ABSTRACT
In psychoanalytic social work the tension between social reality, with which social work is concerned, and the inner world of thoughts and phantasies that psychoanalysis explores, is built into its very name. Psychoanalytic social work is mainly concerned with patients whose inner state makes it hard for them to find their bearings in social reality. Their mental and emotional processes are no longer so flexible as to allow for a reasonably undisturbed adaption to the realities of life. These conflictual inner processes and the deficits in mental and emotional structures become so overwhelming that they cannot any longer be dealt with in the internal world alone. A psychotherapy in the strict sense of the word, in which the conflictual inner problems could be guided towards a more beneficial solution, is unthinkable unless the external environment is stabilised and the problems with social reality are alleviated.
