Personality theories and determinants of psychopathology
PRESENTED BY: ERIC F. PAZZIUAGAN, RN, MAN
Father of psychoanalysis Psychoanalytic theory: all human behavior is caused and can be explained (deterministic theory). Repressed (driven form conscious awareness) sexual impulses and desires motivate much human behavior. “Hysterical” or neurotic behaviors resulted from unresolved conflicts (childhood trauma or failure to complete task of psychosexual development).
Id: part of one’s nature that reflects basic innate desires such as pleasure- seeking behavior, aggression and sexual impulses. Seeks instant gratification, causes impulsive unthinking behavior, and has no regard for rules or social convention. Superego: part of the person’s nature that reflects moral and ethical concepts, values, and parental and social expectations.
Ego: balancing or mediating force between the id and the superego. Represents mature and adaptive behavior that allows a person to function successfully in the world. Anxiety: results from the ego’s attempts to balance impulsive instincts of the id with the stringent rules of the superego.
Conscious: refers to the perceptions, thoughts, and emotions that exist in the person’s awareness, such as being aware of happy feelings or thinking about a loved one. Preconscious: thoughts and emotions are not currently in the person’s awareness, but he or she can recall them with some effort- an adult remembering what he or she did, thought or felt as a child.
Unconscious: realm of thoughts and feelings that motivate a person even though he or she is totally unaware of them. Includes most defence mechanisms and some instinctual drives or motivation. The person represses into the unconsciousness the memory of traumatic events that are too painful to remember.
Much of what we think and say is motivated subconscious thoughts or feelings (those in the preconscious or unconscious level of awareness). Freudian slip: slips of the tongue ▪ Example, saying “You look portly today” to an overweight friend instead of saying “You look pretty today.”
Sexual energy, termed libido, was the driving force of human behavior. Psychopathology results when a person has difficulty making the transition from one stage to the next or when a person remains stalled at a particular stage or regresses to an earlier stage.
Phase Age FocusOral Birth to 18 Major site of tension and gratification is months the mouth, lips and tongue; includes biting and sucking activities. Id is present at birth. Ego develops gradually from rudimentary structure present at birth.Anal 18-36 months Anus and surrounding area are major source of interest. Voluntary sphincter control (toilet training is acquired).
Phase Age FocusPhallic/ 3-5 years Genital is the focus of interest, stimulationoedipal and excitement. Penis is organ of interest for both sexes. Masturbation is common. Penis envy is seen in girls; oedipus complex (wish to marry opposite- sex parent and be rid of same-sex parents is seen in boys and girls.Latency 5-11 or 13 Resolution of oedipal complex. years Sexual drive are channelled into socially appropriate activities such as school work and sports. Formation of the superego. Final stages of psychosexual development.
Phase Age FocusGenital 11- 13 years Begins with puberty and the biologic capacity for orgasm; involves the capacity for true intimacy.
Methods of attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings or events. Most defense mechanisms operate at the unconscious level of awareness, so people are not aware of what they are doing and often need help to see the reality.
Compensation Overachievement in one area to offset real or perceived deficiencies in another area. •Napoleon complex: diminutive man becoming emperor. •Nurse with low self-esteem working double shifts so that supervisor will like her.Conversion Expression of emotional conflict through the development of physical symptom , usually sensorimotor in nature. •Teenager forbidden to see X-rated movies is tempted to do so by friends and develops blindness, and the teenager is unconcerned about the loss of sight.Denial Failure to acknowledge an unbearable condition; failure to admit the reality of the situation or how one enables the problem to continue. •Diabetic person eating chocolate candy. •Spending money freely when broke. •Waiting 3 days to seek help for abdominal pain.
Displacement Ventilation of intense feelings toward persons less threatening than the one who aroused the feeling. •Person who is mad at the boss yells at his spouse. •Child who is harassed by a bully at school mistreats a younger sibling.Dissociation Dealing with emotional conflict a temporary alteration in conscious or identity. •Amnesia that prevents recall of yesterday’s auto incident. •Adult remembers nothing of sexual abuse.Fixation Immobilization of a portion of the personality resulting from unsuccessful completion of tasks in a developmental stage. •Never learning to delay gratification. •Lack of a clear sense of identity as an adult.Identification Modelling actions and opinions of influential others while searching for identity, or aspiring to reach a personal, social, or occupational goal. •Nursing student becomes a critical care nurse because this is the specialty of an instructor she admires.
Intellectualization Separation of emotions of a painful event or situation from the facts involved; acknowledging the facts but not the emotions. •A person shows no emotional emotion when discussing serious car accidents.Introjection Accepting another person’s attitudes, beliefs, and values as one’s own. •Person who dislikes guns becomes an avid hunter just like best friend.Projection Unconscious blaming of unacceptable inclinations or thoughts on an external object. •Man who has thought about same-sex relationships, but never had one, beats a person who is gay. •Person with many prejudices loudly identify others as bigots.Rationalization Excusing own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self- esteem. •Student blames failure on teacher being mean. •Man says he beats his wife because she doesn’t listen to him.
Reaction formation Acting the opposite of what thinks or feels. •Woman who never wanted to have children becomes a supermom. •Person who despises the boss tells everyone what a great boss she is.Regression Moving back to a previous developmental stage to feel safe or have needs met. •Five- year old asks for a bottle when new baby brother is fed. •Man puts like a 4-year old is he is not the center of his girlfriend’s attention.Repression Excluding emotionally painful or anxiety- provoking thoughts and feelings from conscious awareness. •Woman has no memory of mugging she suffered yesterday. •Woman has no memory before age 7, when she was removed from abusive parents.Resistance Overt or covert antagonism toward remembering or processing anxiety-producing information. •Nurse is too busy with tasks to spend time with talking to a dying patient. •Person attends court-ordered treatment for alcoholism but refuses to participate.
Sublimation Substituting a socially acceptable activity for an impulse that is unacceptable. •Person who quits smoking sucks on hard candy when the urge to smoke arises. •Person who goes for a 15-minute walk when tempted to eat junk food.Substitution Replacing the desired gratification with one that is more readily available. •Woman who would like to have her own children opens a day dare center.Suppression Conscious exclusion of unacceptable thoughts and feelings from conscious awareness. •Student decides not to think about parent’s illness to study for a test. •Woman tells a friend she cannot think about her son’s death now.Undoing Exhibiting acceptable behavior to make up for or negate acceptable behavior. •Person who cheats on a spouse brings the spouse a bouquet of roses. •Man who is ruthless in business donates a large amount of money to charity.
Extended Freud’s work on personality development across the lifespan while focusing on social and psychological development in the life stages. Described eight stages of development. In each stage, the person must complete a life task essential to or her well-being and mental health.
Each stage is dependent on completion of the previous stage and life task. Tasks allow persons to achieve life’s virtues: Hope Purpose Fidelity Love Caring Wisdom
Stage Virtue TaskTrust vs. Hope Viewing the world asMistrust (infant) safe and reliable; relationships as nurturing, stable and dependable.Autonomy vs. Will Achieving a sense ofShame and control and free willdoubt (toddler)
Stage Virtue TaskInitiative vs. Guilt Purpose Beginning development(preschool) of conscience; learning to manage conflict and anxietyIndustry vs. Competence Emerging confidence inInferiority (school own abilities; takingage) pleasure in accomplishmentsIdentity vs. Role Fidelity Formulating a sense ofconfusion self and belonging
Stage Virtue TaskIntimacy vs. Love Forming adult, lovingIsolation (young relationship andadult) meaningful attachment to others.Generativity vs. Care Being creative andStagnation productive; establishing(middle adult) next generation.Ego integrity vs. Wisdom Accepting responsibilityDespair for one’s self and life.(maturity)
Explored how intelligence and cognitive functioning develop in children. Human intelligence progresses through a series of stages based on age, with the child at each successive stage demonstrating a higher level of functioning than the previous age. Biologic changes and maturation were responsible for cognitive development.
Sensorimotor- birth to 2 years: the child develops a sense of self as separate from the environment and the concept of object permanence; that is, tangible objects do not cease to exist just because they are out of sight. He or she begins to form mental images.
Preoperational- 2 to 6 years: The child develops the ability to express self with language, understands the meaning of symbolic gestures, and begins to classify objects. Concrete operations: 6 to 12 years: The child begins to apply logic thinking, understands spatiality and reversibility, and is increasing social and able to apply rules; however, thinking is still concrete.
Formal operations- 12 to 15 years and beyond: The child learns to think and reason in abstract terms, further develops logical thinking and reasoning, and achieves cognitive maturity.
Humanism: represents a significant shift away from the psychoanalytic view of the individual as a neurotic, impulse-driven person with repressed psychic problems and away from the focus on and examination of the client’s past experiences. Humanism: focuses on a person’s positive qualities, his or her capacity to change (human potential), and the promotion of self-esteem.
Humanists do consider the person’s past experiences, but they direct more attention toward the present and the future.
He studied the needs or motivations of an individual. He focused on the total person, not just on one facet of the person, and emphasized health instead of simply illness and the problems.
Basic needs at the bottom of the pyramid would dominate the person’s behavior until those needs are met, at which time the next level of needs would become dominate. Individual differences in terms of person’s motivation is not necessarily stable throughout life. Traumatic life circumstances or compromised health can cause a person to regress to a lower level of motivation.
A school of psychology that focuses on observable behaviors and what one can do externally to bring about behavior changes. It does not attempt to explain how the mind works. Believes that behavior can be changed through a system of rewards and punishments.
Classical conditioning Behavior can be changed through conditioning with external or environmental conditions or stimuli. Laboratory experiments with dogs provided the basis for the development of this theory.
Operant conditioning People learn their behavior from their history or past experiences, particularly those experiences that were repeatedly reinforced. Behavior is only that which could be observed, studied and learned or unlearned.
All behavior is learned. Consequences result from behavior- broadly speaking, reward and punishment. Positive reinforcers that follow a behavior increase the likelihood that the behavior will recur. Negative reinforcers that are removed after a behavior increase the likelihood that the behavior will recur.
Continuous reinforcement (a reward every time the behavior occurs) is the fastest way to increase that behavior, but the behavior will not last long after the reward ceases. Random intermittent reinforcement (an occasional reward for the desired behavior) is slower to produce an increase in the behavior, but the behavior continues after the reward ceases.
One’s personality involves more than individual characteristics, particularly how one interacts with others. Inadequate or nonsatisfying relationships produce anxiety, which is the basis for all emotional problems.
Stage Ages FocusInfancy Birth to onset Primary need exists for bodily contact and of language tenderness. Prototaxic mode dominates (no relation between experiences). Primary zones are oral and anal. If needs are met, infant has sense of well- being; unmet needs lead to dread and anxiety.Childhood Language to 5 Parents are viewed as source of praise and years acceptance. Shift to parataxic mode: experiences are connected in sequence to each other. Primary zone is anal. Gratification leads to positive self-esteem. Moderate anxiety leads to uncertainty and insecurity; severe anxiety results in self-defeating patterns of behavior.
Stage Ages FocusJuvenile 5-8 years Shift to syntaxic mode begins (thinking about self and others based on analysis of experiences in a variety of situations). Opportunities for approval and acceptance of others. Learn to negotiate own needs. Severe anxiety may result in need to control or in restrictive, prejudicial attitudes.Preadolescence 8- 12 Move to genuine intimacy with friend of the same sex. years Move away from family as source of satisfaction in relationships. Major shift to syntaxic mode occurs. Capacity for attachment, love, and collaboration emerges or fails to develop.Adolescence Puberty Lust is added to interpersonal equation. to Need for special sharing relationship shifts to the opposite adulthood sex. New opportunities for social experimentation lead to consolidation of self- esteem or self- ridicule. In the self-esteem is intact, areas of concern expand to include values, ideals, career decisions, and social concerns.
Therapeutic Nurse-Patient Relationship Four phases: Orientation phase: directed by the nurse; engaging the client in treatment, providing explanations and information, and answering questions. Identification phase: the client works interdependently with the nurse, expresses feelings, and begins to feel stronger. Exploitation phase: client makes full use of the services offered. Resolution phase: client no longer needs professional services and gives up dependent behavior; relationship ends.
Stage TasksOrientation Patient’s problems and needs are clarified. Patient asks questions. Hospital routines and expectations are explained. Patient harnesses energy toward meeting problems. Patient’s full participation is elicited.Identification Patient responds to persons he or she perceives as helpful. Patient feels stronger. Patient expresses feelings. Interdependent work with the nurse occurs. Roles of both patient and nurse are classified.
Stage TasksExploitation Patient makes full use of available services. Goals such as returning home and returning to work emerge. Patient’s behaviors fluctuate between dependence and independence.Resolution Patient gives up dependent behavior. Services are no longer needed by the patient. Patient assumes power to meet own needs, set new goals, and so forth.
Stranger: offering the client the same acceptance and courtesy that the nurse would do to any stranger. Resource person: providing specific answers to questions within a larger context. Teacher: helping the client to learn formally or informally. Leader: offering direction to the client or the group.
Surrogate: serving as a substitute for another such as a parent or a sibling. Counselor: promoting experiences leading to health for the client such as expression of feelings. Others: consultant, tutor, safety agent, medicator, administrator, observer, and researcher.
The eclectic theorists hold to the fact that no one theory of personality can encompass each and every person. The Eclectic theorist believe in a synergistic personality theory. Synergism in the case of personality theory, is the belief that no one theory is entirely correct. It takes two or more theories to produce what one, by itself, cannot produce.
Cave believes that birth order is significant to the developing personality. The Psychosexual and the Psychosocial stages are believed to be significant to the persons emerging personality. A balance is sought between the two. Love and acceptance are the cornerstone of personality development. These supersede Maslows safety needs as foundational for development. Self-Actualization and The Psychospiritual model suggest that in order to be self-actualized a person must explore their spiritual nature and fill the void of worship.
Man has a natural void in his life that he cannot fill with the greatest upbringing, environment, and perspective on life. The void is a place designated for worship. To be self-actualized, according to Cave, a person must be able to respond to this natural void through relationship with God. With this self-actualization comes the knowledge that we are just creatures, we are