It is widely acknowledged that depression is primarily a women's disorder. One relatively neglected explanation may be that central dynamics of depression (i.e., vulnerability to loss, inhibition of action and assertion, inhibition of anger, and low self-esteem) are essentially distorted aberrations of key aspects of women's normative development. A self-in-relation perspective is used to extend, expand, and refine key aspects of existing theories of depression, and to offer some speculations on differences in depressive symptoms in women and men.In 1978, Arieti & Bemporad, two distinguished writers on the subject of depression, described a personality pattern commonly found to be associated with depression.The necessity to please others and to act in accordance with their expectations . . . makes him unable to get really in touch with himself. He does not listen to his own wishes; he does not know what it means to be himself. . . . When he experiences feelings of unhappiness, futility and unfulfillment, he . . . tends to believe that he is to be blamed for them. (p. 139)The authors append this description with the footnote, "As is customary in English, I refer to the general patient as he and consider him andThe author is deeply indebted to Jean Baker Miller for her support of and contributions to this project, and to Irene Stiver, Janet Surrey, and Judith Jordan for their helpful comments on earlier drafts.

Historically, ethical codes for therapists were drawn up to protect the professions from regulation by external agencies. Implicit in the ethical codes, however, is a model for the client-therapist relationship that fosters the goals of mental health. Just as ethical codes have been given specific content in standards for providers of psychological services in human service facilities, ethical codes can be given specific content in the client-therapist relationship. Therapists need to take responsibility for incorporating ethical standards into their practices so that clients' rights will be an integral part of therapy. We present four illustrative situations: providing clients with information to make informed decisions about therapy, using contracts in therapy, responding to clients' challenges to therapists ' competence, and handling clients' complaints.

This paper seeks to provide some perspective on the frequently asked question: "Should women patients be referred only to women therapists?" This question, put starkly, cannot help but be provocative. An affirmative answer suggests a position that would deprive many of a profession and a livelihood. A negative answer could intimate that the sex of the therapist is irrelevant to the flow of the therapeutic process. The question stirs personal and economic fears that lurk behind the more academic question of "gender influences in the process of therapy," for it potentially implies that the majority of practitioners (men) may be unqualified to treat the majority of patients (women). To advance the discussion of this issue, this paper will emphasize several points. First, the focus will be on the actions of the therapist, not on the decision-making process of the patient. No one theory can predict the individual situation; the final selection is an agreement between two specific persons, not between an abstract "woman" and an abstract "man." Second, given this switch from focus on patient to therapist, the question becomes not whether women or men offer the best therapy for women, but rather, "What therapeutic conditions are most likely to facilitate women's emotional growth, and how might these best be established in therapy?" Third, even if some of the conditions that maximize women's potential are more likely to be associated with therapists of one sex than with the other, this should be seen not as an end point which directs a patient's decision, but as a starting point which could inform the training and supervision of therapists. Thus, the question of therapist gender and its effect on therapy with women highlights an issue of therapist self-awareness and growth rather than one of the patient's selection process.

Logical inconsistencies between Bern's theoretical and empirical definitions of androgyny are discussed. It is pointed out that one can be high in both masculine and feminine traits but that these can be expressed in inappropriate, inflexible, and dysfunctional ways. Case materials illustrative of this situation are presented. Androgyny defined as an equal balance of masculinity and femininity is portrayed on an initial, dualistic notion of androgyny, which is a precursor to a more advanced, hybrid androgynous state. Some issues involved in conceptualizing androgyny in hybrid terms are delineated, along with requisite considerations for the clinician in utilizing this model of androgyny.

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