Module 1E: Pychology Flashcards
Erik Erikson
Psychologist who developed the concepts of stages of life based on a person’s age.
Erikson believed that society and culture affect how the personality of an individual develops and that successful completion of each stage supports the healthy development of the person’s ego.
Erik Erikson’s 8 Stages of Development
The eight stages of development offer a guideline for identifying the psychosocial challenges patients face at different periods in their lives and the tasks they must master before successfully transitioning to the next stage of development.
- Trust vs. Mistrust
- Autonomy vs. Shame and Doubt
- Initiative vs. Guilt
- Industry vs. Inferiority
- Identity vs. Role Confusion
- Intimacy vs. Isolation
- Generativity vs. Stagnation
- Ego Integrity vs. Despair
Trust vs. Mistrust
Stage 1: Psychosocial crisis for infants.
- Successful outcome: trust
- Unsuccessful outcome: mistrust
The developmental tasks for infants are to form an attachment with and develop trust in their primary caregiver and then generalize those bonds to others. They also begin to trust their own body as they learn gross and then fine motor skills.
Autonomy vs. Shame and Doubt
Stage 2: Psychosocial crisis for toddlers.
- Successful outcome: autonomy
- Unsuccessful outcome: shame and doubt
During this stage, toddlers begin to develop a sense of independence, autonomy, and self-control. They also acquire language skills. Parents should be firm but tolerant with toddlers.
Initiative vs. Guilt
Stage 3: Psychosocial crisis for preschoolers.
- Successful outcome: Initiative
- Unsuccessful outcome: Guilt
During this stage, children look for new experiences but will hesitate when adults reprimand them or restrict them from trying new things. Preschoolers have an active imagination and are curious about everything around them. Eventually they will start feeling guilt for some of their actions, which is part of the natural development of moral judgment.
Industry vs. Inferiority
Stage 4: Psychosocial crisis for school-age children
- Successful outcome: Industry
- Unsuccessful outcome: Inferiority
During this stage, children need to receive recognition for accomplishments to provide reinforcement and build self-confidence. If the achievements are met with a negative response, inferiority can be established. Children require acknowledgment of their successes.
Identity vs. Role Confusion
Stage 5: Psychosocial crisis for adolescents
- Successful outcome: Identity
- Unsuccessful outcome: Role connection
During identify vs. role confusion, adolescents try to figure out where they fit in and what direction their life should take. If role confusion sets in, adolescents become followers, which can lead to poor decision-making
Intimacy vs. Isolation
Stage 6: Psychosocial crisis for young adults
- Successful outcome: Intimacy
- Unsuccessful outcome: Isolation
During this stage, young adults begin to think about partnership, marriage, family, and career. Lack of fulfillment in this key area of life can lead to isolation and withdrawal.
Generativity vs. Stagnation
Stage 7: Psychosocial crisis for middle adults
- Successful outcome: Generativity
- Unsuccessful outcome: Stagnation
During this stage, adults continue raising children, and some become grandparents. They want to help mold future generations, so they often involve themselves in teaching, coaching, writing, and social activism.
Ego Integrity vs. Despair
Stage 8: Psychosocial crisis for older adults
- Successful outcome: Ego Integrity
- Unsuccessful outcome: Despair
During this stage, most adults retire; their children, if they have any, no longer live at home. Many will volunteer to retain a feeling of usefulness. Their bodies experience age-related changes, and health becomes a major concern, especially as friends and loved ones die.
Mental Health
Refers to a person’s cognitive abilities, behaviors, and emotions.
There are over 300 recognized mental illnesses
Can be caused by:
- biological issues (such as genetics)
- environmental issues (such as learned behaviors, poor coping mechanisms, traumatic experiences)
- or a combination of both.
Depression
Mood disorder that can be caused by a chemical imbalance in the brain
Signs and Symptoms: Extreme sadness, fatigue, lethargy, hopelessness, pain, digestive issues, extreme lack of motivation (even with activities and hobbies that previously were enjoyable), thoughts of suicide
Treatment: Typically managed best with a combination of therapy, healthy lifestyle, and medication
Attention-deficit/hyperactivity disorder (ADHD)
Chronic condition that typically begins in childhood but can impact individuals throughout their life
Signs and Symptoms:
- Inattention in which the individual struggles to regulate attention and focus, making it difficult to follow directions and stay organized
- Hyperactivity and impulsivity can present as constant fidgeting, excessive talking, and struggling with quiet activities.
- More commonly diagnosed in boys
Treatment: Medications and behavior therapies
Anxiety
Disorders that lead to extreme feelings of worry and fear, to the point that the person’s ability to function and respond to typical situations is inhibited
Signs and Symptoms: Uncontrolled levels of stress, fast heart rate, sweating, and being consumed by worry
Treatment: Therapy, healthy lifestyle, and medication
Post-traumatic stress disorder (PTSD)
A condition resulting from a traumatic or terrifying event
- Not everyone who experiences a traumatic event will develop PTSD.
- War veterans; people who have experienced physical, emotional, or sexual abuse; people who have lived through an attack or natural disaster; and those who have lost a loved one might experience PTSD.
Signs and Symptoms: Intrusive memories (such as flashbacks to the event), negative changes (negative thoughts and hopelessness), changes in reactions (new and potentially aggressive behaviors), trouble with concentration and sleep, self-destructive behaviors, and avoidance (avoiding places, people, or experiences associated with the negative event; avoiding loved ones; avoidance of discussing the event)
Treatment: Psychotherapy, exposure therapy, and medication
Stressor
Anything that causes anxiety or stress.
Many things in the environment cause stress, as do psychological factors (grief, depression, loss, guilt). Even things that are positive (taking a vacation, having an intimate experience, graduating from college) can be stressors.
Environmental Stressors
(aka physical stressors) Are situations that cause enough stress to become obstacles to achieving goals or having positive experiences.
EX:
- Things in the environment: air pollution, ultraviolet rays from excessive sun exposure, overcrowding, language and cultural barriers, discrimination
- Events in the environment: death of a loved one, theft, vandalism, motor-vehicle crashes, physical assault, job, school problems, major disasters (fires, floods, tornadoes, earthquakes, hurricanes, war
Socioeconomic Stressors
Financial stress
EX: retirement, changes in the economy that lead to a loss of investments, identity theft, lack of job security, involuntary job loss (getting fired), or the loss of a home or vehicle.
Why do similar stressors affect people differently?
The mind interprets the severity of the situation and helps the person cope with it in a positive way. People deal with the stressor based on their perception, experience, and resources they have available to them.
Communication Practices with Developmental Delays
- When working with patients who have mental or emotional disabilities determine how they communicate and what level of communication they understand.
- Always address the patient first. Family members and caregivers can assist with this, but do not assume the patient is incapable of communicating.
- Remain calm, avoid showing impatience, and speak at a consistent volume.
- Any time you cannot understand something the patient says, ask for clarification.
- Advocate for patients and always treat them with respect and empathy.
- Provide accommodations to meet patients’ needs and ask how to assist during their visit.
Communication Practices with Chronic Illiness
- Casual, routine opening lines like an excessively cheerful “How are you doing today?” can provoke defensive responses like, “How do you think I’m doing? I’m dying.” Even if the patient doesn’t say that, they might think it. Instead, welcome these patients warmly and respect their dignity. Treat them with kindness and care at all times.
- Offer support and empathy, and allow the patient to set the tone of the conversation. Never say you know how the patient feels. All feelings are unique to the individual, so to express this belittles the person and shows a lack of respect for their individuality.
- Listen carefully to the patient, maintain eye contact, and always ask how to help.
- Prior to beginning medical data collection, use a broad opening like, “What would you like to talk about today?” How the patient answers will help set the tone for the remainder of the interaction.
- Make sure the patient has all the services they need, such as hospice referrals, meal-delivery services, and home health assistance. Support groups and community services can also help; these services can provide social experiences and an outlet for dying patients and their families.
Communication Practices with Physical Disabilities
Provide physical space and remove barriers for those in a wheel chair
Vision loss: provide Braille signs and reading materials along with large-print materials. Use descriptive language when speaking with these patients and avoid touching without verbally alerting the patient first.
Hearing loss: offer services such as online appointment scheduling. Patients might be able to communicate well in person but have considerable difficulty hearing and understanding speech on the telephone, making scheduling difficult. Stand directly in line with the patient’s face when speaking, not from the side or behind them. Pronounce words clearly to allow the individual to see lip movements as well as hear what is said. Do not shout. Clarity of speech is much more important in facilitating understanding. If a sign-language interpreter is requested, by federal law, the office must provide an interpreter.
Defense Mechanisms
Coping strategies people use to protect themselves from negative emotions such as guilt, anxiety, fear, and shame.
- Can be adaptive and help the individual change or adjust as they come to terms with the stressor.
- Maladaptive defense mechanisms hinder change and adjustment.
Apathy
Indifference; lack of interest, feeling, concern, or emotion
Ex: “I don’t care what she puts in my evaluation, it won’t change anything.”
Compensation
Balancing a failure or inadequacy with an accomplishment
Ex: “I ate a lot of candy yesterday, but I also ate a big green salad.”
Conversion
Transformation of an anxiety into a physical symptom that has no cause
Ex: “I get a severe headache every time I see my ex with his new wife.”
Denial
Avoidance of unpleasant or anxiety-provoking situations or ideas by rejecting them or ignoring their existence
Ex: “I am healthy and fit. There is no way I have cancer, so I don’t need all those tests.”
Displacement
Redirection of emotions away from the original subject or object onto another, less-threatening subject or object
Ex: “I had enough trouble handling that last patient. I don’t need to deal with this malfunctioning copier right now.”
Dissociation
Disconnection of emotional importance from ideas or events and compartmentalizing those emotions in different parts of awareness
Ex: “I’m always getting into fights with my neighbors, which is odd because I teach an online course in conflict resolution.”
Identification
Attribution of characteristics of someone else to oneself or the imitation of another
Ex: “I could pass that certification test just like she did, and I haven’t even studied the material.”
Intellectualization
Analysis of a situation with facts and not emotions
Ex: “He didn’t break up with me because he didn’t love me. He just had too much on his plate at work at the time.”
Introjection
Adoption of the thoughts or feelings of others
Ex: “My dad says I should stand up for myself, so I am going to be more assertive.”
Physical avoidance
Keeping away from any person, place, or object that evokes memories of something unpleasant
Ex: “I can’t go to that hospital because that’s where my father died.”
Projection
Transference of a person’s unpleasant ideas and emotions onto someone or something else
Ex: “She leaves more charts incomplete than I do, so why am I getting this warning?”
Rationalization
Explanation that makes something negative or unacceptable seem justifiable or acceptable
Ex: “My partner drinks every night to make himself less anxious about work.”
Reaction formation
Belief in and expression of the opposite of one’s true feelings
Ex: “I really hate being in the military, but I always sign some people up at recruitment events.”
Regression
Reversion to an earlier, more childlike, developmental behavior
Ex: “I can’t do all that paperwork, and you can’t make me.”
Repression
Elimination of unpleasant emotions, desires, or problems from the conscious mind
Ex: “They tell me I was hurt in that robbery, but I can’t remember anything about it.”
Sarcasm
Use of words that have the opposite meaning, especially to be funny, insulting, or irritating
Ex: “You have a nice office if you like working in caves.”
Sublimation
Rechanneling unacceptable urges or drives into something constructive or acceptable
Ex: “When I was a kid, I used to like to pull wings and legs off insects I’d catch. Now I am a biology teacher.”
Suppression
Voluntary blocking of an unpleasant experience from one’s awareness
Ex: “The doctor said I need more tests, but I’m going to take my vacation first.”
Undoing
Cancelling out an unacceptable behavior with a symbolic gesture
Ex: “I had a big fight with my wife last night, but I’m going to buy her some flowers on my way home today.”
Verbal aggression
Verbal attack on a person without addressing the original intent of the conversation
Ex: “Why would you ask me that when you can’t even control your children?”
Elisabeth Kübler-Ross
Developed the five stages of grief theory as a result of her extensive experience in working with dying patients
5 Stages of Grief
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
*Not everyone grieves in the same way. While one person might navigate through the stages of grief one by one and in sequence, others can be in more than one stage simultaneously. Some might skip one or more stages. The duration of the process is also highly variable. There is no right way to grieve.
Denial
During this stage, the grieving person cannot or will not believe that the loss is happening or has happened. They might deny the existence of the illness and refuse to discuss therapeutic interventions. Thought processes reflect the idea of “No, not me.”
Support the patient without reinforcing the denial. It might help to give the patient written information about the disease and treatment options with the approval of the provider.
Anger
During this stage, the grieving person might aim feelings of hostility at others, including health care staff (because they cannot fix or cure the disease). Thought processes reflect the idea of “Why me?”
Do not take the patient’s anger personally. Instead, help them understand that becoming angry is an expected response to grief.
Bargaining
During this stage, the grieving person attempts to avoid the loss by making a deal, such as wanting to live long enough to attend a particular family occasion. The patient might also be searching for alternative solutions. They are still hoping for their previous life, or life itself, or at least a postponement of death. Thought processes reflect the idea of “Yes, me, but…”
Listen with attention and encourage the patient to continue expressing their feelings.
Depression
During this stage, the reality of the situation takes hold, and the grieving person feels sad, lonely, and helpless. For example, they might have feelings of regret and self-blame for not taking better care of themselves. They might talk openly about it or might withdraw and say nothing about it. Thought processes reflect the idea of “Yes, it’s me.”
Sit with the patient and do not put any pressure on them to share their feelings. Convey support and understanding. Referrals to a support group or for counseling can be helpful.
Acceptance
During this stage, the grieving person comes to terms with the loss and starts making plans for moving on with life despite the loss or impending loss. They are willing to try to make the best of it and formulate new goals and enjoy new relationships. If death is imminent, they will start making funeral and burial arrangements and might reach out to friends and family who have not been a part of their recent years of life. There might still be some depression, but there might also be humor and friendly interaction. Thought processes reflect the idea of “Yes, me, and I’m ready.”
Offer encouragement, support, and additional education to the patient and their family and friends during this time.
