See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/258629575 Classical Psychoanalytic Thought, Contemporary Developments, and Clinical Social Work Practice Chapter · January 2008 DOI: 10.4324/9781351310369-3 CITATIONS READS 2 3,012 2 authors: Roberta Rubin Greene Michael Uebel University of Texas at Austin University of Texas at Austin 157 PUBLICATIONS 793 CITATIONS 64 PUBLICATIONS 172 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: Violence during the outbreak of the pandemic View project IS TECHNOLOGY ECOLOGICALLY SUSTAINABLE View project All content following this page was uploaded by Michael Uebel on 20 May 2014. The user has requested enhancement of the downloaded file. 3 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).