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Classical Psychoanalytic Thought, Contemporary Developments, and Clinical Social Work Practice

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Classical Psychoanalytic Thought, Contemporary Developments, and Clinical Social Work Practice Roberta R. Greene and Michael Uebel

Freud's conceptualization of the development, structure, and functioning of the personality ushered in a new era in understanding behavior and in treating the human mind (Baker, 1985). Many view Freud, whose theory offers an ex­ planation of human development and a method of treatment, as a pioneer who fumished fax-reaching concepts "central to nearly every approach to treating psychological problems via psychotherapy" {ibid., p. 20). The influence of Freud's psychoanalytic theory has been so dramatic that it has left a legacy of ideas that continues to shape the direction of contemporary social science, psychology, and neuroscience. Freud's psychoanalytic theory has influenced almost every arena of modem life—literature, art, and law, as well as political, social, and economic systems—to such an extent that his "concept and terminology have infiltrated the thinking even of those who most repudiate his views" (Wood, 1971, p. 46). Psychoanalytic theory, which is now over a century old, and its contempo­ rary offshoots have been important influences on social work practice. Some beheve that these influences have been so strong that they have "permeated not only the casework method, but also the social reality within which social casework is embedded" {ibid.). This chapter presents selected classical psychoanalytic tenets, outlines the major shifts in emphases that have led to the development of ego psychology, object relations, and self psychology schools of thought, and discusses some of the major contributions of these bodies of thought to clinical social work practice. It closes with a discus­ sion of one future direction psychoanalysis is heading, namely, attachment neurobiology. The case study involves a young adult with problems of ego identity. Chapter 4 continues in the psychoanalytic tradition and discusses Erik Erikson's ego psychology.

57 58 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 59

In large measure, social workers' interest in Freudian theory came about be­ The wide-scale adoption of the idea that a cUent may not be aware of important cause of the profession's struggle to find a scientific base for practice (Hamilton, unconscious or krational feelings and thoughts affected how many social work­ [1940] 1951;Homs, 1964). Germain (1971) suggested fhat the premise laid out ers saw fheir role. Using a psychoanalytic model meant that the social worker's in Social Diagnosis by Mary Richmond (1917)—"that uncovering the cause techniques would be geared to interpreting the client's behaviors and motivations will reveal the cure"— led to a strong interest in the medical model or "disease as well as helping the client to understand the meanings of symptoms. The use metaphor" (as conceived by Freud) and with it a "study-diagnosis-treatment of self in the helping relationship also was affected by psychoanalytic theory. framework" (pp. 10-13). Because of this historical commitment to the medical "Almost overnight, advanced practitioners who had now been brought imder 'the model, a perspective with an emphasis on diagnosis, treatment, and cure, it is influence' learned to hsten.. .[and] to observe the cHent's verbal and nonverbal sometimes said that Freudian theory "transformed casework from a trial-and- activity in a more productive way" (Hamilton, 1958, p. 25). error art" to a more precise or scientific framework for helpmg people (Wood, 1971, pp. 45-46). Social workers of the 1960s and 1970s were greatly influenced by Members of the diagnostic and psychosocial schools of social casework par­ the idea that human behavior is unconsciously motivated. ticularly have been affected by Freudian tiieory (Hamilton, 1958; HoUis, 1970; Perhnan, 1957a). The assumption that "there must be painstaking social study, Freud's assumption that adult pathology has its roots in early cMldhood followed by a diagnostic formulation leading to a plan of tieatment" (Hollis, experiences also had a pervasive influence on social casework (Lowenstein, 1964, p. 191) is a major principle of these schools, one based on Freud's medi­ 1985). As a result of the influence of psychoanalytic thought, uncovering hid­ cal model. den childhood motivations for behavior became an important aspect of many Among fhe most important assumptions that many clinical social workers social casework assessments. An acceptance of the subjective meanings cHents adopted from psychoanalytic theory is the view that all behavior is determined attribute to events has been a consistent theme in both psychoanalytic treatment in a purposeful and orderly way. That is, everything a person says or does, even and social casework. The role of many social workers increasingly came to be words or actions that are seemingly irrational, is meaningful and can be explained. one of interpreting a client's motivations and present difficulties in light of past Freud was among the first students of human behavior who took all forms of experiences. behavior as meaningful expressions that could ultunately be understood. Put The idea that the clinical social worker has the responsibihty to understand simply, Freud proposed that all mental phenomena made sense. By sense he his or her own psychological seif also can be traced to Freud's ideas about meant "'meaning', 'intention', 'purpose', and 'position' in a continuous psychical what ti-anspires ui the helping relationship. Because Freud believed there was [psychological] context" (Freud, [1916-17] 1963, p. 61). According to Hollis fhe potential for both chent and therapist to relive significant irrational aspects (1964), Freud's conceptualizations, which help caseworkers "to understand of their developmental histories within the helping relationship, he suggested causation in the developmental sense of how the person came to be the way he that self-awareness was of great importance to the helping person. The classical [or she] is...made a major contribution to the social work profession" (p. 168). . psychoanalytic principle that a helpiag person must first be self-aware before he I or she is able to assist a cHent has been an important influence on social work Freud's theory of human behavior permeates Westem thought and was ad­ practice. Although most social workers today do not follow ortiiodox psycho­ opted by social workers to guide the diagnostic process. analytic methods and may employ a number of different human behavior theories, lis contemporary styles of direct practice stOl reflect influences of Freudian tradition. Although not without dispute, another major approach to practice that many "From our contemporary point of view, the question is not so much 'What did clinical social workers have borrowed from psychoanalytic theory is the idea Freud say?' but 'What has Freud's work led to?'" (Baker, 1985, p. 19). that there are unconscious mental processes and that these processes are of great significance. For example, Hamilton ([1940] 1951) contended that "caseworkers I must sometimes bring to tiie attention of the cHent ideas and feelings, whether The Person-In-Environment BDLstorical Context: acceptable or not, of which he [or she] was previously unaware" (p. 73). Li- Freud's Psychoanalytic Theory eberman (1982), in a discussion of the place of unconscious determinants of A neurologist by training, Freud was educated to view all symptoms as stem- behavior in social work practice, stated tiiat "for a clinician there should be only "j'TC&ng from some organic disorder or brain malfunction. Although Freud began his one answer. The client needs to be understood in depth, beyond the, immediate i. scientific work with a recognition of the biological aspects of psychiatry, he later presentation" (p. 28). ' came to beUeve fhat the science of his day was insufficiently advanced to study 60 Human BehaTior Theory and Social Work Practice Classical Psychoanalytic Thought 61

organic diseases of the nervous system. He therefore tumed to an investigation Hamilton (1958) noted, psychological energy "was likened to steam in a boiler, of psychological functionmg or what he termed "the workings of the mind." and could only be diverted or discharged' (p. 1552). Today, tiie idea tiiat the mind Through his stody, Freud came to believe tiiat people become psychologically is a closed system govemed by a finite amount of energy is no longer accepted. or physicaUy ill because of conflicts in human relationships. That is, mental However, ego psychologists have extended Freud's ideas about ego functioning, ilhiess could be a functional disturbance—m tiiis case, a product of a distiubed suggesting that tiie ego has its own psychic energy, is relatively autonomous, relationship. He hoped that psychoanalysis would give psychiatry "its missing and plays a critical role in assuming coping stiategies. This point of view was psychological foundation" and fhat tiie "convergence of physical and mental seen by many as more congment and useful in social work practice, where a disorder" would become mteUigible (Freud, [1916-17] 1963, p. 21). central issue is a client's strategies for meeting tiie demands of his or her envi­ ronment (Compton, Galloway, & Coumoyer, 2004; Fromm, 1959; Goldstem, Early in Freud's career, he hoped to demonstirate that human 1986; Lowenstem, 1985). behavior was, in large measure, biologically based.- Freud's critics have suggested tihat for several decades (1920-1960) social workers became too immersed in psychoanalytic theory. It was argued that Freud was concemed tihat others in tiie scientific community thought tiiat tiiere the profession's strong emphasis on intrapsychic phenomena created a schism was "no objective verification of psychoanalysis" and doubted the credibility within the profession—dividing it between those who were more interested in ofthe psychoanalytic metiiod (ibid., p. 19). He rebutted this position by stating tihe "person" and those who placed a stionger emphasis on tiie "envkonmenf that "one leams psycho-analysis on oneself, by stiidymg one's own personality" (Woodroofe, 1971). On the other hand, it has been argued tiiat tiie profession's (ibid.). Freud's theoretical views challenged so much of the scientific flunMng understanding of mfrapsychic phenomena has been sttengtihened through an and norms of his day that he himself saw his ideas as controversial. eclectic use of psychoanalytic principles, and that, despite this stiong interest Freud began his work when psychology emerged as an independent discipline in tihe"person, " the profession has remained equally environmentally concemed m tiie mid-nineteentii century. In the scientific fradition of his day, tiie explanation (Caroff, 1982; Cohen, 1980). During World War II and postwar years, when an of complex experiences was reduced to a number of elementary phenomena, an interest in pohtical and social factors came to the fore, social work practitioners approach known as reductionism (Hall & Lindzey, 1957). The major scientific focused tiheir mterest on how a cUent leams to master his or her environment. focus in psychology at that tune was fhe identification and study of tiie stiuctural elements of tihe conscious mind. The stiong tendency of psychologists of Freud's Contemporary Applications day was to place the unconscious beyond the realm of serious scientific analysis Contemporary psychoanalytic thuiking, tends, for the most part, to be based (Nye, 1975). Freud, who made tiie concept of tiie unconscious tiie cornerstone on ego psychology (Corey, 2000). Altiiough ego psychology does not deny the of his theory and beheved that a person's unconscious could be an object of existence of uittapsychic conflict, it places a greater emphasis on tiie striving scientific study, added an entirely different and contioversial dimension. of the ego for mastery and contiol over the environment than does orthodox Another reason for Freud's controversial reception was his treatment of Freudian tiioughf Ego psychology pays particular attention to adaptation and sexuahty, which, for his day, was "novel to the point of scandal" (Wood, 1971, defense (repression). Ego psychologists, who examine tiie functioning of tiie p. 51). Most shocking was his attiibution of sexuality to the young cMld. Today ego throughout the life cycle, represent a critical change in botii cUnical and it is clear that some of the controversy was based on misunderstandings of theoretical emphasis. Their emphasis on tiie impact of tiheenvironmen t and tiie Freud's statements. Freud did not equate infant and adult sexuahty. Rather, he more rational and problem-solving capacities of the ego in fostering adaptive suggested that personality was developed in psychosexual stages during which behavior has been an important perspective m social work practice (Goldstein, there was movement of psychic energy from one erogenous, or gratifying, zone 1984, p. xvii). of the body to tiie next, witih each stage presenting psychological conflict and For many, tiiis school of thought known as ego psychology marked the retum gratification. to a better balance between personality and situational factors m social work Freud was ahead of his day m foreseeing tiiat tihe laws of chemistiy and phys­ practice. For example, Wood (1971) suggested tiiat ego psychology renewed the ics could be apphed to humans. Although some of his concepts have become profession's focus on tiie person-environment consteUation. Hamilton (1958) outdated, many of his cential ideas, when modified, have made important con­ proposed that ego psychology developed "a fresh orientation to [casework] tieat­ tributions to social work practice. For example, early systems theory influenced ment' by refocusing casework practice on tiie ego as an autonomous, separate, Freud to posit the view that tihere is a fixed sum of psychic energy available to and distinct personahty stmcmre. She went on to state that by emphasizing ego tiie personality that must be exchanged among the id, ego, and superego. As strengflis, "tiie casework metiiod was fundamentidly reorganized' to be concemed ^umiy ana social Work Practice Classical Psychoanalytic Thought 63

with the "stresses of reahty" (p. 22). The view of human functioning proposed in which cUnical material is mterpreted both m temis of drive and conflict issues by ego psychologists is stiU a prevalent one m the dhrect practice of social work and in terms of tiie psychology of tiie self. For self psychologists, tiie pnncipal bnk Enkson whose theory made a major contribution to this perspective is discussed m Chapter 4. F-^i^-peuuve, is focus is on tiie interrelated issues of personal mtegrity, self-esteem, agency, af­ fective tone, and authenticity. Another contemporary offshoot of Freudian theory is object relations, which Self psychology holds tiiat the fundamental need of the person is to organize developed over roughly the past forty years in the U. S. and the past sixty in his or her psyche into a cohesive configuration. Anxiety, tiien, is explained as Europe mamly England. The path to object relations theory led through the representing tiie direct tiireat to psychical cohesion. Kohut's term for tiiis is "disintegration anxiety," or tiie fear of tiie self breaking up. Anxiety is seen to Freud. Anna Freud made major contributions to the development of psycho­ arise in tiie context of failures of empatiiy. It is no surprise, tiien, fliat self psy- analytic theoiy by shifting her focus to an elaboration of the defenses L how cholo<^ists practice a tiierapeutic stance tiiat is tiie polar opposite of tiie detached they operate Rather than bemg concemed primarHy with drives, she devoted a and s^geon-Uke demeanor of tiie classical psychoanalyst. Self psychologists great deal of attention to defining the ego and how it operates to protect its own foster "an ambiance of emotional vitaUty and responsiveness" (BrandeU, 2002a, mtegnty (A. Freud, [1936] 1966). p 161) involvmg empatiuc responses to tiie person's need for expenences of Object relations theorists, acknowledging their debt to psychoanalysis mirroring and idealization, which are considered requisite for tiie constancy view themselves as developers, elaborators, and carriers ofthe tradition (Bion,' of self experience and experience of tiie otiier. Self psychology approaches 1962; Fairbaun 1954; Kemberg, 1976). Object relations is grounded in tiiese to understandmg tiie cUent's subjective experience involve two fundamental tiieonsts view tiiat personality stmctiireis aresult of tiie natore of mterpersonal phases- a phase of understandmg tiiat gives way to a phase of explanation and experiences. The theory focuses on intemalizations of formative relationships interpretation (Kohut, 1984). Witiiin tiie field of social work generally, empatiuc in a person s history tiiat are based on need attachment and separation and is immersion in tiie cUent's self experience is considered to be tiie foundation of tiius developmental and historical m approach. It pays special attention to tiie effective crisis intervention and is a key aspect of supportive tiierapies and time- here-and-now of mtemalized past dramas between self and object, while at tiie limited psychodynamic psychotiierapies. same time attendmg to tiie process of differentiation and mataration of self and object representations. The contiibutions of object relations flieorists have en­ Basic Assumptiions and Terminology abled modern psychoanalytic tiiought to relate itself especiaUy to tiie outpourin- of Stadies about tiie early development of young children (Bowlby 1969 1973° Freud's Psychoanalytic Theory Brazelton, 1969; Mahler, Pine, & Bergman, 1975; Stem, 1985). By observins As conceptaahzed by Freud from about 1895 to 1932, psychoanalytic tiieory tiie simtianties between tiie normal developmental behaviors of young children is deterministic. That is, earUer events control (detennme) later events ^Ji^ and tiie ways in which disturbed adult patients behave toward botii extemal assumption underlies aU of his conceptaaUzations. For example, Freud ([1905] and mtemal objects or people, object relations tiierapists have been able to 1953) saw infants as having drives tiiat are durected toward certain goals, most draw unportant practice msights mto understandmg the meamngs of patients' notably attaining oral gratification (see tiie section on Explaimng Development behaviors. Witiim social work practice, object relations perspectives conttibute Across tiie Life Cycle). Freud's most general purpose, and anotiier underlying especiaUy to tiiose mterventions tiiat underUe mteractive processes, e.g., couples assumption, was to demonstiate or prove tiiat aU experiences, feehngs, tiioughts, famtiy, and group tiierapies (Borden, 2000). More recently, Saari (2002) has fantasies, and dreams make sense. developed a posttnodemist account of tiie tiieory and practice of psychotiierapy Freud was a prolific writer who elaborated his tiieoiy of human personahty tiiat, consistent witii object relations.tiieory and social work's "person-m-sittia- for more tiian forty years. During tiiat time, he produced a nmnber of models to tion" perspective, examines how mdividuals constmct an understandmg of tiieir explainpsychic sttuctares and tiie meaning of behavior. Forpurposes of clanty, each envuonment pnor to buUding a personal identity of Freud's models is described separately, altiiough his tiieory is best understood The last m^or school we wiU outUne briefly here, self psychology, has been tiirough tiie integration of tiie infomiation from each model (Table 3.1). Freud s descnbed as a mixed model" approach (Greenberg & MitcheU, 1983) That is' tiieory has led to tiie elaboration of contemporary uses of his concepts. as a mixed model stirategy, self psychology mamtains tiiat a full understanding ot people s natare must take into account botii instinctaal (i.e., classical Freudian Economic Model dnve tiieoiy) and relational factors. Witii tiie pubUcation in 1977 of tiie maior The economic model-which is tiie foundation for futare models-proposed book The Restoration ofthe Self, Hemz Kohut developed a complementaiy tiieory two major ideas: (1) tiie fixed amount of psychic energy among id, ego, and 64 Human Behavior Theory and Sodal Work Practice Classical Psychoanalytic Thought 65

Table 3.1 pattems, jokes and errors, works of art, and neurotic symptoms. Freud's mterest Psychoanalytic Theory: Basic Assumptions in unconscious mental Ufe also led to a stady of dreams (residues of waking • AU mental Ufe is meaningful. mental activity). He viewed dreams as the "distorted substitate for sometiUng • Nothing happens randomly or by chance. else, something unconscious," and beheved tiiat the task of interpreting a dream • Each psychic event is determined by preceding events. is to discover tius unconscious material (Freud, [1916-17] 1963, p. 114). • As a three-part energy system, the personality is fueled by psychic energy that can be invested in varying degrees in objects. Freud's various models describe the origins of mental activity^ and • Behavior is biologically based, propelled by tensions created by innate sexual or ag­ gressive drives. how practitioners may understand and interpret behaviors. • Society is a necessary controUing influence on primitive biological needs. • Each psychosexual stage is an outgrowth and recapitulates earUer ones. The perspective fhat behavior and motivation have roots in different levels • Personahty is an outgrowth of aU five stages. The major events in personahty forma­ of awareness, that is, that the individual may not be aware of his or her motiva­ tion occur in the fhst five to six years of Ufe. tions or causes of behavior, has had an important influence on social casework. • Consciousness, or being aware of one's own thoughts and feeUngs, is the exception ratiier tiian tiie rule; tiierefore, tiieindividua l is unaware of most of his or her mental The tiieme tiiat tiie social worker needs to take an active role in interpretmg tiie process. underlying meanings of behavior cuts across social work Uterature. For example, • Unconscious or unknown motivations in large measure are responsible for conscious Cohen (1980) stated tiiat m clinical social work practice behavior needs to be actions, feeUngs, and thought. understood m terms of "ideas, wishes, feelmgs, and fantasies, and conflicts .that • The helping process involves uncovering underlying causes of abnormal or destractive are both in and out of awareness" (p. 28). Kadushm (1972), altiiough modifying behavior. tiiis tiiought sUghtly, proposed that social workers foUow the dictum that "no • Motivations that are symboUc of unconscious needs are desires that can be interpreted through an understanding of overt behaviors. communication is without meanmg" (p. 35). Shuhnan (1984, 2005) proposed • The helping process is a corrective emotional experience. tiiat putting tiie cUent's feeUngs mto words so tiiat he or she knows the worker understands is a critical aspect of the social worker-cUent relationship. superego, and (2) tiie quantity and quaUty of instinctaal demands on behavior; Structural Model tiiat is, Freud suggested tiiat aU behavior is govemed by drives and tiie purpose of aU behavior is to dispose of psychological, instinctaal energy. Freud's topographical model was foUowed by tiie stinictaral model, which integrates many of his earher ideas. In the stinictaral model, Freud suggested Topographic Model tiiat the personahty is made of tiiree major parts or systems—^tiie id, tiie ego, and the superego. Altiiough each part of the personaUty has its unique functions and Perhaps Freud's greatest contiibution to understandmg personahty is his properties, they mteract to form a whole, and each subsystem makes a relative suggestion tiiat tiiere are tiiree levels of consciousness (Corey, 2000). Mental contiibution to an individual's behavior. Each part of tiie personaUty as described processes fhat are conscious are within awareness; preconscious mental pro­ is a conceptoaUzation and should not be thought of as having an actaal exis­ cesses are capable of becoming conscious "without more ado" or are fairly tence (Figure 3.1). The id is tiie original, mherent system of tiie personaUty and accessible; and unconscious mental processes are outside awareness and cannot consists of everything present at birth, including instmcts and the reservok of be stadied dkectiy (Freud, [1923] 1961, p. 15). Freud stated tiiat consciousness psychic energy. The id houses drives tiiat produce a state of tension tiiat propels is tiransitory and tiiat it is the exception ratiier tiian tiie rule. The three states of the person to activity to reduce tiie tension. It has only one consideration—that consciousness, or layers of awareness, should not be tiiought of as distinct or is, to reduce tensions either by activity or by image, such as the formation of absolute categories, but as matters of degree. The assumption tiiat most of a dreams and fantasies. person's thoughts and feelings are outside awareness became tiie bulwark of Freud's psychoanalytic theory. The id is fhe foundation of personaUty and remams infantUe m its functions and thinking tiiroughout life. It cannot change witii time or experience because Freud gave as evidence of unconscious processes at work the human tenden­ it is not hi touch witii tib.eextema l worid and does not know about laws, logic, cies to forget (names, impressions, and experiences); to lose and mislay belong­ reason, or values. If tiie id retains contiol over a large amount of energy m the ings; to make errors, sUps of tiie tongue, and sUps of tiie pen; to misread; and adult, his or her behavior wiU be relatively unpulsive, primitive, and krational to bungle actions. His beUef in the predominance of unconscious processes led m nature. Freud made a major contiibution hi his perspective tiiat krationality is to his interest in fireeassociation , resistance, pattems of Ukes and dislikes, Ufe 66 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 67

Figure 3.1 socially appropriate or acceptable and eventuaUy leads to pleasure is a primary An Illustration of Freud's Structural Model function of the ego. The ego operates by thinking through a plan of action to see if it wiU work or C-onaclpus not. If the mental test does not work out, then it is thought through again until a solution is found. This is known as reality testing. Reality testing allows for greater mastery of impulses and a sttengtihened abiUty to distinguish between Preconscious fantasy and reality. An important aspect of many cUnical social workers' ap­ proach to practice is to enhance ego functioning and tihe cUent's ability to test U nc:p.ns.qi;GU s reaUty by assisting the cUent to tiiink through his or her options.

Freud's concept of ego mastery set the foundation for how Nye, R. D. (1975). Three Views of Man: Perspectives from Freud, Skinner and Rogers. social workers approach person-in-envkonment. Monterey, CA: Brooks/Cole.

Freud suggested that even the person who has successfuUy passed through a regular part of anyone's thought processes, and when these krational thoughts the psychosexual stages of development and is a mature functioning adult wUl predominate to the extent that the individual has difficulty ha functioning, prob­ experience confUct between these demands. Such conflict leads to anxiety, or lems ensue. an omnipresent state of tension that motivates people to act. Ln an attempt to Freud beheved tihat there are two modes of thinking, primary and secondary deal with anxiety, ego defenses are developed. That is, Freud saw anxiety as a process (Lowenstein, 1985). Primary process thinking, according to Freud, normal part of the human condition. When tiheeg o fails in its attempt to use the originates in tihei d or unconscious and is characterized by lack of logic, time, reaUty principle and anxiety is experienced, unconscious defense mechanisms and order. This form of mental process or thinking knows no obj ective reality and that distort reaUty come into play—feeUng overwhelmed by "a sense of danger." is selfish, wishful, and omnipotent in nature. In the infant, this form of thinking The more adaptive tihe ego defense structure, or tihe pattem of use of defense means fliat there is no recognition of anything extemal to the self and the child mechanisms, the healthier the individual is said to be. An assessment of a cUent's beheves all needs wiU be met as if by magic. In the adult, primary process think­ defense stracture is an important aspect of a psychoanalyticaUy oriented helping ing can be recogiuzed in individuals who engage in wishful thinking with Httle process. This aUows the social worker to evaluate whether to attempt to work regard for reahty. Freud suggested tihat primary process thinking predominated toward interpreting and/or modifying these stinictures. in early childhood and wtil occur throughout Ufe. However, Freud considered Among tiie defense mechanisms of particular interest to Freud were regres­ tihe predominance of primary process in adults to be pathological. The idea that sion (returning to earUer stages of behavior), repression (excluding painful or the image of the object is thought of by the id as if it were the actual object is a threatetdng thoughts and feelings firom awareness), reaction formation (wardmg centtal concept in contemporary psychoanalytic thought. Clients who frequentiy of negative impulses by expressing the opposite impulse), projection (attribut­ use magical or wishful thinking need help in distmguishing between fantasy ing to others one's own unacceptable deskes), rationalization (explaining away and reaUty. Another important characteristic Freud attributed to the id is that it failures or losses), introjection (taking in the values and standards of others), operates according to tihe pleasure principle. This means the processes ofthe id identification (seemg oneself as someone else, usually someone successful), are concemed solely with tension reduction and gratification. (When tension is sublimation (diverting sexual energies to a higher channel or activity), undoing reduced, the person receives gratification.) (reconstracting previous actions so that tihey are less tihureateiung),an d denial The ego tihen "is that part of the id which has been modified by the dkect (faUing to acknowledge reaUty). influence of tiie extemal world" (Freud, [1923] 1961, p. 25). To take kito account The superego is tiie thkd and last system of tiie personaUty to develop and tihe extemal reaUty, psychic energy is shifted from the id to form the ego, the consists of the values and ideals of society tihe chUd derives from his or her executive arm of personaUty tihatcontiol s and govems the id. The ego becomes parents. The formation of the superego is an important part ofthe socialization differentiated firom the id as the individual needs to transact with the objective process, which consists of placing one's sexual and aggressive impulses under world. The ego is govemed by the reality principle, or the abiUty of the ego to control. The moral or judicial branch of the personaUty, along with the ego, postpone the discharge of energy or not to seek gratification untU it is appropri­ enables an individual to contiol behavior. ate. Being able to tolerate tension untU a metihod of discharge is found that is 68 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 69

The Dynamic Model Table 3.2 Summary of Tasks of Each of Freud's Psychosexual Stages The dynamic model, based on the view that an mdividual is propelled by drives, or primitive urges, and is conflicted by contradictory societal expecta­ Stage tions, dominated classical Freudian thought. Freud ([1930] 1964, [1933] Oral Separate/Individuate. 1964) suggested that a conflict exists between a person's internal pleasure- Form object relationships. seeking forces fhat wish to release sexual and aggressive energy and the social Anal Accept responsibiUty and control environment that demands inhibition. Inherited instincts form the core of Negotiate with others in authority. the personality and, according to Freud, bring about an innate propensity to Phallic , Adopt one's gender orientation with a view of one's place in the fam­ use one another for sexual and destructive purposes if not checked by ego ily consteUation. defenses and societal forces. Freud proposed that psychological activity is Demonstrate a capacity for deaUng with the value orientation and eth­ determined by a constant need to reduce instinctual tensions and restore ics of one's society. psychological balance. This perspective on behavior is called the "dynamic model." The dynamic model influenced object relations theorists who adopted Latency Move to more advanced uses of ego defenses. Freud's idea that psychic energy may \>&come, fixated, or heavily invested in Genital Work and love successfuUy. an object or person.

Explaining Development Across the Life Cycle An overabundance of gratification at a particular stage or a sttong cathexis brings about what Freud called a "fixation." Freudian developmental theory centers on a dual process involving biological Fixation occurs when psychic energy becomes heavily invested in a particular maturation and the development of related psychological stmctures. Personahty stage. Fixations, particularly minor ones, are a general feature of psychosexual pattems are seen as a function of constimtional predispositions and a result of development—"everyone has a fixation of some kind" (Hogan, 1976, p. 38). an individual's early hfe experiences. How an individual has experienced early Because energy that is fixated is not as readily available to move on to the next Ufe stages is said to determine how later Ufe events wUl be handled. This point stage, fhe result is that development is fmsttated or incomplete. This may impede of view can be said to minimize conscious choice (Baker, 1985). the individual's capacity to reach fuU maturity. Regression is a predisposition Freud proposed that there is a sequence of universal stages from birth to to retum to behaviors of earUer stages, particularly under sttess. The comple­ adulthood defined in terms of the region of the body providing primary erotic mentary processes of fixation and regression "give a distinct fiavor to a person's gratification at that time. In other words, psychoanalytic theory suggests that interpersonal style" {ibid.). psychological maturation consists of the unfolding of predetermined phases In this context, a person's developmental history is a critical determinant of with specific tasks at each phase involvhig fhe transformation of sexual ener­ later behavior, and much of what an adult does is beUeved to be determined by gies. These have been teim&ilpsychosexual stages. The resolution of each stage early chUdhood experiences (Baker, 1985, in press). Early behaviors that develop centers on a psychological issue (Table 3.2). during tiie first six to seven years of Ufe become the prototypes for the charac- Psychoanalytic theory suggests that the orientation of the personaUty is an ' teristics, ttaits, and behaviors of adulthood. These pattems of behavior fumish outcome of the resolution of psychosexual stages. This perspective is caUed fhe the social worker with clues about the cUent's developmental history. "genetic" or developmental model. . The first of Freud's stages is the oral stage, which occurs durmg the first year of Ufe and involves the erotic pleasure or satisfaction derived from nurs- Freud revolutionized how we think about child development. ' ing. Pleasurable stimulation of the mouth, Ups, and tongue is associated with That process of reevaluation continues today. '[ the mother figure. The prototypes or basic pattems of these behaviors, as witii ;;, tiie patterns of each stage, can be seen in adulthood. For example, a person who The genetic model assumes that there is no clear-cut demarcation of stages I has had his or her oral needs met relatively weU during this stage is more apt to and that there may be overlap between stages. At each stage of development reach out to others and not be overly aggressive and acquisitive. Deprivation of the individual concentrates energies on the part of the body that defines that * ctral gratification is assumed to lead to problems in aduUs such as withdrawal, stage. To pass through a developmental stage successfully requires tUe optimal extteme dependency, and an inabiUty to form intense relationships. The task of amount of gratification (there must not be too much or too Uttle gratification). ' this, stage of development is to achieve separation and mdividuation. 70 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 71

During the anal stage, which takes place from one to three years of age, the Freud suggested that to achieve mental healtih in adultihood it was necessary anal zone becomes critical in personahty formation. The locus of erotic stimula­ to pass tiirough tiie psychosexual stages successfuUy (witih minimal tension/con­ tion shifts to the anus, and personahty issues center around ehminatory behavior, flict). This required an optknal amount of gratification at each stage—not too the retention and expulsion of feces. Agaui, the manner of resolution of the stage much or too Uttle. According to Freud, previously weU-functioning adults regress becomes the prototype or pattem for adult behaviors. Freud's ([1908] 1959) under severe sttess and, in the process, retam to earUer adaptive pattems. This idea that anal erotism can appear, through subhmation, as an adult character perspective may be said to underUe social work crisis intervention. trait (e.g., strict toUet trainmg leads to compulsive traits such as stinginess .and tidmess, popularly called "anal retentiveness") is well-known. Westem psychiatric practices have their origins in Freud's The Oedipal oz phallic stage, which takes place between three and six years concepts of psychopathology. of age, is Freud's most comphcated, widely discussed and, perhaps, most con­ troversial stage. At this tune, sexual interest and excitation becomes more intense In tihe relatively healtiiy hidividual, tiie parts of tiie personaUty are in synchro­ and centers around the genitaha. According to orthodox psychoanalytic view, nization and aUow tiie individual to ttansact weU witii the world as demonsttated the basic controversy during this stage is the child's unconscious desires for the by the abiUty to maintain "commerce vvith the extemal world," use defenses parent of the opposite sex. This conflict is known as the Oedipus conflict in boys effectively, delay gratification, and place one's sexual and aggressive impulses and the Electra complex in girls. Freud believed identification (the mtemaliza- under contiol. It is the social work practitioner's role to help tihe cUent achieve tion of another's characteristics) with the parent of the same sex was one of the a more reaUstic balance. major outcomes of the phaUic stage. This successful resolution of the Oedipus The haUmark of tiie healtiiy personaUty, according to Freud, is an ego tiiat is conflict determmed an mdividual's sex-role identification and gender identity. weU developed and can deal effectively with anxiety. Ego defenses, which allow In tihe adult, when these sexual unpulses arise, they would be channeled toward instincts to be satisfied without excessive punishment or guilt, are a means of sexual union and expressed through a number of emotions, including loyalty, reUevmg tihe ego of excessive anxiety. The ultimate indicator of a healthy per­ piety, fihal devotion, and romantic love. Freud also proposed that the superego sonaUty is identified by tihe capacity to love and work. Freud sttessed tiiat being was the heir of the Oedipus complex. Identification with the same-sex parent able to love and work is tied to the abUity to find sociaUy acceptable outiets for was identified as the mechanism for this sociahzation process. potentiaUy desttnictive instincts. He suggested a straightforward answer to the The latency stage, which occurs between tihe ages of six and twelve, was question of mental healtii, statmg it is often resolved by decidmg the practical viewed by Freud as a tune when infantile sexual energies lay dormant. By this issue of tihe cUents "capacity for enjoyment and of efficiency" (Freud, [1916- tune, the major stiructures of tiie personahty are formed, as are the relation­ 17] 1963, p. 457). ships among its subsystems (id, ego, superego). The genital stage, ages twelve through eighteen, marks the retum of repressed sexuahty. Earher sources of Understanding Cultural Differences: Cross-Cultural Social Work Practice sexual pleasure are coordinated and matured. According to Freud, the abihty to work productively and to love deeply, witii tihe latter involving the achievement Although many of Freud's ideas were tied to the scientific and cultural of sexual orgasm, are the centtal characteristics of tihis stage. attitudes of the day, to his credit, Freud also was interested in tiie basic and excitiing discoveries of antiuopologists about tiie nature of human cultures and Psychological Health or Adaptiveness tihe differences among them. Many of the basic anthropological smdies were In Freud's model, psychological healtih is ideal. Freud beheved tiiat most pubUshed during his Ufetune (Benedict, 1935; Malmowski, 1922). However, mdividuals do not reach full emotional mamrity, but even if tiheydo , tihey wUl Freud, educated as a physician during the late nineteentii century, tended, in experience psychological conflicts! Psychopathology in Freud's view was linked tiie opinion of many of those who came after him, to underestimate tiie extent to tiie quahty and quantity of insthicmal drives, tiie effectiveness of tiie ego to which culttires hifluence tihedevelopmen t of human personaUty by tiie teach­ defenses in modulating tiheexpressio n of such drives, the level of maturity of ing (sociahzation) tihat tiiey do. Some of what Freud viewed as basic human an individual's defensive functioiung, and tihe extent of superego sanctions or natiire is seen to be specific to a particular culture. When one compares across guilt. Patihology arises when the drives are excessively fmsttated or excessively cultiires, much of what Freud viewed as "hievitable" seems to be specific to his gratified, and there is early ttauma during the oral, anal, and phallic stages. Unre­ culture and time. solved, unconscious conflicts precipitated during these early stages were thought The ways in which Freudian tiieory dealt with issues about the development to be the major cause of psychological problems in aduhs. of women is an example of a major pomt of conttoversy. On tiie one hand, Freud 72 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 73

([1925U961, [1931] 1964, [1933]'1960) clearly was interested in aUeviating toward sexual orientation worked together to produce a final sexual identification women's Ulnesses and in training and teaching women professionals the theories (Nye, 1975). Freud did beheve that homosexuahty was not witiiin the "normal" and practice of psychoanalysis (Gay, 1988, p. 509). On the other hand, there are range of behavior, and this behef, unfortunately, has continued to shape tiie many theorists who see Freudian theory as "male oriented" and as emphasizing thinking and practice of some psychoanalyticaUy oriented tiierapists. According "the male as a model for normalcy" (Wesley, 1975, p. 121). to Isay (1989), tiie behef that homosexuahty is abnormal has "interfered with our being able to conceptualize a developmental pathway for gay men and tiius IVlany of Freud's critics beheve his theory was not universal, but based has seriously knpeded our capacity to provide a psychotiierapy tiiat is neuttal on a male model m the context of 1920s Vienna. and unbiased by cultural expectations" (p. 5).

Homey (1939) and Jones (1955), both stadents of Freud and distmguished Understanding How Humans Function as Members of Families, psychoanalysts hi thek own right, saw Freud's views of women as both biased Groups, Organizations, and Communities and inaccurate (Gay, 1988, pp. 519-521). In the opinions of both Homey and Freud sttessed that there is a major conflict between the pleasure-seeking Jones, Freud thought of women as derivatives of men, and disregarded the fact namre of individuals and tiie existence of civihzed society (Freud, [1930] that femininity is not just the result of fhe frastration of women's attempts to be 1964). His view of human nature was such tiiat he argued tiiat it is tiie innate "masculine." Rather, both argued that feminkuty and femkune quahties are fhe tendency of humans to explok each otiier for sexual and destractive satisfaction. primary birthright of women and have equal vahdity with those quahties that "Society beheves that no greater threat to its civihzation could arise tiian if the are identified as masculine. One of the most damnuig arguments about Freud's sexual instincts were to be hberated and retimed to thek original aims" (Freud, poor concepttiahzation of development m women is made by GiUigan (1982), [1916-17] 1963, p. 23). He proposed that the development of civilization rested wko contends that Freud, although surrounded by women, "was unable to ttace on tiie mhibition of primitive urges andtiiek diversion mto socially acceptable in women the development of relationships, morahty, or a clear sense of self" channels. Freud's ([1910] 1957, [1939] 1964) fascmation witii great men such (p. 24). as Moses and Leonardo da Vmci appears to stem firom an interest in how psy­ Gould (1984), m a historical analysis of tiie social workUterattire, questioned chological functions were tumed to higher social and cultaral achievements. tiie wide-scale adoption of "antifemkust" psychoanalytic views of women into He called tiie process of channehng psychic energy into acceptable altematives social casework practice (p. 96). Her review documented tiiat Freud's ([1925] "sublimation." 1961, [1931] 1964, [1933] 1960) views on tiie differential psychosexual devel­ opment of men and women were widely dissemmated into social work without Family a critical evaluation of Freud's original writings. Among the challenges about the universahty of Freud's theory is his concep- The apphcabihty of Freud's tiieory to different family forms or stmctures mahzation ofthe Oedipus complex. Freud suggested that tiie oedipal sitoation is qu^tionable. Cross-culttiral research suggests tiiat family styles probably was the centtal organizing principle m gender identification. Increasingly this are more a function of culturaUy shaped variables than tiie biologicaUy driven view has come to be challenged by modem analysts and Freudian, mcluding so- forces proposed by Freud (BrisUn, 1981). Such field studies seem to mdicate called post-Freudian, scholars (Goleman, 1990; Safouan, 1981; Wetzel, 1976). that practitioners should apply principles developed within a specific cultiire at a While tiiis too has come to be seen as a reflection of tiie scientific climate m particular historical time cautiously. By its very natiire, classical psychoanalytic which Freud worked, defenses of tiie universahty of tiie Oedipus complex, tiiat metiiods were concemed witii the intemal dynamics of tiie personaUty and witii also recognize the degree to which culture shapes sexual attimdes, have been an analysis of the tiierapist-cUent relationship. It is said tiiat Freud "left a legacy made. Waelder (1960), for example, points out tiiat "an Oedipus complex in the of conviction that it was counter-productive and dangerous for a counselor to generahzed sense is a kind of prematiire rehearsal of tiie future sexual role witii- become involved witii more tiian one member of the same famUy" (Broderick, parent or parent substitutes as objects, and with details varying witii the child's 1981, p. 16). konicaUy, contemporary family systems work has incorporated envkonment, is probably universal" (p. 114). many of tiie ideas origkiaUy advanced in orthodox psychoanalytic theor}'—-shift- Theorists also have challenged Freud's ideas about homosexuahty. Freud kig from a focus on the individual to the family emotional relationship system suggested that everyone is constitutionally bisexual, by which he meant tiiat (Kerr, 1981). Ackerman ([1972] 1984,1981), a pioneer in tiiis form of treatment an individual's basic makeup includes same-sex and opposite-sex components. extended the psychoanalytic approach to include the psychodynamics of family Freud beUeved that tiie family experience combined with mherited tendencies functioning and the therapist-cUent ttansference. 74 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 75

Groups Table 3.3 Assumptions about PsychoanalyticaUy Oriented Practice Freud ([1921] 1955) beHeved that his concepttializations about the human personahty extended to how people behave m groups. He wrote in Group Psy­ • Examining and explaining the symboUc nature of symptoms is the path to reconstruc­ chology and the Analysis ofthe Ego that "mdividual psychology.. .is at the same tion of past events, particularly childhood traumas. tune social psychology" (p. 69). For the most part, Freud viewed the psychol­ • Uncovering pertinent repressed material and bringing it to consciousness is a neces­ ogy of the group, which he beheved produced an environment fhat weakens sary ingredient in the helping process. the power of the superego and in which primary process thinking prevails, as • Expressing emotional conflicts helps to free the individual from traumatic memo­ a negative mfluence. He suggested that, in groups, people tended to behave ha ries. a more chUdhke fashion. He felt that the strong emotional ties that bmd the • Reconstructing and understanding difficult early Ufe events wUl be curative. individual to the group members aud to fhe faflierlike leader accounted for the • Using tiie relationship of tiie helping person and cUent as a microcosm of cmcial powerful influence of the group. experiences is an important part of the helping relationship. This view of the power of the group is reflected hi most psychoanalyticaUy • Developing seU-awareness and seU-control are the goals of social work interven­ oriented group treatment approaches (Bion, 1959). Psychoanalytic group tion. treatments build on orthodox thinking about the etiology of mental iUness, tiie nature of psychosexual stages, and tiie predominance of unconscious processes. Exploring mfrapsychic processes, analyzing tiie mteraction between cUent and enced freatments. In tiiis context the manifest content, or the explicit aspects of helpmg person, interpreting and overcoming resistance, and developing insight symptoms or dreams, is conscious and can be related by tiie cUent in freatment. are among the keys to successful group tieatment. The latent content, or hidden, unconscious wishes tiiat cannot be expressed, is interpreted by the therapist. Direct Practice in Social Work: Intervening in the Person-Situation to Enhance Psychosocial Functioning Freud estabhshed tiie foundation for many forms of therapy in which Psychoanalysis, designed to deal witii tiie causes and dreatment of abnormal practitioners are experts who interpret cUent problems. behavior, is a therapeutic procedure aimed at investigating the source and the rehef of emotional symptoms. In general, psychoanalytic freatments attempt to As a client attempts to recover or reUve the past, conflicts emerge. Because restiiicture tiie cUent's feeUngs about the past to develop insight about and cor­ tills is a pamful process, resistance (a refusal to aUow msight to lead to the rect current difficulties. The goal of psychoanalytic styles of freatment also is to surfacing of imconscious motivations) is to be expected. Working through, or restiiicture the individual's intemal psychological organization so tiiat it is more the gradual acceptance by the chent of unconscious fantasies and expectations, flexible and mature. To reach this goal, psychoanalyticaUy oriented freatments is a lengthy and difficult undertakmg. In tiie process, however, Freud beUeved aim to bring more mental processes under conscious control. a catUarsis—a sense of reUef—occurred. PsychoanalyticaUy oriented treatment, however, cannot be easUy divided into Freud extended his interest in self-awareness to the cUent-tiierapist relation­ assessment and mtervention phases. Throughout tiie helpmg process tiie tiierapist ship. He conceived of tiie two major concepts to help analyze the therapeutic must make several assumptions (Table 3.3). Freud said of psychoanalysis tiiat it processes of transference and counterttansference. Transference is the "does not take symptoms of an iUness as its point of attack but sets about remov- cUent's special interest in or feelings about the therapist that aUow the cUent mg its causes"(Freud, [1916-17] 1963, p. 436). The ultimate goal of hitervention to reexperience eaxUer relationships within the clinical experience. Freud then is to provide accurate interpretation that wUl result in insight (ibid.). described this process as the cUent transferring intense feelings of affection (or hostility) toward the therapist, "which are justified neither by the doctor's Dream analysis (or the explanation of forbidden wishes) mdfree association behavior nor by tiie sitoation that has developed during freatment" (Freud, (a technique requking that the cUent take responsibiUty to produce tiie content [1916-17] 1963, pp. 440-41). Freud beUeved that as these feelmgs are re- bf freatment by sayhig whatever comes to mind) were used to uncover uncon­ experienced with the helping person they can be brought to a more positive scious material. Once this material was uncovered, it could be dealt with at the resolution. Countertransference is the irrational feeUngs the therapist has conscious level in the present. for the cUent. The resolution of these feelings may requke a consultation The interpretation (relating the themes that explain tiie pattems and origins of with another therapist. behavior) of symboUc meanings is an important aspect of psychoanalytic-influ- 76 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 77

Time-Limited Psychotherapy Glossary

Contemporary psychoanalytic and psychodynaroic styles of tieatments, Anal retentive. A personaUty style characterized by extteme orderliness and which contain many of tiie elements described, have often involved shortening or compulsive behavior. the amount of time needed for each cHent Some of tills shortening is due to the Anal stage. Freud's psychosexual stage during which the focus of tension and economic pressures created by a managed mental health care environment. As gratification shifts to the anal area and toUet ttaining activities are centtal. early as 1964, however, the concem over long waiting hsts for treatinent led the Anxiety. A state of tension that is always present at some level and motivates then dhrector of psychiatry at Boston Umversity School of Medicine to develop a one to act. short-term tieatment protocol (Mann, 1973). Mann (1973) contended tiiat because Catharsis. Emotional expression and release brought about by talking through short forms of psychotiierapy awaken tihechent' s "horror of time," time should problems. be centtal to the helping process (p. 9). The horror of time concept suggests that Cathexis. A great degree of psychic energy, which is hmited m total quantity chents experience tihe force of time in tiherapy as they did tiie force of leavmg and is attached or bound to an object childhood and moving to adultihood. Childhood time is filled with fantasy and Conscience. A subsystem of the superego that deals with what is considered pleasure, and is experienced as infinite. Childhood time also is connected to a moraUy bad, thereby produchig guUt person's closeness witii his or her motiher. On tiheothe r hand, adult time is hnked Conscious. Mental processes of which one is aware. to reality and the understanding of niortahty., Countertransference. The irrational emotional reactions or fantasies that practi­ In commonsense terms, Maim (1973) beUeved that practitioners should not tioners experience in response to a cUent foster dependence in the helping process. His stmctured protocol outlined Death instincts. Unchecked aggressive impulses. a twelve-session approach that is clearly presented and agreed to by the Determinism. The behef that behavior is a function of certain preceding vari­ client. There is an intake or consultative interview in which the cUent and ables that bring about action m an orderly or purposeful way. practitioner discuss the central conflict that motivates the client to seek help. Dream analysis. An interpretation of the underlying meaning of dreams. Historical data are also collected to formulate the treatment plan. While Dreams. An expression of tihe most primitive workings or content of the some interest is taken in the childhood source of the problem, the focus of mind. treatment is the cential adaptive issue relevant to the client's immediate use. Dynamic model. Freud's ideas about the competition between innate drives The urgency of time places tihe practitioner and client in a therapeutic alli­ and societal demands. ance necessary to solve the issue in the given time. The practitioner's skill Ego. The executive arm of the personaUty; its chief function is to interact witih in identifying the cential issue and in interviewing the cUent wUl determine the environment. tihe success of tteatment. Ego defense mechanisms. Unconscious mental processes tiiat distort reaUty to ward off anxiety and safeguard the ego from id impulses and pressures Clinical Social Work and Psychoanalysis: New Directions of the superego. Ego defense structure. The pattem of use of ego defenses. It is safe to say tihat, within contemporary social work, the place of psycho­ Ego functioning. The abiUty of tiie ego to cope adaptively and to master reaUty analysis as a theory, a practice, and an academic disciphne is not nearly as cen­ effectively. ttal as it was just twenty years ago (BrandeU, 2002b; Goldstem, 2002; SmaUer, Ego ideal. A subsysteni of tiie superego that deals with what is morally good. 2002). Psychoanalysis has, however, been at the center of a revival of research Electra complex. The female counterpart of tihe Oedipal conflict in which tihe conceming how humans relate to one another. Three key psychoanalyticaUy-ori- Uttie girl expresses mterest in tihe parent of tiie opposite gender and rivaUy ented theorists (Cozohno, 2002; Schore, 2003a, b; Stem, 1985,2005) have been with the parent of the same gender. The resolution of this conflictual situa­ among tihe most articulate about building on the theory of attachment (Bowlby,- tion is gender identification. 1969, 1988) witih the insights offered by recent neurobiological fimdings. To­ Erogenous zones. The body area tihati s tihe focus of tiie discharge of tension gether, tihese theorists have expanded the theoretical and clinical conceptions and sensual pleasure. of self and otiher, and, in the process, have strived to add to tihe psychoanalytic Fixated. To be arrested at an early stage of development; areas of mental func­ insights of self psychology (Kohut, 1977, 1984) and object relations theory tioning are intermpted at a particular psychosexual phase, interfering with (Kemberg, 1980). maturation. 78 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 79

Free association. A technique in counseluag requiring .the cMent to say whatever Phallic stage. Freud's psychosexual stage occurring at about age three years comes into consciousness no matter how inappropriate it may seem. when tensions and gratification shift to the genitals. Gender identification Genetic point of view. An approach that retrospectively reconstructs an indi­ and superego formation occur as a result of tihe resolution of the Oedipal vidual's psychological history to define the infantile roots of adult behavior confiict and pathology. Pleasure principle. A means of operation of tiie id in which tension reduction Genital stage. Freud's final psychosexual stage during which psychological and gratification are paramount. identity is integrated. Preconscious. Mental processes that an individual is capable of making con­ Id. The innate subsystem of fhe personahty made up of imconscious representa­ scious. tions of sexual and aggressive drives. Primary process. Unconscious, primitive mental functioning that attempts to fuUUl Identification. Taking over the personahty features of another person. Matching a wish or discharge tension by producing an image of the desired goal. mental representation with physical reahty. Projection. A defense mechanism in which the source of anxiety is attributed Insight. Conscious recognition of previously repressed memories or fantasies. to something or somebody in the extemal world rather tihan to one's own Interpretation. The process of the helping person hstening, observing, and impulses. Attempts to get rid of one's own unacceptable characteristics by clarifying a cUent's meaning of events. assigning them to someone else. Introjection. An ego defense mechanism in which the mdividual unconsciously Projective identification. A defense mechanism in which one places aspects takes another's feeUngs and or ideas into oneself. of the self on another. Latent content. Unconscious or hidden content in feelmgs and dreams. Psychic determinism. A philosophy tiiat describes behavior as occurring in an Libido. Sexual energy and drive. orderly, purposive manner and as an outcome of specified variables. Life instincts. Drives equated with sexual energy and positive Ufe forces. Psychoanalysis. A method of psychotiierapeutic tteatment for emotional distur­ Manifest content. Conscious or expUcit content of feelings and dreams. bance; a method of studying and developmg a tiheoretical explanation for Medical model. A perspective with an emphasis on diagnosis, tireatment,an d cure. behavior. Neurosis. Mental illnesses defined by Freud as caused by extteme anxiety Psychosexual stage. A period of predetermined time in which there is a shift brought about by overwhelmingly threatening id impulses. To be arrested in tihe focus of sexual and aggressive energy during tiie course of mamra- at certain levels of development short of maturity. tion. As each stage unfolds, emotional pattems are formed that detennine Object. An intemal representation of a person, place, or symbol. tiie adult personaUty. Object choice. The uivestment of psychic energy in an action, person, or image RationaUzation. A defense mechanism in which tiiere is an offering of reason­ that wiU gratify an histinct. able-sounding explanations for umeasonable, unacceptable feelings or Object relations theory. A body of concepts of individual personality develop­ behavior.. ment emphasizing attachment and separation in tihe final individuation of Reaction formation. A defense mechanism in which there is a replacement in tihe self. consciousness of an anxiety-producmg impulse or feeUng by its opposite. Oedipal conflict. The conflict fhat occurs during Freud's phaUic stage when a ReaUty principle. A means of operation of tiie ego in wUicU tihere is an attempt Uttie boy expresses interest in the parent of the opposite gender and rivalry to conttol anxiety by mastering tiie environment. Postponement of gratifica­ witih tiie parent of the same gender. The resolution of this conflictaal sima- tion is delayed untU it is appropriate tihrough tihis process. tion is gender identification. Reality testing. A mental test to weigh whether a plan of action is best for Omnipotence. A sense of being aU powerful derived from the id's inabUity to warding off anxiety. test reaUty. Reductionism. A tiiought process that reduces an explanation of complex events Oral aggressive. A personaUty style cUaractenized by lashing out in an im­ to elementary phenomenon or events. mature fashion. Regression. A defense mechanism in which there is a retum to behavior pattems Oral dependent. A personaUty style characterized by a strong longhig for characteristic of earUer levels of functioning, often precipitated by stress. maternal support Repression. A basic defense mechanism in which ideas are pushed out of Oral stage. Freud's psychosexual stage covering the period from birth to eigh­ awareness. teen months when activity and gratification are centered around the mouth, Resistance. A defense mechanism used to avoid facing reahty. Often used in lips, and tongue. therapy to avoid tihe helping person's interpretations. 80 Human Behavior Theory and Social Work Practice Classical Psychoanalytic Thought 81

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Eric Erikson, although originally part of fhe mainstream of psychoanalytic tiiought, made critical departures from ortiiodox Freudian .tiieory. These de­ viations from classical psychoanalytic thinking, which included understanding the healthy personaUty across tiie hfe cycle and tiie development of tiie ego as a social phenomenon, aUowed for new, important emphases in many forms of psychotherapeutic practice (Table 4.1). Erikson's major contiibution—tiie conceptoaUzation of a developmental approach to ego mastery—^is the focus of this chapter. The case stody iUustrates a chent experiencmg difficulty with the psychosocial crisis generativity versus stagnation. Erikson possessed an opthnistic, biopsychosocial view of development A positive outlook about people's abiUty to change, tiie behef that cUents possess a sense of inner unity, good judgment, and a capacity to do weU predonUnated in Erikson's philosophy. For example, Erikson believed that the healthy ego of tiie chUd propeUed the chUd toward tiie next stage of development, witii each stage offering new opportunities. He emphasized tiiat "there is Uttie m inner develop­ ments which cannot be harnessed to constructive and peaceful initiatives if only we leam to understand the conflicts and anxieties of cMldhood" (1959, p. 83). The interest of the social work profession in Erikson's principles has contiibuted to a inore hopeful, less fatalistic view of personaUty development Erikson was one of the very few great personaUty theorists (Jung was another) to view development as occurring tiffoughout the Ufe cycle (Hogan, 1976). Er­ ikson proposed that development takes place in eight Ufe stages, starting with the infant at birtii and ending with old age and deatii. He viewed each stage of development as a new plateau for the develophig self or ego to gain and restore a sense of mastery. A Ufe cycle perspective on development drew new attention to middle and old age, and refocused research and tteatment issues. For example, many researchers have seen their findUigs as refining Erikson's propositions about midUfe generativity (Goleman, 1990; Levmson, 1978), and

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