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Chapter 4. Psychodynamic Practice
Psychodynamic ideas provide a rich fund of ideas for practice; they emphasize the importance of people’s
feelings and internal conflicts in the development and resolution of problems. Historically, they have had a
strong impact on how social work is practiced and helped shape its focus on people’s psychological
reactions to their social environment as the source of personal and social problems. Psychodynamic
practice demonstrates how the problem-solving objective of social work supports the existing social order
by helping people to adjust to the society around them.
Terminology
Anxiety and ambivalence are derived from the inadequate resolution of problems earlier in life and lead to
powerful feelings of aggression, anger, and love.
Attachment refers to the behavior and emotional reactions of children seeking proximity to a person
whom they perceive offers security in an environment in which they fear danger.
Attunement is the process of appreciating and responding to emotions and attitudes that lie underneath
the surface behavior.
Coping is the ability to manage present problems without anxiety.
Defenses and resistance are two common psychological barriers to working on life issues. They derive
from a poor resolution of past problems.
Transference and countertransference refer to the effect of past experience that is transferred into present
behavior patterns. Practitioners can reflect on how clients react to them and how this makes them feel, so
that they can directly experience how clients behave with others and how other might fee.
Relationships with people may be used to model effective thinking and self-control, and as a vehicle to
gain influence and confidence to explore psychological issues—‘relational practice’.
Working-through is a process of repeatedly remembering crucial examples of problem behavior as they
occurred, exploring what happened and thinking about way in which events and their emotional
consequences might have been different.
Key Ideas
Psychodynamic perspectives underlie traditional social work.
Psychodynamic perspectives come from psychoanalysis, which emphasizes that the mind is the dynamo—
the mind both motivates and directs or manages a person’s behavior. Since the 1960s practice theory
emerging from this idea has been called ‘psychosocial’ because it look at how the mind and behavior
influences and are influenced by the social environment. These ideas were influential during the period
1930-60 when social work was becoming established and therefore underlie ‘traditional’ social work that
many other theories in turn developed from or reacted against. As a result, psychodynamic ideas still
influence everyday practice and Western culture. However, psychoanalysis (as opposed to psychodynamic
perspectives) is mainly only used in specialize psychiatric settings are rarely used by social workers.
Psychoanalytic theory includes three main aspects.
Psychoanalytic theory describes metaphorical structures in the mind such as the id, ego, and superego.
Second, this theory demonstrates how people build up these structures by going through psychological
stages, and how their behavior may be affected in the long term by disruptions to this development.
Finally, psychoanalytic treatment theory addresses dealing with behavioral problems that come from
disrupted development. Current ideas that come from these three historic elements of psychoanalytic
theory include: ego theory (how patterns of thinking develop and affect/control their behavior); object
relations theory (how people’s perceptions of things outside themselves affect their behavior); attachment
theory (how people ‘s behavior is affected by experiences of attachment to others); self theory (how the
structure of people’s identifies affects there interactions with others); and relational theory (how people
operate in their relationships, and what they bring to them from their past).
Distinct streams of thought within psychosocial theory are now taken as basic ideas.
Distinct streams of thought within psychosocial theory are now usually taken together as basic ideas about
practice. Psychosocial (formerly diagnostic) theory focuses on diagnosis, assessment, and classification of
treatment as a basis for exploring the ‘person-in-situation’ (or ‘person-in-environment’ PIE). Functional
theory emphasized the function of social work agencies in giving practice its form and direction including
the idea of self-determination, importance of structuring practice around time, and the emphasis on
process and growth. Problem-solving casework focused on exploring problems that clients present and on
improving their capacity for coping with them. This forerunning of task-centered casework that
emphasized problems analysis it is still used as the conceptual basis of important texts, which connect it
with ecosystems theory.
Residential care/psychodynamic group work illustrates psychodynamic theory.
Psychodynamic theory applied to residential care depends on three theoretical developments. First,
planned environment therapy used by some schools for young people with emotional and behavioral
disorders. Second, milieu therapy which is mainly an American concept based on psychodynamic
groupwork is used with maladjusted young people. Third, psychodynamic theory aids the design of
therapeutic communities used in community mental health settings such as day hospitals and hostels. The
therapeutic community is the most widely influential model of residential care practice. This is based on
an informal, communal atmosphere; group meetings; shared work; all residents have a therapeutic role
with each other; authority is shared between staff and residents; and common values include the belief
that individual problems are mostly about relationships with others, therapy is a learning process, and
members share a basic psychological equality as human beings.
Several values issues arise from psychodynamic theory’s individualism and determinism.
Psychodynamic perspectives in social work focus on the individuality of each human being and the unique
way in which internal emotions and drives create each individual’s behavior. This view respects human
beings by helping them to make sense of their experiences and the present strains and stresses. This in
turn led social work to give prominence to the self-determination and individualization of clients an their
problems. However, focusing on the psychological can result in victim blaming and affirm cultural, racial,
and gender stereotypes. Psychodynamic practice also may create more barriers to change than practice
theories focused on the present and the future. And, they do not address social change or excluded or
oppressed groups, as they do not offer social explanations for client problems. Another key values issue
within psychodynamic theory is that it is deterministic, based on earlier experiences in particular
childhood. Because the theory assumes that psychological defenses are very difficult to change, simply
understanding may not allow individuals to make changes and possibly they cannot. This is in opposition
to social work’s value base that strongly emphasizes that people can make changes.
Issues
Debates continue over the science and empirical support for psychodynamic practice.
Psychodynamic theory attempts to analyze aspects of the mind primarily using case studies in order to
create a science of the mind based on careful observation, critical analysis, and philosophical debate. For
positivist critics, psychodynamic theory is flawed because it is based on metaphorical ideas about mental
structures and movements that are inferred from behavior and self-description. However, there is an
increasing body of evidence that most forms and psychotherapy and counseling in which practitioners
rigorously apply a model of psychodynamic practice are effective in helping many people. There is also a
growing body of research regarding the use of particular practices related to relational and attachment
ideas. Moreover, the basic principles of psychological social work practice can b seen in influencing each
other so as to produce broadly similar types of eclectic practice. Overall, psychodynamic theory does
provide a rich set of interpretive idea to help practitioners explore what is happening in peoples’ minds.
Psychodynamic practice fails to incorporate the social issues that affect practice.
Psychodynamic practice does emphasize psychological factors and interventions to the virtual exclusion of
social and sociological explanations and social interventions. Thus the possible range of interventions is
limited and suggests a very limited concern for social reform. Other problems follow from this internal
emphasis, such as the tendency to blame people for what has happened to them by making individuals
responsible for problems and causes. For example, alcoholism needs a ‘cure’ rather than being seen as a
response to social experiences. However, not everyone reacts the same way to social pressures, so
individual psychological factors may also be important alongside social factors. In addition,
psychodynamic theory is social in the sense that it understands people’s life issues as stemming from how
the psychological and the social interact, as in attachment, relational, and object relations theories.
Psychodynamic practice has limitations as a basic for social work practice.
Psychodynamic intervention focuses on changing behavior through insight. This means that practitioners
aim to influence people over time by getting them to understand themselves better through building a
relationship with them and trying to influence them over a period of time. Psychodynamic interventions
prefer clients who can express themselves well and take part in discussion and self-examination. This
approach is not as suitable for less articulate clients, working-class people, and people with more practical
problems. Since psychoanalysis is non-directive, refusing to give advice or organize practical moves
toward change reduces social work effectiveness.
The cultural assumptions of psychodynamic practice are also subject to debate.
Psychodynamic theory takes a white, middle-class perspective as the norm and deviations are abnormal
and should be ‘cured’. This is a particular problem when dealing with children who have significant
variations across cultures and ethnicities, for example, or homosexuality and the role of women in society.
Psychodynamic theory’s development separate from social work restricted ideas.
Psychodynamic theory does not now form a central basis for social work nor does psychodynamic theory
adopt social work ideas. However, insights from psychodynamic theory might help with understanding
racist behavior and in dealing with minority ethnic groups. Psychdynamic theory thus has less influence in
social work than it might for two reasons. First, the historic cultural assumptions of psychodynamic theory
established ‘normal’ ways of relating to others. Second, while psychodynamic theory might adopt ideas, its
isolation as a complex and separate stream of thought means that this will happen only occasionally.
The assumption that earlier experience strongly influences current behavior is questioned.
The central assumption of psychodynamic theory is that present behavior arises from past experience, in
particular, relationships. Thus psychodynamic theory’s ‘deterministic’ assumptions do not fit with current
views that clients’ current concerns are important priorities or with the shared value principle of social
work agencies, which are positive and look to the future.
Final thoughts…
Despite the provenance of psychodynamic theories and ideas, social work practitioners are usually
cautious about use of developing into the past rather than the present predicaments. While
psychodynamic ideas can be applied in many different situations, they are primarily used in mental health
and so offer connections between social work practitioners and other professionals in those settings.
However, despite the criticism of practical problems using psychodynamic theory in social work, there are
advantages to understanding the large body of psychodynamic writings. Psychodynamic theories are a rich
source of ideas and metaphors for therapeutic and clinical settings as well as providing a great deal of the
day-to-day language used to express common ideas about how people are influenced by their past in their
thinking.