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Bower, M. (2011). Families Who Experience Help as the Problem: A Seminar Given in December 2010 as part of the Making Research Count Programme. Cpl. Fam. Psychoanal., 1(2):255-256.

(2011). Couple and Family Psychoanalysis, 1(2):255-256

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Families Who Experience Help as the Problem: A Seminar Given in December 2010 as part of the Making Research Count Programme

Marion Bower

‘Making Research Count’ is a consortium of local authorities and universities in the UK who put on seminars about research that is relevant to social work. It is run from King's College, London, and most of the seminars take place there. Going into King's was a whiff of my own experience of being a student, as crowds of young people drift by on their way to lectures, or perhaps just drifting …

My seminar was on ‘Families who experience help as the problem’. It was not based on formal research, but on many years' clinical experience as a social worker and psychoanalytic psychotherapist. The presentation was based on a chapter of that title which I wrote for a book that I edited for social workers, Psychoanalytic Theory for Social Work Practice: Thinking Under Fire (2005).

The presentation described families who have chronic histories of abuse, mental health problems, and delinquency. Helpful interventions are often spoiled or go nowhere and workers may be intimidated or abused. The behaviour of these families is often rationalised as being due to previous bad experiences of professionals. Many social workers have caseloads almost entirely composed of families like this, and there is an urgent need to have a model to describe how these families function.

My presentation put forward a psychoanalytic model based on an object relations concept of pathological organisations of the personality, originally developed to understand narcissistic patients. These types of internal organisations were first described by Joan Riviere (1936) as an interlocking series of manic defences. Herbert Rosenfeld (1971) described how cruel and omnipotent parts of the personality can control and intimidate needier, saner parts of the self. He described this organisation of the self as a ‘mafia’. More recent work by John Steiner (1993) looks at the development of these organisations and at the sadomasochistic links between parts of the self. This model of individual pathology can be opened out in three dimensions to explain these hard to help families. It shows that a direct link can be made between sophisticated psychoanalytic theory and grass roots social work.

At the end of the lecture, a social worker came up and said, ‘Professionals can behave like this, too.’

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