Chapter 2 Theories and Therapies Flashcards
What is one of the most anxiety provoking activities?
Dealing with other people
What do Psych theories help us do?
provide plausible explanations for perplexing behavior
Name the 3 parts of consciousness according to Freud
Conscious
PreConscious
SubConscious
Explain Conscious Mind
TIP OF ICEBERG
Perceptions Memories Thoughts
Fantasies Feelings
Explain PreConscious Mind
Just below the surface
Material that can be easily retreived.
Explain UNConscious Mind
Unconscious Mind
Repressed memories passions unacceptable urges
Memories and emotions associated with TRAUMA
Needs therapy to retrieve this material
Freud’s Three Major Parts of Personality
Id, Ego, Superego
ID
Birth
Unconscious
Impulsive
Cannot tolerate frustration.
Cannot problem solve and is illogical
EGO
Found in conscious, subconscious, and unconscious awareness.
Problem solver.
Develops with a few years of life.
You have to delay gratification.
If you are hungry - plan how to get food.
SUPEREGO
Age 3-5 years
Also found in all 3 levels of awareness.
Moral component
ALL the should NOT’s
If too strong, person will feel inferior and self-critical
What is the purpose of
DEFENSE MECHANISMS?
Helps to ward off anxiety by preventing
conscious awareness of
threatening feelings.
Name 2 features of
DEFENSE MECHANISMS
- Operate on unconscious level (except suppression)
- They deny, falsify, distort reality to make it less threatening.
Name some Defense Mechanisms
Altruism
Compensation
Conversion
Denial
Displacement
Dissociation
Identification
Intellectualization
Projection
Rationalization
Regression
Repression
Splitting
Sublimatioin
Suppression
Undoing
Oral Stage
Age?
Source of satisfaction?
Primary Conflict
Task?
0-1 year
Mouth
Weaning
Mastery of gratification of oral needs
Ego begins 4-5 months
Desired Outcome of Oral Stage
Trust in environment
Realization that needs can be met
Fixation at Oral Stage
Passivity, gullibility dependence
Sarcasm
Oral habits - smoking, nail biting
Anal Stage
Age?
Source of Satisfaction?
Conflict
Tasks
1-3 years
Anal Region - expulsion/retention of feces
Toilet training
Begins self-control over instinct, delayed gratification
Anal Stage
Desired Outcome
CONTROL OVER IMPULSES
ANAL STAGE
FIXATION AT
Anal retentiveness -
Stingy, rigid, OCD or
Anal expulsive -
Messy, destructive, cruel
PHALLIC STAGE
Age
Source of Satisfaction
Conflict
Task
3-6 years (oedipal)
Genitals masturbation
Oedipus and Electra
Identify with parent of same sex
Beginning of superego
Phallic Stage
Desired Outcome
Identification with parent of same sex
Phallic Stage
Fixation
Reckless, self-assured, and narcissistic person
lack of resolution may result in inability to love and issues with
sexual identity
Latency Stage
Age
NO Source of Satisfaction
NO primary conflict
Tasks
6-12 years
growth of EGO -
ability to care and relate to others outside home
Latency Stage
Desired Outcome
Development of skills to cope with environment.
Latency Stage
Fixation
Difficulty identifying with others
and developing social skills
Sense of inferiority and inadequacy
Genital Stage
Age
Source of Satisfaction
NO primary conflict
Task
12 years and beyond
Genitals, sex
Develop satisfying sexual and emotional relationships
emancipation from parents
Planning life goals
personal identity
Genital Stage
Desired Outcome
The ability to be creative and find pleasure in love and work.
Genital Stage
Fixation
Derails emotional and financial independence
impair personality identity and goals
disrupts ability to form satisfying intimate relationships
Name 3 tools of
Classic Psychoanalysis
Free association
Dream analysis
defense mechanism recognition (denial, projection, rationalization)
Name TWO Concepts
From Classical Psycoanalysis
Transference
affectionate or hostile
feelings to healthcare worker
that had originally in childhood for sig other
Countertransference
Feelings a healthcare worker has for patient. Need to be self-aware.
PsychoDynamic Therapy
Similar tools as original
Short term
for worried well not severe
Here and now, not past
More interaction between both
Freud and nursing process
understanding of childhood and personality development
use ofConscious and Unconscious mind concept to understand root causes of suffering
Attentive listening.
Who developed
INTERPERSONALY THERAPY
Harry Stack Sullivan
1892-1942 USA
Humans are driven by the need for interaction
What emotion did Harry Stack Sullivan believe was the most painful condition?
Lonliness
H S Sullivan believed what relationship was the most crucial for personality development?
The early relationship with significant other.
H S Sullivan said the purpose of all behavior was to get NEEDS met through _______ to reduce _______
H S Sullivan said the purpose of all behavior was to get needs met through Interpersonal interactions_______ to reduce anxiety.
How did H S Sullivan define
ANXIETY?
any painful feeling or emotion. that comes from social insecurity or prevents biological needs from being satisfied.
H S Sullivan’s
Security Operations
means?
Security Operations
are the measures that people use to reduce ANXIETY and to increase
SECURITY.
These make up the self-system.
How long does Interpersonal Therapy Last?
Short term
What THREE type of problems that respond well to
INTERPERSONAL THERAPY?
- grief and loss
- interpersonal disputes
- role transition
major depressive disorder
Who developed the first systematic framework for psych nursing
and established the foundation for professional practice of psych nursing?
Hildegard Peplau 1909-1999
Interpersonal Relations in Nursing 1952
Influenced by H S Sullivan
Name 2 things that Peplau was the first to do?
identified psych nursing as essential to nursing and as a speciality of nursing.
Described the nurse- patient relationship as foundation of nursing practice
what nurses do WITH patients.
Peplau’s Nursing Theory
how nurse helps patients to make positive changes in health
Illness offers opportunity for personal growth can coping strategies
Self-awareness to keep focus on patient
observe the patient and themselves
Peplau’s most universal contribution to psych nursing
application of H S Sullivan’s theory of anxiety
interventions to lower anxiety
lower anxiety and you improve the patient’s ability to think and function
Patricia Benner
Caring as foundation for nursing
bearing witness to suffering
Dorothea Orem
Goal of self-care as integral to nursing
esp working with seriously mentally ill patients.
Sister Calista Roy
Continual need to adapt physically, psychologically, and socially -
Nurse assisting patients to adapt so they can cope.
Betty Neuman
Impact of internal and external stressors on equilibrium of the system -
nurse helps patients to use stress reducing strategies
Joyce Travelbee
meaning in the nurse patient relationship
importance of communications
affirming suffering and alleviating it through communication skills
What is Behavior Theory
If behavior changes, personality changes
uses the process of conditioning
pairing a behavior with a condition that reinforces or diminishes the behavior.
What is classical conditioning theory and who invented it?
Ivan Pavlov 1928
Involuntary not spontaneous choices
bell food salivation
Who developed Behavorism?
John B. Watson 1919
personality traits learned through classical conditioning
control the environment and you can train anyone to do anything
Who began OPERANT CONDITIONING THEORY?
B.F. Skinner 1987
Voluntary behavior is rewarded through reinforcement which makes the behavior occur more frequently.
Positive and Negative reinforcement
Punishment
no reinforcement is extinction. tell a joke no one laughs, stop telling jokes
What is BEHAVIORAL THERAPY?
Directed at specific problems
Do not need to know why to change it.
what problems can BEHAVIORAL THERAPY Help the MOST
phobias, ETOH, schizophrenia, etc
Name FIVE TYPES of behavior Therapy
Modeling, operant conditioning
exposure and response prevention, aversion therapy, and biofeedback.
Behavioral Therapy
Modeling
therapist provides a role model for specific behavior and the patient learns through imitation
Behavioral Therapy
Operant conditioning
behavior modification with positive reinforcement
autistic and mentally disabled
severe and persistent mental illness
Behavioral Therapy
Exposure therapy
For people who have anxiety due to fears, phobias, or traumatic memories.
Behavioral Therapy
Aversion Therapy
ETOH, paraphilic disorders, shop lifiting, aggressive behavior, aggressive, self-mutilation.
nail bitting - bitter substances on anils
controversial
Behavioral Therapy
Biofeedback
can relax muscles and reduce pain
Implications of behavioral therapy and nursing
Token economies - positive reinforcement
smoking cessation =- reducing cues to smoke
What is COGNITIVE THEORY?
Name 2 main ones
Thoughts come before feelings and actions
Rational-Emotive. and Cognitive Behavior Theory
Cognitive Theory
Rational-Emotive Theory
Albert Ellis 1955
ABC
Activating event, beliers, emotional consequences
Negative thinking. half full or half empty
cant change past change how we are now
Cognitive Behavioral Therapy
Aaron Beck 1979
CBT
active, directive, time limited structured
Depression anxiety phobias, and pain
Who is Hildegard Peplau?
mother of psychiatric nursing
framework is her book Interpersonal Relations in Nursing
established the foundation for professional practice of psych nursing
first nurse identify psych nursing as essential to gen nursing and as a specialty
First nursing theorist to describe patient nursing relationships as the foundation of nursing practice
Not do to patients but WITH patients
nurses are participants and observers
sullivan’s theory of anxiety and its application to perception and learning
Peplau More
1909-1999
Rutgers 20 years
interview techniques grad education importance
summer workshops in state hospitals
Peplau’s Phases
Pre Orientation - prior to meeting. self-awareness
Orientation - rapport, formal and informal contract mutual
problem solving, genuineness
Working Phase - gather date facilitate change, goals
Termination phase - final summarize goals objectives, exchange memories, incorporate into daily living.
