HHS310: H & HS Culture: The Helping Relationship (CGD1716A)

Personality Theories

Genetic, social, and individual factors combine to create the total personality; if we are to understand the human condition, we need to think about this complex entity. People have been wondering about themselves for thousands of years, and their ideas have been many and varied. Among modern theories, the ones that are have traditionally been most generally accepted and widely used as a basis for human service practice are the psychoanalytic theory, the learning theory, and the humanistic holistic theories. More recently, feminist theories are being more commonly used as well. Each has influenced and been influenced by the others, and all are influencing those now engaged in ongoing thinking about this age-old enigma—the human being. Current practice models reflect these basic theories. Workers need to be knowledgeable about them and able to evaluate and make use of their constructs. Work with people will reflect the worker’s conception of the nature of the personality, how it develops, and the impact of outside forces—individuals and groups—on that development. Out of such theories come processes for enabling desired change to take place. Workers use their concepts in understanding themselves as well as others and in working with others, again as individuals, in groups, or in larger societies.

Psychoanalytic Theory

Sigmund Freud (Table 3.2), the “father of psychoanalysis,” was one of the giants who, in words supposedly first used to describe Charles Darwin, “saw what all men saw and thought what no man thought.” Although Freud is now criticized for being too much of a determinist in his belief that all behavior is caused by instinctual drives of sex and aggression, for his sexist attitudes, and for using unscientific methods of gathering data, his impact on the development of personality theories has been tremendous. His terminology—namely conscious, unconscious, id, superego, ego, defense mechanisms—are all part of modern language and are defined as follows (Walrond-Skinner, 1986): Conscious The part of the psyche that is open to immediate awareness.

Unconscious hat region of the mind that remains unavailable to a person until it emerges into consciousness through events such as dreams and free associations.

Id he major portion of the unconscious; strives only to bring about the satisfaction of a person’s instinctual needs.

Ego A part of the personality whose task is to mediate the conflicting demands of the superego, the id, and external reality. he ego has a range of functions including observation, reality testing, rational thought, and perception.

Levine, Joanne. Working with People: The Helping Process (Page 48). Pearson Education. Kindle Edition.

Table 3.2 Highlights of Psychoanalytic Theory and Psychoanalysis: Sigmund Freud (1856–1939)

•Theory is based on the understanding that one’s mental life is made up of both the conscious and the unconscious

• Belief in a threefold (id, ego, superego) mental apparatus that functions in close relationship to the physiological systems of the body

• Concept of psychological adaptation whereby the mental apparatus attempts to produce a “steady state” and reduce conflict as much as possible

• Psychoanalysis works to make unconscious material conscious through techniques such as analysis of dreams and free association

Superego The part of the unconscious that acts as a monitor and critic of the ego through conscious functions such as observation, evaluation, criticism, and conscience.

Defense Mechanisms he unconscious means by which the ego protects itself from the instinctual demands of the id and the threats perceived in the external world. Defense mechanisms are employed as a normal part of functioning and serve to protect the individual from anxiety that he or she cannot handle. They include such things as regression, repression, rationalization, splitting, sublimation, denial, and intellectualization.

SCHOOLS OF PSYCHOANALYTIC THEORY Like all thinking, Freud’s theories reflected the times and the culture in which they were developed. His disciples went in many directions, altering his original conceptions with their own ideas and directions. Freud focused on the internal life of the person, and his theories of change dealt with changing the person within. He saw the genetic background and the environment as important but secondary to the primary relationship of the client with the worker.

One of the more important uses of Freud’s theories comes through the work of those who built on his ideas and changed their emphasis. Anna Freud, his daughter, Heinz Hartmann, and Erik Erikson have been instrumental in the development of what is known as “ego psychology.” his theory (Table 3.3) postulates that work must not be done only to resolve internal conflicts but also the demands of the environment. These adaptive functions are learned during maturation, and Erikson’s work on development throughout the life cycle is particularly useful for workers who deal with social situations and their demands on people. Finally, another outgrowth of Freud’s work was analytical psychology, developed by Carl Jung, a psychiatrist. Though he was greatly influenced by Freud, Jung’s theory differed in many respects from psychoanalysis. For example, Jung believed that we are meant to progress, to move in a positive direction, and not just to adapt, as the Freudians and behaviorists would have it. his perspective is invaluable for human service workers who strive to help clients, communities, and organizations reach their fullest potentials.

Levine, Joanne. Working with People: The Helping Process (Page 49). Pearson Education. Kindle Edition.

Table 3.3 Highlights of Ego Psychology: Anna Freud (1895–1982), Heinz Hartmann (1894–1970), Erik Erikson (1902–1979)

• Psychoanalytic theory includes an emphasis on the autonomous functions of the ego, which are not viewed as only being influenced by unconscious drives including cognition, perception, and memory

• The ego is primarily seen as enabling the regulation and adaptation of the personality to external reality

• This concentration on ego strengths and the adaptive potential of the ego have provided the foundation for briefer treatments including crisis intervention

Feminist Theories

All theories are subject to critiques and reevaluation in the face of new ways of thinking. Such is the case regarding psychoanalytic and related theories. They were harshly criticized by feminist scholars who felt they addressed only the psychological experiences of men. Because of this, women’s psychological development was often labeled as abnormal rather than different from men’s—but legitimate in its own right (Table 3.4). Feminist theorists were also strongly influenced by the women’s movement’s emphasis on the deleterious effects of social and economic oppression on the psychological development of women and girls (Stout & McPhail, 1998; Unger & Crawford, 1992). Feminist theories continue to be revised as women scholars from diverse backgrounds critique and refine what has been done before.

Major contemporary feminist theorists include Nancy Chodorow, who postulates that masculine–feminine identities and roles are not biologically determined but are “reproduced” in every generation by social arrangements (Chodorow, 1999). Carol Gilligan contends, based upon her research that studied women’s moral development, that men and women have different but equally valid approaches to moral issues: Men have a sense of morality based upon an ethic of rights while women have a sense of morality based upon an ethic of responsibility (Gilligan, 1982). Jean Baker Miller, a psychiatrist, and her colleagues presently work at the Jean Baker Miller Training Institute of the Stone Center at Wellesley

Table 3.4 Highlights of Feminist Theories and Therapy: Nancy Chodorow (1944– ), Carol Gilligan (1936– ), Jean Baker Miller Training Institute (est. 1995), Sandra Bem (1944– )

• An approach to psychotherapy and theory that has developed out of the philosophy of the women’s movement

• Reactions to the strong sexist bias that many women feel exists in the major personality theories

• All feminist theories and therapeutic techniques share some common elements: debunking psychological concepts regarding sex differences (especially those found in psychoanalytic theory); a positive view of the female body; emphasis on the development of equal responsibility, talents, skills, and power in women; a fusion between personal and political goals regarding change; and an emphasis on the egalitarian nature of the therapeutic relationship

Levine, Joanne. Working with People: The Helping Process (Page 50). Pearson Education. Kindle Edition.

College and examine the effects of power and social status on personality development. hey propose that because women are a subordinate group in society, psychological characteristics, including passivity, docility, dependency, lack of initiative, and helplessness, emerge as a way to cope with this oppression (Miller, 1986). Sandra Bem, a psychologist and expert on gender roles, explores the ways that people organize, categorize, and use gender-related information as they think about and solve problems. his can lead to stereotypes of how men and women should behave, think, and act (Bem, 1981; Unger & Crawford, 1992). These feminist theories clearly challenge human service workers to increase their self-awareness about gender stereotypes and how they hinder helping relationships with clients.

Learning Theory

It is generally accepted that learning theory (Table 3.5) began with the psychologist Ivan Pavlov’s famous experiments in which dogs were conditioned to respond to stimuli through association with eating. He has been followed by a long list of distinguished psychologists who first focused their attention on tests and measurements of human intelligence but more recently have turned to the development of learning theories and therapy dealing with mental health problems. John B. Watson was the first of this group to emphasize strongly the importance of environment and the facts that all behavior is learned and that only observable and testable facts are significant.

Probably one of the best-known behaviorists is B. F. Skinner, who developed the ideas of respondent behavior (that which is brought about by a specific stimulus and can be conditioned) and operant behavior (that which produces consequences that tend to be repeated when reinforced and discontinued when not reinforced). Many different practice models have developed from the theories of the behaviorists, who operate by setting up controlled situations in which behavior can be conditioned and reinforced. These models are widely used in teaching, in treating problems of human relationships, and in working with personal problems that lead to destructive behaviors. As behavior modification develops, certain features are assuming greater importance. One is the detailed specification of objectives with the possibility of subgoals that serve as steps on the way to the desired behavior. Another is the development of behavioral assessment techniques that permit specific definition of the problem and selection of the appropriate treatment, followed by assessment of the behavior change that results so that necessary alterations can be made in the treatment.

Table 3.5 Highlights of Learning Theory: Ivan Pavlov (1849–1936), John Watson (1878–1958), B. F. Skinner (1904–1990)

• This theory focused on external behavior that could be observed, not the inner mental life of the individual

• Maladaptive behavior is viewed as either a deficiency of functional learning or an acquisition of dysfunctional learning

• Treatment approaches are geared toward eliminating or reducing the frequency or intensity of the problem behavior

Levine, Joanne. Working with People: The Helping Process (Page 51). Pearson Education. Kindle Edition.

Presently, assessment procedures can be classiied into three types: (1) self-report by the client; (2) direct observation of behavior by, for example, parents, siblings, institutional personnel, and so forth; and (3) physiological measures based on various tests. Work is in progress on various laboratory instruments to be used in assessment.

Humanistic Holistic Theories

The growth of knowledge never stands still and is never complete. For many, psychoanalytic theories were not subjected to sufficiently scientific testing or were too mechanistic, and learning theories, though perhaps more practical than psychoanalysis, were seen as too controlling, as negating the factor of individual choice, and as not allowing for the “humanity” of the person. The development of humanistic theory was a logical next step (Table 3.6). Abraham Maslow, Carl Rogers, and others began to develop ideas of “self-actualization,” based on their view of people as essentially motivated toward growth and fulfillment, rather than beings who are controlled by instinctual drives of sex and aggression or who are objects to be manipulated into socially desirable learned behaviors. The focus of these theories is that the individual is constantly in a process of “being and becoming,” basically motivated to live in such a way that the best within is realized. Through development of meaningful relationships with others, as in a group situation or with another person, significant work can be done to achieve self-awareness or self-utilization. These theories are holistic, dealing with the totality of the individual and emphasizing flexibility, openness, and freedom from outside control.

Other Theories

In addition to these four basic personality theories (psychoanalytic, learning, humanistic holistic, and feminist), there are at least four others whose influence on human service practice has been sufficiently significant to deserve mention. These are Albert Ellis’s rational-emotive therapy (see following section on brief therapies), Fritz Perls’s Gestalt theory, Eric Berne’s transactional analysis, and William Glasser’s reality therapy. Fritz Perls, a psychoanalyst, developed Gestalt therapy, one of the forerunners of our modern emphasis on holism. It is based on the theory that people have an inherent drive toward growth, health, and self-actualization, which are achieved by a balanced wholeness. Perls emphasized acceptance of self in the present rather than dealing with the past and that tended toward emphasis on individual right at the expense of social responsibility. Eric Berne started out, too, as a psychoanalyst but separated himself from the classical movement and developed transactional analysis. his is based on the theory that human personality is divided into three separate ego states—the parent, the adult, and

Table 3.6 Highlights of Humanistic Holistic Theories: Carl Rogers (1902–1987), Abraham Maslow (1908–1970)

• Emphasis on engaging the whole person and focusing on the future rather than on the past

• Attention is paid to the relationship between the therapist and the client with BOTH seen as growing and changing from the therapeutic encounter

• Important tasks of therapy include self-actualization, personal growth, and self-understanding

Levine, Joanne. Working with People: The Helping Process (Page 52). Pearson Education. Kindle Edition.

the child—and the basic human motivating force is the desire for recognition and that personal problems arise from within the personality. By recognizing and taking responsibility for these ego states, primarily through group interaction, they can be dealt with more constructively. William Glasser, a psychologist trained in psychoanalysis, developed his reality therapy based on the premise that basically people need a distinct identity and tend to develop a “success” or “failure” identity, the former through secure love and feelings of worth, the latter through inadequate love and a feeling of worthlessness. Personal responsibility and actions to change such feelings are emphasized. In addition to the so-called scientific theories that are based primarily on research and are all products of Western society, other cultures have differing theories about how people grow and develop to maturity. Many of these rest on faith in a set of religious beliefs that explain human functioning on the basis of particular dogma. It is essential not to overlook the fact that all theories are culture bound: hey are postulated by people who are influenced by their own culture and by the times in which they live. “Nonscientiic” theories must be respected and understood if we are to work successfully with people who believe in them.

Brief Therapies

These refer to a wide variety of therapies, all of which strive to help clients find satisfactory solutions to their problems using as few sessions as are needed (Table 3.7). Though all brief therapies have an overt focus on being time efficient, they draw on theories and techniques from earlier approaches, including psychoanalytic and learning theories (Cooper, 1995). While many types of brief therapies are frequently used, there are several that have attained prominence in the human services. One is rational-emotive therapy, developed by Albert Ellis, a psychologist. his therapy is based on a theory that postulates that causes of feelings and actions lie not in actual life experiences but in how we perceive such experiences (Ellis, 1996). Ellis declared that by examination and rational thinking about these erroneous ideas, we could change both them and subsequent behavior. In this therapy, clients learn to think rationally about their problems. Another relevant therapy is cognitive therapy, developed by Aaron Beck, that, like Ellis, draws upon learning theories. his approach emphasizes that cognitive processes afect behavior and that behavior can be changed through addressing a person’s negative thoughts about his or her life, self, and experiences with the world.

Table 3.7 Highlights of Brief Therapies

• There are many different types of brief therapies but all are derived from psychoanalytic, learning, and/or humanistic theories

• Brief therapies all strive to be efficient and effective

• Brief therapies have limited treatment goals with clear outcomes, an emphasis on intervening in the present, and an emphasis on client strengths

• Brief therapists play an active role in keeping clients focused from session to session on what they are trying to accomplish

Levine, Joanne. Working with People: The Helping Process (Page 53). Pearson Education. Kindle Edition.

Drawing upon learning theories and Freud’s theory about the unconscious, psychiatrist Milton Ericks on developed the utilization model of hypnotherapy. Erickson’s approach is based on the assumption that people receive and process information outside of conscious awareness and that cognitive changes can occur without conscious awareness of the processes involved. Thus, during the hypnotic trance, the client is provided with indirect suggestions by the counselor about how to solve problems, thereby triggering the client to unconsciously solve the problem. his approach is ultimately based upon the belief that people can use their strengths to solve their problems (Nugent, 1996).

Finally, solution-focused therapy draws upon the ideas of Milton Erickson and was developed by Insoo Kim Berg, Steve de Shazer, and others at the Brief Therapy Center in Milwaukee, Wisconsin. A major assumption of solution-focused therapy is that focusing on the positive, the solution, and the future facilitates change in the desired direction. Therefore, the counselor and the client focus on solution-oriented talk rather than on problem-oriented talk. here is an assumption that it is unnecessary to search the past to find solutions and that small changes in thinking and behavior can lead to significant life changes (Walter & Peller, 1992).

Managed care has greatly expanded the use of brief therapies, because limiting costs has often meant limiting the number of counseling sessions covered by insurance. It is therefore imperative that workers remain current about research regarding the effectiveness of brief (and all other) therapies and also to document the outcomes of their own interventions. These eforts will help ensure that clients receive the best care possible. Whatever the type of therapy used, it is also critical to have a counselor who is skilled in using that technique. These actions are ethical responsibilities as seen in the NASW Code of Ethics; social workers are mandated to practice within their areas of competence and develop and enhance their professional expertise through continually striving to increase their professional knowledge and skills (NASW, 2008).

Brief Therapies

These refer to a wide variety of therapies, all of which strive to help clients find satisfactory solutions to their problems using as few sessions as are needed (Table 3.7). Though all brief therapies have an overt focus on being time efficient, they draw on theories and techniques from earlier approaches, including psychoanalytic and learning theories (Cooper, 1995).

While many types of brief therapies are frequently used, there are several that have attained prominence in the human services. One is rational-emotive therapy, developed by Albert Ellis, a psychologist. his therapy is based on a theory that postulates that causes of feelings and actions lie not in actual life experiences but in how we perceive such experiences (Ellis, 1996). Ellis declared that by examination and rational thinking about these erroneous ideas, we could change both them and subsequent behavior. In this therapy, clients learn to think rationally about their problems.

Another relevant therapy is cognitive therapy, developed by Aaron Beck, that, like Ellis, draws upon learning theories. his approach emphasizes that cognitive processes affect behavior and that behavior can be changed through addressing a person’s negative thoughts about his or her life, self, and experiences with the world.

Levine, Joanne. Working with People: The Helping Process (Page 54). Pearson Education. Kindle Edition..