Psychoanalytic Theory

Document Sample
Psychoanalytic Theory Powered By Docstoc
					Psychoanalytic Theory Overview

One might consider that Freudian psychoanalytic theory is basically a family theory as Freud
considered how the individual develops over time within the context of a family, specifically interacting with mother and father, later siblings.

Psychoanalytic theory was the first of many psychodynamic theories to follow many within a direct line
from Freudian thinking.

Freud ‘discovered’ the unconscious which is the basis for all psychodynamic theories Psychodynamic theories hold that human behavior is primarily the function of reactions to internal
(thus mostly unconscious) stimuli: instincts, urges, thoughts.

Behavioral theories on the other hand hold that behavior is in response to external stimuli: Phenomenological theories hold that the human is in process of becoming and just ‘is’. Theories of human behavior give rise to how behavior changes.

responses are learned and over time appear as automatic. Some would hold the possibility of internal stimuli, however, such cannot be seen and/or measured and thus are not a fit subject for science.

– For example, if behavior is result of unconscious motivation, treatment would aim at making
the unconscious conscious and behavior change would follow.

– Additionally, an assumption is that current behavior is the result of early childhood experiences
primarily in the family. Again treatment would focus on uncovering childhood experiences and connecting them to current behavior; examining the appropriateness of current reactions.

By contrast, behavioral theory posits behavior is response to stimuli and learned over time through
reinforcement of resulting behavior. Treatment would focus on changing the stimuli resulting in change of behavior. Both psychodynamic and behavioral theories have changed overtime with additional knowledge about human behavior derived from experimental and experiential means.

 Current psychodynamic theories are derived from Freud’s original concepts with addition of new
knowledge and information. More recent theorists are known as Neo-Freudians. Few, if any, practice as Freud once did. Self psychology and object relations theory are prominent.

 Psychoanalysis was not conceived as just a method of treatment, but also as a training method for new
analysts. Basically it was an attempt to surface and interpret all material located in the unconscious. This process was deemed to be curative for the patient.

 For the trainee, the purpose was to develop an acute awareness of one’s own psyche so as to prevent
interference from one’s own biases with the analysis of another. This is called counter-transference.

 Freud named the level of consciousness - unconscious, conscious and preconscious (not in much use

Freud developed a topography of the self:

id, ego and superego.

Freud also posited that human behavior was built up over time through distinct stages.  Freudian stages were oral, anal, oedipal, latency, genital. Observation of infants revealed to him the
preoccupation with feeding and nurturance; excretion and toilet training, discovery of genitals and sensation from erogenous zones.

 Following is a period of

when the child is less preoccupied with their bodily functions and concerned about relations in the social world.

 When adolescence presents another radical physiological change, once more the person is preoccupied
with the body and sexual feelings and activities now they are living in an adult body.

Anxiety – normal anxiety exists in response to real and imagined dangers for the outside world as well
as in response to our own thoughts, impulses, and our own conscience.

To cope with anxiety and prevent our ‘self’ from being overwhelmed the ego protects the self with
mechanisms to ward off anxiety (called defense mechanisms). These are largely unconscious and serve the purpose maintaining balance in motion. – Most textbooks list these as they have been developed overtime. Some are more adaptive than others, getting the person into more trouble than the original stimuli would warrant. Much of adult restrictive behavior may be in response to things that happened long ago. –Some are growth producing…such as sublimation.

Neo-Freudians are all those who followed Freud adding to the basic theory or modifying the original

Freud‘s daughter, Anna further developed the stage theory with important contributions to adolescent
development. Her work with children in England during WWII contributed to understanding of separation from parents and placement of children.

Erik Erikson was an analyst who added the dimension, ‘social’, to the Freudian stages and drew them
over the life cycle.

Erikson is misinterpreted by some as believing that one either trusts or mistrusts. Erikson’s theory
posits a balance between attributes in the stages he developed.

He did not dismiss Freudian stages, but added the psychosocial part.
Freud's theory to welcome the additions

One does not have to give up

Rank, Jung, and Adler all followed with specific variations of Freud’s theory adding to psychoanalytic
thought. Most did not disagree with the basic premises of this thought; that is, most behavior is a result of motivations which are largely unconscious (we may have conscious reasons also). These unconscious (or forgotten) motivation stem from early childhood experiences with our primary caregivers. These are the mother and the father, actual and fantasized.

 Object Relations theory is another addition to traditional theory.

Margaret Mahler, a German analyst, working in this country after WWII conducted research into the attachment of young children which was the impetus for Object Relations theory.

 Mahler focused on the development of a separate sense self after birth as the child matures physically
and emotional to come to see self as separate and apart from the nurturer. The process of individuation takes place from mid first year to 3 or so. Subsequent relations are tied to one’s subsequent ability to remain whole and separate apart from other in relationship, intimate and not.

Current theorists tie narcissism and borderline states to this stage of development. Most work in psychoanalytic arena is in the field of Ego Psychology – a concern with the ‘executive’ An answer to the question:
function of the personality. The focus is on ego strengths. The strengths’ perspective is an outgrowth of this.

What does one strengthen in a person/family? The ego functions that are working well or hold the possibility of working well. There would include –Reality testing –Judgment –Sense of reality of the world and self –Regulation and control of drives, affects, and impulses –Object relations –Thoughts processes –Adaptive regression in the service of the ego –Defensive functioning –Stimulus barrier –Autonomous functioning –Mastery – competence –Synthetic – integrative functioning  Treatment – psychoanalysis is rarely used a treatment for specific problems: too long and too demanding, therapists are rare. May not be appropriate for mainstream public.

Originally ‘casework’ used this theory as the basis for assessment and treatment. Working through early
family issues was costly, time consuming, and not always fruitful.

Theory is helpful in understanding families and individuals.
treatment: treatment of specific problems.

Understanding can help frame shorter term

INTERPERSONAL PSYCHOTHERAPY (IPT) First developed as time-limited research treatment for depression. Problems usually occur in social and interpersonal context Treats current interpersonal problems. Has been proven effective in clinical trials. Component processes Symptom function:
development of affects and physical signs and symptoms presumed to have both physical and psychological precipitants. learning based on early childhood experiences, concurrent social reinforcement, and personal mastery and competence.

Social and interpersonal relations: interactions in social roles with other persons derived from

Personality and character problems: enduring traits of anger or guilt; poor psychological
communication with significant others and difficulties with self-esteem. Personality patterns are part of a person’s predisposition to interpersonal problems.

IPT intervenes in the first two processes. Interpersonal Problem Areas:
–Grief –Interpersonal role disputes –Role transitions –Interpersonal deficits

–Grape Family – – Intervention after the death of the father would have focused on grief and loss and helped the family
moved forward in ways that would have been growth producing for all members of the family. – At this point in time we see, again, the family moving away from grief, avoiding that process and continuing in activities that may or may not be goals directed. –Gilbert will take care of Arnie and Amy will take care of Ellen. – Intervention in terms of loss and grief is a step toward moving members of the family to growth producing goals. – Role disputes are issues in the family that Gilbert and Amy carry with then as they move on. Both these adults have put on hold assumption of legitimate adult roles to continue to care for siblings. – This carries a hazard for them and their younger siblings. Arnie and Ellen both need role models who have matured to the point of meeting their own needs and the needs of others. Gilbert and Amy may not do this and continue the dependency model set by parents. – Death of mother presents role transitions. Yet Arnie and Amy are not availing themselves of the opportunity. – Interpersonal deficits – exploration of strengths within each family member (including Arnie and Ellen) could be a tool for moving each member toward self actualization. There is a conspiracy of denial amongst the four; denial of individual needs forecloses on the possibility of more positive outcomes.

Practice Models

–IPT has been presented as a model –Other appropriate models that allow for the latitude of using psychodynamic understandings. –Strengths Perspective – Family therapy permits the working through of what is called the family the family does
together –Focus on family relations – •Parental coalition and influence on child adjustment •Mother and father have a stable coalition; children cannot play one against the other. •Mother and child have a coalition; child plays one against the other •Child becomes the caretaker of one or another parent. –Separateness-relatedness dialectic: family's ability to provide intimacy, individuation, &emancipation –Family affect – anger-sadness-shame.

Ackerman states that ‘cure’ first of all is ‘removal of symptoms’; Second, is the dissolution of vulnerability to illness. Treatment is expected to strengthen the personality
so that the person will not again fall ill, to provide immunization against further invasion of illness.

Third, personality must have undergone a basic change signifying adaptive strength and capacity for To feel free and happy, to realize potential, and to be an efficient, productive person. Finally, cure may mean the person is freed of anxieties and can now love others, share with them and
contribute to family, friends, and community. Strengths and Weakness resistance to illness and in a positive sense ability to realize potential; capitalize on person resources.

Weakness – theory is most complex and has moved beyond original Freudian concepts into many
schools. Theory is more and more complex with each new rendition.

Strength – still offers great promise in understanding human behavior and family relations when one
takes time to study. Also, new short term models can fit today's practice environment. Implications for Practice The most useful piece is the understanding of ego functions which is highly useful in strengths perspective. Fits short term models.

New material on attachment theory is helpful in assessment; may not work in short term models.
DIVERSE POPULATIONS In work with every person, the social worker hears a group.  Ethnic and/or diversity sensitive practice requires understanding others’ culture, life styles as well as an appreciation of value of diversity in person’s lives. Understandings include (1) unique understandings of groups; (2) differences between the dominant culture and others (3) differences within cultures. Social workers must balance consideration of (1) universal norms (2) group specific norms (3) individual norms in assessment and treatment. Balanced consideration helps in differentiating between normal and abnormal behavior and in consideration of etiological factors. Finally, cultural norms are considered in planning and implementing treatment, and most especially in plan that includes the family. POLICY – Numerous policies are built around influences of Freudian psychology. Most child welfare policy considers the importance of families for children, family preservation, early intervention models; adoption, foster care to name a few.

Promotion of well being.

We have sufficient understandings from this theory on the importance of preservation of families for children. We lack the will to institute policy to assure family well being.

Values and ethics: Social work recognizes the respect for individuals and the family as an important Use of model is in accord with 4.01 Competences and 5.01 Integrity of the profession in the NASW
COE institution of society. Of all helping profession families have been a central focus of social work. To this end social work has and continues to pioneer models that focus on families.

Lingjuan Ma Lingjuan Ma