical practice. The need for this examination of the dynamics of power is obvious. As the editors point out, “In spite of all of the funding directed to so-called empowerment programs over the past few decades, few social workers have been trained to analyze power dynamics, and even fewer have been given the space to struggle with power—power to, power over, power within and power with—on a personal level and as part of their professional training.” Understanding Power offers a candid exploration of the issues at stake in this crucial dimension of our clinical practice and of our lives.

I believe the editors (Elaine Pinderhughes, for certain!) have been preparing for this book their whole lives. Elaine has been thinking and talking to others about issues of power and how they fit into systemic thinking since she was a child.

Many years ago, Elaine mentioned to Murray Bowen that she had noticed that he had waited many years before publishing his ideas on societal regression. She wondered if this was because he knew the idea would be hard for people to digest because of the power issues embedded in this systems concept. His response was one of his wry, silent smiles. I believe Bowen’s response reflected his realization that Elaine was on to him; she had recognized how controversial his ideas were. She took great advantage of his concept of the societal projection process in the evolution of her own thinking about how racial power operates in our society and how projection can explain the power dynamics involved in the way bias, myth, and stereotyping sustain this anxiety, reducing function in families and other systems (see Pinderhughes, chapter 1).

I first got to know Elaine while publishing her early paper on this subject in our book, Ethnicity and Family Therapy, in 1982. She has been challenging my thinking about systems theory and concepts of power ever since. I doubt we have ever had an outing together when we didn’t sooner or later get onto the topic of how power operates.

In the half century that family systems theory has been developing, many have struggled to understand how to take power into account systemically. We have been mystified for many years in our society and in our field by the workings of power. Most family therapists have eschewed analyzing how power operates directly. Indeed, Gregory Bateson, one of the most brilliant of all systems thinkers, was deeply skeptical of the concept of power altogether (Guddemi, 2010). Some systems thinkers seemed to suggest that considering power makes systemic thinking impossible. This is, of course, not true at all. But we also cannot think of power as a simple equation that can be quantified with a formula. As Foucault (discussed by David Anderson Hooker in chapter 2) made so clear, power is a relational phenomenon, exercised only in relation to others. Bateson (1972), of course, said that all things exist only as relational phenomena. In any case, power is an essential component, constantly in operation in all systems.

The complexity of the subject of power and its centrality to systems thinking are the reasons this book is such an important contribution to our field. It is a great stimulus to our integration of the analysis of power into systems thinking.

The many arenas in which power operates at a societal level must be thought of together. Race, gender, social class, ethnicity, sexual orientation, body size, ability status, and many other dimensions must all be taken into account as we live our lives, assess clients’ problems, and try to empower them. This book is a tremendous boon to us in pushing this thinking forward.

Almost half a century ago, Martin Luther King labeled the systemic issues of power in our society brilliantly in relation to racism. His insights on the relationship of power to systemic thought still hold true:

One of the great problems of history is that the concepts of love and power have usually been contrasted as polar opposites. . . .We’ve had it wrong . . . and this has led Negro Americans in the past to seek their goals through love and moral suasion devoid of power, and white Americans to seek their goals through power devoid of love and conscience. . . . It is precisely this collision of immoral power with powerless morality which constitutes the major crisis of our times. (King, 1967)

King seemed to understand at the most profound level the complexities of the systemic intertwining of love and power. It is only by taking the complexities of the systemic intertwining of love and power into account and contending with them that we can maximally help ourselves and our clients to be demystified about how power is organizing their lives and our society. This complexity is, of course, embedded in the very contours of the health care and mental health care we deliver.

The dangerous aspect of power is when it refers to power over others, not when it pertains to power to collaborate with others or power to make one’s dreams come true.

A crucial reason why we need to develop a good analysis of power is the way we are mystified by those who use power without love. This mystification is intentional. It is an essential aspect of how the powerful manipulate power. Their maneuvers are designed to conceal how they use power to maintain societal control.

The U.S. government built slavery into the Constitution, and it remained in place institutionally for almost 100 years without the word “slavery” ever being used. Women have been kept out of power and taught to obey and serve for generations on the basis of the mythology that this is the “natural” state of humanity or a structure that aligns with certain religious ideals. Our media mystify the way laws support extreme distortions of the social justice implied by the concept of “liberty and justice for all.”

The mythology of individual will and agency in determining one’s fate is perpe­trated by those in power to hide the way power actually operates. We are meant to believe that everyone has an equal chance in our society when, in fact, power is kept in the hands of the few at the top of our society.

This is why learning to analyze power dynamics is so critical for clinical theory, research, and practice. Unless we unpack the systemic patterns of power abuse, our theories, media, and institutions will keep us from recognizing how power operates to keep some at the margins and others at the center of our society.

Like our constructions of gender, sexual orientation, and social class, whiteness is a social construct, not a reality. It has no biological basis whatsoever. It is meant to give power to one group at the expense of others and to maintain that power through institutional patterns of white supremacy, which have been kept in place generation after generation.

It is essential that the theory and practice of our educational, mental health, health care, and political systems shift to take account of these power patterns and that we rectify our situation, so we can truly experience “liberty and justice for all.”

This book goes far toward unraveling the mystifications in which our lives are embedded. Those deprived of power must contend with adaptive behaviors that derive from powerlessness. For those with extra privileges afforded to the dominant groups of our society, the price of an unjust system is harder to see. It is difficult for those with unearned privileges of whiteness, maleness, heterosexuality, high socioeconomic status, and other assets to remain mindful of the disabilities of obliviousness to unearned power and the disadvantages of a lifetime of learning not to notice the inequities.

For me, coming from a primarily privileged social location in our society on most dimensions except gender, the hardest dimensions of power to understand and to own have been those of my white privilege, social class privilege, and sexual orientation privilege. I believe this is largely because society intentionally makes those with privi­lege feel comfortable with their superior status. What is much harder to notice is the deadening that such privileges lead to. As Peggy McIntosh (1988) described so well long ago, we carry an invisible knapsack of privilege, free checks, and credit cards to which others have no access. I have used McIntosh’s own working paper on correspondences between race and gender to help me get more conscious of the areas of my privilege. I think about what I wish men would appreciate about gender inequities. I try to keep doing conscious translations to become more aware of what others require of those of us with white privilege, heterosexual privilege, and social class privilege.

Recently reading Eula Biss’s (2015) essay on racial privilege, “White Debt: Reck­oning with What Is Owed—and What Can Never Be Repaid—for Racial Privilege,” I was shocked by her question of “whether white supremacists are any more dangerous than regular white people, who tend to enjoy supremacy without believing in it.” What is so scary about whiteness is our complacency and failure to even realize the societal degeneracy of which we are a part.

Biss’s (2015) conclusion is that “whiteness is not an identity but a moral problem,” which seems obvious once you think about it. But how can we wake ourselves up? How can we not use our power to perpetuate the immorality of the system? Our denial involves an erasure, as Biss asserted, of both the past and the present—denial that the myths of “liberty and justice for all” has never been true and is not true today.

I think it is extremely difficult for those of us who are white to appreciate what the power of our whiteness, our unearned privilege, and our participation in the oppres­sion of nonwhites does to us in subtle ways. There is a kind of blankness, coldness, superficiality, and a deadness that comes from never acknowledging our unearned advantages. The acknowledgment would cause us not only pain but tremendous cog­nitive dissonance to see ourselves as participants in the oppression of others, whether actively or by our silence about their disadvantage, which is really about our advantage at their expense.

But I find it very hard to get a clear hold on this idea. Biss (2015) compared it to living in a house so long we forget that it still has a big mortgage. Despite not paying it off, we’ve come to feel the house belongs to us anyway! Ta-Nehisi Coates (2014) compared it to having huge credit card bill, but, because we have decided not to charge any more, we “remain befuddled that the balance does not disappear, although we are not paying off the debt” (p. 27). How can we who are made to feel so comfortable and at home in our skin overcome our complacency and blindness to our actual place in the universe? We must challenge ourselves to understand how power has influenced our own blinders to do any real power analysis of the systems in which we participate.

Power determines which theories and clinical practices get accepted; what kind of evidence is considered relevant to diagnosis or treatment; and what research gets done by whom, with whom, and on what topic. Excellent challenges of this dominant research structure are provided by Davis in chapter 15 and Tilsen in chapter 16 of this book. Throughout U.S. history, most mental health interventions have been oriented toward a paradigm of individual adjustment to life circumstances, with almost no analysis of the organization of our nation that involved slavery, colonization of certain populations, marginalization, exploitation, and systematic demeaning of certain groups within the society (see Hye-Kyung Kang, chapter 8). Such perspectives mystify both mental health workers and consumers, operating on the assumption that adjusting consumers to the “American way of life” is a good thing, no matter what.

The authors of this book have explored the importance of power in therapy on many dimensions. Pinderhughes offers an excellent overview of the issues (chapter 1). Hooker explores in depth the multigenerational dimensions of trauma that make clinical attention to history essential for understanding our clients’ experiences. Jackson (chapter 4) offers an excellent chapter on what empowering therapy entails. Other authors explore working with African Americans in therapy (McAdams-Mahmoud, chapter 3; Jones, chapter 6; and Akinyela, chapter 7), work with Native Americans (Robbins, Drabenstot, and Rischard, chapter 5), social work with immigrants (Hye-Kyung Kang, chapter 8), work in organizational consulting (Romney, chapter 9), and work in community fam­ily therapy (Rojano, chapter 10). In chapter 11, Mahoney and McGaffigan explore the renegotiations of power in client-designed and -controlled care services for aging and to decide how their service dollars are spent.

In chapter 12, Tawa and Tauriac take on the complex topic of teaching about power in racialized cultural contexts and describe methods to overcome students’ resistance to accepting awareness of their own group’s structural disadvantages within the dominant culture. As they point out, “the notion that some groups are favored challenges a deeply internalized view of the world as safe and just.” This is a crucial point in teaching about power: attending to each person’s experience of power and powerlessness and the impact that awareness of it may have on the person’s sense of self and of the world around us.

Further dimensions of power in cultural training are illustrated by Mostow in chapter 13, which describes incorporating training on race and power in medical educa­tion and in chapter 14 by my own dear colleagues of the BICAP group, who relate how power intersects with race, gender, and social location for a group of committed and thoughtful trainers who explore their own personal and group processes.

The pernicious potential of power to destroy human lives—as still happens for all those groups oppressed by race, poverty, gender, and so on—is the reason we need a clear analysis of how power operates in our world. The editors and authors of this crucial and timely book have done us a great benefit in laying out a roadmap for our consideration on how to understand power in clinical practice.

Monica McGoldrick

REFERENCES

Biss, E. (2015, December 2). White debt: Reckoning with what is owed—and what can never be repaid—for racial privilege. New York Times. Retrieved from http//www.nytimes.com/2015/12/06/magazine/white-debt.html

Coates, T.-N. (2014, July). The case for reparations. Atlantic Monthly. Retrieved from http://www.theatlantic.com/magazine/archive/2014/06/the-case-for-reparations/361631/

Guddemi, P. (2010). A multi-party imaginary dialogue about power and cybernetics. Integral Review: Toward Development of Politics and the Political, 6(1), 197–207.

King, M. L., Jr. (1967, August 16). Where do we go from here? Annual report delivered at the 11th convention of the Southern Christian Leadership Conference, Atlanta. Retrieved from https://kinginstitute.stanford.edu/where-do-we-go-here

McIntosh, P. (1988). Working paper: White privilege and male privilege: A personal account of coming to see correspondences through work in women’s studies. Wellesley, MA: Wellesley College Center for Research on Women.

Pinderhughes, E. B. (1982). Afro-American families and the victim system. In M. McGoldrick, J. K. Pearce, & J. Giordano (Eds.), Ethnicity and family therapy (pp. 108–122). New York: Guilford Press.

Understanding power is essential to the provision of human services. Human services providers (therapists, counselors, physicians/other health care personnel, teachers, and others such as judges and parole officers) are charged with helping people who are directly or indirectly affected by the way power has operated in their lives. As a result of how power operates, service users struggle with numerous challenges marked by ignorance, conflict, confusion, despair, and a sense of entrapment.

Human services providers are called to help service users transform their ignorance into knowledge, relieve the stress of their entrapment in powerless roles, and alleviate the conflicts within themselves or with others. To accomplish this, human services providers have the legitimate right—and thus the power—to impart knowledge and to evaluate, diagnose, treat, and dispense needed resources. Power therefore is implicated in the creation and maintenance of the problems and needs service users present; in the goals sought and strategies used to help them; and, very important, in the relationships they have with the providers who seek to help them.

To overcome feelings of powerlessness, people must find, discover, reclaim, or enhance their own power and liberate themselves from disempowering, entrapping social roles and behaviors. Once this has been achieved, they can use their power to solve their problems, reach their life goals, and meet their needs. When helping service users, practitioner effectiveness depends on an understanding of the forces that constrain or enhance the ability of people to use their power. This means understanding the following about power: (a) its purposes; (b) what it looks like and how it can be identified; (c) how and when it is acquired, maintained, and enhanced, and how it is constrained; (d) how and when it is abused and exploited; (e) its consequences for those who have it (that is, those who have leadership, privilege, high social status, and resources) and those who do not; and (f) how it is exercised effectively and justly.

Of critical importance is the understanding that power is amoral. As psycholo­gist Kenneth Clark (1974) (whose research was used to validate the Supreme Court’s landmark decision on Brown v. Board of Education) asserted, we are “caught in a con­tinual struggle against the immoral exercise of power” (p. 12). Because power itself is amoral (due to its relative, dynamic shifting nature), it can be—and often is—exercised immorally. It is necessary that power be exercised so that, as Clark wrote, “the right of any group of human beings to impose their will upon other human beings must be restrained . . . by means consistent with morality, without resorting to methods that violate human respect, human dignity, and human life” (p. 12). This is a moral impera­tive, and it is the perspective of the editors and contributors of this book.

We offer this exploration of power as a step in the process of building a coherent and useful understanding of its operation. We believe that this meta-conceptualiza­tion will help human services providers to use the power of their professional roles to facilitate people’s attempts to have power and exercise it effectively. It is intended to articulate the contradictions, paradoxes, and dilemmas that confront people as they seek to exercise their own power. Finally, although it does not present specific models of intervention, this writing is offered as a guide to the thinking needed for designing interventions. The concept of power presented here is not finished; it is open for revi­sion and explicitly invites fuller explanation.

Although the focus of this book is primarily on the issue of power in service pro­vision to individuals, groups, families, organizations, and small communities, we also look broadly at the operation of power on all levels, including large communities and nations, for insights into common and differing dynamics. It is our hope that this book will make the case that such information should be basic to the training of all human services practitioners and that it will spur the initiative to expand the knowledge needed for effectiveness and change.

In the first chapter, I present some basic concepts explaining the multilevel, bidi­rectional, and recursive operation of power; its effects; and the thinking needed for effective intervention. In subsequent chapters, practitioner/scholars from social work, psychology, medicine/psychiatry, nursing, and the ministry explore how they use their understanding of the operation of power in practice, research, teaching, training, and supervision. Our contributors describe how their understanding of power has shown up in their work, in their relationships with service users, and in how and where they intervened. They also describe the approaches they used and the approaches they feel are still needed. In the final chapter, the authors summarize the insights drawn from the preceding chapters, presenting newer ideas about shifting power usage. We have also included a syllabus for a graduate course or in-service training on power.

Our hope is that readers of this volume will come to see what my lifelong research has demonstrated: that power plays a primary role in human interactions and that understanding and making right use of power are the keys to efficacy in all helping relationships.

Elaine Pinderhughes

REFERENCE

Clark, K. B. (1974). Pathos of power. New York: Harper & Row.