Tuesday, November 1, 2016

Self Psychology for Social Workers: Interview with Tom Young, Ph.D.

[Episode 107] Today's episode of the Social Work Podcast is about self-psychology. Tom is a retired professor of social work from Widener University and the author of several publications on social work and self psychology. In today's episode Tom talks about the role of empathy in self psychology, the function of mirroring, idealizing, and twinship experiences in the development of the self, how self psychology can be applied in individual, couple, and family contexts. Tom talks us through a case involving an adolescent male and shares resources for those interested in learning more.



Transcript

Download MP3 [52:22]


Introduction

Hey there podcast listeners, Jonathan here. Today's episode of the Social Work Podcast is about self-psychology. Self psychology is part of the psychodynamic tradition which includes drive theory, ego psychology, and object-relations theory. I know some of you hearing the word “psychodynamic” and thinking, "old stuff.” But I have some good news for you. Self Psychology was developed in the 1960s by Heinz Kohut in Chicago. And in the world of therapy, the 1960s isn’t really that long ago. It is about 15 to 20 years after after Carl Rogers started developing person-centered therapy which is still the most commonly used therapy, and about the same time that Tim Beck was developing cognitive therapy, which is probably the therapy with the most research behind it.

Self psychology is neither widely used, nor does it have much empirical support. So why should you listen to the rest of this episode? Well, my guest, Dr. Tom Young, is really interesting. And he makes a good argument that self-psychology is the psychodynamic approach that has the best fit with social work. Tom is now a retired professor of social work from Widener University and the author of several publications on social work and self psychology. Tom sees self-psychology as the only truly strengths-based psychodynamic therapy. That said, one of the critiques of self psychology is that Kohut, like many theorists of his day, traced nearly every psychological problem back to the mother. In Kohut's case, he blamed mothers for a failure to empathize with their child. Kohut was the first psychodymanic theorist to put empathy at the center, an act which some have suggested ushered in the era of relational dynamic therapy. As Tom discusses, empathy in self psychology is a way of addressing unmet developmental needs, which is slightly different than the way Carl Rogers saw empathy. Speaking of development, Tom and I talked about three experiences that Kohut said were fundamental in the development of the self: mirroring, idealizing, and twinship. Don't worry, Tom will bring those ideas to life.

One term that Tom uses that might need a little more explanation is "selfobject" (and that’s without the hyphen – just one word, selfobject).  Kohut saw "selfobjects" as "things" that serve psychological functions for the "self" that help us stay cohesive.  They perform those functions through reflecting back who we are, providing us someone or something to idealize, or helping us feel connected to others.  So selfobjects are literally outside of a person, but are essential components of the internal "self." Selfobjects can be people, objects, or activities. Here are a few examples:

  • Have you ever had the experience of going out with new parents only to realize that they have completely lost the ability to talk about anything other than their baby? Even though the baby outside of them and hopefully at home with a babysitter, their baby is an essential part of the parents self-identity. 
  • If you take a mobile phone from a teenager and they say "it is like you're ripping my arm from my body," the phone is a selfobject. The mobile phone connects teens to peers and that connection peers is one of the ways that the developing teen feels whole. 
  • When you went away to college, did your parents give away your bedroom to a younger sibling, or remodel it so it looked nothing like your room. Did you feel upset, like they were giving away a part of you? Kohut would say that your bedroom was a selfobject. If you were surprised at how much you felt the loss of your room, Kohut would say that makes sense since we're only made aware of the role that the selfobject plays when it is taken away. 
  • But once we’re aware of its role, we can consciously turn to it during times of stress for reinforcement.  I think the easiest way to think about this is to think of a song or piece of music that has gotten you through tough times. I've had several friends for whom Stevie Nicks tunes have gotten them through their worst times. Literally times when they wanted to kill themselves. Music acted as a reinforcement, a way to put their fractured self back together, even if just for a few minutes. And sometimes a few minutes of hope is all people need to stay.



Tom talks about how self-psychology can be used with individuals, couples, families and groups and he shares a case study of self psychology with an adolescent male. We end with resources for folks interested in learning more.

Before we get to the episode I want to give a couple of shout outs. First, thank you to everyone who responded to my request to fill out our Podtrac Audience survey. Thousands of people download the podcast, but I know very little about you. In less than two weeks I had over 100 responses. Thank you! If you haven’t filled out the survey, please do. You can find the link on the upper right side of socialworkpodcast.com. So, what did you tell me? You really liked the guests, the introductions, the topics, the audio quality and the host (thank you so much). Two thirds you have listened to 6 or more episodes. Four people responded to the survey without having listened to an episode. Which is, well, I don’t know what to make of that. You didn’t like it when episodes don’t have transcripts and you don’t like the infrequency of episodes. And I hear you on both of those. Transcripts: In the last episode I invited you to donate a transcript. I want to thank the folks who have offered to transcribe episodes of the podcast. Big shout out to John West for donating his transcription of episode 104 - Guardian of the Golden Gate: Interview with Kevin Briggs. If you’re interested in donating a transcript in exchange for a shout out in the next episode, please send me a message on the Social Work Podcast Facebook page: facebook.com/swpodcast. As for the frequency of the podcast, I get them out as quickly as possible. I’m working on some ways to automate some of the tasks with the goal of making the podcast more regular. Until then, I humbly offer you my irregularly scheduled podcast.

And now, without further ado, on to episode 107 of the Social Work Podcast: Self Psychology and Social Work: Interview with Tom Young, Ph.D.


Interview


[09:00]
Jonathan Singer: Tom, thanks so much for being here today and talking with us about self psychology. And my first question for you is, what is self psychology?

Tom Young: Well, it’s a theory. Right? And theories are sort of mental metaphors that explain what makes people tick, how they behave, and why. And this particular theory which came out of psychoanalysis, it’s a little bit inaccessible to a lot of normal people, not that psychoanalysts aren’t normal [laughs] so I try to keep it simple and also show how it’s deceptively simple. So, for example, it’s a theory that places the self at the very center of development. It’s completely different from Freud’s view. It’s not about sex. It’s not about aggression. It’s about the self’s desire for cohesion, for productivity, for feeling vital, alive, and living a meaningful life. And the way the person invented it, his name was Heinz Kohut—died in 1981—the way he mapped it out makes a certain amount of sense to me even though I think the words that he used were somewhat cumbersome. He said every self needs to feel self-esteem and in order to have self-esteem, in order to feel good about yourself, you have to experience being admired and enjoyed by other people. Right? So he called that experience a mirroring experience which is a little bit of a poor choice of words in my view because it’s not a simple reflection. Right? It’s like I risk showing you what I am interested in, what kind of person I am, and then I wait to see how you respond to it. Right? If you respond to it with interest, with enjoyment, with appreciation, then I feel like you sort of get me. Right? And if I have repeated experiences of that kind then it sort of consolidates within me a good feeling about myself and self-esteem. All right. The second thing he thought that we all needed in order to be healthy, vital, productive selves, was sort of an ability to regulate our own emotions and our behaviors so that when we interact with other people and with things in the world we have a certain amount of flexibility and, for lack of a better word, self-control in the process. And his view of how that comes about is quite similar to what I just described for self-esteem. His view is that when a person is little, anybody who has had a two year old knows this, and they start to tottle, and they are sort of cruising around the house, and they are like unguided missiles; they can bang into just about any corner of an object that you have and they’re immediately hurt. Right? They didn’t expect the corner of the table to reach out and, you know, knock them in the head and so they turn in their distress and in their pain, they turn to the parent to make it better. Right? So, the parent can only do what parents do. You pick the child up, you try to comfort them, you kiss the boo-boo, you try to distract them so that they don’t sort of stay [laughs] caught up in that period of uncontrollable sobbing that is typically the case. And then typically what a parent will do after comforting a child will be to say, “oh, come on, let’s try to play this,” so there is sort of a two-part process or two phases to this experience that I am trying to describe; one is sort of the comforting and soothing part and then the other is the sort of the inspiration, “let’s get back into the game,” part.

[13:37]
Excuse me for being a little bit masculinist here, because it’s mostly mothers that do this initially, of course, but again, repeated experiences—he called these idealizing experiences, Kohut did so that’s the buzzword, just like mirroring. Idealizing? What does this mean? For a lot of people it just doesn’t connect with anything. The way that I make sense of it is that you have the young child needing to reach out to a stronger, more powerful adult who is sort of an “ideal” to the child for lack of a better word, and through that interaction the child gets comforted, soothed, and then also inspired to move ahead or move along. Right? And again, if you have repeated experiences of this kind when you’re growing up what happens is that you begin to internalize this process of being able to sort of recognize your own discomfort and soothe yourself. I mean even this phrase self-soothing sort of comes in a fairly direct way right out of self psychology as well as the capacity to reinvigorate yourself, inspire yourself, or find sources of reinvigoration and inspiration for yourself. So it’s not something that happens in one interaction. Right? It happens in multiple interactions over time. And the third piece of the puzzle that Kohut crafted is in some ways the hardest to understand. He asserted that every self needs what he called twinship experiences. It’s much harder to explain, but I’ll do my best here. A twinship experience is the experience of being with someone that you feel is like you and that you are like them. Right? So this is an experience of belongingness, of connectedness, of participating in some kind of community no matter how small it is. And the best way to understand twinship is to not have it and see what happens when you feel like you are the only person like you in a room. So, for example, since we are both social work educators we know of students from minority groups who end up in a classroom where they are the only one from their group and boy, do they feel disconnected, alienated sometimes, inept… They really feel… And I don’t know, since I lived on the Southside of Chicago for ten years and used public transportation a lot, there were times when I was the only white person on a bus. Right? And I knew then what it felt like to not have that twinship connection. Right? I mean you really feel like you are a fish out of water. Incidentally, I think a lot of kids with learning difficulties, and attention deficit problems have this experience when they are very young. When they first go to school, nobody knows they have this problem. They know they’re different, but nobody else knows that they are different, and so it sets in motion a pretty difficult chain of development until somebody gets it. Right?

[17:19]
Jonathan Singer: Ok, so you have those three experiences in childhood and—

Tom Young: Repeatedly.

[17:25]
Jonathan Singer: Repeatedly. These three repeated experiences. It’s a developmental process. Right?

Tom Young: Right.

[17:30]
Jonathan Singer: Not just once. And so what do you get from having those three experiences repeatedly?

Tom Young: Right. That’s a good question. Well, what you get or you should get is the capacity to be able to monitor your own self-esteem and regulate it because in this universe compost happens and there are all sorts of slings and arrows that come our way. We suffer disappointments, our feelings get hurt, we feel betrayed, we feel ignored, or we feel injured, or disrespected. Right? These are all sort of situations that I think of as fairly common occurrences. And if you get these three things that we’ve been talking about then you should have the capacity: first, to monitor and manage your own emotional reactions. Second, to monitor and manage your own behaviors in the wake of those emotional reactions if you can think that way. Third, you should be able to identify other people who can help you when you can’t do it yourself because you’ve had repeated experiences where you know the kind of response that you need and the kind of person who is most likely to deliver it if you seek it out. Right? So there’s a way in which this process, the developmental process that we have been talking about, never ends and this is really something that we have to continue until our last breath. Right? We really need to be connected to the right kinds of others in order to function at our maximum productivity, efficiency, or whatsoever. In fact, we were talking earlier about evidence and support of this theory, I tell my students, “Don’t take my word for it. Do this experience with yourself. If you’re in the presence of somebody who really gets you, who understands what you’re going through, and who is comforting and inspiring in the way I have been describing, in addition to their understanding and appreciating you and you feel that you are with someone that is like you and you are having this experience in the present moment, not developmentally, but in the present moment today, if you are with someone who delivers those three things to you, do you function better than you would if you didn’t have this person?” They all say right away, “Yeah, we understand what you are getting at.” They understand you. I think that was what Kohut was getting at, too. This theory really is a theory for life and so that raises the next question.

[20:45]
Jonathan Singer: And the next question is—so if you don’t get these three things and you don’t get the twinship experience, the mirroring, and the—

Tom Young: Idealizing.

[20:56]
Jonathan Singer: And the idealizing. Then what happens? How does the person experience life?

Tom Young: This is where I think the theory becomes most useful for social workers because, remember, Kohut put the self in the center of this psychological universe which is really a psychosocial universe. Right? It’s all relational. It’s all interactive. The self needs to feel good about itself. The self needs to feel that it is an agent under its own control. The self needs to feel connected as a member of some sort of community, right? So if you don’t get it in the ways that we’ve just been talking about then you find ways to make up for it in a kind of a substitute way. Right? So all of the sudden things like substance abuse, violence and aggression, sexual addictions become problematic substitutes for getting self-esteem, the feeling of control and regulation, and the feeling of belonging and connectedness. I say they’re problematic because we know what drugs, sex, and violence do. Rock and roll, of course, is exempted. That is really, I think, what is most helpful for social workers because the rest of the world tends to view drugs, sex, and violence in a very sort of moralistic way. I mean, right, it’s dangerous, and it's destructive. That’s all true, but if you are going to help somebody get out from under these, I can’t think of them all but addictions of a certain kind, you have to understand what the function of the dysfunction is.

[22:50]
Jonathan Singer: Right. And you can’t say, “Well, you’re addicted to drugs because you are a morally deficit person.”

Tom Young: Right. [laughs] Actually somebody has probably already told them that, and for somebody who is, let’s just say, dependent on—pick cocaine because it’s one of those substances that makes you feel big, makes you feel good, makes you feel smart, and makes you feel happy. You know? It’s all the things you would hope happens without needing the cocaine. Right? If somebody is going to kick cocaine then we have to provide them with an alternative experience that doesn’t involve the white powder.

[23:37]
Jonathan Singer: So would you say that cocaine provides an idealizing experience?

Tom Young: I think that’s a great question. I think that recreational drugs can provide multiple selfobject experiences. I hadn’t used that word selfobject before so I have to backtrack a little bit right now, right? The cocaine becomes the self’s object because the self is using the cocaine to generate this enhanced feeling of strength. This is the idealizing part. It generates happiness, maybe a certain feeling of sort of togetherness, and cohesion. “I am on my game. I’m high but I’m on my game” kind of thing. And then, I don’t know whether it also has an impact on self-esteem. [laughs] I haven’t had that much experience personally with cocaine but I think that there is this sort of illusion of just good feeling that comes from it so that’s what I mean when I think a particular substance can actually generate more than one selfobject experience. Sort of thinking out loud here about violence and rage, I think rage is not so much a twinship experience; an aggressive rage is really a substitute for feeling very vulnerable and very powerless, and there is nothing quite like rage to reverse that feeling.

[25:20]
Jonathan Singer: So let’s say you have a client who comes in who’s got addictions, who is aggressive—maybe this is a kid in a juvenile justice setting.

Tom Young: Sure.

[25:31]
Jonathan Singer: And you start to understand his situation using these concepts. These are things that are a reflective of not getting certain things developmentally. How does that turn into treatment? How does that turn into what you do? What do you do with that now?

Tom Young: [laughs] That’s a great question, because I think this is the hardest part of the theory for most people because, first of all, our culture wants the violence to stop and wants them to stop using drugs, right, so immediately we’re sort of predisposed to want to change this kid and his behavior. Secondly, we might actually be, I don’t know, maybe frightened a little bit or disgusted in some sort of moral way with his behavior, depending on what form the violence has taken. So what this theory asks us to do is to put all that desire to change him on a shelf or on a backburner and first, understand what is it like for him. Right? I mean how does he actually feel when he hits somebody? What does it do for him? It’s almost like a slow motion replay process that I think is fundamental. I think it’s at the heart of empathy. Right? It’s like we look at this behavior from the outside, and we think we know what it means but that’s not really what is important here. What is important is to understand it from the inside. What is it like for him? What are the kinds of situations, and the feelings, and the thought processes that he’s having leading up to scoring some drugs and using them. What kind of situations, what kinds of provocations precede a violent episode on his part? How is he actually feeling when someone calls him a racial slur or any sort of derogatory name? Because, just to carry on with this a little bit, what I think frequently happens is that there is this almost feeling of panic that the self is going to be obliterated, taken over, controlled, or demolished in some ways.

[28:27]
Jonathan Singer: So you understand the violence as protective in a sense like, “I am going to attack first before I am attacked. I am going to defend myself before somebody destroys me.”

Tom Young: Yes, that is another way in which the self psychology completely turns Freudian psychology on its head. Aggression is not primary in self psychology as it is in Freudian psychology. Aggression is a byproduct. It’s almost like a break down product, right? If the self is not feeling safe, is not feeling cohesive, or appreciated then violence is admittedly a poor substitute but it works. Right? So people hear about self psychology and usually when people like me hold forth on it, we make a big deal about empathy and most people start to yawn after two or three minutes, right, because they say, “Oh, empathy, yeah, we know about empathy.” Well… [laughs] We don’t know about empathy. None of us really knows what it’s like for another person until we try to understand that other person and that other person helps us understand them so, for example, I tell my students, “You know about your assessments and your treatment plans? Until your client feels, really feels that you get them, you don’t really have anything you can count on because only when a person feels—like if I feel that you get me and that you appreciate me, I will tell you things about me that I wouldn’t tell you until I felt that you got me.” So for this hypothetical kid that you are talking about in the juvenile justice system with a record of violent behavior and substance abuse, it won’t be until he really feels in some sort of emotionally safe way that we get him, it won’t be until then that he tells us how it is that he becomes violent and how it is that he resorts to using drugs and when, and where, and then we can formulate a treatment plan. Right? We can start to talk to him in words that are not unique to self psychology. We can start talking about triggers. We can talk to him about starting to monitor his own emotional reactions to things, even get him to predict when he’ll cross the line, when he goes into the red zone. Then we can start to talk to him about it and say, “OK, so we know that going into the red zone happens. We know what happens to you when you go into the red zone. You get busted. You end up talking to people like me. Right? What would work for you other than violence as you are approaching the red zone?” And what’s interesting about this is how people create their own treatment plans. I mean they think of things that are much more effective and much more creative typically than we do. We say, “Oh, well, get a punching bag.” Well, you know the kid’s not going to carry around a punching bag around the neighborhood, right?

[31:50]
Jonathan Singer: That’s right or, you know, come up with your anger thermometer.

Tom Young: Exactly. So I think that is the hard thing for clinicians, clinical social workers, clinical psychologists, psychiatrists, psychiatric nurses, I mean for all of us really, is to get behind that behavior and to really go that extra step in understanding what’s going on inside the person. If we succeed with that then we’re actually working with the person and finding ways for them to achieve good feelings about themselves, the capacity to regulate their emotions and their behaviors, and the ability to interact with other people in a way that works for them, meaning works for them so that it keeps them out of that red zone.

[32:46]
Jonathan Singer: So it sounds like empathy is a central concept and empathy is almost a tool to allow your client to trust you—that you get them. I know in social work, we often talk about empathy in terms of Carl Rogers—genuineness, empathy, unconditional positive regard. Is there a way in which self psychology understands or conceptualizes empathy differently?

Tom Young: Well, I don’t think it would be radically different. What’s radical is probably the emphasis placed on it, the centrality of it, in terms of interventions that are derived from the theory. I don’t want to talk trash about the Rogerian thing. It’s more than repeating back to the person what they’ve said; it’s generating with words your understanding of a person in his or her context, which is both contemporary, “where they live now,” but also historical. So, for example, when I meet with clients and I ask them, going back to this hypothetical situation with the kid we were talking about before, if we get to talking about approaching the red zone, one question I want to ask is, “Now, I think this has happened to you lots of times in your life. When was the first time you remember coming up to this red zone like this?” So your empathy does deepen. The more you understand what a person is actually going through, the more you are entering his universe and leaving yours in the waiting room someplace. This is also a hard thing for people and for clinicians to do, I think. It’s hard to sustain what Kohut referred to as an empathic immersion in someone else’s psychological life: psychologically understood both in contemporary and historical context. It’s not easy to do. We all have our own brains. You can’t unhook them and disengage them while you are doing this so it’s key to be able to keep yourself focused on this person’s experience, and understanding this person’s experience. So then, to get back to your question, you’re right, empathy is not only an assessment tool, but when the person starts to feel it, it actually has therapeutic effects even though we are not even talking therapy or intervention, yet. We’re talking understanding, but the more a person feels understood, as we were saying before, the better they function even in the moment.

[36:10]
Jonathan Singer: So that raises the question—assessment and then intervention—are there things that are specific to self psychology in terms of intervention?

Tom Young: I don’t think there’s anything specific. I think that’s one of the reasons why to my knowledge self psychology has not generated a manualized treatment that can be evaluated in a standard research fashion, but I do think that as your understanding of the person deepens in this empathetic way we were talking about before, that you begin to see both historically in the person’s life and in the way the person interacts with you what that person’s self is seeking for most now. I don’t know how long it has been since you have worked with adolescent kids but I remember working with adolescent kids in a psychiatric inpatient unit and you could tell which kids were starved for mirroring experiences. I mean they will tell you how wonderful they are for hours on end and it’s really because they have been treated like little snots.

[37:42]
Jonathan Singer: Like they are not wonderful.

Tom Young: Like they are not wonderful. That’s right, and other kids will sort of present themselves as being pretty much totally unregulated. I mean we say that they have impulse control problems, right? Well, that’s a person that needs a strong figure to stay with them when they are feeling unregulated and figure out ways to deliver some of that comforting and calming… I mean, that tone of voice, just the way you position yourself physically with a kid. You don’t get in his face. You sit down alongside of him. You try to initiate conversations like, “You’re looking a little out of sorts. What’s going on?” You get a kind of conversation going where you actually accept the role of the idealized other, where you accept the role of the self-esteem bringing mirror. Right? Or you accept the role of just “being with,” particularly for those kids who feel so different from the rest of the universe.

[39:00]
Jonathan Singer: So the treatment process is actually being those three types of self-objects.

Tom Young: That’s right. It’s more a therapy of being than it is of doing.

[39:15]
Jonathan Singer: I can see how that would be tough to manualize because you wouldn’t say, “Sessions 3 through 7: You are the mirroring object.” [laughs]

Tom Young: [laughs] Right.

[39:24]
Jonathan Singer: Because it wouldn’t make any sense and you know, we have been talking about kids but this treatment can work for anybody because you said this is process that goes on throughout your life.

Tom Young: That’s right.

[39:38]
Jonathan Singer: Is this something you could use with couples and families? Not just individuals?

Tom Young: Yes, I think so. In my own work, I do see many couples. And if you stop and think about the kinds of experiences that we were talking about earlier, in a marriage or it doesn’t even have to be marriage but a committed long term relationship, it doesn’t have to be heterosexual, it can be homosexual, what are some of the things we are looking for from our partner? Aren’t we looking for some sort of that acceptance that builds self-esteem? Aren’t we looking for comfort when we’re disappointed and down? Aren’t we looking for somebody that we feel we can sort of navigate this world with together, that we belong with, and that belongs with us? So what I think happens with a lot of couples in distress is that something has happened in their life together that has made them fearful that they’re not going to get this from the other person and as soon as they get fearful that they are not going to get this from the other person then the other person becomes like the enemy. And so the very foundations of intimacy get eroded by this fear that the other person is going to hurt us rather than provide those kinds of experiences. So when I work with couples I spend a lot of time trying to say, “What’s your worst fear here and isn’t that fear that you’re not going to get some of these good things?” This is true with families, too, I think. The funny thing about families is that some children can remind their parents of the person they were afraid they might become or the child will remind the parent of a sibling who has gone astray. What happens is that the parents in a family situation start interacting with the child out of fear that the child is going to become something they don’t want the child to become. Then that fear also erodes the process or compromises or corrodes the process of the kid getting the sort of self-esteem enhancing, the self-control building, and the interpersonal kinds of skills. So I think the theory can underpin a lot of systemic work. For those of your listeners who are interested, I did try to articulate that in an article that was published in the Social Service Review back in the early 90s called, “Environmental Modification and the Self Psychological Perspective.” I think a lot of social workers end up in positions where they could help systems recalibrate so that the people in those systems would get more of the sort of self-enhancing experiences with each other rather than this fearful, fear based distancing kind of interactions with each other. I think I find it a pretty versatile theory in terms of working with children, with adolescents, with adults individually, or in couples, or as parts of family systems. Other people have applied it to working with groups. I have not done that. It’s sort of interesting to think about how in a group experience as sort of as envisioned by Yalom, to think who underneath that group process would be getting these kinds of experiences, and what a group facilitator could do to make it possible for the group members to provide them to each other? So I think that there is an application there, too, although it’s not something that I am particularly knowledgeable about.

[44:05]
Jonathan Singer: Are there resources that you can recommend for folks who want to know more? We can put links to those on the Social Work Podcast website.

Tom Young: Ok. Well, this could get a little autobiographical here. I only met Heinz Kohut once, but I knew his wife for about three years. During a particular stressful time in my life, I was seeing her for counseling or therapy. Betty Kohut was her name. She was a social worker, and she had a very close friend named Miriam Elson who was also a social worker. Miriam Elson actually worked professionally with Heinz Kohut as well as being friends with him socially, and she’s written a book called Self Psychology in Clinical Social Work. I mean it could maybe even be about 15 years old now but it’s still available. It’s in paperback and I think it’s published by Norton. And then there’s a book that Helene Jackson edited, the exact title of which escapes me at the moment, but people like that because each chapter applies the theory to work with a different population so that you can get more target problem focused in that book than you can in the one by Miriam Elson. There is a series that a lot of people don’t know about that I think is very valuable called Progress in Self Psychology. I think that’s put out by The Analytic Press. It was edited by a man named Arnold Goldberg for years. He doesn’t do it anymore, but Goldberg was collaborator and contemporary of Kohut’s. Every year there were annual conferences in self psychology. People came and gave papers applying the theory to different situations and those papers then got compiled in this series called Progress in Self Psychology. I think it is one of the richest sources for people who really want to know, “How do I use this stuff?”

[46:35]
Jonathan Singer: That’s great. Well, we will put links to those on the Social Work Podcast and, of course, any of the stuff that you have published, we’ll put links to those on there as well.

Tom Young: Great.

[46:46]
Jonathan Singer: So what are some of the limitations of self psychology?

Tom Young: Well, I think a big limitation in our current era is that everybody wants a fix for any one of the disorders in the DSM. Right? I mean if you have anxiety, if you have depression, if you have OCD, obsessive compulsive disorder, or panic with or without agoraphobia, and on and on and on, it makes perfect sense that everyone would want to know, look, isn’t there a treatment for this? Isn’t there an intervention that fixes this?

[47:30]
Jonathan Singer: Right, like dialectical behavior therapy for women with borderline personality disorder who self-harm?

Tom Young: Exactly. In all fairness to self psychology, it was not developed with that goal in mind. So a potential limitation is that if you are looking to sort of cure schizophrenia or reconstruct a borderline personality disorder [laughs] or eliminate panic attacks with self psychology, that’s a waste of time because self psychology really is an empowering psychology. So the person is always bigger than, more than the symptom or the disorder, and what self psychology is trying to do is to empower the self that’s contending with the disorder or the diagnosis. So even a person struggling with schizophrenia can be related to or interacted with in a way that is guided by self psychology and if it’s done in the way that we’ve been talking about before then the person struggling with schizophrenia feels empowered to deal with his or her schizophrenia and similarly for the other disorders that were mentioned. Lots of time I think and I don’t understand exactly why this is, maybe just because it came out of psychoanalysis, but people sometimes criticize self psychology for being a deficit model and I guess it is because, you know, the absence of mirroring developmentally or the absence of idealizing leads to a sort of psychoanalytic world view with structural deficits in the personality. Yeah, you can go there but I don’t think Kohut was coming from that place at all. He was coming from what is every self striving for. Every self seeks to be healthy. Every self wants these kinds of experiences because it makes you a more vibrant, a more cohesive, a more productive, a more creative person. That’s the way all selves want to be so I see the theory not as a deficit model but more as a strength based model really with a focus on empowering the self no matter with what the self is contending with in terms of these other kinds of disorders.

[50:05]
Jonathan Singer: And that really fits with social work.

Tom Young: I think so.

[50:08]
Jonathan Singer: Yeah, because social work, the way that it is being taught these days, the ways that it has been taught for 15 to 20 years is “focus on strengths,” the strengths perspective, focus on what your client brings to the table, resilience, and all those sorts of things. And it sounds like self psychology from your understanding and how we have talked about it really fits well with that.

Tom Young: I couldn’t agree more and I am so glad you mentioned resilience because I think the resilience research converges on this theoretical formulation of self psychology. If you get these kinds of experiences that we have been talking about, you are a more resilient person no matter what your circumstances are.

[50:45]
Jonathan Singer: So that could be one of the reasons why somebody who is at risk could be resilient because they had these experiences of somebody mirroring their goodness and who was able to over years provide them with that.

Tom Young: Exactly, and we call them protective factors. [laughs] Right?

[51:07]
Jonathan Singer: [laughs] That’s right, the protective factors.

Tom Young: Protective factors in the risk and resilience framework. Right.

[51:15]
Jonathan Singer: Well, Tom, this has been great. Thank you so much for taking time out in talking with us about self psychology. I really appreciate the insight into the model and I hope that folks out there listening get as excited about it as I am.

Tom Young: That’s great, Jonathan. Appreciate the opportunity. Thank you very much.

End
Transcript generously donated by Amy Smith, early childhood special education paraprofessional.

References and Resources



APA (6th ed) citation for this podcast:

Singer, J. B. (Producer). (2016, November 1). #107 - Self Psychology for Social Workers: Interview with Tom Young, Ph.D. [Audio Podcast]. Social Work Podcast. Retrieved from http://www.socialworkpodcast.com/2016/11/self-psychology.html

7 comments:

Chocolate Covered Life said...

This was very helpful, I never knew how much I related to self psychology in my work with clients. I just bought Self Psychology in Clinical Social Work off BetterWorldBooks for $5, I look forward to this read and to incorporating more of these principles in my practice!

Eva Pedersen said...

Great work as always Jonathan - bringing a diverse range of topics and presenters to the table.
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I was a bit dumbstruck by Dr. Young's response when you asked about how self-psychology's conceptualization of empathy may be different or similar to the Rogerian conceptualization. Dr. Young's initial response was something to the effect, it's more than repeating back what the client is saying. This is exactly the point that Rogers was attempting to make when responding to criticisms about the therapeutic use of empathy. Rogers felt there was a rather rote and superficial way of using empathy that was not at all what he was referring to in his theory. On the contrary Rogers talked about empathy as the act of suspending one's self-perception and experience in order to truly enter the world of the client and further, to express that understanding through accurate reflections of meaning that deepened the client's self understanding. Not only did Rogers conceptualize therapeutic empathy but he also operationalized it for research purposes. So I was a bit dumbstruck by Dr. Young's suggestion that self-psychology had some sort of original or deeper understanding of this construct. I think a large body of literature and research shows that Rogers gets the credit for developing our understanding of empathy as a powerful therapeutic tool and all that come after are building upon his amazing contribution to the field.
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Thanks again. Love the show! Eva from BC Canada

Jonathan B. Singer, Ph.D., LCSW said...

Eva - So glad you like the podcast. Thank you. I agree with you. I thought Dr. Young's description of empathy was 100% consistent with Rogers.

- Jonathan

N. Bronson said...

Hi. I appreciated finding this podcast on self psychology, which has informed and inspired my work with patients for many decades. I can attest to the therapeutic power and profound usefulness of Kohut's ideas with individuals, couples and families. One point I would like to add which differs with Dr. Young is about borderline personality disorder. One of the revolutionary aspects of self psychology was Kohut's demonstration that patients with so-called narcissistic or borderline personality organizations were treatable (analyzable) within a self psychology model. Self psychology can also be beautifully integrated with treatments for trauma and other conditions associated with great vulnerability and suffering. Kohut showed how such individuals can function on a higher level, experience a much stronger sense of self, and show growth and improvement within a therapeutic relationship guided by self psychology. Nancy L. Bronson, PhD

Barbra Resnick said...

Thank you so much for this episode! I am a clinical social worker in Orlando who specializes in working with oppositional adolescents. I've always said that every good therapist has a specific natural gift. Mine is that I can quickly get to know a person's true self beyond all of their presentations and defenses. I use this as a basis for all of my work with clients.
I've always thought of myself as coming from an existential, client-centered orientation and while I still think that, I now realize that conceptually, the way I understand a client and our work together is rooted in self psychology. I feel most energized by those moments where I am truly "with" my client.
I found this episode exciting and I can't wait to learn more. I certainly had an experience of mirroring while listening to Dr. Young describe the work I do almost exactly! Thank you again from a fellow Longhorn!

Rachel Goldfarb Kowalenko said...

Hi Dr. Singer, thanks for this pod cast, I find you really have a great way of explaining the concepts and showing how they can apply to the day to day social work we are doing. I am a medical social worker who went back to school late in life and late in my career. I am one year away from completing my MSW.
I am so happy to have these pod casts as another way to be educated.
Be well, Rachel Goldfarb Kowalenko, CSW

Laura Jo Acuna Zavalney said...

I loved this episode. I had not learned this topic earlier and when I began to hear about it, I realized I had a basic, intuitive sense about it. I am a much better audio leaner so continuing education on the go is my style.