PSYCHODYNAMIC THEORIES

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PSYCHODYNAMIC THEORIES

• EGO PSYCHOLOGY

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WHAT ALL PSYCHODYNAMIC PERSPECTIVESARE MORE OR
LESS CONCERNED WITH

• The Drives
• Pleasure
• Aggression
• Relationship
• Mastery and Competence

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WHAT ALL PSYCHODYNAMIC PERSPECTIVESARE MORE OR
LESS CONCERNED WITH - II

• Unconscious motivational and emotional processes
• Conflict and compromise among opposing needs
  (internal vs. internal needs, or internal needs
  vs. external constraints)
• Defense / Coping mechanisms
• The roles of attachment and relationship
  experiences in personality development
• (Ego psychology is attuned to these issues but
  does not necessarily act on them all the
  practitioner can stay in the present, and focus
  on the persons conscious life.)

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EGO PSYCHOLOGY EGO

• People are born with an ego ( a natural capacity
  to adapt to the environment) that develops
  throughout the lifetime
• Your ego is pretty much your conception of who
  you are it is the you that thinks, feels, and
  acts in a reasonably consistent manner
• It is everything you do to reflect, plan, and act
  in ways that allow you to fit in more or less
  adequately with the environment in which you live
• BUT - there are unconscious elements of the ego
• To say this more academically, the ego is the
  part of the persons mind that negotiates between
  his or her basic needs and the demands of the
  environment.
• In social work, ego psychology ALWAYS emphasizes
  the person - environment perspective.

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EGO PSYCHOLOGY

• Conscious Awareness
• _____________________________________________
• Unconscious mental processes

The Ego
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A WORD ABOUT EMOTIONAL FUNCTIONING IN EGO
PSYCHOLOGY

• Emotions are feeling states with specific
  survival value
• Primary emotions are biologically programmed
  (Happiness, sadness, fear, anger, interest /
  excitement)
• Secondary emotions are learned
• Problems in social functioning may occur as
• Emotions do not achieve their aim of
  changing our relationship with the
• environment to facilitate adaptation
• We may deny, distort, avoid, or repress an
  emotion, and thus be unable to constructively
  manage a person-environment challenge
• Emotional experiences may be poorly
  regulated (either minimized or not
• controlled).

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MAJOR EGO FUNCTIONS - I(and questions to
consider in their assessment)

• Awareness of the External Environment Is the
  client oriented to time, place, and person? Is
  there evidence of a thought disorder
  (hallucinations, delusions, loose associations)?
• Judgment When making decisions, can the client
  choose behaviors that are likely to promote good
  adjustment and movement toward goals? Does the
  quality of the clients judgment vary in
  different circumstances?
• Sense of Identity Does the client have a
  reasonably coherent physical and psychological
  sense of self? Does the client maintain
  appropriate psychological boundaries from
  others?

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MAJOR EGO FUNCTIONS - II

• Impulse Control Does the client control his or
  her actions in accordance with social norms? Does
  the client ever lose control of behavior or
  emotions to a degree that creates significant
  problems in social functioning? Is the client
  internally constrained from action or emotional
  expression?
• Interpersonal (Object) Relations Does the client
  manage his or her relationships appropriately
  (toward personal goal attainment)? Does the
  client act as if other people are unique rather
  than replications of people from the past? Does
  he or she manage some types of relationships
  (such as work or social relationships) better
  than others (family or other intimate ties)?
• Regulation of Thought Processes Can the client
  control and direct thoughts toward objects that
  are functional for goal attainment? Are the
  clients actions goal focused? What are the
  clients strengths? What are the clients
  motivations?

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MAJOR EGO FUNCTIONS - III

• Defense / Coping Mechanisms Which defenses are
  prominent? Are they rigid or flexible? Do they
  seem to be adaptive or a source of conflict for
  the client?
• Stimulus Regulation Can the client screen and
  select external stimuli to maintain a focus on
  relevant life concerns? Does the client tend to
  become overwhelmed or underwhelmed?
• Cognitive Functions Is there evidence of
  impairment in attention, concentration, memory,
  or learning? Does the client have skills in any
  of these areas? If impairment exists, is it
  organic in nature?

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DEFENSES IN EGO PSYCHOLOGY

• These are coping mechanisms utilized to protect
  against anxiety they also distort reality to
  varying degrees
• Comparing flexible (healthy) with rigid
  (unhealthy) defenses
• Future vs. past orientation
• General reality adherence vs. significant
  distortion
• Is adaptive functioning and goal achievement
  promoted?
• Does the defense minimize internal and
  interpersonal conflict?

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AN EXAMPLE OF THE COMPLEXITY OF DEFENSES
ADAPTIVE VS. MALADAPTIVE DENIAL

• Denial of fact (an event has occurred) vs. denial
  of implication (what it means)
• When change is possible, denial may be
  maladaptive
• When change is not possible, denial may be
  adaptive (at least for awhile)
• The timing of denial (it may serve a positive
  purpose of helping us gather our resources to
  eventually deal with the challenge)
• Levels of denial
• Facts
• The threat created by the information (its
  personal relevance)
• The urgency of the need to respond
• Emotional reactions

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SOME ASSESSMENT ISSUES RELEVANT TO EGO
PSYCHOLOGY

• Reality Testing
• Orientation to time, place, and person
• Reaching appropriate conclusions about cause and
  effect relationships
• Reasonably accurate perceptions of external
  events and the intentions of others
• Differentiating ones own thoughts and feelings
  from those of others
• Self-Concept
• Self-esteem
• An awareness of one's strengths and limitations
• An acceptance of ones strengths and limitations

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SOME ASSESSMENT ISSUES RELEVANT TO EGO
PSYCHOLOGY - II

• In addition to physical, cognitive, and
  behavioral assessment
• Assess Emotional Functioning
• Capacity for emotional expressiveness and control
• Range of emotions the client expresses
• Appropriateness of affect (blunting?)
• Any evidence of mood disorders (such as
  depression, suicide)
• The social worker must understand cultural
  differences in
• emotional expression

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TWO TYPES OF INTERVENTIONIN EGO PSYCHOLOGY

• Ego Support
• Psychological and environmental
• May be short or long-term
• Accentuates client strengths
• Promotes reflection, problem solving, motivation,
  action
• Ego Modification
• More psychological, less environmental
• Tends to be longer-term
• Attacks defenses, arouses anxiety
• Seeks depth in uncovering developmental arrests
  and adjusting
• patterns of perception and action

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INTERVENTION STRATEGIES IN EGO
PSYCHOLOGYEXPLORATION / VENTILATION

• What the Social Worker Does
• Elicits the clients feelings about an area of
  concern
• Helps the client
• Express those feelings
• Explore those feelings
• Maintain a focus on relevant feelings

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What The Technique Does For The Client

• The Client
• Feels less alone, less overwhelmed, more in
  control
• Is freed from incapacitating anxiety, guilt,
  depression
• Sees problems as more manageable
• Is moved to action
• Develops greater hope, confidence, motivation,
  self- acceptance
• More clearly recognizes his or her emotional
  reactions and emotional style
• Acquires insight
• Lowers defenses
• Develops positive feelings about the social
  worker

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PARTIALIZING (STRUCTURING)

• What the Worker Does
• Breaks down problems into manageable parts
• Focuses the intervention and the clients
  attention
• Observes time limits
• Assigns homework (client activities outside the
  session)
• Engages in reflective discussion of the above
  steps (if practical) to promote the clients
  insight

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What This Technique Does for the Client

• Relieves the clients sense of being overwhelmed
• Provides an action focus for clients who have an
  action orientation
• Provides new opportunities for learning
• Stimulates effort from the client
• Success experiences enhance the clients sense of
  mastery and competence

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PERSON - SITUATION REFLECTION

• What the Social Worker Does
• Makes comments, asks questions, offers tentative
  explanations that
• promote the clients reflective capacity
• Leads rational discussion of the pros and cons of
  the clients taking
• certain actions
• Assumes a moderately directive and structured
  stance, perhaps including
• confrontation
• Provides here and now interpretations (tentative
  explanations) of client
• behaviors

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What This Technique Does for the Client

• Promotes a clearer evaluation of feelings,
  self-concept, attitudes, and
• values
• Produces a better understanding of others or some
  external situation
• Increases insight into the nature of his or her
  behavior and its effects on
• others
• Improves judgment and the ability to consider a
  wider range of
• problem solving options

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EDUCATION

• What the Worker Does
• Provides information about environmental
  resources
• Provides information essential to the clients
  functioning (biological,
• psychological, or social)
• Helps the client understand the effects of
  behavior on others
• Helps the client understand others needs and
  motivations
• May involve role plays, planning, promotion of
  new client behaviors

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What This Technique Does for the Client

• Increases options for change
• Increases fund of knowledge for problem-solving
  activities
• Increases insight
• Increases investment in the process of
  intervention, if the workers
• strategies are perceived to be comprehensive

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ADVICE AND GUIDANCE (DIRECT INFLUENCE)

• What the Worker Does
• Makes suggestions about ways of thinking,
  reviewing feelings, or behaving
• Explores the clients expectations when advice is
  requested (and if the
• request is denied, explains why)
• Gives advice in a context of reflective
  discussion, if possible
• Often guides the client to a decision rather than
  giving direct advice
• States an opinion
• Emphasizes a course of action the client is
  already contemplating
• Cautions the client against certain actions
• Manages the risks of giving advice openly with
  the client
• Avoids giving advice about most major life
  decisions
• Usually gives advice or makes suggestions
  tentatively
• Always acts to meet the clients (not the
  workers) needs

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What This Technique Does for the Client

• Promotes adaptive behavior for the client who is
  overwhelmed or in crisis
• Provides tentative solutions to problems or
  challenges that can be implemented and then
  reviewed
• (This technique may be required to connect with
  or meet the intervention expectations of some
  client populations)

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DEVELOPMENTAL REFLECTIONWhat the Social
Worker Does

• Utilizes exploration / description / ventilation
• Assumes a directive, structured stance to get at
  appropriate topics for
• reflection
• Explores connections between the clients present
  state and past
• experiences with comments, questions, and
  tentative explanations
• Intentionally arouses the clients anxiety at
  times
• Helps the client to better understand (interpret)
  past issues that may be
• influencing the present problem, and ways
  of dealing with these
• Points out and confronts the clients maladaptive
  and contradictory (words
• vs. actions) thoughts, feelings, and
  behaviors
• Utilizes the nature of the clinical relationship
  to help process these issues

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What This Technique Does for the Client

• Helps identify and consider long-standing
  patterns of functioning,
• including defenses and their relative
  effectiveness
• Encourages new habits of thought about the past
  and the ways it
• affects current behavior
• Promotes insight into patterns of behavior that
  may stem from
• irrational feelings, conflict situations, or a
  developmental arrest
• Provides a rationale for experimenting with new
  patterns of thought
• and behavior (not unique to this technique)
• (This technique can be used with clients who have
  a capacity for
• reflection, but generally not with children and
  many younger
• adolescents)

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THE EGO AND THE ENVIRONMENTDIVERSE POPULATIONS
SOCIOPOLITICAL CONTEXT OF ENVIRONMENT Memberships
Race Gender Economic Status Socialization Health
Vulnerability to Trauma Oppression Culture and
Acculturation Stigma
PERSON
EGO Ego Functions Coping Mechanisms Mastery
Competence
Focus on memberships and strengths build
confidence, self esteem, personal power provide
options and choices link client with resources
connect to mutual aid and peer groups, encourage
collective and political action