Therapeutic Change in Everyday Life: 

A Unique Challenge for Social Work

      Reflecting a common view among psychoanalysts, Kernberg (1999) implicitly suggests that meaningful personal transformation only occurs in the context of exploratory psychotherapy or psychoanalysis.  Yet social workers, exposed to a wide array of personal difficulties and helping relationships, observe significant change and growth in a wide array of human situations.  These phenomena are most commonly observed in ordinary family relationships.  As Donald Winnicott (1965a) observed, the “average family is all the time preventing and clearing up the disturbances in this and that child, usually without professional help.  It is a mistake for a psychotherapist to ursurp the total family functioning except where this functioning is doomed to failure because of some inherent defect” (p. 143).  He suggested that social workers (in what has been classically called “casework”) provide “therapy of the kind that is always being carried on by parents in correction of relative failures in environmental provision....  What do such parents do?  They exaggerate some parental function and keep it up for a length of time, in fact until the child has used it up and is ready to be released from special care (D. Winnicott, 1963, p. 227).

      Winnicott’s wife, Clare, a distinguished social worker and psychoanalyst who had been analyzed by Melanie Klein and supervised by Michael Balint, Hanna Segal and Herbert Rosenfeld (Kanter, 2000), likewise was reluctant to place psychoanalysis at the apex of a pyramid of therapeutic experiences.   Referring to the professional development of social workers, she noted that “some may need and want (psychoanalysis), but that is an entirely personal affair.  What I am saying, however, is that we can, if we want to do so, use every means available to enable ourselves to grow up and to further our development
into mature human beings.  To grow up means learning to live with ourselves and putting up with ourselves the way we are. 

      We have to be able to tolerate sometimes feeling awful or confused or ignorant and at other times feeling good or clever or lucky.  If we cannot tolerate the whole range of feelings of which we are capable, we can easily become rigid and seek to make everyone else, including our clients, fit in with our patterns and our time....

      Friendships, reading, and cultural activities of all kinds, and holidays, all enrich our lives and our knowledge of the world and of ourselves.  We know that every situation in which we can be ourselves, and enjoy ourselves, not only adds another dimension to life, but liberates us for further experiences.  Our personal life is the base from which we operate, and to which we return.  The firmer the base, the freer we are to make excursions into the unknown”  (C. Winnicott, 1971, p. 51). 

      Such perspectives pose a unique intellectual challenge for social workers interested in psychoanalytic theory.  Instead of focusing solely on the processes of therapeutic action within the psychoanalytic situation, social workers, by reason of their engagement with human concerns outside of the consulting room, have a unique opportunity to study how these life experiences influence, and even transform, personal or intrapsychic functioning; to examine the unique relationship between what Donald Winnicott (1965b) has identified as “maturational processes and facilitating environments.”

References:

Kanter, J. (2000).  The untold story of Clare and Donald Winnicott: How social work influenced modern psychoanalysis.  Clinical Social Work Journal, 28(3), 245-261.

Kernberg, O. (1999).  Psychoanalysis, psychoanalytic psychotherapy and supportive psychotherapy:
contemporary controversies.  International Journal of Psycho-Analysis, 80(6).

Winnicott, C. (1971).  Development toward self-awareness.  In Toward Insight of the Worker with People.  Shrewsbury (UK), Shotton Hall.

Winnicott, D. (1963).  Psychiatric disorder in terms of infantile maturational processes.  In Maturational Processes and the Facilitating Environment, New York: International Universities Press, 1965.

Winnicott, D. (1965a).  A concept of trauma in relation to the development of the individual within the
family.  In Psycho-Analytic Explorations.  Cambridge: Harvard University Press, 1989.

Winnicott, D. (1965b).  Maturational Processes and the Facilitating Environment, New York: International Universities Press.