PSYCHODYNAMIC THEORIES EGO PSYCHOLOGY

WHAT ALL PSYCHODYNAMIC PERSPECTIVES ARE MORE OR LESS CONCERNED WITH The Drives Pleasure Aggression Relationship Mastery and Competence

WHAT ALL PSYCHODYNAMIC PERSPECTIVES ARE 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 The Ego 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 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 INTERVENTION IN 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 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 that promote the client’s reflective capacity Leads rational discussion of the pros and cons of the client’s taking certain actions Assumes a moderately directive and structured stance, perhaps including confrontation Provides here and now interpretations (tentative explanations) of client behaviors

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

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 / ventilation Assumes a directive, structured stance to get at appropriate topics for reflection Explores connections between the client’s present state and past experiences with comments, questions, and tentative explanations Intentionally arouses the client’s 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 client’s maladaptive and contradictory (words vs. actions) thoughts, feelings, and behaviors Utilizes 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 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)

THE EGO AND THE ENVIRONMENT: DIVERSE 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