Transcript Theories of the Ego

Theories of the Ego
The Unconscious, Ego Psychology
& coping with crises
SSS 571
Psychodynamic theory
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Freud's biopsychosocial approach
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Two Freudian models of the mind
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Ego Psychology and autonomous ego functions
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Coping and Adaptation
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Change Concepts
“Psychodynamic Theory” is NOT just one theory…
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It is a set of theories
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Our focus today:
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Drive or structural theory
Ego Psychology
Object Relations Theory
Self Psychology
Relational Theory
Classical theory (drive theory & ego psychology)
Focus of advanced psychodynamic theory (SSS 723):
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Contemporary theories (object relations, self psychology, & relational
theory)
What is psychodynamic theory?
It is a set of theories that describe...
the changing inner energies that motivate, dominate,
& control people’s behavior
It provides a framework that examines...
past experiences & present reality, as well as the
internal & external forces that impact emotional
development
It looks from “the inside out & the outside in”
Freud's Path
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How did a medically trained neurologist come to
describe this particular theory of the mind?
Charcot & the state of art of psychological care in
the 19th century
Freudian problems in Victorian context
The Couch
Psychodynamic Commonalities
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Personal history (particularly early childhood
experiences) influence development.
The psyche is formed at the intersection of internal
and external forces.
A dynamic unconscious (UCS) influences
thoughts, feelings and behaviors.
The “Talking cure” is influenced by transference.
Basic Premises of all Psychodynamic
Theories
 Internal & external forces—both conscious & unconscious,
based on past experience & present reality—interact to motivate,
dominate, & control human behavior, personality development,
& social functioning
 The internal mind affects how we relate to the external
environment & the external environment affects the internal
mind in a dynamic interaction throughout the life span
Assumptions about human behavior
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All biological, psychological, & social factors interact in a
complex way to impact development & adaptation throughout
life
Humans learn to adapt to the external environment through
relationships shaped by in-born genetic capacities , culture, &
socio-historical context
Early childhood experiences & relationships shape personality
development & interact with present reality to shape adaptation
in current life
Two Freudian Schemata
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The importance of theories of the mind-a
framework in which to understand presenting
problems.
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Topographic theory
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Structural theory
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Freud's theory developed and changed, but built on
what had come before
Topographic Model
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Conscious (cs)-the part of the mind that interacts
with the external world, and which can reflect on
itself.
Pre-conscious (pcs)-the part of the mind in which
thoughts, feelings and ideas are being prepared for
outward expression. Can be brought to attention.
-------------------------------------------------------------- Unconscious (ucs)-governed by the pleasure
principle. The cauldron of wishes, desires and
fears that make up the bulk of our mind.
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“These wishes of our Unconscious, ever stirring,
never dying—immortal, one might say—
remind us of the legendary Titans whose
shoulders from time immemorial bore the
great mountain-masses laden upon them by the
victorious gods, which even now still quake
from time to time from the convulsions of
their limbs…” (Int. of Dreams, 363, J. Crick,
trans.)
Aspects of a Freudian Theory of
the Mind:
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The unconscious
Disavowed wishes and dreams
Controlled chaos and a mechanism of control
Persistent (but moderately mutable) mental
representations
A personal history
Freudian Psychosexual Stages
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Oral stage (First year of life)
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Anal stage (2-3 yrs)
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Focus on primary gratification through genitals; awareness of erotic
feelings for parents; emergence of triangular relationships
Latency stage (5 or 6 through puberty)
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Focus on primary gratification through holding on & letting go,
corresponds with toilet training
Phallic (Oedipal) stage (3-5 yrs)
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Focus on primary gratification through oral means
Focus on repression of erotic feelings
Genital stage (puberty through adulthood)
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Focus on primary gratification though meeting adult sexual needs
The move to Structural Theory
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Guilt, anxiety & self-loathing
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Drive theory's mechanism of change
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Observation informs theory
Structural Theory
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Id
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Superego
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Ego
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(Where did the ucs go?)
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(A note on translation.)
The It (Id)
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The home of our sexual and aggressive urges.
Fully unconscious, although the unconscious is not
fully id.
“the dark inaccessible part of our personality...We
approach the id with analogies: we call it chaos, a
cauldron full of seething excitation.”
The Over-me (Superego)
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Both conscience and punisher.
The seat of moral expectations and regulation of
self-esteem associated with meeting those
expectations.
Identification & moral development
The I
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Conscious and unconscious
has an integrative function & provides
psychological cohesion
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mediates between the Id and the Superego
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The (non-unitary) Executive.
Post-Freudian Ego Psychology
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Anna Freud elaborated the mechanisms that the
ego uses to maintain homeostatis, and mediate the
impingements from inside (the id, the ucs ego, the
superego) and outside (unacceptable reality).
Heinz Hartmann developed a theory of the
mechanisms of the ego that are independent of
psychodynamics, and inherent in the mental
structure from birth.
How does the ego develop?
• Ego development occurs as result of:
• meeting basic needs
• identification with others
• learning
• mastery of developmental tasks
• effective problem-solving
• successful coping
• The ego develops capacities to function in the world,
known as “ego functions”
• Enable people to function in coherent, organized manner
Hartmann's ego functions
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Some ego functions are inborn & hereditary &
function autonomously, i.e., “conflict-free”
At birth, we are “preadapted” to an “average
expectable environment”
Some functions (perception, memory, intelligence,
thought processes, motor activity, reality testing)
are separate from the drives
Bellack's list of ego functions:
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Reality testing
Judgment
Sense of reality of the world & the self
Modulating & controlling drives, affects, & impulses
Object or interpersonal relations
Thought processes
Adaptive regression in the service of the ego
Defensive functioning
Stimulus barrier
Autonomous functioning
Mastery-competence
Synthetic-integrative function
Ego Defenses
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“The defensive methods so far discovered by
analysis all serve a single purpose—that of
assisting the ego in its struggle with its instinctual
life. They are motivated by the three principle
types of anxiety to which the ego is exposed—
instinctual anxiety, objective anxiety and anxiety
of conscience. In addition, the mere struggle of
conflicting impulses suffices to set the defencemechanisms in motion.”--Anna Freud, The Ego
and the Mechanisms of Defence
How defenses operate:
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Defense mechanisms operate out of conscious awareness,
while coping mechanisms are conscious
Defenses protect individuals from intolerable or
unacceptable impulses
Effective defenses enable optimal functioning without
undue anxiety, while maladaptive defenses distort reality
& impair overall ego functioning
Anna Freudian Ego Defenses
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Repression
Reaction formation
Projection
Isolation
Undoing
Regression
Introjection (internalization)
Turning against the self
Reversal
Sublimation
Displacement
Other Defenses
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Denial
Intellectualization
Humor
Splitting
Altruism
Asceticism
Dissociation
Eriksonian Ego Psychology
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The work of Erikson not only grew out of a
critique of Freud's psychsexual stages, it also
integrated observations from post-Freudian ego
psychology.
Erickson’s Eight Stages of Man
Epigenetic Stages
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Basic trust vs. mistrust
Autonomy vs. shame & doubt
Initiative vs. guilty
Industry vs. inferiority
Identity vs. confusion
Intimacy vs. isolation
Generativity vs. stagnation
Integrity vs. despair
Ages
(0-18 mo)
(18-3 yr)
(3-6 yr)
(6-11 yr)
(11-18 yr)
(young adulthood)
(middle adulthood)
(old age)
Virtues
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Hope
Will
Sense of purpose
Competence
Personal identity
Love
Care
Wisdom
What is a crisis?
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An upset in psychological equilibrium triggered by:
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outside harm or threat from the environment
internal developmental or biological changes
interpersonal challenges, conflicts, or losses
Symptoms may include anxiety, guilt, shame, sadness,
envy, disgust, fear
“Traumatic stress”—actual or threatened severe injury or
death of oneself or significant others
Diathesis/stress model of mental
illness
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“Diathesis”—a predisposition to develop disease or
morbid condition
“Diathesis/stress model”—an interaction of life
experiences with biological variables (genetics,
neurochemistry, neuroanatomy)
Each person has a unique vulnerability to stress
Coping and Adaptation
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Our efforts to manage stress & meet new challenges
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Biological coping (demands on nervous & hormonal systems)
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“fight-or-flight”
“tend-and-befriend”
Psychological coping
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Defense mechanisms (internal, unconscious traits)
Coping styles or capacities (fluid states, changeable)
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Problem-focused—change environment
Emotion-focused—change internal self
Individual's ability to cope with
stress is influenced by:
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Capacity to adapt & restore equilibrium
Interpersonal relationships
Current environmental supports & resources
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“social supports”—resources that provide material,
emotional, & instrumental support
personal supports perhaps salient—affirm identity,
compensate for deficits
Core Change Concepts
ACCORDING TO CLASSICAL THEORY &
EGO PSYCHOLOGY
Psychopathology, according to
classical theory
 Unresolved “conflicts of the mind” between id, ego, & superego
or between ego & external environment:
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May cause “fixation” at developmental stages
May cause weak ego functioning , leading to difficulties with adaptation
May cause inadequate defensive functioning leading to symptoms
 Symptoms of unresolved conflict (e.g., anxiety, depression,
compulsions, or sociopathy) are:
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Efforts to overcome or work through conflicts
Efforts to compensate for conflicts
Transference—a key to all dynamic
treatments
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Transference defined as:
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The feelings & wishes from past experiences
placed onto another in the present
 The central component of the “talking cure”
 A means for viewing client’s unresolved conflicts
by the interaction with the clinician
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Countertransference defined as:
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The clinician’s feelings about the client in treatment
Through understanding transference, clients may develop
insight & self-understanding, leading to change
Treatment based on ego psychology
EGO-MODIFYING
TREATMENT
EGO-SUPPORTIVE
TREATMENT
Focus: past & present; conscious,
Focus: current behavior, conscious
unconscious, & preconscious
Nature of change: insight & conflict
resolution
Curative process: make unconscious
conscious through interpretation
Use of relationship: use &
understand positive & negative
transference
thoughts/feelings; limit past focus
Nature of change: ego mastery,
increased understanding, better person-inenvironment fit
Curative process: strengthen ego,
shore up defenses, promote adaptation
Use of relationship: real
relationship, positive transference,
corrective relationship
Interventions & treatment populations
EGO-SUPPORTIVE
TREATMENT
EGO-MODIFYING
TREATMENT
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Types of interventions:
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Nondirective, reflective, interpretive;
“free association;” work with
environment not emphasized but may
be used; usually long-term tx.
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Direction, support, education,
structure, some reflection;
environmental modification;
provision & mobilization of
resources; short- or long-term tx.
Appropriate clients:
Persons with good ego strengths, but
maladaptive functioning
Types of interventions:
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Appropriate clients:
Persons encountering crises, life
transitions, extreme stress; with low
tolerance & impulse control
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“…a knowledge of psychodynamic
forces can illuminate what is going on
in any human interaction or
communication,
no matter how brief it is.”
--Berzoff, J., Flanagan, L., & Hertz, P. (Eds.). (2008). Inside out and outside in (2nd ed.). NY: Jason Aaronson, p. 2.
Ego Psychology’s use in
social work practice
SOCIAL WORK THEORISTS
& EGO PSYCHOLOGY TODAY
Social Work’s long history with ego
psychology
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Ego psychology was very influential in early social work
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Mary Richmond (1867-1928), wrote Social Diagnosis (1917)
Backlash emerged in 1960-1970s due to civil rights
movements, war on poverty
Founding of Clinical Social Work Journal (1972) & Federation
of Societies for Clinical Social Work (1971) re-emphasized
social work’s psychodynamic roots
Well-known MSW psychodynamic
scholars
 Howard Parad, wrote Crisis Intervention, Ego-oriented Casework
 Eda Goldstein, wrote Ego Psychology & Social Work Practice, Short-
term Treatment in Social Work: An Integrative Perspective, SelfPsychology and Object Relations Theory in Social Work Practice
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Jerald Brandell, wrote Psychodynamic Social Work
Joan Berzoff, wrote Inside Out and Outside In: Psychodynamic
Clinical theory and Psychopathology in Contemporary
Multicultural Contexts
Psychodynamic theory in current SW
practice
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Ego psychology is used as underpinning for supportive
treatment
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Ego-supportive treatment takes a “strengths-based approach”
Focuses on adaptation, restoring equilibrium, & building social supports
Especially useful in work with clients who are severely mentally ill,
homeless, in crisis, recently traumatized, in nursing homes
Contemporary psychodynamic practice is embraced by current
practitioners in brief & long term treatment
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Especially in work with individual clients with personality disorders or
complex trauma; or in working with couples
Freudian Controversies
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Universality
Oedipus conflict, penis envy, and the politics of
gender
Homosexuality
Fantasy and reality
Critiques of Freud
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Biology and mental illness.
The problem of repression.
Too many sexual urges, not enough positive
influences.
Freud & Einstein...human nature and hope.
Critiques of Ego Psychology
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Freudian theory foregrounds the importance of the
unconscious, while post-Freudian ego psychology
tends to give primacy to the (more or less
conscious) ego.
When mastery and “proper” ego functioning are
the focus of treatment, the therapist may become
the model of normalcy.
Cultural factors often ignored.
Evaluating Freudian Theory
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Evidence
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Application
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Usefulness
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Inclusiveness