This paper contends that the psychiatrist-woman patient relationship is affected by a number of powerful, yet often subtle, pressures. There are three major interacting sets of factors: the medical and mental health systems and the process of medicalization of life that has taken place over the last century; the psychiatrist, his or her training, attitude and theoretical background; and the woman patient, her socialization and view of the world which is based on perspectives formulated from a male viewpoint. As a result of these factors, any woman referred to a psychiatrist is likely to be given a psychiatric diagnosis, her problems viewed as individual and intrapsychic, the societal obstacles she faces ignored or minimized, and treatment probably geared to helping her adapt to traditional expectations. The implications for therapy are discussed, with emphasis on the need to appreciate how women have been forced into a second-hand understanding of the world. Alternatives to traditional psychotherapy are discussed briefly, stressing the need for recognition and use of these resources.