****The following are additional notes made some years ago regarding psychodynamic approach within social work

practice. The points made are relevant today and therefore have not been updated. With this in mind however please note that the reference list has been included only because various authors are cited and does not reflect a current list of references please refer to your module handbook for a current list of updated references Psychodynamic Approach Introduction !ackground "istory many influences feed into the psychodynamic approach within social work which have led to many different interpretations and ways of practising psychodynamic social work an approach in social work that is referred to as #psychodynamic$ has it roots in psychoanalysis the work of %igmund &reud and others psychoanalysis started with' but certainly didn$t and hasn$t stopped with &reud it is important when you read to ask not #What did &reud say($ but #What has &reud$s work led on to($ )*ishman +,,+ .b/ect 0elations primarily 1elanie 2lein hugely important especially in this country )and 3go psychology 45oldstein6 which was more influential in 7%A- 8 placing emphasis on the importance of human relationships in motivating people to engage with each other as opposed to &reudian notion of satisfying instincts and drives Winnicott !owlby and &airbairn developed the concepts further particularly in relation to work around children' parenting and forming attachments developments particularly in this country still the emphasis on early relationships but it is the need for these relationships that motivate people as opposed to instinctual drives 3rikson built on &reud$s and !owlby$s work by putting forward a theory of developmental stages that encompass the whole life cycle placing individual development in family' social and cultural conte9ts Psychoanalysis has also been interpreted from a wide range of political perspectives e.g. :uliet 1itchell )+,;<- Psychoanalysis and &eminism )Penguin :ac=ues *acan )+,;,- The &our &undamental >oncepts of Psychoanalysis )Penguin- *inks with 1ar9ism ? main theories that act as a broad basis for psychodynamic approach are &reudian personality theory' and human growth and development theory )&reud' 3rikson Psychodynamic @ dynamic relationship and the tensions within a person and uses a #conflict model$ of personality AI1A is for the service user to become a fully functioning person' who has more control and choice over what they do' and is not driven by unconscious' unresolved past events with an emphasis on the ego$s capacity for adaptation and problem8solving. This development takes place within a central framework' that is' the relationship of the service user with the social worker.

>ore elements within this aim areA making the unconscious conscious )revealing hidden thoughts and feelings- in other words bringing into someone$s consciousness a conflict or crisis that they have chosen to bury or forget about involving bringing into awareness how past e9periences have effected the present )the presenting past- the past is constantly with someone effecting and influencing what they do in the present known by &reudians as #psychic determinism$ where our actions are determined by inner forces that developed in childhood of course' developments within psychodynamic thought would not /ust refer to childhood but any past e9periences and would state that a single traumatic event in childhood is rarely sufficient to e9plain someone$s current situation more it is the response to that traumatic event and subse=uent general patterns of behaviour since. enabling people to resolve repressed conflicts crisis related to their development offering insight and therefore more control and choice over behaviour )particularly undesirableservice user #developing$ or #changing$ is attributed to the actions' interventions and e9pertise of the social worker

T"3 &.>7% of the approach is concerned with three 2ey 0elationshipsA8 %elf and others that is self and particular significant others it can be argued that we have many more parts to our self than put forward by &reud$s model which some see as #simplistic$ B parts )id' ego' superego8that we carry around with us those who have been important to us internalised aspects and values of other people Past and Present 39perience moving away from &reud$s notion of #treatment dealing with the patient$s past$ onto focusing on what is happening in the #here and now$ but recognising that the past is actively present and constantly interfering influencing our present behaviour' feelings and reactions. W.!ion$s work involving #helping$ relationships stated that the past gives an emotionally meaningful conte9t to the individual$s present. Through the #helping$ relationship could see how someone was reacting and be able to help them to e.g. highlight some pattern in their behaviour that they were repeating within the #helping$ relationship. >ome back to this when we look at transference. Inner and .uter reality moving away from only considering a person$s inner world to considering the important relationship between a person$s inner thoughts feelings and the environment even &reud recognised that a ma/or function of the ego was to manage the demands of society. This has been a big influence in #ego psychology$ in fact moving away from aim of

giving people insight into concentrating on how people manage their relationships with the outside world through e9tending rational control of their lives. These three key relationships include A>T7A* 03*ATI.C%"IP% P*7% 03*ATI.C%"IP% !7I*T 7P ICT30CA**D &0.1 3EP30I3C>3 )transferential- the emphasis and focus of psychodynamic approaches are on the processes of these relationships the B key ones )past and presentand their interactions.

23D >.C>3PT% Personality Theory assumes that people$s personality is made up of id )child #wants$ #drives$ #urges$ #feelings$ #pleasure principle$- and the superego )parent #should$ #rules$ #guilt$' #moral principles$ #teaching$- the ego )adult #thinking$ #reality principleconcept of unconscious 8 the idea that some thinking and mental activity is hidden from our knowledge distinction between our conscious )large part of the ego- and unconscious )superego and id- parts of our mind the ego tries to keep a balance between the gratification of needs and impulses )id- and the sacrifice of this gratification to the demands of reality 4 managing relationships with people and things outside ourselves 8ob/ect relations6 the superego develops general moral principles which guide the ego )there can be tension here if superego is to dominant or restrictive 4too much guilt6 or permissive 4too little guilt6ego lives under great pressure from the three sides id' superego and demands of other people and environment these pressures conflicts can result in an9iety and the ego deals with an9iety by bringing into play various defence mechanisms defence mechanisms are usually unconscious or at least place unwanted thoughts' feelings et. into the realm of the unconscious protecting the ego from instinctual drives of id' condemnation of the superego and the demands of reality repression denial' pro/ection' splitting' sublimation and rationalisation are e9amples repression @ resistance arises when some thoughts and feelings are not compatible with other beliefs that we hold strongly mind does not allow the contested ideas into the conscious by repression pro/ection @ unwanted ideas associated with something the ego wants to protect become attached in our minds to another person or thing pro/ective identification the person to whom the feelings and impulses are being pro/ect is manipulated into believing that he she actually has these feelings and impulses 8 important departure within the ob/ect relations school that defences involve other people and become inter instead of intra8personal

splitting contradictory ideas and feelings are kept in separate mental compartments and applied to different people or situations with inconsistent results sublimation energy directed towards unwanted activities )often se9ualare redirected to more acceptable activities rationalisation acceptable reasons for particular activities are devised' when real ones are unacceptable and repressed defences' such as repression' are dynamic in the sense that they cause someone to act even if they are unaware of them concept of #dynamic unconscious$ this e9plains self8destructive' illogical and irrational behaviourF important to make more things conscious so that we can have more control over what we do. seeking help is usually a sign that defences have broken down under stress #I want to be my old self again$ help me get my defences back up again. there are helpful and unhelpful defences intellectualising a painful e9perience by using written lists to help to think through things maybe helpful the ongoing denial of a loss or pro/ecting the cause of that loss onto others may not be 8 worker needs to be aware during assessment of situation which they are

Guestions does unconscious e9ist( cannot prove it yet #psychodynamic$ approaches techni=ues relationship are about enabling the service conscious bad press with so8called #false memory suggestions this is the cornerstone of the employed in the working user to make feelings etc. syndrome$ being therapist

worth mentioning that 3go Psychology )7% 5oldstein referred to in Payne- moving away from working with the unconscious and concentrating on the conscious part that is the ego in terms of strengthening people$s ego with the view of enabling them to cope with things in a more positive way "uman 5rowth and Hevelopmental Theory

psychodynamic theory sees people as developing towards maturity in a se=uences of stages' each one dependent upon the successful negotiation of the earlier one for its success psycho8se9ual development stages of &reud oral' anal' phallic 3rikson$s encompasses the whole life cycle emphasising cultural and social pressures rather than inner drives )%ee >hapter ? in :.*ishman +,,+-

many criticisms of &reud$s heterose9ist view of se9ual development and 3rikson$s se9ist and racist terms and assumptions 1.:acobs )>hap. ++ in :.*ishman +,,+- highlights ma/or themes that are worked and reworked throughout life' particularly at times of loss and change' as opposed to clear8cut developmental stages' negotiated )or notonce and for all. trust and dependency ) linked to the first stage I8+8 of childhood when the baby is so dependent- problems within this theme can be associated with e9periences of deprivation or loss in infancy and would involve someone distancing themselves or being over8dependent clinging behaviour the problems related to this theme if it is not worked on are around being recognised for what is a sense of being 8 for some people it can be as acute as not having a basic sense of #being$ )personality difficulties authority and autonomy linked to the second stage ?8B 8 where there is increasing independence and mobility and testing out of rules etc. problems within this theme can be associate with e9periences of authoritarian parents powerful figures and would involve someone wanting to be told what to do or being antagonistic to authority the problems related to this theme if it is not worked on are around being recognised for what one does or does not do competition and co8operation linked to the third stage J8K 8 relates to the acceptance of oneself and by others' as a man or a woman and being able to fully e9press oneself and not limited to the gender stereotypes from family or culture this theme is around gender and se9uality the problems related to this theme if it is not worked on are around relating to others relationship problems change and loss throughout life as personal development means change personal growth always implies some sort of loss although its intensity and effect will differ it may be a welcomed growth and therefore the loss does not have such an effect. first B themes are linked in with stages of childhood development but there is a re8emergence of themes throughout particularly in periods of change and loss C! maturational crisis can be compounded by situational crisis

T"3 P0A>TI>3 >entrality of the worker service user relationship the psychodynamic approach uses the processes of the relationship between the worker and the service user within the relationship there is the e9perience of patterns' emotions and reactions of past relationships this re8enactment of the past in the

present can offer insight and understanding' and new ways of dealing with problems the relationship is referred to as a #triangle of insight$ ):acob +,,+involving past' present and worker service user relationships other relationships are reflected in the worker service user relationship patterns may be repeated and the worker must be aware that they are and not repeat the pattern of response but respond in a new way the service user will slowly translate the new ways of relating to others the service8user e9periences a caring relationship i.e. the #good parent$ and this helps to work through painful e9periences whilst being held and contained processes of the relationship involveA8 T0AC%&303C>3 positive or negative feelings a service user may have about a significant other person in their past are transferred into the present and onto the social worker )all relationships have an element of transference-. It is important to understand transference so that relationships can be focused on reality and seeking to lessen repetitive themes and dependency can be the key to understanding puLLling behaviour >.7CT30T0AC%&303C>3 feelings that are stirred up in the social worker in response to the service user$s behaviour or story it is important that the worker involved is clear about what feelings are personal to them social workers can end up responding to their countertransferential feelings e.g. service user may relate to a social worker as all giving' all powerful and wonderful parent and the social worker lives up to this fantasy by becoming unable to say #no$ and unable to be honest about their and the services$ limitation.

Assessment of 3go %trengths a service user$s ego needs to be assessed in terms of its strength to tolerate self8scrutiny what are the stresses on the functioning of the service user$s ego( consideration needs to be given to e9ternal as well as internal pressures the functions of the ego are to provide stability' e=uilibrium and predictability it manages our thinking' perceptions' planning and problem8solving it makes /udgements and decisions' adapts to reality and controls impulses it is responsible for personal growth' coping with stress' using skills and tolerating frustration' loss' pain and sadness it produces self8assertion' ability to verbalise feelings rather than act them out and directs out striving' our attempts to achieve and to care overwhelmed ego @ use of ego sustaining supporting skills or indirect work )>oulshed and .rme +,,M' "ollis +,KJ strong ego @ use of ego modifying skills or direct work )>oulshed and .rme +,,M' "ollis +,KJ ego sustaining @ involves support in terms of acceptance' ventilation of feelings' demonstrating coping behaviour' keeping in touch with reality'

offering advice and guidance' giving information and using resources to help with #e9ternal$ problems. Hefences may need to be strengthen. ego modifying @ involves service user gaining insight by social worker using confrontation' reflective communication' clarification and interpretations of what is happening in the relationship and of service user$s defences this increases the service user$s self8awareness or insight and this strengthens their sense of self )ego ego sustaining work will then lead onto ego modifying work social worker assessment and intervention )particularly interpretationinvolves making use of personality and developmental theory e.g. what themes in development is the service user struggling with( 7%3% IC %.>IA* W.02 it is difficult to identify use in present practice but its influence has been e9ceptional e.g. terms such as #insight$' #unconscious$' #aggression$' #an9iety$' #maternal relationships$ come from psychodynamic theory used as common language in social work and everyday life. e.g. areas of emphasis of social work 8 mental health and disturbed behaviour' emphasis on childhood and child development' child$s relationship with significant adults e.g. basis of good social work 8 listening' accepting attitude and avoidance of over8directiveness processes within the relationship can be used within supervision to understand the comple9ities of social worker$s own relationship with service user' their own relationships within the social work team and dynamics within a case conference )Pearson et al +,MM' 1arshall +,,I to understand comple9 human behaviour and behaviour that appears as if there is no reason for it service users whose problems appear to reside in themselves )intrapersonal long8term work with people who have neurosis' compulsions' obsessions' e9cessive dependency' unable to face a particular emotion' #act out$ rather than talk through their difficulties psychodynamic counselling' family therapy and #casework$ therapeutic communities' e.g. 0ichmond &ellowship and Arbors * 39amples of practice on references handoutA Trowell :. and !ower 1. )+,,<N most of the /ournal references

1AIC AHOACTA53% reinstates the worker as central to the social work taskF

compatible with s.w. values of giving the service user more control' awareness and self8determination by trying to make conscious the unconsciousF the past gives an emotionally meaningful conte9t to the individual$s presentF it =uestions the marginalisation of therapeutic approaches to social work which has been dominated recently by checklists' procedures and brief interventionF

>0ITI>I%1% .& P%D>".HDCA1I> APP0.A>" focus of concern is the individual social structural factors and issues of oppression are ignoredF emphasises conflicts and pathology rather than strength and creativityF based on a pathological' medical model social worker @ e9pert and there is little room #e9change$ between service user and social workerF theory of personality development itself is oppressive e.g. superiority of the male genitalia gay relationships seen as #abnormal$F helps people to accept their environment' instead of change challenge itF stresses insight into origins of problems but does not change themF emphasises internal processes which may divert attention from more urgent everyday pressures on service usersF relies heavily on verbal ability less articulate service users are disadvantagedF disempowers service user as use of )unhelpful- defences is seen as the service user$s fault' not always made clear to service users why the interest in past e9periences' and /argon can be clinical and obscureF theory faulty( does the unconscious e9ist( how do we know that it works like &reud stated it is unobservable( is the personality structure of the id' ego and superego an illusion( does it clash with the social work value of self8determination as it is deterministic in the way it views one event causing anotherF social workers are not meant to pose as miniature psychoanalystsF social workers have not got the time to work effectively and safely with this approachF

&or more discussion on criticisms and limitations see Payne )+,,;- and 1ilner and .$!yrne )+,,M- on reference list.

0eferencesA Psychodynamic Approach Adams r.' Hominelli *. and Payne 1. (1998) Social Work Themes, Issues and Critical Debate Ch 14 Howe D. Psychosocial Work acmillan !rearley : (1991) A Psychodynamic Approach to Social Work Ch ! in "ishman #$ (ed) %andbook o& Theor' &or (ractice Teachers in Social Work #)(

!urton 1. and Havey T$ The Psychodynamic Paradigm Ch 5 in Wool&e *$ and Dr'den W$ (eds) %andbook o& Counsellin+ (s'cholo+' Sa+e )+>oulshed O. and .rme :$ (1998) Social Work (ractice, an introduction ! rd ed$ Ch - Psychosocial Approach . acmillan $ "inshelwood 0.H$ (198-) What ha//ens in +rou/s, /s'choanal'sis, the indi0idual and the communit' "owe H. (198-) 1n Introduction to Social Work Theor', Tradition in Social Work - Ch 8 . 1ldershot, Wild2ood %ouse$ "owe H. (1993) 1ttachment Theor' &or Social Work (ractice The Psychoanalytic acmillan

:acobs 1. (1991) Psychodynamic Co nselling Ch 11 in "ishman #$ (ed) %andbook o& Theor' &or (ractice Teachers in Social Work . #essica )in+sle' 1a9ime :.3$ (1984) Some Psychological !odels o" #lack Sel"-concepts in 1hmed S$, Cheetham #$, and Small #$ (eds) Social Work 2ith 5lack Children and their 6amilies "on+ond 5$T$ 5ats&ord75ritish 1+encies &or 1do/tion and 6osterin+$ 1c*eod :. (1998) Introduction o& Counsellin+ 8 nd ed$ Ch ! The Psychodynamic Aproach . 9/en :ni0ersit' (ress )+1ilner :. and .$!yrne P. (1998) 1ssessment in Social Work Ch - $A !ap o" the %cean& Psychodynamic Approaches' acmillan$ Cathan :. (199-) Psychoanalytic Theory (Ch ;$8) in Da0ies Com/anion to Social Work 5lack2ells Payne 1. (199-) odern Social Work Theor' Ch ! Perspecti(es acmillan (ed) The 5lack2ell Psychodynamic

Pearson 5.' Treseder :.' and Delloly 1. (ed) (1988) Social 2ork and the le+ac' o& 6reud, /s'choanal'sis and its uses . acmillan$ Trowell :. and !ower 1. (1993) The <motional =eeds 9& >oun+ Children 1nd Their 6amilies *outled+e ( )* papers on the topic o" sing psychoanalytic ideas in the comm nity+ Delloly 1 (198?) Social 2ork theor' and /s'choanal'sis ;an =ostrand *einhold Woods 1. and "ollis &. (199?) Case2ork, a /s'cholo+ical /rocess 8 nd ed$ =e2 >ork, *andom %ouse$ :.70CA*% !ull 5. (199?) 1 Case &or (s'chod'namic Social Work :ournal of %ocial Work Practice 4(!74) 199? /94 1?4

5reene !. (199-) (s'chothera/' 2ith 1&rican 1merican Women, inte+ratin+ &eminist and /s'chod'namic models %mith >ollege %tudies in %ocial Work 4-(!) #une 199- /899.!88 "orowitL :. (1998) Contem/orar' (s'choanal'sis and Social Work Theor' >linical %ocial Work :ournal 84 (4) Winter 1998 /!49.8! :ordan !. (198-) 6allen Idol . >ommunity >are 18$8$8- /$84.83$ 1arshall 0. (199?) (s'chod'namic =ature o& Con&licts Within @rou/s %enior Curse ;ol$1? arch 199? / 8?.81 ulti.disci/linar'

1oyes !. (1988) The /s'chod'namic method in social 2ork some indications and contraindications Practice 0ol$8 no$! / 8!4 48$ Cathan : (199!) The 5attered Social Worker, 1 (s'chod'namic Contribution To (ractice, Su/er0ision 1nd (olic' :ournal of %ocial Work Practice - /-!.8? Cathan : (1994) The (s'chic 9r+anisation o& Communit' Care, 1 )leinian (ers/ecti0e :ournal of %ocial Work Practice 8 /11!.188 %chofield 5$ (1998) Inner and 9uter Worlds, 1 (s'chosocial 6rame2ork &or Child and 6amil' Social Work >hild and &amily %ocial Work ;ol$ ! /3-.4Temperley :. and "immel %. (1984) Trainin+ &or (s'chod'namic Social Work :ournal of %ocial Work Practice 8(!) 1984 /4.14

0hiannon :ones *ecturer 2eele 7niversity .ctober ?I+?

1ydocs keele teaching swt s+ r/ones