4.7 Gender and power in helping relationships

Discussion

1. The institutional power of the female worker has some bearing on what happens, especially if the worker has the power to ‘section’, or to decide or withhold treatment, or to use other sanctions, or has the power of the professional ‘expert’. The service user will feel relatively powerless in the face of this institutional power. However, in a society where the power of men over women is still present, he brings a certain kind of gendered power to the encounter. For many female care workers, the fear of violent and sexual abuse deployed by a male service user, even if it is an unwarranted fear, is a reality in their encounters with them. This is especially true for workers in vulnerable situations: for example, those who meet service users alone, or away from their ‘home’ territory.

   At a different level, female workers may be made uncomfortable by the sexual gaze of a male service user, as this too is a form of gendered power. In cases where treatment involves touch – such as nursing, and some forms of body therapy and residential care – the worry about the encounter taking on sexual meanings becomes more overt. Male service users, despite their relative institutional powerlessness, might also deploy the kind of strategies that were identified in professional relationships. They may use certain ways of talking and arguing that are intended to intimidate a female worker, making her job more difficult.

2. In this instance the male worker's gendered power, reflecting men's power over women in the wider society, might act to reinforce the institutional power of the worker over the service user. The example that is often cited is consultations between male doctors and female patients, especially when this involves physical examination. At the same time, female patients or clients may complain of feeling intimidated or bullied by doctors or other male professionals. Of course, this is not to say that female workers cannot be intimidating towards either female or male service users. However, in these cases institutional or professional power is not backed up by the gendered inequalities that persist in the wider society.