Chapter Nine

1. Chapter Nine Psychosocial Theories

2. Object Relation Theories • Theories focusing on relations with others • Primary tasks in life focus on relations with others • Many theories with some overlap: • Patterns of relating to others established in early childhood • Patterns recur throughout life

3. Mahler’s Theory • Initial state of infant—fusion or symbiosis with mother • Differentiation between self and mother does not exist • Development represents a process of separation- individuation • This need is in conflict with the need to be taken care of • If process goes too fast = separation anxiety • At age 3, stable representation of mother develops, which is derived from experiences • Uses image as lens to view mother in future • Uses image to generalize to other people • These patterns form the core of adult patterns of relationships

4. Self Psychology (Kohut) • Relationships create the structure for the self • Initial needs involving others (selfobject) are narcissistic • Responding to a child’s narcissistic needs in an empathic accepting way establishes a sense of self • Initial sense of self is grandiose • Grandiosity eventually evolves into ambition and self-esteem • Love illustrates an adult form of mirroring—people represent selfobjects for each other and demonstrate mutual mirroring

5. Attachment Theory • Attachment—basic element of human nature involving an emotional connection to others • Infant attachment • Carries survival benefits (proximity maintenance) • Develops as mother (caretaker) responds to infant’s needs and provides a dependable base from which the infant can explore the world and retreat from threat • Patterns of infant attachment—Strange Situation Test • Secure attachment—distress at mother’s departure and happy enthusiasm at return • Insecure attachments: • Ambivalent—unusually upset at departure; approach, rejection, and anger at return • Avoidant—calm at departure; avoidance and rejection at return

6. Adult Attachment Patterns • Idea that working models of relationships developed in childhood carry over into adulthood (Hazan and Shaver) • Relationships of Secure people: • More happy; friendly; trusting; longer lasting • Mental model of love: It’s real and it stays • Relationships of Avoidant people: • Less accepting of lovers’ imperfections • Mental model of love: Cynical, romantic love doesn’t last • Relationships of Ambivalent people • Obsessive; preoccupied; extremes of emotions, sexual attraction, and jealousy; love at first sight • Mental model of love: Falling in love is easy, but doesn’t last

7. Alternate Conceptualizationof Adult Attachment • Two dimensional approach • Self (positive vs. negative) / Other (trustworthy vs. not trustworthy) Other (Hazan and Shaver Labels) (Avoidance) Self

8. Stability and Specificity • Stability • Mixed findings that suggest overall a moderate level of stability across time • Review of literature suggests a prototype for close relationships arises in infancy and persists in the face of new experience • Those who show patterns of change over time may be those who are insecure, but have periods of security • Specificity • People demonstrate different patterns for relationships in different contexts (close friends, groups)

9. Other Implications of Adult Attachment • Avoidant: • Socialize less at work; greater desire to keep busy • Seek less support during stress; provide less support to stress partners • Less responsive caregiving • Greater use of distancing coping • Ambivalent: • Unhappiness with job recognition and security • Higher levels of compulsive caregiving • Higher levels of self-criticism and wishful thinking coping • Pairings: • STABLE— Secure – Secure; Avoidant men – Ambivalent women • UNSTABLE— Ambivalent – Ambivalent; Avoidant – Avoidant; Ambivalent men – Avoidant women

10. Psychosocial Development • Developed by Erik Erikson • Stages from birth to old age (life-span development) • Each stage characterized by a central conflict around which growth potential and vulnerability are high • No single stage is more important than another • Central themes • Ego identity and its development is critically important • Develops from transactions with social reality • Changes in response to events in social environment • Competency and personal adequacy • Competency is key motivator of behavior • Competence results from mastery of a stage

11. Early Psychosocial Stages • Infancy (Year 1) — Trust vs. Mistrust • Basis for proving the world is predictable and developing the ego strength of hope • Early Childhood (Years 2–3) — Autonomy vs. Shame and Doubt • Basis for feelings of control and competency and developing the ego strength of will • Preschool (Years 3–5) — Initiative vs. Guilt • Basis for a sense of power in the world and developing the ego strength of purpose • School Age (Years 5–11) — Industry vs. Inferiority • Basis for sense of value, citizenship, and developing the ego strength of competence

12. Adolescence • Identity vs. Role Confusion (Years 12–20) • Basis for an integrated sense of private and social self and developing the ego strength of fidelity • Role confusion can create difficulties selecting a career and cause the person to identify with popular heros and groups

13. Later Psychosocial Stages • Young Adulthood (20s) — Intimacy vs. Isolation • Basis for close, warm relationships and developing the ego strength of love • Adulthood (to 60s) — Generativity vs. Stagnation • Basis for positively influencing the future and developing the ego strength of care • Old Age — Ego Identity vs. Despair • Basis for sense of order and meaning in life and developing the ego strength of wisdom

14. The Epigenetic Principle • Core issues of each conflict exist simultaneously, but are particularly focal at a given stage • Implications: • Outcome of earlier crisis influences orientation to later one • Solutions for a crisis, prepare one for upcoming crises • Resolutions of previous crises are reshaped at each new stage

15. Erikson’s Link to Other Psychosocial Theories • Issues of trust permeate all theories • Object relation theories imply a sense of trust required for an investment of energy in others • Trust is a key issue in secure attachment

16. Assessment • Similar to those in ego psychology with a focus on relationships • Since childhood experience is seen as an important determinant of adult behavior, emphasis is on childhood assessment • Play as a means of assessment allows expression of concerns not possible with words

17. Problems in Behavior • Problems are rooted in relationship issues • Narcissism may stem from inadequate childhood mirroring (Kohut) • Insecure attachment creates risk for depression

18. Therapy • Play therapy techniques for children • Emphasis on role of relationships • Desire to restore sense of connectedness with others • Therapist uses role to allow patient to reorganize problematic parts of self and ways of relating to others