Which is why Smalltalk's refactoring browser has a manual intervention step to allow you to see what it proposes to do, and remove any steps you don't agree with, as well as the ability to scope your refactorings to a package or class to limit the scope to more relevant data. Either way, it's sufficient to get 99% of the benefits of automated refactorings without the 100% guarantee static typing provides; good enough for me.

Automated refactoring was invented in Smalltalk, claiming it's a benefit only static typing provides is to not know history.

I can't speak to Smalltalk, but any namespaced Lisp system can figure out what references what. The key is that the searches happen through the REPL, not grep/ag. So if I tell CIDER to find all instances of a Clojure symbol, it can use the namespace to avoid false positives.

I can ask my Lisp IDE to find callers for methods based on the sub/class of arguments.