PSYCHODYNAMIC THEORIES

EGO PSYCHOLOGY

WHAT ALL PSYCHODYNAMIC PERSPECTIVESARE MORE OR LESS CONCERNED WITH

The Drives

Pleasure

Aggression

Relationship

Mastery and Competence

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 person’s conscious life.)

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 person’s 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.

EGO PSYCHOLOGY

Conscious Awareness

_____________________________________________

Unconscious mental processes

The Ego

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).

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 client’s 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?

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 client’s actions goal focused? What are the client’s strengths? What are the client’s motivations?

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?

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?

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

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 one’s own thoughts and feelings from those of others

Self-Concept

Self-esteem

An awareness of one's strengths and limitations

An acceptance of one’s strengths and limitations

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

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

INTERVENTION STRATEGIES IN EGO PSYCHOLOGY:

EXPLORATION / VENTILATION

What the Social Worker Does

Elicits the client’s feelings about an area of concern

Helps the client:

Express those feelings

Explore those feelings

Maintain a focus on relevant feelings

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

PARTIALIZING (STRUCTURING)

What the Worker Does

Breaks down problems into manageable parts

Focuses the intervention and the client’s attention

Observes time limits

Assigns homework (client activities outside the session)

Engages in reflective discussion of the above steps (if practical) to promote

the client’s insight

What This Technique Does for the Client

Relieves the client’s 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 client’s sense of mastery and

competence

PERSON - SITUATION REFLECTION

What the Social Worker Does

Makes comments, asks questions, offers tentative explanations thatpromote the client’s reflective capacity

Leads rational discussion of the pros and cons of the client’s takingcertain actions

Assumes a moderately directive and structured stance, perhaps includingconfrontation

Provides here and now interpretations (tentative explanations) of clientbehaviors

What This Technique Does for the Client

Promotes a clearer evaluation of feelings, self-concept, attitudes, andvalues

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 ofproblem solving options

EDUCATION

What the Worker Does

Provides information about environmental resources

Provides information essential to the client’s 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

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 worker’s

strategies are perceived to be comprehensive

ADVICE AND GUIDANCE (DIRECT INFLUENCE)

What the Worker Does

Makes suggestions about ways of thinking, reviewing feelings, or behaving

Explores the client’s 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 client’s (not the worker’s) needs

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)

DEVELOPMENTAL REFLECTION

What the Social Worker Does

Utilizes exploration / description / ventilationAssumes a directive, structured stance to get at appropriate topics for reflectionExplores connections between the client’s present state and past experiences with comments, questions, and tentative explanationsIntentionally arouses the client’s anxiety at timesHelps the client to better understand (interpret) past issues that may be influencing the present problem, and ways of dealing with thesePoints out and confronts the client’s maladaptive and contradictory (words vs. actions) thoughts, feelings, and behaviorsUtilizes the nature of the clinical relationship to help process these issues

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 itaffects current behavior

Promotes insight into patterns of behavior that may stem fromirrational feelings, conflict situations, or a developmental “arrest”

Provides a rationale for experimenting with new patterns of thoughtand behavior (not unique to this technique)

(This technique can be used with clients who have a capacity forreflection, but generally not with children and many youngeradolescents)

THE EGO AND THE ENVIRONMENT:DIVERSE POPULATIONS

PERSON

SOCIOPOLITICAL CONTEXTOF ENVIRONMENT

MembershipsRace

GenderEconomic Status

SocializationHealth

Vulnerability to TraumaOppression

Culture and AcculturationStigma

EGOEgo Functions

Coping MechanismsMastery & 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