Table of Contents

Table of Contents
Contributors

Foreword: Silence No More
Judith Worell

Section I: Setting the Stage: Social, Biomedical, and Ethical Issues in Understanding Women's Depression

Chapter 1: Introduction: Culture, Self-Silencing, and Depression: A Contextual-Relational Perspective
Dana Crowley Jack and Alisha Ali

Chapter 2: The Social Causes of Women's Depression: A Question of Rights Violated?
Jill Astbury

Chapter 3: Drugs Don't Talk: Do Medication and Biological Psychiatry Contribute to Silencing the Self?
Richard A. Gordon

Chapter 4: The Itinerant Researcher: Ethical and Methodological Issues in Conducting Cross-Cultural Mental Health Research
Joseph E. Trimble, María R. Scharrón-del Río, and Guillermo Bernal

Section II: Self-Silencing and Depression across Cultures

Introduction to Section II: On the Critical Importance of Relationships for Women's Well-Being
Judith Jordan

Chapter 5: Women's Self-Silencing and Depression in the Socio-Cultural Context of Germany
Tanja Zoellner and Susanne Hedlund

Chapter 6: Gender as Culture: The Meanings of Self-Silencing in Women and Men
Linda Smolak

Chapter 7: 'I Don't Express My Feelings to Anyone': How Self-Silencing Relates to Depression and Gender in Nepal
Dana Jack, Bindu Pokharel, and Usha Subba

Chapter 8: Silencing the Self across Generations and Gender in Finland
Airi Hautamäki

Chapter 9: The Meaning of Self-Silencing in Polish Women
Krystyna Drat-Ruszczak

Chapter 10: Exploring the Immigrant Experience through Self-Silencing Theory and the Full Frame Approach: The Case of Caribbean Immigrant Women in Canada and the U.S.
Alisha Ali

Chapter 11: Deconstructing Gendered Discourses of Love, Power, and Violence in Intimate Relationships: Portuguese Women's Experiences
Sofia Neves and Conceição Nogueira

Chapter 12: Authentic Self-Expression: Gender, Ethnicity, and Culture
Anjoo Sikka, Linda (Gratch) Vaden-Goad, and Lisa K. Waldner

Chapter 13: Silencing the Self and Personality Vulnerabilities Associated with Depression
Avi Besser, Gordon L. Flett, and Paul L. Hewitt

Chapter 14: Sociopolitical, Gender, and Cultural Factors in the Conceptualization and Treatment of Depression among Haitian Women
Guerda Nicolas, Bridget Hirsch, and Clelia Beltrame

Section III: The Health Effects of Self-Silencing
Introduction to Section III: Empowering Depressed Women: The Importance of a Feminist Lens
Laura S. Brown

Chapter 15: Supporting Voice in Women Living with HIV/AIDS
Rosanna F. DeMarco

Chapter 16: Facilitating Women's Development through the Illness of Cancer: Depression, Self-Silencing, and Self-Care
Mary Sormanti

Chapter 17: Eating Disorders and Self-Silencing: A Function-Focused Approach to Treatment
Josie Geller, Sujatha Srikameswaran, and Stephanie Cassin

Chapter 18: Self-Silencing and the Risk of Heart Disease and Death in Women: The Framingham Offspring Study
Elaine D. Eaker and Margaret Kelly-Hayes

Chapter 19: Silencing the Heart: Women in Treatment for Cardiovascular Disease
Maria I. Medved

Chapter 20: Disruption of the Silenced Self: The Case of Pre-Menstrual Syndrome
Jane M. Ussher and Janette Perz

Chapter 21: 'I Wasn't being True to Myself': Women's Narratives of Postpartum Depression
Natasha S. Mauthner

Chapter 22: Seeking Safety with Undesirable Outcomes: Women's Self-Silencing in Abusive Intimate Relationships and Implications for Healthcare
Stephanie J. Woods

COMMENTARY
Janet M. Stoppard

Appendix A: The Silencing the Self Scale

About the Author

Dana C. Jack, EdD, is Professor at Fairhaven College of Interdisciplinary Studies/Western Washington University. Her research examines women's depression and anger in the U. S. and internationally, and qualitative research methods. She was a Fulbright Scholar to Nepal in 2001, and is author of three books, including Silencing the Self: Women and Depression.

Alisha Ali, PhD, is an Associate Professor in the Department of Applied Psychology at New York University. Her research examines social influences on women's depression, including the effects of emotional abuse, racism, and harassment. She is currently principal investigator on a series of studies examing economic empowerment for survivors of domestic violence.

Reviews

"I could not put down this highly interesting volume of essays that provides some of the most powerful and stunning insights into a reframing of women's depression! I strongly recommend this impressive book for all providers of health services as well as for educators and policy makers."

--Melba J. T. Vasquez, PhD, President, American Psychological Association
"This volume is perhaps the most powerful and poignant account of the silencing of women's voices across time and culture that has been published. It is a book that informs. It is a book that enlightens. It is a book to be treasured, and to be remembered long after it has been read and placed on the shelf."

--Anthony J. Marsella, PhD, Professor Emeritus, Department of Psychology, University of Hawaii
"The authors in this volume listen to women with a methodological tuning fork, precise and sensitive to women and context, and they read women's depression like a smoke alarm on cultural abuses of power. In the caring and delicate hands of Jack and Ali, women's narrations of depression signal a global call for justice and gendered human rights."

--Michelle Fine, PhD, Distinguished Professor of Social Psychology, Women's Studies and Urban Education, Graduate Center, City University of New York
"This book demonstrates the importance of self-silencing in the lives of women (and men) in many societies. The relationship to depression is useful for clinicians and researchers, and shows a means of getting at clinically relevant cultural information in a disciplined and practical way."

--Arthur Kleinman, MD, Esther and Sidney Rabb Professor of Anthropology, Harvard University, and Professor of Medical Anthropology and Psychiatry, Harvard Medical School
"A vivid and scholarly portrayal of how gender and cultural influence interact to shape the expression of mood disorder."

--Zindel V. Segal, PhD, Cameron Wilson Chair in Depression Studies and Professor of Psychiatry, University of Toronto
"What a stunning achievement! In the face of a medical establishment that views and treats depression as primarily a problem of faulty neurochemistry, this compelling book argues persuasively (and with solid evidence) for the powerful role of oppression in shaping women's mental health. This volume is required reading for mental health providers, scholars, and activists interested in understanding and improving women's lives."

--Lisa A. Goodman, PhD, Professor, Department of Counseling and Developmental Psychology, Boston College
"Overall, Jack and Ali's book is fertile with opportunities for psychotherapists. Each chapter offers numerous implications for prevention, intervention and treatment. I echo the book's jacket quote by Lisa Goodman, PhD, that "this book should be required reading for mental health providers, scholars and activists interested in understanding and improving women's lives"...The gift of this book is its benefit to everyone."
--Penelope L Norton, PhD, Voices: The Art of Science of Psychotherapy
"Silencing the Self Across Cultures: Depression and Gender in the Social World is a
valuable contribution to our profession. It is an academic work that builds upon previous
research." --PsycCRITIQUES
"A final commentary summarizes the research limitations of the constructs of self-silencing, depression, and gender, and calls for continued research on conditions that promote depression. An excellent review of current research springing from second-wave feminism. Summing Up: Highly recommended. " --Choice
"This thorough and impressive book is partly all about connection between people, and what happens when it's missing or faulty...There is a lot to digest in this volume, but generally it is written in an approachable style, notwithstanding the statistical analyses in some chapters. The inclusion of narratives from women is welcome, giving voice to the research findings and providing a human, grounding touch. It is not written for the lay person, but more for
practitioners, academics and researchers in the field." --Metapsychology
"Although the length and density of this volume may be daunting, it reminds readers of the complexity of women's experience and serves as excellent resource forteaching, planning research, and organizing effective interventions with diverse groups of women and men." -- Carolyn Zerbe Enns, PhD, Psychology of Women Quarterly