chapter 3 Flashcards

1
Q

Denial

A

Unconscious refusal to admit an unacceptable idea or behavior.

ex: Mr. Davis, who is alcohol-dependent, believes that he can control his drinking if he so desires.

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2
Q

Repression

A

Unconscious and involuntary forgetting of painful ideas, events, and conflicts.

ex: Ms. Young, a victim of incest, no longer remembers the reason she always hated the uncle who molested her.

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3
Q

Suppression

A

Conscious exclusion from awareness anxiety-producing feelings, ideas, and situations

ex: Ms. Ames states to the nurse that she is not ready to talk about her recent divorce.

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4
Q

Rationalization

A

Conscious or unconscious attempts to make or prove that one’s feelings or behaviors are justifiable

ex: Mr. Jones, diagnosed with schizophrenia, states that he cannot go to work because his co-workers are mean, instead of admitting that his illness interferes with working.

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5
Q

Intellectualization

A

Consciously or unconsciously using only logical explanations without feelings or an affective component

ex: Ms. Mann talks about her son’s death from cancer as being merciful and shows no signs of her sadness and anger.

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6
Q

Dissociation

A

The unconscious separation of painful feelings and emotions from an unacceptable idea, situation, or object

ex: Ms. Adams recalls that when she was sexually molested as a child, she felt as if she were outside of her body watching what was happening without feeling anything.

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7
Q

Identification

A

Conscious or unconscious attempt to model oneself after a respected person

ex: Ms. Kelly states to the nurse, “When I get out of the hospital, I want to be a nurse just like you.”

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8
Q

Introjection

A

Unconsciously incorporating values and attitudes of others as if they were your own

ex: Without realizing it, Mr. Chad wishes, talks, and acts similarly to his therapist, analyzing other patients.

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9
Q

compensation

A

Consciously covering up for a weakness by overemphasizing or making up a desirable trait

ex: Mr. Hahn, who is depressed and unable to share his feelings with other patients, writes and becomes known for his expressive poetry.

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10
Q

sublimation

A

Consciously or unconsciously channeling instinctual drives into acceptable activities

ex: Mr. Smith, a former perpetrator of incest who fears relapse, forms a local chapter of Sex Addicts Anonymous.

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11
Q

Reaction formation

A

A conscious behavior that is the exact opposite of an unconscious feeling

ex: Ms. Wren, who unconsciously wishes her mother were dead, continuously tells staff that her mother is wonderful.

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12
Q

Undoing

A

Consciously doing something to counteract or make up for a transgression or wrongdoing

ex: After accidentally eating another patient’s cookies, Ms. Donnelly apologizes to the patients, cleans the refrigerator, and labels everyone’s snack with their names.

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13
Q

Displacement

A

Unconsciously discharging pent-up feelings to a less threatening object

ex: A husband comes home after a bad day at work and yells at his wife

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14
Q

projection

A

Unconsciously (or consciously) blaming someone else for one’s difficulties or placing one’s unethical desires on someone else

ex: An adolescent comes home late from a dance and states that her date would not bring her home on time.

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15
Q

conversion

A

The unconscious expression of intrapsychic conflict symbolically through physical symptoms

ex: A student awakens with a migraine headache the morning of a final examination and feels too ill to take the test. She does not realize that 2 hours of cramming left her unprepared.

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16
Q

Regression

A

Unconscious return to an earlier and more comfortable developmental level

ex: A 6-year-old child has been wetting the bed at night since the birth of his baby sister

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17
Q

id

A

Personality process that wants to experience only pleasure; is impulsive and without morals.

18
Q

ego

A

Personality process that focuses on reality, while striving to meet the needs of the id. The ego experiences anxiety and uses defense mechanisms for protection.

19
Q

superego

A

Psychoanalytic structure of the mind equivalent to the conscience (sense of right and wrong). It develops in early childhood and provides the ego with an inner control to help cope with the id.

20
Q

consciouseness

A

small area; a state of awareness

21
Q

unconsciousness

A

large area; consist of 1. memories 2. conflicts 3. experiences 5. repressed material

22
Q

preconciousness

A

memories that can be recalled to consciousness w/ some effort

23
Q

reality anxiety

A

stemming from an external real threat

24
Q

neurotic anxiety

A

dealing w/ the fear that instincts will cause a person to do something to invite punishment

ex: being promiscuous

25
Q

moral anxiety

A

guilt experienced when an individual acts contrary to his or her conscience

ex: stealing money from a friend

26
Q

Psychoanalytic (Freud)

A

Individuals are motivated by unconscious desires and conflicts. Personality is developed by early childhood.

Insight into unconscious conflicts and processes

Personality reconstruction
Patient: “All women hate me.”
Immediate response: “Tell me about one woman with whom you are having trouble.”

Illness results from childhood conflicts, and ego defenses are inadequate to cope with anxiety.

Change is a process of insight.

Using free association, dream analysis, and analyses of transference and resistance

Insight-oriented response: “Tell me about your relationship with your mother.”

27
Q

Developmental (Erikson)

A

Biologic, psychological, social, and environmental factors influence personality development throughout the life cycle.

Growth involves resolution of critical tasks at each of the eight developmental stages.

Mastering developmental tasks through achievement of insight; continued development through death; analyzing developmental issues, fears, and barriers to growth to achieve insight

Patient: “I can’t do anything right. Help me.”
Immediate response: “I hear your doubt in yourself; but I did see you make a positive decision this morning.”

Lack of resolution of tasks causes incomplete development and difficulties in relationships.

Change involves reexperiencing and resolving developmental crises. Change is a process of growth.

Facilitating mastery of developmental tasks with support and problem solving

Growth-oriented response: “I can help you look at ways to develop your self-confidence.”

28
Q

Interpersonal (Sullivan, Peplau)

A

Interpersonal relationships and anxiety facilitate development of the self-system.

Development occurs in stages with changing types of relationships.

Faulty patterns of relating interfere with security and maturity.

Security operations protect against anxiety and interfere with learning.

Developing satisfactory relationships and maturity; relative freedom from the interference of anxiety; learning effective interpersonal skills

Patient: “I can’t sit still. I’m too nervous.”
Immediate response: “Let’s take a walk for a few minutes.”

Change is a process of reeducation.

Examining current interpersonal difficulties; using therapist-patient relationships as a vehicle for analyzing interpersonal processes and testing new skills; consensual validation, validation, reality testing, and reflecting positive appraisals

Reeducation response: “Let’s talk about what kind of things you get nervous about and what you can do about them.”

29
Q

Cognitive-behavioral (Beck, Ellis)

A

An individual has value simply because he or she exists.

Individuals have potential rational and irrational thinking.

Substituting rational beliefs for irrational ones

Eliminating self-defeating behaviors

Patient: “My wife makes me so angry.”
Immediate response: “What did your wife do that you didn’t like?”

Irrational beliefs produce irrational emotions and behaviors.

Increased responsibility for feelings, behaviors, and change

Change involves changing beliefs to change feelings and behaviors.

Challenging irrational beliefs; cognitive homework

Cognitive-behavioral response: “What is self-defeating about the statement you just made?”

Change is a process of rational thinking.

Role playing and testing out new behaviors

30
Q

Stress (Selye, Lazarus)

A

Stress is any positive or negative occurrence or emotion requiring a response.

Stress produces physiologic and psychological responses.

Developing effective coping mechanisms
Reducing bodily tensions

Patient: “I’m so tense, I can’t sleep.”
Immediate response: “I have a relaxation exercise I can show you.”

Inadequate handling of stress can lead to physical or mental illness, or both.

Change is a process of problem solving.

Increasing resources and social supports

Managing stress

Using biofeedback

Using relaxation training

31
Q

Problem-solving approach

A

“You’ve said you’re worried about seeing your family tomorrow. Let’s talk about what you might say to them.”

32
Q

Trust versus mistrust (0-18 mo)

A

Realistic trust of self and others

Confidence in others

Optimism and hope

Sharing openly with others

Suspiciousness or testing of others

Fear of criticism and closeness

Dissatisfaction and hostility

Denial of problems

Withdrawal from others
or
Overly trusting of others

Naive and gullible

Sharing too quickly and easily

33
Q

Autonomy versus shame and doubt (18 mo-3 yr)

A

Self-control and willpower Realistic self-concept and self-esteem

Pride and a sense of good will

Simple cooperativeness

Knowing when to give and take

Delayed gratification when necessary

Self-doubt or self-consciousness

Dependence on others for approval

Feeling of being exposed or attacked

Sense of being out of control of self and one’s life

Ritualistic behaviors

Projection of blame and one’s feelings
or
Excessive independence or defiance, grandiosity

Reckless disregard for safety of self and others

Unwillingness to ask for help

Impulsiveness or inability to wait

34
Q

Initiative versus guilt (3-5 yr)

A

An adequate conscience Initiative balanced with restraint

Appropriate social behaviors

Curiosity and exploration

Healthy competitiveness

Original and purposeful activities

Excessive guilt or embarrassment

Passivity and apathy

Avoidance of activities or pleasures

Rumination and self-pity

Assuming a role as victim or self-punishment

Reluctance to show emotions

Underachievement of potential
or
Multiple incomplete projects

Little sense of guilt for actions

Excessive expression of emotion

Labile emotions

Excessive competitiveness or showing off

35
Q

Industry versus inferiority (6-12 yr)

A

Sense of competence

Completion of projects

Pleasure in effort and effectiveness

Ability to cooperate and compromise

Identification with admired others

Sense of direction

Balance of work and play

Feeling unworthy and inadequate

Poor work history (quitting, being fired, lack of promotions, absenteeism, lack of productivity)

Inadequate problem solving and follow through on plans

Manipulation of others or violation of others’ rights

Lack of friends of the same sex
or
Overly high achieving

Perfectionistic/obsessive-compulsive

Reluctance to try new things for fear of failing

Feeling unable to gain love or affection
unless totally successful

Being a workaholic

36
Q

Identity versus role diffusion (12-18 or 20 yr)

A

Confident sense of self

Commitment to peer group values

Emotional stability

Development of personal values

Sense of having a place in society

Establishing relationship with the opposite sex

Testing out adult roles

Lack of or giving up of goals, beliefs, values, productive roles

Feelings of confusion, indecision, and alienation

Vacillation between dependence and independence

Superficial short-term relationships with opposite sex

or
Dramatic overconfidence

Acting out behaviors (including alcohol and drug use)

Seductive or “macho” behaviors

37
Q

Intimacy versus isolation (18-25 or 30 yr)

A

Ability to give and receive love

Commitments and mutuality with others

Collaboration in work and affiliations

Sacrificing for others

Responsible sexual behaviors

Commitment to career and long-term goals

Persistent aloneness or isolation

Emotional distance in all relationships

Prejudices against others

Lack of established vocation; many career changes

Seeking of intimacy through casual sexual encounters

or
Possessiveness, jealousy, abusiveness to loved ones

Dependency on parents or partner, or both

38
Q

Generative lifestyle versus stagnation or self-absorption (30-65 yr)

A

Productive, constructive, creative activity

Personal and professional growth

Parental and societal responsibilities

Self-centeredness or self-indulgence

Exaggerated concern for appearance and possessions

Lack of interest in the welfare of others

Lack of civic and professional activities or responsibilities

Loss of interest in marriage, extramarital
affairs, or both

or

Too many professional or community activities to the detriment of the family or self
Taking care of others, not oneself

39
Q

Integrity versus despair (65 yr to death)

A

Feelings of self-acceptance

Sense of dignity, worth, and importance

Adaptation to life according to limitations

Valuing one’s life

Sharing of wisdom

Exploration of philosophy of life and death

Sense of helplessness, hopelessness, worthlessness, uselessness, meaninglessness, or all of these
Withdrawal and loneliness

Regression

Focusing on past mistakes, failures, and dissatisfactions

Feeling too old to start over

Giving up on oneself and life

or
Inability to reduce amount of activities when needed

Overtaxing strength and abilities

Feeling indispensable

Acting as if life is forever

40
Q

Stage I: Alarm Reaction

A

Mobilization of the body’s defensive forces and activation of the potential for “fight or flight” (+1 to +2 anxiety)

Release of norepinephrine and epinephrine, causing vasoconstriction, increased blood pressure, and increased rate and force of cardiac contraction

Increased hormone levels

Enlargement of adrenal cortex

Marked loss of body weight

Shrinkage of the thymus, spleen, and lymph nodes

Irritation of the gastric mucosa

Increased level of alertness

Increased level of anxiety

Task-oriented, defense-oriented, inefficient, or maladaptive behavior might occur

41
Q

Stage II: Stage of Resistance

A

Optimal adaptation to stress within the person’s capabilities (+2 to +3 anxiety)

Hormone levels readjust

Reduction in activity and size of adrenal cortex

Lymph nodes return to normal size

Weight returns to normal

Increased and intensified use of coping mechanisms

Tendency to rely on defense-oriented behavior

Psychosomatic symptoms develop

42
Q

Stage III: Stage of Exhaustion

A

Loss of ability to resist stress because of depletion of body resources; fight, flight, or immobilization occurs (+3 to +4 anxiety)

Decreased immune response, with suppression of T cells and atrophy of thymus

Depletion of adrenal glands and hormone production

Weight loss

Enlargement of lymph nodes and dysfunction of lymphatic system

If exposure to stressor continues, cardiac failure, renal failure, or death might occur

Defense-oriented behaviors become exaggerated

Disorganization of thinking

Disorganization of personality

Sensory stimuli might be misperceived with appearance of illusion

Reality contact might be reduced with appearance of delusions or hallucinations

If exposure to stressor continues, stupor or violence might occur