Abstract
Self psychology can help explain multiple meanings and experiences of being chronically homeless. While it is clear that homelessness is primarily caused by structural deficits and not individual characteristics, for people who are chronically homeless, this way of existence may have developed to serve a variety of coping, cohesive, and self-preserving functions as they have learned to survive and adapt to hostile environments. Through the use of self psychologically informed clinical practice, this paper explores the subject’s multiple meanings and experiences as well as the nuanced processes that led her to successfully attain permanent housing. The paper begins by discussing macro etiologies of homelessness, constructs in self psychology and strives to link the two in theory and practice by exploring one person’s life of chronic homelessness. The paper also explores ethical challenges as coercive elements factor into the case.
Similar content being viewed by others
References
Akhtar, S. (1995). A third individuation: Immigration, identity, and the psychoanalytic process. Journal of the American Psychoanalytic Association, 43(4), 1051–1084. doi:10.1177/000306519504300406.
Allgood, S., & Warren, R. S. (2003). The duration of homelessness: Evidence from a national survey. Journal of Housing Economics, 12, 273–290. doi:10.1016/j.jhe.2003.09.001.
Atwood, G. E., Orange, D. M., & Stolorow, R. D. (2002). Shattered worlds/psychotic states. A post-Cartesian view of the experience of personal annihilation. Psychoanalytic Psychology, 19(2), 281–306.
Baker, H. S., & Baker, M. N. (1987). Heinz Kohut’s self psychology: An overview. American Journal of Psychiatry, 144(1), 1–9.
Baron, J. B. (2004). Homelessness as a property problem. Urban Law Journal, 36(2), 273–288.
Barrow, S., Soto Rodriguez, G., & Córdova, P. (2004). Final report on the evaluation of the closer to home initiative. New York, NY: Corporation for Supportive Housing. Retrieved from http://www.raincityhousing.org/docs/Closer_to_Home_Initiative.pdf.
Bazelon, D. L. (1975). Institutionalization, deinstitutionalization and the adversary process. Columbia Law Review, 75(5), 897–912.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260.
Bradford, D., Gaynes, B. N., Kim, M. M., Kaufman, J. S., & Weinberger, M. (2005). Can shelter- based interventions improve treatment engagement in homeless individuals with psychiatric and/or substance misuse disorders? A randomized controlled trial. Medical Care, 43(8), 763–768.
Bromberg, P. A. (1996). Standing in the spaces: The multiplicity of self and the psychoanalytic relationship. Contemporary Psychoanalysis, 32(4), 509–535.
Carr, G. D. (2011). Psychotherapy research: Implications for practice. Psychiatric Times, 28(8).
Caton, C. L. M., Wilkens, C., & Anderson, J. (2007, March). People who experience long-term homelessness: Characteristics and interventions. Paper presented at the 2007 National Symposium on Homelessness Research, Washington DC. Retrieved from http://aspe.hhs.gov/hsp/homelessness/symposium07/.
Chinman, M. J., Rosenheck, R., & Lam, J. A. (1999). The development of relationships between people who are homeless and have a mental disability and the case managers. Psychiatric Rehabilitation Journal, 23(1), 47–55.
Chinman, M. J., Rosenheck, R., & Lam, J. A. (2000). The case management relationship and outcomes of homeless persons with serious mental illness. Psychiatric Services, 51, 1142–1147.
Culhane, D. P., & Metraux, S. (2008). Rearranging the deck chairs or reallocating the lifeboats? Homelessness assistance and its alternatives. Journal of the American Planning Association, 74(1), 111–123. doi:10.1080/01944360701821618.
Culhane, D. P., Metraux, S., & Hadley, T. R. (2002). Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing. Housing Policy Debates, 13(1), 107–163.
Dennis, D. L., & Monahan, J. (1996). Coercion and aggressive community treatment: A new frontier in mental health law (pp. 1–9). New York, NY: Plenum.
Draine, J., Salzer, M. S., Culhane, D. P., & Hadley, T. R. (2002). Role of social disadvantage in crime, joblessness, and homelessness among persons with serious mental illness. Psychiatric Services, 53(5), 565–573.
Elvins, R., & Green, J. (2008). The conceptualization and measure of therapeutic alliance: An empirical review. Clinical Policy Review, 28(7), 1167–1187.
Farrell, D. C. (2010). The paradox of chronic homelessness: The conscious desire to leave homelessness and the unconscious familiarity of the street life. Journal of Human Behavior and the Social Environment: Special Edition on Homelessness, 20(2), 239–254. doi:10.1080/10911350903269872.
Fosshage, J. L. (1995). Self psychology and its contributions to psychoanalysis. International Forum of Psychoanalysis, 4(4), 238–246. doi:10.1080/08037069508409554.
Fosshage, J. L. (2003). Contextualizing self psychology and relational psychoanalysis. Contemporary Psychoanalysis, 39(3), 411–448.
Graybar, S. R., & Leonard, L. M. (2005). In defense of listening. American Journal of Psychotherapy, 59(1), 1–18.
Halperin, S. (2004). The relevance of immigration in the psychodynamic formulation of psychotherapy with immigrants. International Journal of Applied Psychoanalytic Studies, 1(2), 99–120. doi:10.1002/aps.62.
Hartnett, H. P., & Postmus, J. L. (2010). The function of shelters for women: Assistance or social control? Journal of Human Behavior in the Social Environment, 20(2), 289–302. doi:10.1080/10911350903269948.
Hoffman, L., & Coffey, B. (2008). Dignity and indignation: How people experiencing homelessness view services and providers. Social Science Journal, 45(2), 207–222. doi:10.1016/j.soscij.2008.03.001.
Josephs, L. (1991). When the patient is psychotic. In H. Jackson (Ed.), Using self psychology in psychotherapy (pp. 169–179). New York, NY: Aronson.
Kanter, J. (1990). Community-based management of psychotic clients: The contributions of D. W. and Clare Winnicott. Clinical Social Work Journal, 18(1), 23–41. doi:10.1007/BF00759068.
Klinkenberg, W. D., Calsyn, R. J., & Morse, G. A. (1998). The helping alliance in case management for homeless persons with severe mental illness. Community Mental Health Journal, 34(6), 569–578.
Kohut, H. (1977). The restoration of the self. Madison, CT: International Universities Press.
Kohut, H., & Wolf, E. S. (1978). The disorders of the self and their treatment: An outline. International Journal of Psychoanalysis, 59, 413–425.
Kuhlman, T. L. (1994). Psychology on the streets. Mental health practice with homeless persons. New York, NY: Wiley.
Kuhn, R., & Culhane, D. P. (1998). Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: Results from the analysis of administrative data. American Journal of Community Psychology, 26(2), 207–232.
Lichtenberg, J. D., & Kindler, A. R. (1994). A motivational systems approach to the clinical experience. Journal of the American Psychoanalytic Association, 42(4), 405–420. doi:10.1177/000306519404200204.
Luhrmann, T. M. (2008). “The street will drive you crazy”: Why homeless psychotic women in the institutional circuit in the United States say no to offers of help. American Journal of Psychiatry, 165(1), 15–20. doi:10.1176/appi.ajp.2007.07071166.
Martin, J. (2008). Self psychology theory. In N. Coady & P. Lehmann (Eds.), Theoretical perspectives for direct social work practice: A generalist-eclectic approach (2nd ed., pp. 199–217). New York, NY: Springer Publishing.
Martin, D. J., Garske, J. P., & Davis, K. D. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Counseling and Clinical Psychology, 68(3), 438–450.
Milburn, N. G., Ayala, G., Rice, E., Batterham, P., & Rotheram-Borus, M. J. (2006). Discrimination and exiting homelessness among homeless adolescents. Cultural Diversity and Ethnic Minority Report, 12(4), 658–672. doi:10.1037/1099-9809.12.4.658.
Milby, J. B., Schumacher, J. E., Wallace, D., Vuchinich, R., Mennemeyer, S. T., & Kertesz, S. G. (2010). Effects of sustained abstinence among treated substance-abusing homeless persons on housing and employment. American Journal of Public Health, 100(5), 913–918.
National Alliance to End Homelessness. (2007). Fact checker: Accurate statistics on homelessness. Retrieved from http://www.endhomelessness.org/section/_search/?q=2007+fact+checker%3A+accurate+statistics+on+homelessness.
O’Flaherty, B. (1995). An economic theory of housing and homelessness. Journal of Housing Economics, 4, 13–49.
O’Flaherty, B. (2004). Wrong person and wrong place: For homelessness, the conjunction is what matters. Journal of Housing Economics, 13, 1–15. doi:10.1016/j.jhe.2003.12.001.
O’Flaherty, B., & Wu, T. (2006). Fewer subsidized exits and a recession: How New York City’s family homeless shelter population became immense. Journal of Housing Economics, 15, 99–125. doi:10.1016/j.jhe.2006.08.003.
Pao, P.-N. (1983). Therapeutic empathy and the treatment of schizophrenics. Psychoanalytic Inquiry, 3, 145–167.
Pollio, D. (1990). The street person: An integrated service provision model. Psychosocial Rehabilitation Journal, 14, 57–69.
Preston, S. D., & de Waal, F. B. M. (2002). Empathy: Its ultimate and proximate bases. Behavioral and Brain Sciences, 25(1), 1–20. doi:10.1017/S0140525X02000018.
Rew, L., Fouladi, R. T., & Yockey, R. D. (2002). Sexual practices of youth. Journal of Nursing Scholarship, 34(2), 139–145.
Robben, A. C. G. M., & Suárez-Orozco, M. M. (2000). Cultures under siege: Collective violence and trauma. Cambridge, UK: Cambridge University Press.
Rowe, C. (1994). Reformulations of the concept of selfobject: A misalliance of self psychology with object relations theory. In A. Goldberg (Ed.), A decade of progress: progress in self psychology (pp. 9–20). Hillsdale, NJ: Analytic Press.
Rowe, C. (2005). Treating the basic self: Understanding addictive, suicidal, compulsive, and attention-deficit/hyperactivity (ADHD) behavior. New York, NY: Psychoanalytic Publishers.
Rowe, C. E., & Mac Isaac, D. S. (1989). Empathic attunement: The technique of psychoanalytic self psychology. Lanham, MD: Rowman & Littlefield Publishers. Inc.
Shane, M., Shane, E., & Gales, M. (1997). Intimate attachments: Toward a new self psychology. New York, NY: Guilford.
Siegal, D. J. (2001). Toward an interpersonal neurobiology of the developing mind: Attachment relationships, “mindsight”, and neural integration. Infant Mental Health Journal, 22(1–2), 67–94.
Simpson, G. A., Williams, J. C., & Segall, A. B. (2007). Social work education and clinical learning. Clinical Social Work Journal, 35(1), 3–14. doi:10.1007/s10615-006-0046-4.
Smerud, P. E., & Rosenfarb, I. S. (2005). The therapeutic alliance and family psychoeducation in the treatment of schizophrenia: An exploratory prospective change study process. Journal of Counseling and Clinical Psychology, 76(3), 505–510.
Snow, D. A., & Anderson, L. (1993). Down on their luck. Berkeley, CA: University of California Press.
Stec, J. (2006). Why the homeless are denied personhood under the law: Toward contextualizing the reasonableness standard in search and seizure jurisprudence. Rutgers Journal of Law and Urban Policy, 3(2), 321–353.
Swick, K. J. (2008). The dynamics of violence and homelessness among young families. Early Childhood Education, 36, 81–85. doi:10.1007/s10643-007-0220-5.
Tolpin, M. (1986). The self and its selfobject: A different baby. In A. Goldberg (Ed.), Progress in self psychology (pp. 115–142). New York, NY: Guilford.
Tsembaris, S., & Asmussen, S. (1999). From streets to homes: The pathways to housing consumer preference supported housing model. In K. J. Conrad, M. D. Matters, P. Hanrahan, & D. J. Luchins (Eds.), Homeless prevention in treatment of substance abuse and mental illness (pp. 113–131). Binghamton, NY: Haywood.
US Department of Housing and Urban Development. (2003). Notice of funding availability for the collaborative initiative to help end chronic homelessness. Federal Register, 68(17), 4019.
US Department of Housing and Urban Development. (2010). The 2009 annual homeless assessment report to congress. Retrieved from http://www.hudhre.info/documents/5thHomelessAssessmentReport.pdf.
Walsh, J. (2010). Therapeutic communication with psychotic clients. Clinical Social Work Journal, 39(1), 1–8. doi:10.1007/s10615-010-0287-0.
Weinreb, L., Rog, D. L., & Henderson, K. A. (2010). Exiting shelter: An epidemiological analysis of barriers and facilitators for families. Social Service Review, 84(4), 597–614. doi:10.1086/657108.
Wolf, E. S. (1988). Treating the self: Elements of clinical self psychology. New York, NY: Guilford.
Wong, Y.-L. I. (2002). Tracking change in psychological distress among homeless adults: An examination of the effect of housing status. Health and Social Work, 27(4), 262–274.
Wright, R. G. (2007–2008). Homelessness and the missing constitutional dimension of fraternity. University of Louisville Review, 46, 437–471.
Zeber, J. E., Copeland, L. A., Good, C. B., Fine, M. J., Bauer, M. S., & Kilbourne, A. M. (2008). Therapeutic alliance perceptions and medication adherence in patients with bipolar disorder. Journal of Affective Disorders, 107(1), 53–62.
Zerger, S., Strehlow, A. L., & Gundlapalli, A. V. (2008). Homeless young adults and behavioral health. American Behavioral Scientist, 51(6), 824–840. doi:10.1177/0002764207311990.
Zlotnick, C., Kronstadt, D., & Klee, L. (1998). Foster care children and family homelessness. American Journal of Public Health, 88(9), 1368–1370.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Farrell, D. Understanding the Psychodynamics of Chronic Homelessness from a Self Psychological Perspective. Clin Soc Work J 40, 337–347 (2012). https://doi.org/10.1007/s10615-012-0382-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10615-012-0382-5