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Psychosocial > PsySoc Week 1 > Flashcards

PsySoc Week 1 Flashcards

1
Q

Denial

A

Denial is the refusal to accept reality or fact, acting as if a painful event, thought or feeling did not exist

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2
Q

Regression

A

reverting to an earlier stage of development in the face of unacceptable thoughts or impulses

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3
Q

Acting out

A
  • performing an extreme behavior to express thoughts or feelings the person feels incapable of otherwise expressing.
  • Can serve as a pressure release.
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4
Q

Dissociation

A
  • when a person loses track of time and/or person, and instead finds another representation of him or herself to continue in the moment.
  • People who have a hx of any kind of childhood abuse often suffer from some form of dissociation.
  • Can lead to ‘multiple personality’ d/o.
  • Have a disconnected view of themselves in their world.
  • Time and their own self-image may not flow continuously.
  • In this way, a person who dissociates can ‘disconnect’ from the real world for a time, and live in a world not cluttered with thoughts, feelings or memories that are unbearable.
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5
Q

Compartmentalization

A
  • a lesser form of dissociation, wherein parts of oneself are separated from awareness of other parts and behaving as if one had separate sets of values.
  • An example might be an honest person who cheats on his or her income tax return and keeps their two value systems distinct and unintegrated while remaining unconscious of the cognitive dissonance.
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6
Q

Projection

A

-projecting a person’s undesired thoughts, feelings or impulses onto another person
who does not have those thoughts, feelings or impulses
-Often the result of a lack of insight and acknowledgement of one’s own motivations and feelings.

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7
Q

Reaction formation

A

-converting unwanted or dangerous thoughts, feelings or impulses into their opposites.

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8
Q

Repression

A

-the UNCONSCIOUS blocking of unacceptable thoughts, feelings and impulses

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9
Q

Displacement

A

the redirecting of thoughts, feelings, and impulses directed at one person or object, but taken out upon another persons or object. People often use displacement when they cannot express their feelings in a safe manner to the person at which they are directed.

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10
Q

Intellectualization

A
  • the overemphasis on thinking when confronted with an unacceptable impulse, situation or behavior without employing any emotions whatsoever to help mediate and place the thoughts into an emotional, human context
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11
Q

Rationalization

A
  • putting something into a different light or offering a different explanation for one’s
    perceptions or behaviors in the face of a changing reality.
    -“He was a loser all along.”
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12
Q

Undoing

A

-the attempt to take back an unconscious behavior or thought that is unacceptable or hurtful

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13
Q

Sublimation

A
  • the channeling of unacceptable impulses, thoughts, and emotions into more acceptable ones.
  • It can be done with humor or fantasy.
  • Humor when used as a defense mechanism is the channeling of unacceptable impulses or thoughts into a light-hearted story or joke.
  • Humor reduces the intensity of a situation, and places a cushion of laughter between the person and the impulses
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14
Q

Compensation

A
  • a process of psychologically counter-balancing perceived weaknesses by emphasizing strength in other arenas.
  • By focusing on one’s strengths, a person is recognizing the cannot be strong at all things and in all areas in their lives.
  • “I may not know how to cook, but I can sure do the dishes!”
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15
Q

Assertiveness

A
  • the emphasis of a person’s needs or thoughts in a manner that is respectful, direct and firm.
  • Becoming more assertive is one of the most desired communication skills and helpful defense mechanisms most people want to learn, and would benefit in doing so.

-PAY ATTENTION HERE! YOU WILL NEED TO TEACH ASSERTIVENESS SKILLS TO MANY OF YOUR PATIENTS/CLIENTS!!!!

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16
Q

Primitive Defense Mechanisms

A
  1. Denial
  2. Regression
  3. Acting out
  4. Dissociation
  5. Compartmentalization
  6. Projection
  7. Reaction formation
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17
Q

Less Primitive, More Mature Defense Mechanisms

A
  1. Repression
  2. Displacement
  3. Intellectualization
  4. Rationalization
  5. Undoing
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18
Q

Mature Defense Mechanisms

A

-Mature defense mechanisms are often the most constructive and helpful to most adults, but may require practice and effort to put into daily use.

  1. Sublimation
  2. Compensation
  3. Assertiveness
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19
Q

Mental Illness

A
  • refers collectively to all diagnosable mental disorders.
  • Effects of the illnesses include sustained abnormal alterations in thinking, mood, or behavior associated with distress and impaired functioning.
  • The effects of mental illnesses include disruptions of daily function; incapacitating personal, social, and occupational impairment; and premature death.
  • Mental illness is associated with increased occurrence of chronic diseases such as cardiovascular disease, diabetes, obesity, asthma, epilepsy, and cancer
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20
Q

Most common mental illnesses

A

Anxiety & mood disorders

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21
Q

Depression

A

-Depression estimates generally are highest in the Southeastern states

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22
Q

DSM IV Axis I

A

-Assesses individual’s presenting clinical status/condition (i.e. why did this person come to you for assistance?)
-May include CLINICAL SYNDROMES that may be focus of clinical attention, such as:
schizophrenia, GAD, MDD, substance dependence
-Axis I conditions are roughly analogous to illnesses/diseases in general medicine;
-More than one diagnosis permissible/ encouraged

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23
Q

Axis I Disorders

A
  • Substance-use disorders
  • Alzheimer’s dementia (other disorders related to irreversible destruction/ malfunction of brain tissue)
  • Anxiety disorders
  • Eating disorders
  • Psychosexual/gender-identity disorders
  • Major mood disorders
  • Schizophrenia
  • PTSD
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24
Q

DSM IV Axis II

A
  • PERSONALITY DISORDERS: longstanding personality traits (may or may not be involved in development of Axis I disorder) & Developmental Disorders (aka MR)
  • encompasses problematic ways of relating to world, such as:
  • histrionic personality disorder, paranoid personality disorder, antisocial personality disorder
  • More than one diagnosis permissible/ encouraged
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25
Q

Axis II Disorders

A
  • Personality disorders
  • Mental retardation (Developmental Disabilities)
  • Specific learning disabilities
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26
Q

DSM IV Axis III

A
  • GENERAL MEDICAL CONDITIONS potentially relevant to understanding/ managing case such as:
  • Cirrhosis, Overdose, Cocaine
  • More than one diagnosis permissible/ encouraged
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27
Q

DSM IV Axis IV

A
  • PSYCHOSOCIAL/ENVIRONMENTAL problems: STRESSORS that may contribute(d) to current disorder, particularly those that have been present during prior year
  • Checklist approach for various categories of problems:
  • family, economic, occupational, legal
  • for example: “Problems with primary support group”
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28
Q

DSM IV Axis V

A
  • GLOBAL ASSESSMENT OF FUNCTIONING: clinicians indicate how well individual is coping at present time; Scale from 1 to 100
  • 60-70 mild symptoms (depressed mood, mild insomnia, mild difficulty in social/occupatnl/school fxing)
  • 50-60 moderate symptoms (flat affect, occasional panic attacks, moderate diff. soc/occuptnl/school fxing)
  • 40-50 serious symptoms (suicidal ideation, severe obsessional rituals, serious imprmt. soc/occ/school fxing)
  • 30-40 impairment in reality testing/communicating (speech illogical/obscure/irrelevant, or maj. imprmnt soc/occ/sch)
  • 20-30 behavior considerably influenced by delucions/hallucinations (incoherent, inappropriate behv, suicidal preoccupation; inability to fx almost all areas)
  • 10-20 danger of hurting self/others (suicide attempts, violent, manic excitement, failure to maintain hygiene)
  • 1-10 persistent danger of hurting self/others, inability to maintain personal hygiene, serious suicidal attempt
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29
Q

Acute

A

used to describe disorders of relatively short duration (under 6 months)

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30
Q

Chronic

A

disorders of duration of 6 months or longer

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31
Q

Episodic/recurrent

A

used to describe unstable disorder patterns that tend to come and go, like bipolar disorder

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32
Q

Psychoanalytical theory

A
  • Based on work of Sigmund Freud in late 19th and early 20th centuries
  • Organizes personality into three parts:
  • ID
  • EGO
  • SUPEREGO
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33
Q

Id

A

– is largely unconscious; comprised of primitive drives and instincts, needs and conflicts that the ego is unable to integrate

  • Unconscious drives & instincts
  • Thinking: Primary process
  • Illogical, undisciplined, pleasure seeking
  • Dreams and unbidden thoughts
34
Q

Ego

A
  • psychological component that has contact with the external world; it functions logically and works to achieve a balance between the internal drives and the external expectations
  • The EGO developed through learned experiences in reaching compromises and applying logic and discipline in an attempt to adapt to the environment
  • EGO is where the OT Intervention is aimed
  • Conscious contact w/world
  • Thinking: Secondary process
  • Logical, works to achieve balance between internal drives and external expectations.
    - Attempts to adapt to environment
35
Q

Superego

A

– the social component of personality that serves as an individual’s moral code, his or her sense of ‘good’ and ‘bad,’ right and wrong. It is often illogical and unrealistic in its quest for idealism and perfection

  • Preconscious level
  • Thinking: Judgmental
  • Shapes a moral code, sense of right/wrong
  • Can be illogical & unrealistic about quest for perfection
  • Internalized from the culture
36
Q

Psychosexual stages

A
  • According to Freud, one’s personality is largely determined by one’s early childhood experiences
  • Psychosexual stages of development, spanning a range of 18 years from birth to maturity, are differentiated by changes in objects that potentially provide need satisfaction.
  • When needs are satisfied, the child thrives and is able to develop and move on to the next stage
  • When needs are continually frustrated, he or she develops a fixation that can remain in the unconscious and cause many problems seen in adulthood (i.e. symptoms of illness)
37
Q

Oral Stage

A

Oral Stage: Birth to 1 year

  • early – sucking;
  • late - biting
  • Theme: Trust, dependency
  • Regression: Psychosis
38
Q

Anal Stage

A
  • Anal Stage: 1-3 years
    • early – excreting;
    • late-retaining
  • Theme: Control/autonomy
  • Regression: Neurosis, character disorders
39
Q

Phallic Stage

A
  • Phallic Stage: 3-5 years
    • genital interest;
    • penis envy
  • Theme: Oedipal/Electra complex
40
Q

Latency Stage

A
  • Latency stage: 5-12 years
    • sublimation of sexual drive;
    • superego develops
  • Theme: Skill development; social role development; emergence of guilt
41
Q

Genital Stage

A
  • Genital stage: 12 to adulthood
    • Puberty; Capacity for intimacy
  • Theme: Sexual identity
    • Adult responsibility for love and work
42
Q

Remediation (recovery) vs compensation?

A
  • Remediation (Recovery): Change the person to increase the skill (increase ROM and strength)
  • Compensation: Change the environment or task or add AT to make the challenge more possible (lower height of cabinets; replace steps with ramps)
43
Q

Cognitive-behavioral FOR

A
  • This FOR is thought to be compensatory

- Use awareness and rational/sound thinking to change behavior

44
Q

Behavioral FOR

A

-Facilitate and reinforce desirable behaviors. Extinguish negative behaviors

45
Q

Psychodynamic FOR

A
  • Encourage the growth and development of a person’s ego strength
  • This theory related to the dynamics of the psyche
  • Dynamics (ever-changing actions and interactions) of the psyche (mind, soul, intellect, mental part of the self)
  • And constructs from later derivative views for EGO WORK
    • Ego psychology
    • Humanistic psychology
    • Human spirituality
    • Positive psychology
46
Q

Early psychodynamic FOR

A
  • Strands from early psychoanalytic views for ANALYSIS
    • Components of the personality
    • Drives and psychic energy
    • Defense mechanisms
  • Sigmund Freud
  • Carl Jung
47
Q

Origins of Psychoanalytic Theory

A
  • 1890s: Sigmund Freud (a neurologist) sought an effective treatment for patients with psychological symptoms.
  • Foundational belief: The existence of mental processes that are not conscious *
  • Since the time of Freud’s first work, the theory has undergone many revisions.
48
Q

Analysis of the psyche

A
  • Breaking down a construct or entity or process into its parts or components
  • Considering the elements of an entity in order to understand it better
49
Q

Psychic Energy

A
  • A finite amount of psychic energy (energy for the psyche) is shared by all three parts of the personality
  • Some people cease to function in the world (psychosis) or function poorly (neurosis) when too much energy is being used by one personality component, causing clinical symptoms.
50
Q

Signs of overactive id

A
  • Drives are in charge; no concern over harming others or self; immorality of all kinds
    • Example: Boston Marathon Bombers
51
Q

Signs of overactive superego

A
  • Person seems dominated by guilt, shame, and a press toward perfectionism
    - Example: (movie ‘Doubt’ with Meryl Streep – nun that accuses priest of child abuse)
52
Q

Drives and the components of personality

A
  • Id is the source of libidinal and aggressive drives (drives for pleasure and dominance).
  • Superego reflects external expectations and shapes moral sense, shame, and guilt
  • Ego BALANCES (or serves as moderator between) personal drives and external expectations.
53
Q

Libidinal drive: “Life force”

A
  • Sexual/pleasurable energy
  • Urge to perpetuate life, to love, to generate and/or reproduce
  • Seen in the making of relationships
54
Q

Aggressive drive: “Death force”

A
  • Hostility, hatred, urge to destroy or dominate

- Expressed in tendency to be self-sufficient and keep others at a distance

55
Q

Relationships of drives to Depression

A

Depression

  • Anger turned inward
  • Aggressive drive turned on self
56
Q

Relationships of drives to Anxiety

A

Anxiety

  • Conflict over control of psychic energy within the personality.
  • Fear that the id will take over and cause chaos
  • Fear the superego will take over and cause guilt
  • “Defense mechanisms” ward off (defend against) anxiety to protect the ego
57
Q

Unconscious thought

A
  • Knowledge/memories no longer needed
  • Shameful content that may or may never have come to consciousness
  • Perceptions/memories too difficult for ego to handle: abuse as a child
  • Exerts a powerful force on behavior
58
Q

Preconscious thought

A

-Not in current awareness but can be recalled easily.

59
Q

Conscious thought

A

-Occurs in full awareness.

60
Q

Defense Mechanisms

A
  • Defense mechanisms are manners in which we behave or think in certain instances to better protect or ‘defend’ ourselves from unpleasant thoughts, feelings and behaviors.
  • Categorized by how ‘primitive’ they are. The more primitive a defense mechanism, the less effective it works over the long-term. However, they can be effective in the short-term.
  • Most defense mechanisms are unconscious; most of us don’t realize we’re using them in the moment.
61
Q

Symbols, Projections & Communication with the Unconscious

A
  • Rarely, except when psychotic, does the content of the unconscious become know.
  • Psychoanalytic therapy’s main thrust is to help an individual become aware of his or her unconscious conflicts and fixations, so that the mature ego can deal with the effectively and resolve them.
  • Awareness of unconscious material is very complex.
  • The unconscious is not organized or logical and is not remembered in words or complete thoughts.
  • Highly emotional material may take the form of symbols that represent experiences that originally produced them.
62
Q

Projective Tests

A
  • In psychology, a projective test is a personality test designed to let a person respond to ambiguous stimuli, presumably revealing hidden emotions and internal conflicts. This is sometimes contrasted with a so called “objective test” in which responses are analyzed according to a universal standard (for example, a multiple choice exam).
  • The responses are content analyzed for meaning rather than being based on presuppositions about meaning, as is the case with objective tests.
  • Drives & Fixations may surface
63
Q

Fixations

A
  • Sigmund Freud theorized that some humans may develop psychological fixation (an obsessed focus on) due to:
  • A lack of proper gratification of needs during one of the psychosexual stages of development , OR
  • Receiving a strong impression from one of these stages, in which case the person’s personality would reflect that stage throughout adult life.
  • An excessively strong manifestation of these stages can lead to a kind of partial fixation, which then constitutes a weak (or focal) point in the structure of the personality.
64
Q

Ego function

A
  • Psychiatric diagnoses (in DSM-IV-TR) give information about the strengths or limitations of the ego (adaptive and logical self).
  • Psychosis (a complete break from reality): Reflects a severely impaired ego. Neurosis indicates that one component of the personality is problematic (id or superego)
  • The more impaired the ego, the less the person can make good judgments, and the more structure we apply in OT.
  • Stress, physical illness, fatigue, use of drugs/alcohol all influence (usually reduce) ego function.
65
Q

Psychoanalytic aims: Improve functional performance through the following:

A
  • Enhance functions of the ego: Balance primitive drives vs societal expectations
  • Uncover unconscious thoughts/drives (dreams, free association, projection) or conflicts to assess how these might motivate both adaptive & maladaptive behavior.
66
Q

Carl Jung

A
  • The psyche tends toward wholeness.
  • The self is composed of the ego, the personal unconscious, and the collective unconscious. The collective unconscious contains archetypes which manifest in ways particular to each individual but somehow common to the human species.
  • Archetypes are human energies and patterns of thought and action. They give the psyche its dynamic properties and help organize it. Their effects can be seen in many forms and across cultures.
67
Q

JUNG’s Archetypes: The deepest elements of ourselves

A
  • THE SHADOW embodies chaos and wildness of character. The dark side of ourselves.
  • THE ANIMA is the feminine soul in a man’s psyche.
  • THE ANIMUS is the masculine soul in a woman’s psyche.
  • THE SELF includes not just “me” but “God in me.” There is a part of self that connects to the universe- and is the representative of “wholeness.”
68
Q

Carl Jung’s contributions

A
  • Recognition of the spiritual dimension of the human psyche.
  • Dream work is important in Jungian psychology. Recognition of the role of images that spontaneously arise in the human psyche to communicate the dynamic processes taking place in the personal and collective unconscious, images which can be used to help the ego move in the direction of psychic wholeness.
  • Recognition that there are several different organizing principles within the psyche, and that they are at times in conflict.
69
Q

Images

A
  • Carl Jung saw the mandala as “a representation of the unconscious self,” and believed that paintings of mandalas enabled him to identify emotional disorders and work towards wholeness in personality.
70
Q

Ego Psychology: More modern psychodynamic thought

A
  • Foundations in psychoanalytic theory
  • Focus on conscious, rather than unconscious aspects of personality/self
  • The ego is the motivating force for change
71
Q

Functions of the ego: Areas for OT Intervention

A
  • Reality testing
  • Judgment
  • Sense of self
  • Self-control
  • Object relations
  • Thought processes
  • Adaptive regression
  • Defensive functioning
  • Stimulus barrier
  • Autonomous functioning
  • Synthetic integrative functioning
  • Mastery/competence
72
Q

Functions of the ego: Reality testing

A
  • Ability to grasp reality and differentiate between internal needs/perceptions and reality and external expectations.
    • Client can identify and use environmental and societal input in order to learn about the world and adapt.
    • Client understands when personal perceptions differ from the “norm”
  • Ability to relate to others about a common reality
    • Client can benefit from the feedback of others.
    • Client can take a second look at reality when given differing views.
73
Q

OT & Reality Testing

A
  • OT provides life experiences that offer the client input about reality.
    • Client gets to “test” reality by doing things
  • OT provides opportunities that offer feedback from others.
    • Client gets to understand perspectives of others.
74
Q

Functions of the ego: Judgment

A
  • Good judgment is an exercise of these processes (many of them cognitive):
  • Accurate and realistic perceptions of life challenges
  • Identification of intended behaviors and likely consequences
  • Prediction of effects of personal behaviors
  • Control of responses until options are considered
  • Understanding of what it takes to accomplish something.
75
Q

Examples of impaired judgment seen by OT

A
  • A client who is unaware of the extent of his deficits post stroke wants to go home w/out rehab and without thought of how his wife might care for someone who needs total assistance.
  • A client leaves the house in winter without wearing a coat.
  • Client with TBI walks nude down the hallway, unaware of his effect on others.
  • Child tosses a very heavy medicine ball at a frail elderly grandfather.
  • Teen brags to a group of strangers that she is driving without a license.
  • (Consequences not being considered?)
76
Q

OT interventions to develop good judgment

A
  • Increase activity/experiences that will enhance:
  • Accuracy of an individual’s perceptions
  • Understanding of the demands of various actions/activities
  • Capacity to observe effects of personal behaviors
  • Capacity to anticipate effects of actions in the world
  • Awareness of consequences of possible behaviors
77
Q

Functions of Ego: Sense of Self

A
  • Self-concept: Global understanding or idea of one’s self, traits, personality, identity. Includes sense of self-efficacy or how effective one believes that one is.
  • Body image: Perception of the physical self.
    - Can be distorted by illness
  • Self-esteem: How one feels about one’s self, identity, abilities, qualities. Self-worth is a synonym.
78
Q

Functions of the ego: Self Control (of drives and impulses)

A
  • Drives for pleasure. Drives for dominance.
  • Addictions (eating, gambling, substance abuse, sex, smoking)
  • Aggression, verbal, emotional, and physical (road rage, animal abuse)
  • Illnesses such as pyromania, kleptomania
  • Social problems such as juvenile delinquency, domestic or school violence, bullying
  • Self-destructive behaviors (cutting, trichotillomania)
79
Q

Functions of the ego: Object relations

A
  • Development of relationships (people and productive work)
    • Object relations theory: People develop attachments to other persons (parents first) and objects in order to meet needs and satisfy drives.
  • Attachment theories: Parent-infant bond is the basis for all later relationships with people
  • Freud: Adequate object relations are foundational to an individual’s capacity to love and work.
80
Q

OT and object relations

A

A blend of:

  • Interpersonal work
    • Social skills training through psycho-educational approaches and activities
      • Nurturing a plant or animal
      • Developmental groups (movement from parallel to mature)
  • Empathy development: Group activities, role playing, games, use of stories, artwork

Productive work

  • Work-related exercises:
    • Values clarification, interest checklists, skills assessment
    • Skills training: teambuilding, conflict resolution, perf skills

Psychosocial (2 decks)

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