Human Behavior and the Social Environment Micro Level: Individuals and Families Second Edition Katherine van Wormer Copyright 2010, Oxford University Press. For classroom use only; all other reproductions or circulation is prohibited. Chapter 1 Human Behavior: Theoretical Concepts To see the world in a grain of sand. And heaven in a wild flower. Hold infinity in the palm of your hand And eternity in an hour. William Blake, Auguries of Innocence, 1789 I am a part of all I have met. Tennyson, Ulysses, 1842 This chapter will: Introduce concepts relevant to social work theory and the study of micro-level human behavior Provide an overview of four major theoretical perspectives (psychodynamic, cognitive, ecosystems, and empowerment approaches) Conduct a critical analysis of each theoretical framework Discuss implications for social work practice The Study of Human Behavior A skilled social worker: must have a solid understanding of people’s needs at various stages of development needs knowledge of human behavior as a core knowledge base to guide generalist social work practice To assess a problem, social workers need a solid understanding of these processes: Biological Psychological Social Spiritual *These essential elements sometimes parallel, but often overlap and interlock. Learning about Human Behavior Learning from the microcosm “To see the world in a grain of sand” Key to the whole is contained in the part. Study of depth over breadth Note the holon pictured in the text. Learning from the study of paradox Embrace opposites Out of failure may come success (Ex.- My Losing Season) Turning Points in People’s Lives Story of Mrs. Anné and her neighbors, 1949 Hurricanes such as Katrina Karen Armstrong, who left the convent Consider other turning points in people’s lives. Turning points: can involve a change in outlook, worldview, lifestyle, choice or fate; may relate to relationship are recognized only later may involve positive or negative outcomes [new material] negative—may be related to loss, failure, health paradox—negative into positive *THEORY – a group of related hypotheses, concepts, and constructs, based on facts and observations, which attempt to explain a particular phenomenon - can be small range (micro level explanations) - may be a grand theory (to explain societal patterns) (Social Work Dictionary) Theoretical perspective—lacks explanatory power, an approach, such as feminism, strengths approach …Theory Often used in informal sense, as “I have a theory about that.” Different theories are required for different situations. Practice and theory are intertwined. To see in perspective is to see parts in terms of the whole—the micro-macro view. Sometimes it’s useful to forget the whole and focus on the part – practitioners urge clients to partialize a problem or break it down into manageable parts. Critical Thinking - - Includes the application of appropriate theories to the situations that social workers encounter Self awareness is crucial; - Awareness of one’s belief systems and biases, values Of where the beliefs and values came from - Relevant to generalist practice is the ability to discern the underlying, latent purpose in social policies. Critical consciousness involves an understanding of the encompassing social-structural context of human problems. Critical Thinking and Practice Fallacies Relying on a small number of case examples and testimonials; Vagueness in identifying client problems; Putting too much faith in newness and trends; becoming “true believers” Relying on authorities rather than research to guide practice; Basing strategies based on initial research success without appropriate follow-up. Because of their influences on social work practice at the individual level, this chapter explores four theoretical perspectives of micro level behavior: Psychodynamic Cognitive Ecosystems Empowerment Critical Analysis of the Major Theories of Human Behavior Questions we will ask of each theory: To what extent are the theory and its concepts empirically valid? What does the evidence show? What can we learn of human behavior from this theory? Does the theory take into account both risks and resiliencies? Does the theory account for cultural, gender variations in human behavior? Does the theory reflect social work ethics and values? Psychodynamic Theory Derived from psychoanalysis Freud considered it scientific-- built on personal observation and experimentation Initial focus of Freud’s theory on powerful instinctual forces that drive development and behavior - love, hate, sex, and aggression (forces that bring us into conflict with social rules) Freud’s theory of the meaning of dreams Freud’s mode of psychosexual development (oral, anal, phallic, oedipal, latency, and genital stages) Freud’s Psychodynamic Theory Key Concepts: primarily concerned with internal psychological processes importance of early childhood experiences existence of unconscious motivation—seen in dreams existence of ego (rationality) and superego (morality) existence of defense mechanisms Freud’s Psychodynamic Theory cont. Key analytical concepts: psychosexual development defense mechanisms regression, repression, reaction formation, projection, sublimation free association as the method of recall therapeutic techniques of interpretation (including that of transference, defenses and dreams) important role of the unconscious and past, often traumatic experiences, repressed memories Psychodynamic Perspective cont. Freud’s theories spawned many generations of neo-Freudian scholars (ex: Alfred Adler & Carl Jung--they later broke with Freud due to theoretical differences) Erich Fromm combined Freudian and Marxist perspectives, analyzed society, focus on aggression and war Critical Analysis of this Theory Good evidence for: Trauma theory Effect of poor parenting Unconscious motives Empirical evidence? How to verify? Penis envy Meaning of dreams—fMRI discoveries …Critical Analysis What does this theory teach about human behavior?—body-mind connection. Inclusion of risks and resiliencies?—mostly risks Attention to culture and gender?—hard on women. Consistent with social work values?—lacking in attention to social justice issues Ethical issues—interpretation of incest claims. Cognitive Approach Cognition – derived from the Latin cognoscere: to learn, to know This approach a reaction to psychodynamic theory, grew out of behaviorism Theorists relied on empirical testing to validate their ideas. Principles: Concern of therapy should be with the conscious reasoning process Focus on the behavior itself as affected by the individual’s own cognitive approach Behavior seen as affected by perception or interpretation of the environment during the process of learning Albert Ellis and Aaron Beck are the most prominent writers in this field. Albert Ellis Ellis is the founder of Rational Emotive Behavior Therapy (REBT) Based on Cognitive-Behavioral Theory (CBT) REBT, like CBT of which it is a part, concentrates on people’s current belief, attitudes and self-statements Human behavior in terms of the ABC Model (A) antecedent event (B) resulting behavior (C) behavioral consequences Short-term treatment favored, with the therapist taking a very directive, didactic role in exposing the client’s irrational thoughts Aaron Beck Wrote in the area of clinical depression and anxiety disorders Beck’s Inventory of Depression is widely used to gauge the level of patient depression Problems arise from errors in thinking, focused on the contribution of dysfunctional moods and psychiatric symptoms Common Thinking Errors 1. 2. 3. 4. 5. all or nothing thinking overgeneralization minimizing/magnification personalizing perfectionism Critical Analysis of Cognitive Theory What does the evidence show? Excellent results in therapy Change in thoughts > change in behavior Using cognitive strategies is of proven effectiveness in motivational interviewing with alcoholics in cases PTSD, OCD, children’s emotional disorders What does the theory teach about human behavior? That people can change Motivational approach helped clients recognize the contradictions in their thinking about substance use that would motivate them toward change Motivational Interviewing vs Criminal Personality Resistance is not a force to be overcome, but a cue that we need to change strategies Client seen as an ally; support self-efficacy Discrepancy used to explore the importance of change Goal to elicit reasons for change from the client Stanton Samenow— focus on negative, “the criminal personality.” Offenders to face their acts Therapist attempts to instill a feeling of self-disgust Not a strengths focus …Critical Analysis Little emphasis on resilience (except for Miller) or culture and gender Social work values?—fits with professionalism; when focus is on criminal personality and errors in thinking contradicts strengths perspective Ecosystems Framework Hybrid of general systems theory, which focuses interdependence of relationships, and ecology which is concerned with our interaction between organism and the environment. Emerged in the 1950s and 1960s in the fields of computer science (general systems) and biology (ecology) Mutually interdependent relationship among systems of different sizes is expressed in the concept of holon. Holon--the idea that every system is simultaneously a whole with its own distinctive qualities, a part of a larger system and a container of smaller systems General Systems Theory cont. Cause and effect are viewed as intertwined and inseparable, a non-linear view of reality. The whole is more than the sum of its parts. A social system is adaptive or goal oriented and purposive, striving to maintain equilibrium; Systems model allows the social worker to view the person holistically (as both individual-inner biological drives and social-cultural being). Ecosystems Concepts borrowed from the systems framework: A social system is comprised of members organized in a unit. All systems are subsystems of other systems; a social system is separated from other systems by boundaries; boundaries as open and closed. A change in one member affects the whole system and therefore the equilibrium. Concepts from ecology: Focus on stress and individual adaptation to the stress. Person-in-environment – the person and environment are in constant interaction Cause and effect viewed as intertwined; interactionism; The parts of the whole seen in constant interaction with other parts. Critical Analysis What evidence-based research shows—too broad to be researched empirically except perhaps in plant and non-human life. Ecosystems perspective is consistent with social work values and ethics except that it is apolitical, just a framework for viewing reality. Concepts from deep ecology have implications related to preserving our natural environment and viewing spirituality as found in nature. What this framework teaches about human behavior— Helps us understand family dynamics Provides multidimensional concepts Critical Analysis of Ecosystems, cont. Inclusion of risks and resiliencies?— Risks to human and nonhuman life are incorporated. Missing is an appreciation of power dynamics Attention to culture and gender issues? This model can be further developed as in this text to relate to culture and gender and to link with concept of empowerment. Empowerment Perspective A composite group of theoretical perspectives Includes anti-oppressive and feminist perspectives In the 1980s and 1990s, empowerment concepts, along with the strengths perspective, became predominant theoretical approach in social work. Three themes of empowerment as a model of practice: 1- concern with power 2- critical consciousness 3- connection Critical consciousness - is a crucial means of gaining power through collective solidarity that arises through awareness of the root of power and the need to change the system The Anti-Oppressive Approach Anti-oppressive social work a British approach that recognizes power imbalances and works toward the promotion of change to redress the balance of power Advocates work toward change at the personal, cultural, and institutional levels; advocates radical system-level change: At the feeling level At the idea level—consciousness raising– At the action level, the individual moves into the political realm through organizing. Empowerment cont. Strengths perspective largely associated with Dennis Saleebey who produced the 1st ed. of the strengths perspective in social work practice in 1992 Feminist empowerment approach defined by Mary Bricker-Jenkins as including a focus on Strengths and health, healing Diversity Types of feminism Liberal Radical Socialist Black and Latina Postmodern—against dichotomizing knowledge, critical of positivism Critical Analysis of Empowerment Perspectives Are these perspectives evidence based? These concepts are considerably abstract, empirical testing may be difficult to obtain Research goal is more to enhance people’s empowerment than to test a certain kind of intervention There is evidence, however, for effectiveness of strengthsbased treatment approach. Feminists can provide evidence of sex discrimination, and minorities of racism, etc. Evidence of the effectiveness of mass social action. Empowerment Approaches, cont. What these approaches teach about human behavior--knowledge of oppression in society is important. They largely ignore the importance of biological factors in human development. Psychological difficulties ignored. Much attention to socio-cultural factors. Spirituality is receiving more attention today In Conclusion There is no one correct theory for every client or family or situation, there are truths from the four major perspectives—psychodynamic, cognitive, ecosystems, and empowerment– examined in this chapter, truths that relate to various aspects of human behavior. A strengths-empowerment perspective is most concerned with risks and resilience. Empowerment perspectives lend themselves nicely to a focus on disempowered groups and are sensitive to cultural-gender issues. Social justice is most clearly represented by the anti-oppressive, empowerment approaches. Despite the importance of stressing a client’s strengths and competencies, practitioners will be cognizant of the reality of the standard clinical practice, agency accountability, and the dictates of managed care. This text adopts an empowerment-ecosystems framework for person-inenvironment understandings. Chapter 2 Biological Factors in Human Behavior Nobody doubts that genes can shape anatomy. The idea that they also shape behavior takes a lot more swallowing. Matt Ridley, Genome This chapter will highlight the biological basis of human behavior in the following areas: Addiction ADHD Adolescent development Aggression including battery and rape Anti-social personality The shyness-extraversion continuum Stress Schizophrenia OCD and bipolar disorder 38 The Nature Part of Nature and Nurture The genetic factor—genome means gene plus chromosome Scientists seek to understand role of genes in disease. Human Genome Project to map human genetic material. Results are useful in showing which drugs work. Genes are affected as by depleted uranium. Other scientific developments: MRI technologies and fMRI to view the working brain Twin studies 39 Genes and Addiction DSM-IV-TR dichotomizes substance dependence and substance abuse, Yet most recent genetics research indicates that the tendency toward addiction , like most behavior, exists along a continuum. Substance use disorders go together with mental disorders: Schizophrenia (47%) Bipolar disorder (45%) Anxiety (25%) and depression (24% Early life severe stress weakens the system. Cloninger’s research on adopted sons of alcoholic fathers 40 Addiction and the Brain Actions of alcohol and cocaine that cause intoxication, dependency, and relentless craving during abstinence occur primarily in the brain—shown on MRI and PET scans (See slides of the brain at www.nida.nih.gov) http://www.drugabuse.gov/publications/teaching-packets/brain-actionscocaine-opiates-marijuana/section-iii-introduction-to-drugs-abuse-cocaineopiat-2 Implanted memories of the highs lead to the cravings. Illicit drugs are popular because they “hijack” the brain’s endorphins. The addicted brain, as we now realize, is significantly different from the normally functioning brain. Low levels of the neurotransmitter, serotonin, linked to both addiction and aggression. Alcohol Effects Alcohol, as a drug, affects the central nervous system. Belongs in a class with the barbiturates, minor tranquilizers and general anesthetics – also depressants Long-term damage caused by deficiency in thiamine Development of serious brain disorders Wernicke Korsakoff’s characterized by mental confusion, paralysis of the nerves Liver disease from long-term use Damage heightened with heavy smoking 42 Brain Injury vs. Brain Disease Notion of brain injury—more accurate than the notion of brain in describing the course of events involving changes in brain due to substance use. Serotonin—a neurotransmitter hugely influenced by alcohol and drug use. Cocaine and methamphetamine blocks the reuptake of certain chemicals by neurons in the brain. Motivation for activity related to dopamine. See boxed reading of student: “Hooked on Meth” Current theories of addiction rely heavily on neurobiological evidence showing connections between addiction-related behavior and neural structures and functions. Effects can be reduced by drugs that increase the availability of serotonin.—SSRIs (Prozac, Paxil, Zoloft) 43 ADHD A psychiatric diagnosis that is based largely on behavioral science. Involves deficiencies in dopamine activity and that of another neurotransmitter, norepinephrine 44 ADHD cont. A higher population in U.S. than overseas exhibit ADHD; however, it is over-diagnosed. Probably just a normal personality trait of people who are easily bored, impulsive, and risk takers, highly desirable traits on the frontier and of hunters. Farmers, are quieter, less restless types (Thom Hartmann’s theory). Why Americans are different from Europeans, due to the genes of certain types who were descended from adventurers. 45 Impact of Cognitions Some researchers believe that psychological counseling can actually alter brain chemistry, possibly restoring more normal functioning such as for those with OCD (Schwartz, Brain Lock.) Brain structure and function can be altered by the cognitions in studies of the impact of the psychological trauma on the brain. Biological Aspects of Aggression Using MRI, the scientists are on the threshold of discoveries concerning biochemical processes associated with antisocial personality Characterized by impulsive, forceful activities Exploitative attitudes and blaming of victims characteristic Example– research on prison inmates reveals that males and females with abnormally high testosterone tended to have been convicted of violent crimes. Head injury also changes behavior. 47 Aggression cont. Theories from evolution—most aggressive most apt to reproduce. Evolutionists challenge traditional feminist cultural determinism. Study of chimpanzee male-on-female battering and rape. Female may accept aggressive male out of fear. Bonoboes, however, are gentle primates. Examining data from the global crime statistics in the same- sex murder, practically all are male-on-male. Gender and the Brain The brain consists of two separate structures, a right brain, and a left brain. Differences observed in CT scans and results of strokes. Right brain analyzes nuances of meaning, comprehension; left—recall of knowledge In middle age, two sides work more together. Saleebey indicates that women seem to be hemispherically egalitarian than men. Radical feminists emphasize male-female brain differences, as does science. Studying Homosexuality Biological theories of homosexuality can be clustered under three kinds of research: those that pertain to brain, genes, and hormones. Gorski and Allen examined brains obtained from autopsies of 90 people; They found that an important structure connects the right and the left side of the brain. Known to be larger in women, the structure is larger in gay men. Male gay brain—cognitive performance more in a female direction. More research is needed, especially on lesbians. We do know that women are more flexible in their sexual orientation. Inheritance and Biology Best means of studying the role of hereditary factors—study of identical and fraternal twins. When one twin gay, the other is gay about half the time. Having elder brothers increases chance for gay child. Behavioral genetic studies have provided the strongest evidence of the role of biology plays in influencing human sexual behavior. In humans, the study of rare medical conditions indicates that prenatal hormonal events can influence human behaviors These studies are extremely contradictory. Transgenderism in males—brain gender apparently formed as female before physical traits develop as male. Read “Transgendered: A SelfPortrait.” The Biology of Temperament Most people are in the middle of the introversionextraversion continuum. Ridley explains personality differences in novelty-seeking behavior in terms of one genetic trait--shyness. Theory that Nordic types are more anxious types through evolution. They needed faster heartbeats to generate heat. Impact of stress: damage to health due to heightened alertness and production of stress hormones. Schizophrenia The most serious and personally destructive of all major mental illnesses Difficult to define because patients have different kinds of symptoms. Disordered thoughts, delusions, hallucinations Social withdrawal, sense of emptiness Enlarged ventricles; when brain expands in adolescence, pressure placed on prefrontal cortex. Usually manifests itself during young adulthood, but some think it can traced to womb. Thought to result from excess of dopamine in the brain A number of anti-psychotic medications target the chemical imbalance in the brain. Mood Disorders Bipolar disorder An Unquiet Mind (Jamison) depicts a psychologist's personal struggle. Anti-depressants act by blocking the reuptake or reabsorption of neurotransmitters; this makes them available to improve mood. There is a strong genetic component for the certain forms of severe depressive illness. Obsessive Compulsive Disorder and Anorexia OCD is marked by intrusive, reoccurring thoughts. Can be considered “brain lock”, according to Jeffrey Schwarz, as messages from the front part of the brain get locked there. [Neuroplasticity] Anorexia may be thought of as obsessions about body fat, disbelief that one is thin even when the person is starving. Anorexia occurs mainly in cultures or subcultures that value thinness and present media images of “Barbie doll”-shaped bodies A cultural as well as organic link to this disorder Dementia An organic syndrome largely associated with old age. Characterized by memory loss, confusion, and extreme mood swings Diagnosed through cognitive tests and PET scan Hard to concentrate, lack of flexibility in going from one area of the brain to another. Vascular dementia stems from strokes when blood vessels become clogged by clots Left side—speech impairment and depression Music and the Brain Oliver Sacks, Musicophilia Effect on babies With Alzheimer’s—stored in part of brain that lasts the longest Blind children and gift of perfect pitch Some get seizures brought on by music Can be taught to speak after stroke through music, from right side of brain Science and Ethics Dramatic breakthroughs on the frontiers of science pose perplexing moral quandaries. Ethical values should be available to inquiry and critical examination of the use of science. Clients can benefit from direct social work interventions to help them make informed decisions about genetic testing and to cope, both as individuals and family members, with the results. The social work professional has a long history of working to shape public policy that protects the interests of consumers of health care services. Chapter 3 The Psychology of Human Behavior The rigid righteous is a fool… What is done we partly can compute But know not what’s resisted 59 Overview Chapter is concerned with issues of personal trauma and resilience, as people endure ordinary and extraordinary crisis across the lifespan. The following theorists all view development as taking place sequentially: Maslow Erikson Levinson Gilligan 60 Abraham Maslow Hierarchy of needs: Transcendance Self-actualization Self-esteem Belongingness and love Physiological needs Maslow’s contribution to developmental theory is represented in his well-known construction to human needs. Not age based. Each need at the bottom of the ladder has to fulfilled successively before the next level of higher needs can be achieved. The psychological, as opposed to social, nature of this conceptualization is revealed in its emphasis on individual drives. 61 Erik Erikson Published his influential Childhood and Society in 1950. Erikson offered an optimistic, bio-psychological view of development. Each stage of human development is a crisis characteristically that must be resolved. His model extends over the lifespan and has stood the test of time and is included in virtually all human behavior textbooks. 62 Erikson’s Developmental Stages 1. Trust versus mistrust – infancy up to 18 months. Infants who receive nurturing care learn to trust and this prepares them for lifelong intimacy. 2. Autonomy versus shame and doubt – 18 months to 3 years. Through accomplishing various tasks, children develop confidence and feelings of self-worth. 3. Initiative versus guilt – age 3 to 6. Small children learn to take initiative when they are encouraged to do so; if stymied, they are apt to experience feelings of guilt. 4. Industry versus inferiority – age 6 to 12. How children succeed academically; how they master other activities determines whether they will feel industrious or inferior. Erikson’s Developmental Stages cont. 5. Identity versus role confusion – adolescence. Identity crisis, the trying out of new roles and the shedding of old ones. 6. Intimacy versus isolation – young adulthood. The finding of a soul mate – dominates this period. 7. Generativity versus stagnation - middle age. 8. Ego integrity versus despair – old age. People look back over a life of purpose or, conversely, one that seems meaningless and causes feelings of regret. Daniel Levinson Stage theory. His central conceptual organizing scheme based on study of middle aged males. The Seasons of a Man’s Life Older men as mentors to the young 65 Moral Development Theories Lawrence Kohlberg Linear stage theory places primary emphasis on how people think, not what they do. Children move toward progressively higher levels of ethical understanding. Lawrence Kohlberg cont. 6 Stages Level 1: Preconventional – age 4 -10, behavior related to conditioning Avoid punishment, obedience to authority Work toward rewards Level 2: Conventional – age 10 -13, what is found in society Please others to gain approval Obey norms, laws Level 3: Postconventional - rarely achieved by most adults Laws subject to interpretation, genuine interest in welfare of others Morality completely internalized, respect for universal principles. Carol Gilligan Like Kohlberg’s, a moral development model Cited in the literature in terms of her criticism of sexism in these other models Also a noteworthy theorist in her own right. Her contribution has centered on listening for the voice behind the spoken voice, the voice of the psyche. Saw development in girls in terms of capacity for connectedness, not independence, and sacrifice Saw girl’s development impeded by society Boy also limited by enforced standards of masculinity. Pressure on boy at age 5 parallels pressure on adolescent girl 68 Transpersonal Theory Fowler James Fowler’s theory of religious faith development based on hundreds of interviews with city residents, mostly Christian People move from intuitive to literal to conventional to reflective faith as they grow up. Only a few achieve the level of universalizing faith, directed toward all humanity. Wilber Ken Wilber proposed a transpersonal theory, what is known as a higher level of consciousness. A seeking of a source of power through meditation and dreams, moving beyond the personal. His scheme speaks of a universal stage of religious growth. His evolution is Eurocentric. 69 Stages of Change Like Fowler, stages of change model by Prochaska and DiClemente pertains to one aspect of human behavior—the elimination of self destructive behavior. Model was based on smokers trying to quit. Focus on choice Stages of change: pre-contemplative stage, contemplation, then preparation, action, maintenance, and often, relapse. Interventions can be tailored for each stage of change This model has revolutionized addiction treatment and has been linked to motivational interviewing. 70 Social Identity Who are you? Development of identity is a lifelong process, relates to biology, psychology, social changes such as becoming teen, parent Impact of race: three barriers to development in racist society—social injustice, society inconsistency, powerlessness Class identity: U.S. vs. British outlook, labor party in most European nations People often judged by their occupation in the U.S. Upper class—elite education and exclusive clubs Politicians can manipulate working class by focusing on moral issues of little consequence in the long run. Gender Identity From early childhood, boys and girls are aware of gender. Women share common bodily experience of femaleness and suffer social oppression of sexism, whether or not they are aware of it. A study shows that by 7th to 10th grade, a girl regresses in self confidence and intellectual development. 72 Homophobia Rigid code of gender conformity associated with the societal oppression of gays, lesbians and bisexuals. Related to sexism. Gays and lesbians comprise about 5% of population. The problem of homophobia lies in the heterosexual moralistic culture. Adams, Wright et al, showed that only homophobic men were aroused by male, homosexual stimuli. Confirmed Freudian notion of reaction formation—rejecting in others what we dislike in ourselves. Hate crimes has become pronounced in both military and civilian life of lately. Disability and Self- Concept Self concept of persons with disabilities is modified over time as social realities change. Idealized body image that we see in the ads There may be an evolutionary factor, as Evens suggests, in people’s natural aversion toward those with disfigurement. The mental health professional working with those who are mentally or physically challenged must be cognizant of societal oppression and the need to develop coping mechanisms. Spirituality Involves both physical and non-physical dimensions of being. Spirituality expands consciousness to a realm beyond the physical. English poets such as Wordsworth and the Norwegian people find a source of inspiration in nature. Many social work try to draw a tight distinction between religion and spirituality and fail to draw on strengths of client’s background. Feelings and Human Behavior The perpetual nervousness that persists in some can be reduced through cognitive therapy techniques. Stress management to reduce anxiety. Cognitive approach is of proven effectiveness in treating anxiety and depression. Some strategies are: Planning ahead Learning to handle fears Managing to face fears calmly Identifying what one truly afraid of Being emotionally prepared for likely outcomes Destructive Thought Patterns Unhealthy thinking often causes people to get trapped in negativism and destructive behavior. Examples of illogical beliefs include: All or nothing thinking Jumping to conclusions Over-generalizing about others Making mountains out of molehills Thinking that one must be liked by everyone, etc Thinking you must be perfect Thinking that people are either good or evil Believing that you can’t live without a certain person Anger Anger is a stimulus for all kinds of human behavior—may lead to impulsive, destructive behavior. Anger can flow from a strong emotional feeling coupled with an adrenaline rush. Behavior may include seething inwardly or externalization of feelings onto another. Anger: Treatment Issues Substance abuse treatment centers often use the exercise of having clients list their losses in connection with their addictive behaviors—this will lead to self disgust or depression. Knowledge of feeling and the thought processes connected with these feelings help clients work toward change. Expression of anger may be encouraged in the belief that angry feelings can be released—in fact, such exercises increase the anger. Anger management programs, often recommended for batterers, have been ineffective because anger is often not the cause of the battering but other feelings stemming from a sense of inadequacy. Jealousy An emotion related to anger and the motivation for crime as in some Old Testament stories. Freud believed that jealousy was universal because it originates in painful childhood experiences that everyone shares. Buss reports that jealousy may be deliberately incited by partners who feel insecure. Intimate Partner Violence Violence should be conceptualized in multidimensional terms as a biopsycho-social phenomenon. A background of violence is commonly found in the biographies of abusive men. Battering men often have an irrational fear of abandonment. Jacobson and Gottman’s research— “pit bulls” and “cobras.” Pit bulls are more treatable but tend to stalk their partners. View the power and control wheel at www.duluth-model.org The challenge to feminist theorists is how to explain the often irrational attachment of battered women to their abusers. When the trauma is ongoing, the victim’s coping may seem maladaptive but may be a normal response to an abnormal situation Traumatic Bonding Similar to concept of “brainwashing” or Stockholm syndrome Common in kidnap victims over long period of time, ensures survival in many cases Examples—concentration camp victims while in captivity (Bettelheim’s study), Patty Hearst, Elizabeth Smart, Shawn Hornbeck, and more recently, Jaycee Dugard Victims come to see the world through the eyes of the victimizers, adopting their beliefs as their own. Return to normal when rescued. Trauma Three basic kinds of trauma are trauma from: childhood events such as sexual abuse terrifying events such as rape, ongoing family violence mass disaster situations such as earthquakes or war. Examples of war trauma are: Personal reactions to the horrors that were visited upon the Japanese people at Hiroshima and Nagasaki that are widely known but rarely talked about. When the U.S.-led war on Iraq broke out, German opposition was reinforced by an awareness of what bombing from the air does to people on ground. Vietnam veterans who had flashbacks in seeing bombings of Iraq on TV Trauma cont. Syndrome related to trauma was not identified until 1860s; Freud characterized symptoms further. As spelled out by the APA in the DSM-IV-R, the diagnosis of posttraumatic stress disorder (PTSD) requires the development of characteristic symptoms following exposure to an extremely traumatic stressor. Common symptoms are: Recurrent and intrusive recollections or dreams of the event Intense psychological distress or physiological reactions when the person is exposed to reminders. Effects of Trauma Men (and women) who fought in Iraq and Afghanistan sometimes suffer from lifetime PTSD related to combat One in six in a government study were found to have signs of trauma Traumatized ex-soldiers have a higher rate of unemployment, divorce and violent outburst than persons not suffering from traumas. Medications such as SSRIs can prevent trauma if taken immediately by offsetting the formation of traumatic memories. Cognitive-behavioral treatments may reduce the effects of PTSD. Rape in War In the past, the victims of rape, in general, and of mass rape in war were silenced out of shame. Impact of Brownmiller’s book, Against Our Will: Men, Women, and Rape (1975) Rape of the enemy’s woman seems to be a regular consequence of war; survivor is doubly stigmatized. Now the rape during wars is recognized as an international war crime punishable under law. Human Trafficking (article from NASW News) U.S. government estimates trafficking of about 900,000 every year. NASW’s policy statements on human rights, refugees, child welfare and cultural competence all speak to the issue of human trafficking. According to the Department of Health and Human Services, many trafficking victims will have permanent physical and psychological damage from being brutally beaten or reaped by their traffickers. Once in the U.S., these women are forced to perform sex or hard labor to repay their “debt” for being smuggled into the country. Sexual Exploitation of Trafficked Children Efforts to keep victims disoriented do not end once they are smuggled into the U.S. The psychological effect is to “impair the child for life”. When rescued, they need to develop a sense of physical security. HHS programs and other efforts have not been successful to large extent. Victims often do not speak English and their enslavement is not recognized. Conclusion Horrific events, as described in this chapter, may crush the human spirit. What is even more striking in working with survivors of such trauma is the resilience that is possible with help and support. The best means of prevention of trauma is to provide better protection of our children, and as to war trauma, the best means of prevention is to keep wars from happening in the first place. Chapter 4 Birth through Adolescence Your children are not your children. They are the sons and daughters of Life’s longing for itself. They come through you but not from you. And though they are with you yet they belong not to you. Kahlil Gibran, 1923 Chapter Objectives Focus of the chapter--childhood behavior. This chapter views behaviors across the lifespan according to the key accomplishments expected of the child of a certain age. Major themes: childhood resilience and cross-cultural aspects of child development Famous Stories of Childhood Resilience Novels of Charles Dickens Autobiography of Benjamin Franklin Autobiography of Frederick Douglass Life stories of Maya Angelou and Malcolm X Birth to Two Years Jean Piaget— Earliest period of life—sensorimotor development—from automatic behavior to deliberate responses, imitation 12 to 18 months—game of peek-a-boo—infant learns objects are permanent Erikson—concerned with trust, relationship, his stage more relevant to personality Attachment theory—Spitz’s (1945) study of WWII orphans, need for touch; shown also in Harlow’s monkey study Language develops slowly, use of sign language is beneficial. Cases of intersexual newborns and sex assignment—does the brain have a gender? Cross-Cultural Studies An advantage of cross-cultural studies—the transfer of knowledge about successful innovations, such as “kangaroo care.” The Mexican American “epidemiological paradox”: refers to the paradox of better than expected birth outcomes given income level and teen pregnancies. Lowest infant mortality rate in Asian Americans, highest among Native Americans. Cross-cultural research on responding to crying is mixed: infants whose crying is ignored (Germany) can be insecure, infants whose crying is always responded to (Japan) tend to be overly dependent. In societies where women are devalued, abandonment and mistreatment of infant girls is commonplace. Age 2-7 Piaget’s stage of preoperational thought—language is concrete, can contemplate objects out of sight By 4-5, children can sort objects by color, shape Piaget’s theory is one-dimensional. Erikson’s more holistic stages—this period covers development of autonomy and initiative. Concerned only with the male Sees the female only concerned with her appearance or playing with dolls “the over-scheduled child”—U.S. vs Scandinavia Attachment disorder can arise at this stage, found in birth and foster families. Abuse and Neglect Sexual abuse early in girls tends to lead to overtly sexual behaviors, in teens it leads to depression and substance abuse. Sibling abuse is commonplace. Link between battering of mother and child abuse See fact sheet on child mistreatment— 60% of reported victims experienced neglect Birth to 3 years—highest rates; by race—highest for Hispanics and African Americans Child fatalities—over 1,000 per year, most under age 4, infant boys the highest rate Cross Cultural Education Japanese education begins at home, even prior to preschool. In African and South American tribal groups, education is through parental modeling of occupational behavior. Childhood aggression is handled differently across cultures, mostly based on larger societal view such as hierarchy and general rates of aggression. France—both children punished for fighting; U.S.—punish the one who started it. Story content—American children have more aggression in their stories than children from Sweden or Germany. Age 6-12 Piaget’s period of concrete operations—child thinks logically but still on a concrete level. Erikson’s delineation of the key crisis during this early to middle childhood period is termed industry vs. inferiority. When adults think back to the middle childhood period, most of their memories center around the school – one’s role in the school play, cruel and beloved teachers, failures and honors ,competitions won or not won. School experience can grossly affect the way the individual is shaped during adulthood. Mental Retardation The term mental retardation is used by the American Psychiatric Association to denote sub-average general intellectual functioning that is accompanied by significant limitations in adaptive functioning “in at least two” of the following skill areas: communication self-care home living social skills use of community resources self-direction functional academic skills work leisure health and safety. Learning Disability In Britain, this term refers to all developmental disabilities. In the United States, the term is usually used if there is a discrepancy between the child’s IQ test scores and school achievement. Dyslexia is a form of learning disability often involving a lack of sense of left and right. Because their brains are wired differently, dyslexics are often creative and skilled problem solvers. Since learning disability, according to the standard definition, is unrelated to IQ, a significant number of children with such diagnosis are indeed gifted. ADHD probably more a personality trait than a disability Autism and Asperger’s Syndrome Rise in autism diagnosis “Geek syndrome” theory to explain high rate in the Silicon Valley New technologies such as fMRI show that autistics rely heavily on parts of the brain that specialize in working with the meanings of individual words. Males account for more than 80 percent of the million-plus Americans with autistic disorders. New programming that stresses it is okay to be different, that in difference there is strength. Influence of Temple Grandin. Single Sex Education Since during prepuberty period, girls mature much faster than boys, single sex education became a subject of interest. Scientific research throughout the 1990s showed that differences in brain structure created significant differences in female-male learning styles. However, single-sex schools have not lived up to their promise. Boys vs. Girls in Education Recent media hype—focus on neglect of boys in school High dropout rates, school failure, fights, suicide. Part of anti-feminist backlash, or was too much attention paid to girls’ problems earlier? Girls educational successes seen as taking away from boys. This text takes a both/and, not either/or position. Small and Large Schools According to a research, we know that small schools and small classes have certain advantages over their large school, large class counterparts. Studies show that small public schools have higher attendance rates and lower dropout rates, benefits that are especially pronounced in lower-income communities. PTSD in Childhood In 2007, approximately 800,000 children were found to be victims of child maltreatment (DHHS). When childhood trauma occurs > brain chemistry changes > future psychological problems, especially under conditions of repeated stress. PTSD symptoms—denial of or preoccupation with the event, numbing, flashbacks, intrusive thoughts, guilt feelings, sleep disturbances, jumpiness Cross Cultural Comparisons Very high pressured education in Japan, China, and South Korea, especially for math achievement In Northern Ireland, IQ testing for school placement until recently. In many parts of the world, the children don’t go to school— families struggle to survive Child sex trade in Southeast Asia related to poverty In Africa, children kidnapped as soldiers for war. Work of traditional healers with kids who have been rescued Adolescence Erikson’s focus on identity formation This period usually viewed as a process of distancing oneself from one’s parents Piaget’s period of formal operations. Piaget’s notion of continuing intellectual development now proven in brain scans of prefrontal cortex. Identity, peer group, rebellion – these are the key terms associated with adolescence. Society has often recognized the immaturity of youth by imposing legal restrictions on young people. Erikson anticipated recent brain research findings in his perception of adolescence as a period in life involving more dangers to the individual than any other. Adolescence cont. Peers are the benchmark for adolescent behavior in the U.S. Among the risks that comprise role confusion as singled out by Erikson are: identification with the heroes of cliques disturbance about one’s occupational course “falling in love” the rapidity of genital maturity clannishness and cruelty in exclusion of those who are different. Substance Abuse Substance abuse involvement is one of the leading causes of death for youth. Self reporting surveys of drug use 12th graders over past year: Any illicit drug—36.6% Marijuana—32.4% Cocaine—4.4% OxyContin—4.7% (prescription drug) Alcohol—65.5% Meth (1.2%) Media, government attention on illicit drugs only Government spends billions on war on drugs Longitudinal studies conducted in several European countries compared teacher assessments and later alcohol use; the number one predictor was novelty seeking, low harm avoidance or “daredevil” behavior. Study of 8 year olds in Finland—aggression in boys and crying easily in girls predicted later problems with alcohol. Dating Violence One in 11 a victim of physical dating violence; 1 in 5 girls—includes sexual abuse (CDC, 2009) Teen Dating Warning Signs (see p. 181) Intimidation Isolation Bragging about power over others Possessiveness, obsessive needs, jealous Rough play Substance abuse Male from a male-violent home “Manliness” Boys generally not well-prepared by their parents with information on the maturation of their reproductive organs The forging of a firm identity for young males, in the absence of masculine role models can lead to exaggerated concept of maleness. bell hooks points out that often in our society men show their “manliness” through antisocial behavior: lack of consideration for others, unwillingness to show nurturance, and refusing to communicate. Girls and Adolescence For girls, the pressures for gender conformity mount during the teenage years. For girls and women, the sense of self, as Gilligan indicates, is invested more in maintaining relationships than in establishing hierarchy. Bringing girls into the study of adolescence has brought a new dimension, a revolution, to the science of psychology. Gays and Lesbian Identity Often taken to be heterosexual by their parents and family. Gay children often actively try to assume heterosexual persona. A fundamental assumption of the research literature on identity formation is that “normative” development is heterosexual. Mary Bricker-Jenkins’ description of how an understanding teacher “saved my life” Fundamentalist religious beliefs—Prayers for Bobby School anti-bullying programs Stages of Homosexual Development Developmental stages of awareness of one’s homosexuality are said to include: general sense of feeling different, awareness of same-sex feelings, identity crisis, eventual acceptance of LBGT identity Suicide Risk—LGBT Youth According to a report by the DHHS, gay and lesbian youth are two to three times more likely to commit suicide than their heterosexual counterparts. study—30% of adolescent suicides related to gender issues According to a 2001 Human Rights Watch report, LBGT youth are more likely to use drugs/alcohol, engage in unsafe sex, face being thrown out on the street by parents and more likely to attempt suicide than other youth. Risk factors for suicide, such as gender nonconformity, higher for boys and men. Celibate males more likely to commit suicide Lesbians are somewhat protected by the fact that they recognize their sexuality at a later age, on average, than do boys, allowing them to have already developed life coping skills. Children who are constantly exposed to ridicule or who know they would be if their sexuality were known are vulnerable to internalized homophobia. Minority Ethnic Groups About 1/3 to 1/2 of adolescents who live in the U.S. belong to a minority ethnic group. Formation of a firm ethnic-group identity is important. The pathway of racial identity development is different for dominant group: move from belief in stereotypes to conflict arises through experience with diverse groups, may become advocates or retreat Research on ethnic identity in adolescents showed that youth from diverse backgrounds: often experience a crisis whereby they challenge everything associated with the dominant group or the reverse, that they reject their own cultural heritage. Later, this crisis is resolved and the youth accepts their ethnicity. Minority Groups cont. As hooks indicates, there will be rage, rage because of a system that does not address the psychological wounds caused by the “madness of forming self and identity in white supremacist capitalist patriarchy.” This is expressed in the high levels of suicide and substance abuse prevalent among Native Americans. Coming-of-age rituals: Quinceañera festivities for Latin American girls—more commercial in the U.S. Jewish boys and girls—bar or bat mitzvah Mixed Racial Identity Development To the extent that the models of racial-ethnic identity development assume that youths growing up have just one racial identity, they fail to reflect the reality for biracial, bicultural children. Six periods in the movement toward the development of a racial identity: neutrality awareness of difference impact of difference experimentation transition to acceptance Multiracial Identity 2000 Census 1st time reporting 2.4% reported 2 or more races Half Latino and white One-third white and other race One-sixth white and black One-eighth white and Asian Obama—Dreams from My Father Resilience People who have survived the most difficult of circumstances, often referred to as “the strength of human spirit” or resilience. Resilience is defined as the capability of individuals to cope successfully in the face of significant change, adversity or risk. Scientific studies of children at high risk (from malnutrition, poverty, etc.) are looking at brain chemistry to learn more about the nature of resilience. Research shows biological and psychological factors in interaction often determine behavioral outcomes. The longer the period of neglect, the more serious the damage that is done. Religious faith a source of strength Religious Beliefs Fowler and Wilber are two social theorists who looked at how children’s religious beliefs are modified with maturity. Wilber, like Fowler, was influenced by Piaget’s structured cognitive model yet he ventured into the realm of levels of consciousness that transcends the personal. Religious faith: helps provide structure for children through rituals brings closeness to relatives and people of all ages through sharing in the rituals develops an aesthetic appreciate through art and music involved in the rituals provides for stress reduction and support in times of trouble Implications for Social Workers Healing powers of spirituality now recognized Need to reduce all risk factors for children generally and maximize children’s natural resilience Harm reduction works to reduce harm in highrisk situations such as bullying or abuse at home In a Nutshell Risk and resilience across the first part of the life span – this in a nutshell can be considered the theme of this chapter. The organizational structure of this chapter was drawn from the insights of Piaget on cognitive growth and development, from Erikson’s psychosocial scheme which pinpointed key issues to be resolved across the childhood lifespan and from Fowler’s and Wilber’s conceptualization of the evolution of spiritual understanding. Chapter 5 Early Adulthood Through Middle Age away When I was a child, I spake as a child, I understood as a child, thought as a child, but when I became a man I put childish things. I Corinthians 13:11 This chapter concerns major achievements across the adult life course in terms of intimacy in young adulthood, generativity during the middle years, and ego integrity during the final stage of life. College Life Erikson’s period of intimacy vs. isolation College is traditionally a time of transition and questioning of the beliefs of one’s upbringing. Compared to previous generations of students, more binge drinking, more unplanned sexual activity in some circles and a higher degree of religiosity in others. Economic challenges—present-day realities of increased tuition, textbook prices, parents saving for retirement, and necessity for a car and job. Prolonged transition between adolescence and adulthood has become the norm—living at home, extended educations. The Biology of Mating Rituals Evolutionary psychologist David Buss concludes that, the role of genetics in mating behavior is pronounced. Mating rituals, such as flirting, follow patterns that cross cultures and countries, based on gestures that seem anchored deep within our evolutionary history. Males attracted to fertile-appearing female. Males tend to exhibit behavior that conveys strength and symbols of success. The experience of love as a biological drive that comprises lust, romantic love (narrows focus to one person) and attachment. Attachment is fuelled by: proximity, stress, sex. Exhilaration of early romance does not last. Biology alone does not determine sexual attraction. Personal Happiness Researchers of happiness often study married couples. The personality traits—ability to share, good humor, etc. that make for partner compatibility and enduring friendships. One study found that newlyweds were matched on values and attitudes, but differed on personality traits like extroversion. Yet happy couples were matched on personality, not attitudes. Myers-Briggs Inventory Myers-Briggs inventory utilizes four different subscales: extroversion-introversion sensing-intuiting thinking-feeling judging-perceiving (how one’s experiences are analyzed) This scale is widely used in business and government as a basis of employee selection. Not surprisingly, in today’s efficiency-conscious world, this personality indicator is in widespread use in matching couples on the basis of their score compatibility. For sales types-- ESFPs; engineers– ESTPs Social worker might be ISFJ, less creative type than INSJ; but attention to detail is important in this field People with disorders may be complementary—antisocial and borderline are often paired with OCD or dependent types Sex Sex defies our many attempts to explain the hold it has on people. Rates of sexual activity among teens in the U.S. Comparable to those in Western Europe Yet incidence of adolescent pregnancy, childbearing, contraction of venereal disease far exceeds that found in most other industrialized nations. Besides issues of school and grades, girls most often struggle with such social concerns as knowing how to say yes to a relationship without having to say yes to sex. At all ages, women are more likely than men to contract genital herpes, Chlamydia or gonorrhea. ABC News poll: women— 6 sex partners in life; men—20 70% of men think of sex every day, 15% of women Men 3 times as often look at sexually explicit website. Healthy Love Healthy love is above all reciprocal, non-possessive; it is about giving and receiving both. Obsessive love thinking: I cannot live without your. You are the only person for me. We must agree on everything. We should be happy in each other’s exclusive company. (and among alcoholics) You keep me sober. The Enrich Couple Inventory reveals key ingredients that make for a happy relationship even long after the initial chemistry has faded: good listening skills understanding of each other’s feelings balance in leisure time spent together and apart being easy to talk to creative and agreeable in handling differences including finances and sexual compatibility BJS Statistics Trends in Fatal Intimate Partner Violence l Homicide victims killed by an intimate partner declined from an estimated 3,300 in 1993 to an estimated 2,340 in 2007. l Between 1993 and 2007, female victims killed by an intimate partner declined from 2,200 to 1,640 victims, and male intimate partner homicide victims declined from 1,100 to 700 victims. Intimate Partner Violence The 2004 intimate partner violence fact sheet provides us with a list of consistently observed “markers” for the commission of intimate partner violence: violence in the family of origin behavioral deficits certain and multiple psychiatric diagnoses personality disorders substance abuse anger low self-esteem. Murder-Suicide The nightmare of volunteers and staff at women’s shelter is that battering, love-struck spouses or boyfriends will commit the ultimate act if the woman makes a successful break. Suicide-murder is the term used here to refer to the phenomenon whereby an estranged partner kills the focus of his or her obsessive passion, and suicide is the primary motive. Whole family murder-suicide. Related to economics? Rape A risk factor to intimacy, both in destroying a relationship underway and in inhibiting one’s ability to trust and bond sexually due to the legacy of the past, is rape. CDC estimates—one of six of women victims of rape or attempted rape Gang rape, fraternity rape, prison homosexual assault, some aspects of date and marital rape and the sexual brutality that is inevitable in slavery and war all involve the targeting of women (or women substitutes) as fair game. Rape-Supportive Culture We are, as Jackson Katz terms it, a rape-supportive culture. In a research study from Glasgow, Scotland which has generated worldwide attention, one in five boys and young men thought that forcing one’s wife to have sex would be acceptable. In Our Guys, Lefkowitz reveals the connection between sports hero idolatry in suburbia and sexual violence against women. Marital rape, if not socially sanctioned, has been socially tolerated for a long time. Date or acquaintance rape is rarely reported as well. Fear of sexual violence is a defining characteristic of the male prison experience in the U.S. Gay males and lesbians are also subjected to sexual victimization in the society. Rape continued Thousands of women soldiers raped in Iraq, not by the enemy as was original argument for them not to serve PTSD as a result Prevention on college campuses: Jackson Katz— The Macho Paradox, male mentoring programs to get at the root cause Bystander intervention taught in schools Midlife Crisis Erikson’s stage of generativity vs stagnation. Midlife is the time of noticeable change in strength and appearance. Biological changes apparent at 20th and the following high school and college reunions. People get fatter, lose height, need reading glasses. Some are getting plastic surgery. Menopause is the term most closely associated with middle age, a term traditionally equated with irrational, emotional outbursts in women and mid-life crises in men. 75% of menopausal women experience mild facial flush and perspiration that are popularly called ‘hot flashes” or “night sweats.” In middle-aged men, there is a decrease in sexual functioning and slowness in arousal due to a gradual decline in their testosterone level. Psychology of Human Midlife Psychologically, the middle years are a time of contemplation and even regret. Women at midlife are connecting to self and others by using relevant processes to define themselves and make sense of their experiences. Singles may feel isolated. Subjective well-being is an important issue that relates to psychological functioning during middle age. Boxed reading: “In the Middle of a Middle” describes how this period is dull compared to times of beginnings and endings. Social work is about being in the middle of things as well. Happiness and Psychology Happiness is like depression; it can be contagious. A review of scientific research concluded that each of us has a happiness set point; no matter what happens in life, we tend to return to our natural set point. Myths about happiness that are disproved in research and surveys are that happiness is brought about by money, beauty, youth, intelligence. On the plus side, Layard lists religious faith, leisure time activities, friendship, sense of humor, self-esteem and volunteering as behaviors that all help provide a sense of well-being. Rick Warren’s The Purpose-Driven Life contends that contentment comes with finding meaning in our lives. Forgiveness Forgiveness is a teaching along with compassion that characterizes all the major world religions. Late middle age is a time when many people return to a religious faith of their youth or engage in new, religious beliefs that reflect the individual’s present spiritual state. Forgiveness is about removing the hold that anger and resentment have on us. Forgiving people have lower blood pressure than others. Finding purpose and meaning in a seemingly bleak situation is one component of spirituality. Cultural Perspectives India is one nation where attitudes among the younger generation, especially urban youth, are changing rapidly. Researchers compared attitudes toward sex in 24 countries and found wide varieties in sexual beliefs. “Teen permissive” countries—Germany, Austria, and Sweden. “Sexual conservatives”—the U.S., Ireland, N. Ireland, and Poland. Muslim countries, the most conservative. Domestic violence is an issue not defined as such in most nations. Chapter 6 LATE MIDDLE AGE THROUGH THE END OF LIFE Facts on Aging From Erikson’s generativity vs. stagnation to ego integrity (late middle age) vs despair Young-old from 50-75 and old-old after 75 Pew survey shows older people are happier, less stressed and worried than younger ones Life expectancy over 80 in Japan, Singapore, France, Sweden, and Italy. South Africa has fallen to 43 (AIDS). U.S.: 80.7, white females, 70.2 black males Over 65 is around 20% minorities. Birth rate decline in Western Europe, especially former Soviet Union countries. Age 50-75 Sarah Lawrence-Lightfoot, The Third Chapter, positive account of transitions Post midlife journeys of 40 older Americans— workaholic to take voice lessons, engineer who became an artist, one to write a novel, start new more creative careers The Biology of Old Age Many of the health problems faced by elderly persons result from a general decline in the circulatory system. Physical limitations coupled with lack of adequate transportation limit older persons in their ability to shop, obtain legal counsel or get medical care. Two recent memoirs provide disturbing and unsentimental chronicles of life with a parent in the late stages of Alzheimer’s: The Story of My Father and Death in Slow Motion (the author’s mother’s acts of rage) Cancer is another important target area of research and development. Elderly alcoholics rarely seek treatment on their own, but family members may take them to a substance abuse treatment center for help. Psychological Aging vs. Biological Aging Psychological aging is related to biological aging in the way the mind is very closely linked to the body. Pipher (Another Country) argues that the developmental period of old age is about major physical and social disruption and psychological stresses. Despite their forgetfulness, the elderly have a storehouse of memories. As we live in the present and invest in the future, old age and death are commonly denied. Kübler-Ross’s stages of death and dying: denial anger bargaining depression acceptance Old Age and Health Physician-oriented, and cure-based health care is in many ways unsuited to the needs of older persons who typically have chronic conditions with social dimensions. Increasingly, Americans and some Europeans are seeking ways to exert some measure of control over where and how they die. According to survey, two-thirds of the public and a majority of physicians in the U.S. support physician-assisted suicide as a legitimate right in cases of incurable and debilitating disease. Cancer—narratives of Elizabeth Edwards and Farrah Fawcett The Social Side of Aging In a youth-oriented, fast-paced industrialized society, the process of aging begins to acquire a negative meaning as we move past early adulthood. The social side of aging refers to the cultural expectations for people at various stages of their lives. Race, ethnicity and social class status are significant determinants of an individual’s experience with aging. Cultural Perspectives In many cultures, one’s sense of wellbeing, or general happiness, is not determined from within but rather from positive relations with others, usually the family. Read “Latino Family Ties.” Motivational Enhancement Similar to the cognitive approach in that it is concerned with thought processes is motivational interviewing. Choice important for people of all ages. William Miller has formulated motivational therapy in terms of the following general principles: express empathy develop discrepancy between goals and behaviors avoid argumentation roll with resistance support self-efficacy Late Adulthood Forgiveness and healing are key concepts with much relevance to the helping effort. One of the most difficult tasks of old age is to learn to adjust to everyday life without the care and companionship of a significant other, often to live alone or, in the company of others, to feel alone. Sense of meaning can come from membership in community recreational and volunteer groups, a renewed or continuing church involvement and participation in other activities for spiritual fulfillment. Resilience Reading, “Resilience in Older African American Women” who survived segregated South Part of the Great Migration to Iowa Characteristics shown in their narratives: Respect for elders—father a sharecropper Value of education—father taught himself to read Resistance to oppression Strong religious faith Positive attitude toward life Conclusion From embarking on the journey of life as a grown person to reaching the end of the trail, this chapter has touched upon some pivotal moments. Following a discussion of heterosexuality and gay/lesbian sexuality, the topic shifted from healthy to unhealthy love relationships, a shift that led into the territory of violence and even rape and suicide played out in the form of murder. A discussion of old age – ego integrity v. despair – concluded the life span portion of the chapter and the book. Chapter 7 The Individual and the Family “They are the we of me” Carson McCullers Member of the Wedding This chapter delves into the inner workers of family life—roles and relationships. Definition of Family The role of family: to mediate the relationship between individual and society. Zastrow and Kirst-Ashman define family members as people who are: members of a primary group in constant and intimate interaction, mutually obligated to each other and usually occupying a common residence. The mass-media portrait of the solitary, “nuclear” family devoid of links to extended family Some negative modern developments affecting the American family – changes in eating habits and the many hours spent watching TV or on the Internet. Institutional supports for the family have eroded over the past decade Political lip service to “family values.” Theories about Family General systems theory and ecosystems theory as discussed in chapter 1: The family is a system in interaction with other social systems at the societal level The family is a system within itself. The systems and ecological perspectives have been among the most widespread theoretical frameworks in social work that provide designs for conceiving of personal and environment transactions. Murray Bowen’s formulation had a revolutionary impact on the fields of counseling and social work. Trained as a psychoanalyst Interest in families began in his work at the Menninger clinic in the 1940s and later moved to Georgetown Medical School in Washington, DC Decided that the processes he had earlier observed in diseased families were present in all families Bowen’s Family System Theory Bowen’s family systems theory contrasted with general systems concepts: General systems model grew out of the assumption that similar mathematical expressions and models could be applied to the human domain. Bowen used metaphors from the natural environment. A major contribution of Bowen was his graphic construct for representing key themes that carry over from generation to generation. According to McGoldrick, genogram data can help us look for repeated symptoms such as patterns of conflict across generations, depression or abuse. Family therapists pay close attention to the boundaries among members of the family system and between the family and other systems such as neighbors and schools. Criticism Bowen’s approach criticized for its Anglo-American emphasis on individualism and independence. its ideal of the differentiated self that fails to take into account women’s ways of relating and their focus on closeness the mother-blaming inherent in his theory—his conceptualization of emotional fusion was often the relationship between mother and child. Contributions: Provides a lens for understanding interactions among a number of variables at once; Has expanded the social work profession’s person-inenvironment concepts Has provided fuel for our social work imaginations as we explore the gender roles and family rules so unique to each family. Functional and Dysfunctional Families Healthy families can be said to be where everyone’s boundaries touch, but not overlap. Functional families are characterized by: open communication respect for individual differences and boundaries, stable routines and having a sense of humor Dysfunctional families are said to be enmeshed or disengaged. When boundaries are clearly defined between individuals, one’s thoughts and feelings are respected Enmeshed family members tend to speak for one another; parents tell children what they think or feel; guilt is used to control; and parents show signs that they are not psychologically separated from their own parents On the other end of the spectrum, disengaged families sacrifice belonging for autonomy. Psychiatrist Ernest Hartmann has devised the Boundary Questionnaire to measure what he sees as a basic dimension of personality – the tendency toward thickness or thinness in boundaries. Family Socialization Family communication has a lot to do with socialization--child learns how to behave through feedback and role models. A latent function of the family includes socialization into the norms of society. Gender role socialization starts early and is pervasive In violent families dominance of the weak by the strong – of children by adults, smaller children by larger, male by female – is the rule. Socialization—a two-edged sword. The paradox of the family is that although so many are flawed that family affection serves as a glue that holds lives together. Family can be the buffer against the pain of society and the source of pain, booster a child’s potential and also hold them back, etc. In any case, children do better in families than in any other social arrangements (the one exception is the traditional kibbutz which combines community and family life.). Father-Son Relationships Parent-child relationships are among the most common social roles played over the life-course and the most enduring in terms of social ties. Research on fathering consists of two basic varieties: research on the impact on children of father absence studies of father roles in the home. Father-son relationship often the most difficult dyad in the family— Father may find expressing affection to son difficult. Father may seek success through son or be jealous of mother-son bonding. Son may go to great links to prove himself to his father or to finish the father’s unfinished business—analogy of Henry V in battle and George W. Bush Stories of Barack Obama and John McCain Research on father-son relationships—stress on how the women’s movement has freed both women and men from gender-role Father Daughter Relationship To Virginia Satir, the early father-daughter relationship was instrumental in preparing the girl for life. Perkins studied college women, categorized fathering styles as doting, distant, demanding/supportive, domineering, absent, or seductive. The bulk of the literature on the father-daughter relationship, as any search engine check will show, is concerned with sexual abuse. Girls in homes where fathers were highly involved tended to delay sexual encounters and pregnancy. Hawaiian study found that women married men who resembled their fathers, and men married women who resembled their mothers. In European American families, fathers have strong influence regarding their daughter’s achievements, while mothers have more in African American families. Girls often feel a sense of protection in having a father in the home. Mother-Son Bond Freud had a lot to say about he love between mother and son— Oedipus Complex. As the sons reach adolescence, mothers find it hard to truly understand them, especially if they conform to gender-role expectations, seeking adventure and tinkering with mechanical equipment, especially cars (Erikson). Mother-son relationship differs in many ways from the mother-daughter relationship. Experiment showed mother praised son’s performance more than daughter’s. African-American mother-son bond, Sacred Bond: Black Men and Their Mothers Stories of gay man with AIDS, and of mother who fought the gang to reclaim her son Mother-Daughter Relationship The mother-daughter relationship, according to Christiane Northrup, MD: has more “clout” biologically, emotionally and psychologically than any other relationship in a woman’s life. Attitudes about female body are passed down. Northrup has devised a map of female development in the form of a house with many rooms of passage toward the roof of life hereafter. Another kind of mother-daughter passage occurs in the ties between caregiving daughters and their dependent, advanced-aged mothers. Daughter from Danang—PBS film Daughter returns to Vietnam to meet her biological mother Raises issue of cultural differences and customs in motherdaughter relationships Brother-Sister Relationships Relationships between brothers and sisters are distinctive, often precious and the longest family relationship of one’s life. Studies have shown that of three sibling pairs, sister/sister pairs are the closest and brother/brother compete the most. First-borns often become the family heroes as they may feel pressure to pursue dreams unfulfilled of their parents. Family theorists such as Bowen and Satir firmly believed that ordinal rank in childhood related to later roles Impact of birth order Researcher examined data from biographies of key historical personalities concluded first borns identified with power; later borns more liberal Sisters often grow close late in life. Disabled Siblings Findings in the research literature concerning the long-term impact of growing up in a home with an autistic sibling are contradictory. Children of autistic sibling may hesitate to bring friends home May suffer from lack of companionship and parental neglect But may become more mature and caring as a result The important role that siblings play in providing support systems for each other is rarely explored in the research literature apart from attention paid to family supports, in general. Sibling Relationship The way that parents treat their children may affect how children treat each other when the parent is gone. Resentments linger. Marriage research shows that sibling relationships change drastically following the marriage of one or more of the grown children, frequently creating a wedge – especially when the spouse does not “fit in.” Politics and religion in later life likewise can cause irreparable damage. Aunts and Uncles In literature: David Copperfield, Tom Sawyer, Pollyanna Eulogies to Ted Kennedy by nephew and niece Can provide stability to family Uncles more action centered—Kennedy and sailing Aunts—more about emotional support Text dedicated to the author’s aunts Grandparents The relations between grandparents and grandchildren yield satisfactions that the parent-child often does not. Grandmothers tend to outlive their husbands and play a more active role in caring for their grandchildren than do grandfathers. The maternal grandmother tends to be more involved in the childrearing than the paternal grandmother. Grandparents often pay for “extras” such as piano lessons and summer camp as well as contributing in major ways to house payments and medical expenses. Another factor could be the revision of child welfare policies to acknowledge the importance and convenience of kinship care when child placement is necessary. When parents give birth to a child with a physical disability, the role of the support system is essential to the family’s ability to cope. Family Breakup Family breakup occurs frequently in modern, industrialized society. Given the extent of divorce, the family forms that result in: single parents raising kids joint custody arrangements The stepfamily—defined as a household that contains a child who is the biological or adopted offspring of one of the parents. Divorce and Family Splitting Widely reported media accounts including editorial columns warned about the long-term consequences to children of parental splits. Research of Wallerstein has been extensively used Her data came from her clients who had been getting a divorce Interviewed 30 years later—low marriage rate of the children in her sample Study of Canadian government data found that following the divorce, levels of child anxiety/depression increased. but for highly dysfunctional families, there was a decrease in antisocial behavior. Other research found significant differences in divorced vs. nuclear family children’s test results, but after taking into account income and mother’s education, the differences were negligible. Implications for Social Work Social workers can learn from other nations as well as from diverse cultures— lessons about strong family policies that guarantee that all their people get adequate health care. Kinship care—care offered by members of the African American extended family is today widely used in child welfare departments for all families. Social workers, family therapists and substance abuse counselors can all expect to be working with diverse family forms. The professional must be prepared for the unexpected—prepared to draw on every ounce of our social work imaginations. Conclusion to the book—learning from the microcosm, paradox in human behavior, symbol of the holon—family a whole and a part of another whole The journey of the book was from micro-micro level to micro-macro—the individual in the family.