Psychoanalytic Theory

Overview
One might consider that Freudian psychoanalytic theory is basically a family theory as Freud considered how the individual develops overtime 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; 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. Phenomenological theories hold that the human is in process of becoming and just is.

 Theories of human behavior give rise to how behavior changes.

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 Freuds original concepts with addition of new knowledge and information. More recent theorist are known as Neo-Freudians. Few,if any, practice as Freud once did. 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 ones own psyche so as to prevent interference from ones own biases with the analysis of another. This is called countertransference. Freud named the level of consciousness unconscious, conscious and preconscious (not in much use now) 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 infant reveled 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, 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 producingsuch as sublimation.

 Neo-Freudians are all those who followed Freud adding to the basic theory or modifying the original theory. 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. Eriksons theory posits a balance between attributes in the stages he developed.
He did not dismiss Freudian stages, but added the psychosocial part. One does not have to give up Freud's theory to welcome the additions

 Rank, Jung, and Adler all followed with specific variation of Freuds 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 or fantasized.

 Object Relations theory is another additional 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 ones 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 function of the personality. The focus is on ego strengths.The strengths perspective is an outgrowth of this.

 An answer to the question: What does one strengthen in a person/family? The ego functions that are working well or hold the possibility of working well. These would include
Reality testing Judgment Sense of reality of the world and self Regulation and control of drives, affects, and impulses Object relations

 Thought 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, therapist are rare. Many 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. Understanding can help frame shorter term treatment; treatment of specific problems. One model is 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. Social and interpersonal relations: interactions in social roles with other persons is derived from learning based on early childhood experiences, concurrent social reinforcement, and personal mastery and competence.

 Personality and character problems: enduring traits of anger or guilt; poor psychological communication with significant others and difficulties with selfesteem. Personality patterns are part of a persons 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 the family moving away from grief, avoiding that process and continuing in activities that may or may not be goal 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 hazards 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. A conspiracy of denial exists amongst the four; at the very least denial of individual needs forecloses on the possibility of more positive outcomes.

 Practice Models
IPT has been presented as a model Other models are are appropriate that allow

for the latitude of using psychodynamic understandings. Strengths Perspective Family therapy permits the working though of what is called the family neurosis..work the may family work 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 become the caretaker of one or another parent.

Separateness-relatedness dialectic family's ability to provide intimacy, individuation. And 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 resistance to illness and in a positive sense ability to realize potential; capitalize on person resources.

 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

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 of this understanding of ego functions. Which, also, 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
Ethnic and/or diversity sensitive practice requires understanding of others cultures, life styles as well as an appreciation for the role and value of diversity in persons lives. Understandings include (1) unique understanding 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,and (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 build 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 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. Use of model is in accord with 4.01 Competences and 5.01 Integrity of the profession in the NASW COE