Introduction to Social Work

Chapter 4. Psychodynamic Practice

Psychodynamic ideas provide a rich fund of ideas for practice; they emphasize the importance of people’s feelings and internal conflicts in the development and resolution of problems. Historically, they have had a strong impact on how social work is practiced and helped shape its focus on people’s psychological reactions to their social environment as the source of personal and social problems. Psychodynamic practice demonstrates how the problem-solving objective of social work supports the existing social order by helping people to adjust to the society around them.

Terminology

Anxiety and ambivalence are derived from the inadequate resolution of problems earlier in life and lead to powerful feelings of aggression, anger, and love.

Attachment refers to the behavior and emotional reactions of children seeking proximity to a person whom they perceive offers security in an environment in which they fear danger.

Attunement is the process of appreciating and responding to emotions and attitudes that lie underneath the surface behavior.

Coping is the ability to manage present problems without anxiety.

Defenses and resistance are two common psychological barriers to working on life issues. They derive from a poor resolution of past problems.

Transference and countertransference refer to the effect of past experience that is transferred into present behavior patterns. Practitioners can reflect on how clients react to them and how this makes them feel, so that they can directly experience how clients behave with others and how other might fee.

Relationships with people may be used to model effective thinking and self-control, and as a vehicle to gain influence and confidence to explore psychological issues—‘relational practice’.

Working-through is a process of repeatedly remembering crucial examples of problem behavior as they occurred, exploring what happened and thinking about way in which events and their emotional consequences might have been different.

Key Ideas

Psychodynamic perspectives underlie traditional social work. Psychodynamic perspectives come from psychoanalysis, which emphasizes that the mind is the dynamo— the mind both motivates and directs or manages a person’s behavior. Since the 1960s practice theory emerging from this idea has been called ‘psychosocial’ because it look at how the mind and behavior influences and are influenced by the social environment. These ideas were influential during the period 1930-60 when social work was becoming established and therefore underlie ‘traditional’ social work that many other theories in turn developed from or reacted against. As a result, psychodynamic ideas still influence everyday practice and Western culture. However, psychoanalysis (as opposed to psychodynamic perspectives) is mainly only used in specialize psychiatric settings are rarely used by social workers.

Psychoanalytic theory includes three main aspects. Psychoanalytic theory describes metaphorical structures in the mind such as the id, ego, and superego. Second, this theory demonstrates how people build up these structures by going through psychological stages, and how their behavior may be affected in the long term by disruptions to this development. Finally, psychoanalytic treatment theory addresses dealing with behavioral problems that come from disrupted development. Current ideas that come from these three historic elements of psychoanalytic theory include: ego theory (how patterns of thinking develop and affect/control their behavior); object relations theory (how people’s perceptions of things outside themselves affect their behavior); attachment theory (how people ‘s behavior is affected by experiences of attachment to others); self theory (how the structure of people’s identifies affects there interactions with others); and relational theory (how people operate in their relationships, and what they bring to them from their past).

Distinct streams of thought within psychosocial theory are now taken as basic ideas. Distinct streams of thought within psychosocial theory are now usually taken together as basic ideas about practice. Psychosocial (formerly diagnostic) theory focuses on diagnosis, assessment, and classification of treatment as a basis for exploring the ‘person-in-situation’ (or ‘person-in-environment’ PIE). Functional theory emphasized the function of social work agencies in giving practice its form and direction including the idea of self-determination, importance of structuring practice around time, and the emphasis on process and growth. Problem-solving casework focused on exploring problems that clients present and on improving their capacity for coping with them. This forerunning of task-centered casework that emphasized problems analysis it is still used as the conceptual basis of important texts, which connect it with ecosystems theory.

Residential care/psychodynamic group work illustrates psychodynamic theory. Psychodynamic theory applied to residential care depends on three theoretical developments. First, planned environment therapy used by some schools for young people with emotional and behavioral disorders. Second, milieu therapy which is mainly an American concept based on psychodynamic groupwork is used with maladjusted young people. Third, psychodynamic theory aids the design of therapeutic communities used in community mental health settings such as day hospitals and hostels. The therapeutic community is the most widely influential model of residential care practice. This is based on an informal, communal atmosphere; group meetings; shared work; all residents have a therapeutic role with each other; authority is shared between staff and residents; and common values include the belief that individual problems are mostly about relationships with others, therapy is a learning process, and members share a basic psychological equality as human beings.

Several values issues arise from psychodynamic theory’s individualism and determinism. Psychodynamic perspectives in social work focus on the individuality of each human being and the unique way in which internal emotions and drives create each individual’s behavior. This view respects human beings by helping them to make sense of their experiences and the present strains and stresses. This in turn led social work to give prominence to the self-determination and individualization of clients an their problems. However, focusing on the psychological can result in victim blaming and affirm cultural, racial, and gender stereotypes. Psychodynamic practice also may create more barriers to change than practice theories focused on the present and the future. And, they do not address social change or excluded or oppressed groups, as they do not offer social explanations for client problems. Another key values issue within psychodynamic theory is that it is deterministic, based on earlier experiences in particular childhood. Because the theory assumes that psychological defenses are very difficult to change, simply understanding may not allow individuals to make changes and possibly they cannot. This is in opposition to social work’s value base that strongly emphasizes that people can make changes.

Issues

Debates continue over the science and empirical support for psychodynamic practice. Psychodynamic theory attempts to analyze aspects of the mind primarily using case studies in order to create a science of the mind based on careful observation, critical analysis, and philosophical debate. For positivist critics, psychodynamic theory is flawed because it is based on metaphorical ideas about mental structures and movements that are inferred from behavior and self-description. However, there is an increasing body of evidence that most forms and psychotherapy and counseling in which practitioners rigorously apply a model of psychodynamic practice are effective in helping many people. There is also a growing body of research regarding the use of particular practices related to relational and attachment ideas. Moreover, the basic principles of psychological social work practice can b seen in influencing each other so as to produce broadly similar types of eclectic practice. Overall, psychodynamic theory does provide a rich set of interpretive idea to help practitioners explore what is happening in peoples’ minds. Psychodynamic practice fails to incorporate the social issues that affect practice. Psychodynamic practice does emphasize psychological factors and interventions to the virtual exclusion of social and sociological explanations and social interventions. Thus the possible range of interventions is limited and suggests a very limited concern for social reform. Other problems follow from this internal emphasis, such as the tendency to blame people for what has happened to them by making individuals responsible for problems and causes. For example, alcoholism needs a ‘cure’ rather than being seen as a response to social experiences. However, not everyone reacts the same way to social pressures, so individual psychological factors may also be important alongside social factors. In addition, psychodynamic theory is social in the sense that it understands people’s life issues as stemming from how the psychological and the social interact, as in attachment, relational, and object relations theories.

Psychodynamic practice has limitations as a basic for social work practice. Psychodynamic intervention focuses on changing behavior through insight. This means that practitioners aim to influence people over time by getting them to understand themselves better through building a relationship with them and trying to influence them over a period of time. Psychodynamic interventions prefer clients who can express themselves well and take part in discussion and self-examination. This approach is not as suitable for less articulate clients, working-class people, and people with more practical problems. Since psychoanalysis is non-directive, refusing to give advice or organize practical moves toward change reduces social work effectiveness.

The cultural assumptions of psychodynamic practice are also subject to debate. Psychodynamic theory takes a white, middle-class perspective as the norm and deviations are abnormal and should be ‘cured’. This is a particular problem when dealing with children who have significant variations across cultures and ethnicities, for example, or homosexuality and the role of women in society.

Psychodynamic theory’s development separate from social work restricted ideas. Psychodynamic theory does not now form a central basis for social work nor does psychodynamic theory adopt social work ideas. However, insights from psychodynamic theory might help with understanding racist behavior and in dealing with minority ethnic groups. Psychdynamic theory thus has less influence in social work than it might for two reasons. First, the historic cultural assumptions of psychodynamic theory established ‘normal’ ways of relating to others. Second, while psychodynamic theory might adopt ideas, its isolation as a complex and separate stream of thought means that this will happen only occasionally.

The assumption that earlier experience strongly influences current behavior is questioned. The central assumption of psychodynamic theory is that present behavior arises from past experience, in particular, relationships. Thus psychodynamic theory’s ‘deterministic’ assumptions do not fit with current views that clients’ current concerns are important priorities or with the shared value principle of social work agencies, which are positive and look to the future.

Final thoughts…

Despite the provenance of psychodynamic theories and ideas, social work practitioners are usually cautious about use of developing into the past rather than the present predicaments. While psychodynamic ideas can be applied in many different situations, they are primarily used in mental health and so offer connections between social work practitioners and other professionals in those settings. However, despite the criticism of practical problems using psychodynamic theory in social work, there are advantages to understanding the large body of psychodynamic writings. Psychodynamic theories are a rich source of ideas and metaphors for therapeutic and clinical settings as well as providing a great deal of the day-to-day language used to express common ideas about how people are influenced by their past in their thinking.