University of Pennsylvania – School of Social Practice and Policy Clinical Theory I SWRK 812-001 Fall 2017

Course Description

The purpose of this course is to broaden and deepen participants’ mastery of several theories of development, personality, and behavior that have contributed to social work’s knowledge base across the decades and continue to inform clinical social work epistemology today. Drawing primarily from original sources, we will consider key assumptions, constructs, and propositions of each theory in terms of its congruence with social work’s principles, values, and mission and in relation to the profession’s person-in-environment perspective. In this first semester, we will study the evolution of theories central to psychodynamic thought, from Freud’s early biological model of the mind, through various relational perspectives, to contemporary work in the fields of attachment and interpersonal neurobiology. This examination will constitute a case study of the manner in which theories are socially constructed and will lay the foundation for critical inquiry into the social and political biases inherent in the Western European intellectual tradition from which most theories of human behavior have emerged.

Course Objectives

Through reading, writing, and class discussion, successful course participants will demonstrate a capacity to:

1. Consider the philosophical and epistemological bases of each theory studied; 2. Locate each theory in relation to its historical, cultural, and political contexts; 3. Critically appraise the assumptions, constructs, and propositions of each theory; 4. Evaluate each theory’s goodness-of-fit with social work values, principles, and mission and with the person-in-environment perspective; 5. Assess the nature and strength of research based on the theories covered; 6. Identify the extent to which these theories are equipped to address issues of sociocultural diversity.

Assignments

1. Reading leadership. Divided into pairs, participants will be responsible for developing three (3) questions derived from the required readings for a class of their choice and leading a discussion of said questions. The questions should be e-mailed to all classmates and the instructor no later than the Sunday evening before the class in which the questions are to be discussed. Questions should reflect attention to course objectives and should generate critical thinking and thoughtful discourse.

1 2. Term paper proposal. A 6 page maximum (not including references), double- spaced mid-term proposal for a term paper based on one of the three topic options described below. This proposal should describe the topic of your paper, your plan for developing it, and an outline of your major foci. (A useful way to structure the proposal would be to employ the numbered sections I’ve proposed for each of the three options.) Due by midnight on October 10th – class #6 (no extensions).

3. Term paper

Option 1: An investigation and critical appraisal of the work of a psychodynamic theorist whose work is not specifically examined in the course. Possibilities include, but are not limited to: Jung, Adler, Rank, Horney, Adorno, Fromm, Bion, Lacan, Bollas, Ferenczi, Balint, Casement, and Chodorow. In the paper, (1) consider biographical information that likely informed the theorist’s ideas; (2) describe the historical and cultural context in which the theory developed; (3) assess the adequacy with which the theorist’s work addresses the biopsychosocial dimensions of human functioning; (4) address the implicit cultural biases and assumptions in the theorist’s published record; (5) evaluate any empirical evidence in support (and/or refutation) of the explanatory and/or predictive power of the theorist’s work; and (6) discuss implications of the theorist’s conceptualizations for clinical social work practice.

Option 2: Begin by clearly stating a general research question you would like to investigate. (1) From theories studied this semester, choose one or two that best illuminate your question’s major issues and describe the rationale for your choice; (2) review the central constructs, assumptions and propositions of the theory/theories you choose; (3) review and critically appraise theoretical work and research findings pertinent to your question; (4) on the basis of this review, state a more focused research question and describe how the theory/theories you choose, along with associated research, assist you in narrowing your focus; (5) if appropriate, propose preliminary study hypotheses and identify the type of research methodology best suited to your inquiry.

Option 3: Choose a client/patient from your clinical practice whom you would like to write about in depth, using one or more of the theories we have covered during the semester. In the paper, (1) provide relevant identifying information, history, and presenting problem, using a pseudonym to protect confidentiality; (2) describe why you have chosen to write about this particular case; (3) choose a theory or theories that we have studied this semester and give specific examples of how the theory or theories have helped you to understand your client/patient and how theory has informed the treatment; (4) give specific examples, if applicable, of ways in which the theory or theories did not fully address the biopsychosocial issues that the client/patient is working on in psychotherapy; (5) summarize the ways in which the theory/theories you have chosen do and/or do not fit with the basic tenets of clinical social work practice. The term paper is due by midnight on December 12th – final class (no extensions). It is to be no longer than 15 pages (not including references).

2 *All written work is to be submitted electronically through Canvas, double-spaced in 12-point, Times New Roman font and prepared according to the latest edition of the Publication Manual of the American Psychological Association. *

Texts

Required

Berzoff, J., Flanagan, L. M., & Hertz, P. (Eds.). (2016). Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (4th ed.). Lanham, MD: Rowman & Littlefield.

Cushman, P. (1995). Constructing the self, constructing America: A cultural history of psychotherapy. DA CAPO Press.

Erikson, E. (1959). Identity and the life cycle: Selected papers. New York: Norton.

Freud, S. (1909). The sexual enlightenment of children. New York: Collier, 1963. (Note: This book is out of print. Used copies are available for purchase through Amazon and other online booksellers.)

Kuchuck, S. (Ed.). (2014). Clinical implications of the psychoanalyst’s life experiences: When the personal becomes professional. New York: Routledge.

Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York: Norton.

Note: For those of you who read the Berzoff et al. text in your MSW programs, I suggest that you purchase the Palombo et al. text listed below as optional and read the chapters that correspond to the Berzoff readings.

Optional

Engel, J. (2009). American therapy: The rise of psychotherapy in the United States. New York: Gotham Books.

Gross, S. (2013). The Examined Life. New York: Norton.

Makari, G. (2008). Revolution in Mind: The creation of psychoanalysis. New York: Harper.

Palombo, J., Bendicsen, H. K., & Koch, B. J. (2010). Guide to psychoanalytic developmental theories. New York: Springer.

Schwartz, C. (2015). In the mind fields: Exploring the new science of

3 neuropsychoanalysis. New York: Vintage.

Summers, R. F., & Barber, J. P. (2010). Psychodynamic psychotherapy: A guide to evidence-based practice. New York: Guilford.

Zaretsky, E. (2005). Secrets of the soul: A social and cultural history of psychoanalysis. New York: Vintage Books.

COURSE OUTLINE

Required readings not in required textbooks are on Canvas. Optional readings are not on Canvas and can be found in the library.

Session 1: Introduction to Psychodynamic Theory and Theory Construction

Required

Applegate, J. S. (2000). Theory as story: A postmodern tale. Clinical Social Work Journal, 28, 141-153.

Berzoff et al. Chapter 1: Why psychodynamic theories, why a biopsychosocial context? (pp.1-17).

Schwartz, C. (2015, June 28). Tell it about your mother: Can brain-scanning help save Freudian psychoanalysis? The New York Times Magazine.

Optional

McLaughlin, A. M., Rothery, M., Babins-Wagner, R., & Schleifer, B. (2010). Decision-making and evidence in direct practice. Clinical Social Work Journal, 38, 155-163.

Simpson, G. A., Williams, J. C., & Segall, A. B. (2007). Social work education and clinical learning. Clinical Social Work Journal, 35, 3-14.

Thyer, B. A. (2007). Social work education and clinical learning: Towards evidence-based practice? Clinical Social Work Journal, 35, 25-32.

Session 2: Early Freud: Biologist of the Mind

Required

Berzoff, et al. Chapter 2: Freud’s psychoanalytic concepts, pp. 18-47.

Freud, S. (1896). The aetiology of hysteria. In Strachey, J. (Ed.). The standard

4 edition (vol. 3, pp.191-221). London: Hogarth.

Freud, S. (1896). Further remarks on the neuro-psychoses of defence. In The standard edition of the complete psychological works of Sigmund Freud, 1-24, pp. 162-178 only. London: Hogarth Press, 1953-1974.

Freud, S. (1989). Katharina. In Gay, P. (Ed.). The Freud reader (pp. 78-86). New York: Norton.

Cushman, Chapter 4: Healing through self-domination: Capitalism, the asylum, the untamed female body, and Freud, pp. 91-116.

Kuchuck, Chapter 13: Glassman, N. & Botticelli, S. Perspective on gay fatherhood: Emotional legacies and clinical reverberations. . (pp.162-168

Optional

Buhle, M. J. (1998). Feminism and its discontents: A century of struggle with psychoanalysis. Cambridge, MA: Harvard University Press.

Sulloway, F. J. (1979). Freud’s three major psychoanalytic problems and the Project for a scientific psychology (1895). In Freud, biologist of the mind (pp. 113-126 only). New York: Basic Books.

Session 3: Late Freud: From Biology to Psychology, Brain to Mind

Required

Berzoff, et al. Chapter 3: Schamess, G., Structural theory, pp. 50-63.

Freud, S. (1897). Letters to Fleiss. In Gay, P. (Ed.). The Freud reader (pp. 111- 116). New York: Norton, 1989.

Freud, S. (1909). Analysis of a phobia in a five-year-old boy. The sexual enlightenment of children (pp. 47-183). New York: Collier.

Cushman, Chapter 6: Strange bedfellows: The Americanization of psychoanalysis in the early twentieth century (pp. 140-158).

Danto, E. A. (2009). “A new sort of ‘Salvation Army’”: Historical perspectives on the confluence of psychoanalysis and social work. Clinical Social Work Journal, 37, 67-76

Russell, P. L. (2006). The theory of the crunch. Smith College Studies in Social Work. 76, 9-21.

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Optional

Freud, S. (1930). Civilization and its discontents. In Gay, P. (Ed.), The Freud Reader (pp. 722-772). New York: Norton, 1989.

Session 4: The Interpersonal School

Required

Sullivan, H. S. (1953). The interpersonal theory of psychiatry (Chapters 1-3, Chapters 7 and 10). New York: Norton.

Cushman, Chapter 7: The road not taken (pp. 168-185 only).

Optional

Greenberg, J. R., & Mitchell, S. A. (1983). Interpersonal Psychoanalysis. In Object relations in psychoanalytic theory (pp. 79-115). Cambridge, MA: Harvard University Press.

Session 5: Ego Psychology and Psychosocial Theory

Required

Berzoff, et al. Chapter 4: Schamess, G., & Shilkret, R., Ego psychology (pp. 64-99). and Chapter 5: Berzoff, J., Psychosocial ego development: The theory of Erik Erikson (pp. 97-117).

Freud, A. (1966). The ego and the mechanisms of defense (pp. 3-10 & 30-44). New York: Norton.

Erikson, E. (1959). Identity and the life cycle: Selected papers (pp. 51-176). New York: Norton.

Grosz, S. (2013). A passion for ignorance (pp. 55-70).

Cushman, Chapter 7: Ego psychology’s depoliticized vision (pp. 186-192 only).

Optional

Hartmann, H. (1939). Ego psychology and the problem of adaptation (pp. 3-47). New York: International Universities Press.

Goldstein, E. (1995). Ego psychology and social work practice (2nd. Ed.).

6 New York: Free Press.

Palombo et al. Chapter 2: Heinz Hartmann (pp. 49-60); Chapter 3: Anna Freud (pp. 61-80); Chapter 11: Erik Erikson (pp. 199-224).

Sorell, G. T., & Montgomery, M. J. (2001). Feminist perspectives on Erikson’s theory: Their relevance for contemporary identity development research. Identity: An International Journal of Theory and Research, 3(2), 97-128.

Session 6: British Object Relations Theory TERM PAPER PROPOSAL DUE

Required

Berzoff, et al. Chapter 6: Flanagan, L. M., Object relations theory (pp. 123-154 only).

Hughes, J. M. (1989). Melanie Klein: The world of internal objects. In Reshaping the psychoanalytic domain (pp. 76-83 only). Berkeley, CA: University of California Press.

Hughes, J. M. (1989). W.R.D. Fairbairn: Object relations and ego structures In Reshaping the psychoanalytic domain (pp. 105-117 only). Berkeley, CA: University of California Press.

Cushman, Chapter 7: Melanie Klein and the beginning of object relations theory (pp. 192-209 only).

Burack, C. (1992). A house divided: Feminism and object relations theory. Women’s Studies International Forum, 15, 499-506.

Optional

Palombo et al. Chapter 7: Melanie Klein, pp. 129-145.

Fairbairn, W. R. D. (1952). An object relations theory of personality. New York: Basic Books.

Klein, M. (1957). Envy and gratitude. New York: Basic Books.

Guntrip, H. (1969). Schizoid phenomena, object relations and the self. New York: International Universities Press.

Session 7: Focus on Winnicott

Required

Abrams, J. (2009). What's reality got to do with it?: Projective processes in adult intimate relationships. Psychoanalytic Social Work, 16(2), 126-138.

7 Applegate, J.S. (2002). Parallel paths: A personal journey to Winnicott and beyond. Psychoanalytic Inquiry, 22, 510-518.

Winnicott, D. W. (1953). Transitional objects and transitional phenomena: A study of the first not-me possession. In Playing and reality (pp. 1-25). London: Tavistock.

Winnicott, D. W. (1960). Ego distortion in terms of true and false self. The maturational processes and the facilitating environment (pp. 140-152). Madison CT: International Universities Press, 1965.

Winnicott, D. W. (1971). The location of cultural experience. Playing and reality (pp. 95-103). London: Tavistock.

Cushman, Chapter 8: Donald Winnicott and the emergence of the self (pp. 251-261 only)

Optional

Applegate, J. S., & Bonovitz, J. M. (1995). The facilitating partnership: A Winnicottian approach for social workers and other helping professionals. Northvale, NJ: Jason Aronson.

Applegate, J. S. (1989). The transitional object reconsidered: Some socio- cultural variations and their implications. Child and Adolescent Social Work Journal, 6, 38-51.

Palombo et al. Chapter 8: Donald Winnicott (pp. 147-162).

Phillips, A. (1988). Winnicott. Cambridge, MA: Harvard University Press.

Winnicott, D. W. (1958). The capacity to be alone. In The maturational processes and the facilitating environment (pp. 29-35). London: Hogarth Press. Winnicott, D. W. (1941). The observation of infants in a set situation. Through paediatrics to psycho-analysis (pp. 52-69). New York: Basic Books, 1975.

Session 8: American Object Relations Theory

Required

Mahler, M., Pine, F., & Bergman, A. (1975). The psychological birth of the human infant: Symbiosis and individuation (pp. 41-120). New York: Basic Books.

8 Berzoff, et al. Chapter 6: Flanagan, L. M. Object relations theory (pp. 154-165 only).

Applegate, J. S. (1990). Theory, culture, and behavior: Object relations in context. Child and Adolescent Social Work Journal, 7, 85-100.

Kernberg, O. F. (1976). Instincts, affects, and object relations. In Object relations theory and clinical psychoanalysis (pp. 85-107). New York: Jason Aronson.

Kuchuck, Chapter 17: Pines, D. Stroke and the fracturing of the self: Rebuilding a life and a practice (pp. 224-236).

Optional

Applegate, J. S. (1987). Beyond the dyad: Including the father in separation- individuation. Child and Adolescent Social Work Journal, 4, 92-105.

Colarusso, C. A. (2000). Separation-individuation phenomena in adulthood: General concepts and the fifth individuation. Journal of the American Psychoanalytic Association, 48, 1467-1489.

Jacobson, E. (1964). The self and the object world. New York: International Universities Press.

Palombo et al. Chapter 9: Margaret Mahler (pp. 163-180); Chapter 10: Otto Kernberg (pp. 181-196).

Session 9: The Psychology of the Self

Required

Berzoff, et al. Chapter 7: Flanagan, L. M. The theory of self psychology, pp. 166-195.

Kohut, H. (1977). Epilogue. In The restoration of the self (pp. 267-312). New York: International Universities Press.

Cushman, Chapter 8: Heinz Kohut and the valorization of narcissism, pp. 261-278 only.

Kuchuck, Chapter 7: Ornstein, A. Reflections on the development of my analytic subjectivity (pp. 81-97).

Optional

Goldstein, E. (2001). Object relations theory and self psychology in 9 social work practice. New York: Free Press.

Elson, M. (1986). Self psychology in clinical social work. New York: Norton. Palombo et al. Chapter 14: Heinz Kohut (pp. 257-281).

Bacal, H. A., & Newman, K. M. (1990). Heinz Kohut. In Theories of object relations: Bridges to self psychology (pp. 225-273). New York: Columbia University Press.

Session 10: Infancy Studies

Required

Stern, D. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology (pp. 3-137). New York: Basic Books.

Beebe, B., & Lachmann, F. M. (2002). Infant research and adult treatment: Co-constructing interactions (pp. 1-44). Hillsdale, NJ: Analytic Press.

Tronick, E. (1989). Emotions and emotional communication in infants. American Psychologist, 44, 112-119.

Optional

Applegate, J. S., & Shapiro, J. R. (2005). Early affect regulation: Prelude to attachment. In Neurobiology for clinical social work: Theory and practice (pp. 40-57).

Palombo et al. Chapter 4: Rene Spitz (pp. 81-94). Chapter 13: Daniel Stern (pp. 243- 256).

Session 11: Relational/Intersubjectivity Theory

Berzoff, et al. Chapter 10: Hadley, M., Relational and intersubjective theories theories (pp. 222-240); and Chapter 11: Berzoff, J., Psychodynamic theory and gender (pp. 241-257).

Stolorow, R. D. (1994). The intersubjective context of intrapsychic experience. In Stolorow, R.D., Atwood, G. E., & Brandchaft, B. (Eds.), In The intersubjective perspective (pp. 3-14). Northvale, NJ: Jason Aronson.

Stolorow, R. D., & Atwood, G. E. (1994). Toward a science of human experience. In Stolorow, R. D., Atwood, G. E., & Brandchaft, B. (Eds.), The intersubjective perspective (pp. 15-30). Northvale, NJ: Jason Aronson.

Benjamin, J. (1995). Recognition and destruction: An outline of intersubjectivity. In Like subjects, love objects: Essays on recognition and sexual difference 10 (pp. 27-48). New Haven, CT: Yale University Press.

Kuchuck, Chapter 11: Kuchuck, S. Guess who’s going to dinner? On the arrival of the of the uninvited third (pp. 135- 145).

Optional

Applegate, J. S. (1999). Winnicott and the paradoxes of intersubjectivity. Smith College Studies in Social Work, 69, 203-220.

Davies, J.M. (2004). Whose bad objects are we anyway?: Repetition and our elusive love affair with evil. Psychoanalytic Dialogues, 14, 711-732.

Ogden, T. (1994). The analytic third: Working with intersubjective clinical facts. In Subjects of analysis (pp. 61-95). Northvale, NJ: Jason Aronson.

Session 12: Attachment Theory

Required

Bowlby, J. (1977). The making and breaking of affectional bonds. British Journal of Psychiatry, 130, 201-210.

Berzoff, et al. Chapter 8: Shilkret, R., & Shilkret, C., Attachment theory (pp. 196-219).

Slade, A. (2000). The development and organization of attachment. Implications for psychoanalysis. Journal of the American Psychoanalytic Association, 48, 1147-1174.

Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Introduction and Attachment and reflective function: Their role in self-organization. In Affect regulation, mentalization, and the development of the self (pp. 1-64). New York: Other Press. Optional

Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books.

Fonagy, P. (2001). Introduction to attachment theory and key findings of attachment research. In Attachment theory and psychoanalysis (pp. 5-46). New York: Other Press.

Palombo et al. Chapter 15: John Bowlby (pp. 287-301); Chapter 16: Mary Salter Ainsworth (pp. 303-314); Chapter 18: Peter Fonagy (pp. 335-347).

Session 13: BrainMind: Neuroscience, Neuropsychoanalysis and Psychotherapy

11 Required

Applegate, J. S., & Shapiro, J. R. (2005). The brain: An introductory tutorial; The neurobiology of memory; and affect: Toward a neurological integration. In Neurobiology for clinical social work: Theory and practice (pp. 1-39). New York: Norton.

Solms, M., & Turnbull, O.H. (2011). What is neuropsychoanalysis? Neuropsychoanalysis, 13, 1-13.

Panskeep, J., & Biven, L. (2012). Ancestral Passions. In The archaeology of the mind (pp. 1-46). Optional

Shapiro, J. R., & Applegate, J. S. (2000). Cognitive neuroscience, neurobiology, and affect regulation: Implications for clinical social work. Clinical Social Work Journal, 23, 9-21.

Miehls, D., & Applegate, J. S. (Eds.) (2015). Neurobiology and mental health clinical practice: New directions—new challenges. London: Routledge.

Badenoch, B. (2008). Being a brain-wise therapist: A practical guide to interpersonal neurobiology. New York: Norton.

Cozolino, L. (2006). The neuroscience of human relationships: Attachment and the developing social brain. New York: Norton.

Cozolino, L. J. (2002). Rebuilding the brain: Neuroscience and psychotherapy. In The neuroscience of psychotherapy: Building and rebuilding the human Brain (pp. 15-45). New York: Norton.

Fotopoulou, A., & Tsakiris, M. (2017). Mentalizing homeostasis: The social origins of interoceptive inference. Neuropsychoanalysis, 19, 3-28.

Palombo et al. Chapter 17: Allan N. Schore (pp. 319-333).

Schore, J.R., & Schore, A. N. (2008). Modern attachment theory: The central role of affect regulation in development and treatment. Clinical Social Work Journal, 36, 9-20.

Siegel, D. J. (1999). Attachment. In The developing mind: Toward a neurobiology of interpersonal experience (pp. 67-120). New York: Guilford.

Session 14: Research on Effectiveness and Contemporary Applications

12 *Final Paper Due*

Required

Holmes, D. E. (2016). Come hither, American psychoanalysis: Our complex multicultural America needs what we have to offer. Journal of the American Psychoanalytic Association, 64 (3), 568-586.

Shedler, J. S. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65, 98-109.

Tummala-Narra, P. (2015). Cultural competence as a core emphasis of psychoanalytic psychotherapy. Psychoanalytic Psychology, 32 (2), 275- 292.

Optional

Blatt, S. J. , Auerbach, J. S., Zuroff, D. C., & Shahar, G. (2006). Evaluating efficacy, effectiveness, and mutative factors in psychodynamic psychotherapies. In PDM Task Force, Psychodynamic diagnostic manual (pp. 537-572). Silver Spring, MD: Alliance of Psychoanalytic Organizations.

Cushman, Chapter 10: The politics of the self (pp. 332-356).

Note: This syllabus is meant as a guide. Additional readings and exercises may be assigned as learning needs arise.

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