Social work is fundamentally a relationship-based profession. This presentation draws on psychodynamic theory, object relations theory, attachment theory, relational psychoanalysis, and sociological theories to explain what is meant by a relationship based practice approach to social work.

1. By: Claudia Megele
Principal SocialWorker
Keynote at Middlesex University

2.  We relate to the world and others through
relationships.
 Relationships gives us insight into our internal
worlds and the internal worlds of others.
 Relationships can transform us - lift us up or
break us down.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

3.  “Unless we exist in the eyes of others we may
come to doubt our own existence. Being is a
social and psychological construct; it is
something that is made not given.” (Myerhoff,
2007, p.31 cited in Megele, 2015, p.149)
 ‘Selves are constructed, modified and played
out in interaction with other people’ (Hogg
andVaughan 2005: 139).
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 3

4.  Psychodynamic theory describes:
 How relationships are build
 Template to understand ourselves and others
 Acknowledges the complexities of relationships
 By harnessing the power of relationships we
can empower others and motivate positive
change.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

5.  Important to understand self.
 Sometimes social workers neglect to think
about and engage in the process of knowing
‘self’ and instead focus on skills of relating to
others.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

6.  Why do we like certain people and dislike others?
 What is being evoked in me?
 Validation allows us to be soothed and feel ok about
ourselves.
 We seek someone in who’s mind, presence and heart
we can find ourselves and feel a sense of belonging.
 Relationships have the ability to move ideas and
concepts into experienced reality.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

7.  Maslow (1968:3) “We have, each of us, an essential
biologically based inner nature, which is to some degree
“natural”, intrinsic, given, and in a certain limited sense,
unchangeable, or, at least, unchanging”.
 Maslow is referring to human ‘nature’ and the need for safety and
security and belonging, for loving and being loved, for trust and
trusting.
 Carl Rogers (1980:117) ‘actualising tendency’ …‘an
underlying flow of movement toward constructive fulfilment
of …inherent possibilities’
 For Rogers the actualising tendency was at the core of the
individual person and inherent and would thrive if it met
relationships that facilitated it or wither away if it experienced
neglect or abuse.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

8.  BUT not all experiences are validating some are
non-validating and rejecting or frustrating…
 Have you had experiences where you haven’t
gotten something you wanted …. ?
 Or what about the fear of failure or the fear of
adverse outcomes.
 The fear of non-belonging?Those fears cause
anxiety…
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

9.  Unpleasant inner state that people seek to avoid.
 Acts as a signal to the ego that things are not going well.
 ThreeTypes of Anxiety:
 Neurotic anxiety is the unconscious worry that we will lose control of
the id's urges, resulting in punishment for inappropriate behaviour.
 Reality anxiety is fear of real-world events.The cause of this anxiety
is usually easily identified.
 Moral anxiety involves a fear of violating our own moral principles.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

10. 10
State of emotional
arousal
Child introjects
caregiver’s metabolised
emotions. Child feels
soothed Emotional
Capacity to
take/digest
these emotions
and feelings
and is not
overwhelmed
by them.
Verbal and non-verbal
expression of emotion of
distressed emotions &
feelings
Gives these feelings back in
a more
digestible/acceptable
manner.
Infant/Child
Caregiver
Projection
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

11.  The sense of self we create is a question of a
sense of self that we have known through our
lived experience and human everyday
encounters.
 For example is our life narrative “a treasure of
our experience” or “emotional baggage”? It
depends on our view….
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

12.  Our unconscious thoughts, emotions, beliefs,
patterns, desires, etc.) form our subjective maps of
reality and attribute meaning to our experiences,
hence, influencing our judgement and behaviour.
 The unconscious may find symbolic expression in our
dreams, the so-called slip of the tongue or in jokes.
 The unconscious and preconscious can help us to
understand where our own and others’ strong
emotions, thoughts or beliefs may come from.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

13. Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

14. The American Psychiatric Association defines
defence mechanisms as mental processes that
operate unconsciously to protect individuals
against anxiety or awareness of internal threats
and external stressors.
However, although defences operate primarily at
an unconscious level, individuals may be aware of
their residuals.
(Megele, 2015, p. 60)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

15.  GeorgeVaillant's (1971) categorization of defence mechanisms as
being on a continuum in relation to their psychoanalytical
developmental level.
 Level I - psychotic defences (i.e. delusional projection, psychotic
denial , psychotic distortion)
 Level II - immature defences (i.e. acting out, passive aggression,
fantasy, projection)
 Level III - neurotic defences (i.e. intellectualization, reaction
formation, dissociation, displacement, repression)
 Level IV - mature defences (i.e. humour, sublimation,
suppression, altruism, anticipation)
Source:Vaillant, G. (2011) Involuntary coping mechanisms: a psychodynamic
perspective. Dialogues Clin Neurosci. Sep; 13(3): 366–370.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

16. Primitive Defence Mechanisms Less Primitive, More Mature DM
 Denial Repression
 Regression Displacement
 Acting out Intellectualization
 Dissociation Rationalization
 Compartmentalization Undoing
 Projection
 Reaction formation
Mature Defence Mechanisms
 Sublimation Compensation Affliction
 Self-Assertion Altruism Self-Observation
 Suppression Anticipation
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

17.  Denial is an outright refusal to admit or recognize that
something has occurred or is currently occurring.
 Can occur with those experiencing addition or victims
of traumatic events may deny that the event ever
occurred.
 We do it to save ourselves from anxiety or pain.
 Denial requires a substantial investment of energy.
 Minimising is part of denial.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

18.  Sigmund Freud (1924[1905]) argued that psychological projection
is a defence mechanism in which the individual ascribes their own
unacceptable feelings, emotions or attributes to other objects or
people in the external world.
 For example, a person who may be anxious or litigious may accuse
other people of being anxious or litigious. In other words,
projection is an unconscious defence mechanism in which the
person uses other people or objects as a hook upon which to hang
their own unacceptable or unwanted emotions.
 Although projecting our unwanted qualities and emotions onto
others may be considered an immature defence, on a small scale,
this is a common occurrence in people’s lives and interactions.
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

19.  Eg. Jenny and Sophie in chapter 3 of Psychosocial and
relationship based practice identified with Summer’s
projection of her helplessness and, therefore, felt unable
to influence the situation.
 In Jenny’s words: ‘There’s not much you can do, aside from
watching out for early signs and trying to intervene as soon
as you feel things are heading in the wrong direction again.’
 Projecting into someone or projecting onto someone.
 It can also be used as a means of control.
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

20. 20
State of emotional
arousal
Child introjects
caregiver’s metabolised
emotions. Child feels
soothed Mother
identifies
with the
child.
Projective
Identification
Verbal and non-verbal
expression of emotion of
distressed emotions &
feelings
Gives these feelings back in
a more
digestible/acceptable
manner.
Infant/Child
Caregiver
Projection
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

21.  For example Alice’s account of Friday’s events: ‘At first
mum said no but then he said she was a “sorry old cow” and
she never helped him none with anything. He called her a
“bitch and a cunt” and then she agreed that he could watch
the football.’
 An example of how projective identification can lead to a
process of control.
 Father projects his own anxiety, dread and shortcomings
and the mother takes it on and results in her allowing him
to watch television in the home.
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

22.  User of services project their own anxiety
hoping for a hook wanting the social worker
to take it on.
 What we say and do is more about ourselves
than other people and reveals more of
ourselves than anything else.Who we are and
what our experiences are.
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

23.  Reaction formation is when one takes the
opposite feeling because what they are
actually feeling creates anxiety.
 Alice is using reaction formation as a defence
mechanism to hide her true feelings by
showing indifference and behaving in the
exact opposite way.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

24.  Suppression is a conscious act of trying to forget
or trying not to remember or deal with an
emotion, feeling, event or experience.
 Repression is when the individual unconsciously
blocks such emotions, feelings, experiences, etc,
repressing them into the unconscious.
 These memories don't just disappear; they
continue to influence behaviour.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

25.  Displacement involves taking out our
frustrations, feelings, and impulses on people
or objects that are less threatening.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

26.  Feelings of the individual originate from different sources that are not
always identifiable
 Transference is a process whereby feelings, views & responses belonging
to earlier relationship transferred or projected onto a person in the
present
 May include painful feelings of client/users of services projected onto
social worker
 Can contain useful info about & understanding of the situations relating
to users of services
 Important to examine this material so it doesn’t distort relationships
and/or interventions
Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

27. Mary Joe
Silence in the car is peaceful’
Silence in a car is raising
anxiety before sudden
violence
Silence
How are you ?Well
Really?Yes
Really, Really?Not any more!
Ah, I knew itAargh!
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

28.  The transference of memories of significant
people in our past onto people in our present.
 Our clients/service users transfer: transference
Joe?
 As we transfer: countertransference
Mary?
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

29. Mary Joe
‘My father flew into rages
with us as kids’
‘Silence in a car is raising
anxiety before sudden
violence’
Silence
How are you ?I am fine. How are you?
You’re the one in a bad mood.‘You seem irritated’
SilenceSilence
‘You are such a pain to drive
with’
‘Whatever you want’
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

30.  Think of someone you know whom you don't
like very much.
 On a piece of paper, write down a description
of that person.
 Write down what it is about this individual's
personality that you don't like. Be as specific
as you can be.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

31.  Could this be transference?
 Does that person have a characteristic similar
to someone from your past or present?
 Is this relationship similar to a significant
relationship from your past or present?
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

32.  Response of person onto whom feelings or attitudes have
been transferred.
 Users of services may in turn transfer these feelings onto
social worker, and social worker may have
countertransference to user of services.
 Importance of exploring countertransference:
 Bringing into consciousness enables it to be known & explored
 Increases knowledge & understanding of users of services
and/or situation and informs and assists interventions and
working with users of services
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

33.  Alice has not been speaking with Jacklyn and their relationship has
been tense. Alice blames Jacklyn for moving her from Julie’s
home. Jacklyn understands that it is easier for Alice to blame her
instead of facing the difficult truth that it was Julie who was only
willing to accommodate Alice for four days.
 In this example, Alice redirects her emotions toward her aunt
toward the social worker.The way Jacklyn responds to Alice is the
countertransference.
 Transference and countertransference are also important in
supervision and many other relationships. By reflecting on this
you can learn what is behind the relationship.
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

34.  Mentalisation is attending to what is in our own and other
people’s minds (i.e. our own as well as others mental
states)
 Empathy is concerned with the other person’s mental
state
 Psychological Mindedness is about introspection and
personal insight
 Self refection can be thought of as self mentalising
 Mindfulness is about attentiveness and being mindful
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 34

35.  Feeling with people – empathy – making a
connection
 Empathy is a choice – connecting with a part of
myself that knows that feeling
 Sympathy is feeling alongside rather than with
people
 Response versus connection: It’s connection that
makes things better. Response with no
connection has limited impact.
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 35

36. Source: Forrester, et al. (2008)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness 36

37.  Self and other awareness (emotionally intelligent social worker);
 Ability to hold anxiety and to reflect and see self and other;
 Enhances ability to understand the complexity of relationships and manage
complex relationships and dynamics;
 Relies on understanding family narratives, understanding how past experience
affects current attitude and behaviour and how you work to change both;
 Theoretical grounding, not ignoring intuition but not dictated by it;
 Facilitates confidence and ability for respectful challenge and to resolve;
 Mindful embodied practice of social work theories, values, principles and
capabilities that result in the creative and thoughtful art of relationship;
 By being present and offering containment and a holding relationship that is
empowering for users of services and enables positive change.
Source: Megele (2015)
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

38.  Signs of safety
 Solution focused
 CBT
 Systemic approaches
 Motivational interviewing
 Strength based approaches
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

39. Freud
1856 –1939
Klein
1882 – 1960
Bion
1897 – 1979
Winnicott
1896 – 1971
Anna Freud
1895 – 1982
Jung
1875 – 1961
Transference Object Relations Containment Transitional Object Psychoanalytic
Oedipus complex CounterTransference True & False Self child psychology
Projective Identification
Archetype &
collective unconscious
Individual psychology
‘inferiority complex’
Adler
1870 – 1937
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

40.  Megele, C. (2015) Psychosocial and Relationship-Based Practice. CriticalThinking
 Vaillant, G. (2011) Involuntary coping mechanisms: a psychodynamic perspective. Dialogues Clin
Neurosci. Sep; 13(3): 366–370.
 Sudbery J. (2002) ‘Key Features ofTherapeutic Social Work:The Use of Relationship’. Journal of
Social Work Practice 16, 2: 149-161
 Wilson, K, Ruch, G, Lymbery, M & Cooper, A, (2011), chapter 11 ‘Planning and intervening’, in
Social Work: An introduction to Contemporary Practice, 2nd edition Harlow, Pearson Education.
 Bower, M (ed.) 2005, PsychoanalyticTheory for Social Work Practice:Thinking under Fire,
Abingdon, Routledge. (Particularly Olive Stephenson’s Foreword and Chapter 1, Bower, M
‘Psychoanalytic Theories for SocialWork Practice’.
 Healy, K 2005, Social work theories in context: Creating frameworks for practice. Basingstoke:
Palgrave Macmillan, chapter 7, ‘Three Waves of SystemsTheory’.
 Hollis, F, 1972, Casework: a PsychosocialTherapy, NewYork, Random House
 Perlman, H, 1957, Social Casework: A Problem-Solving Process, Chicago, University of Chicago
Press
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness

41.  Pre-seminar reading: please read chapter 3 from Psychosocial and
Relationship – Based Practice (Megele, 2015) before Monday’s
seminar.
 What are your initial feelings regarding Alice and her situation?
 What are some examples of ego defences in the case study presented in
chapter three and how do they influence the interaction between the
social worker and Alice?
 Can you identify instances of transference and counter transference
within chapter three and how can this be used from a relationship based
practice perspective?
 What is the importance of relationship in social work practice and how
can an understanding of psychodynamic approaches help in relationship
building with service users?
© Claudia Megele Emotional Labour, Mentalising, Empathy & Mindfulness