A “pervasive and excessive need to betaken care of that leads to submissiveand clinging behaviors and fears ofseparation”(APA. 2000)
Dependent individuals want others to makedaily decision for them.They need direction and reassurance.These individuals feel inferior and cling toothers excessively.Avoiding responsibility and expressinghelplessness.
Dependent individuals also expect that ifthey perform good deeds for others, they willbe rewarded by someone doing something forthem.Passivity and concealing of sexual feelingsand anger are a means of avoiding conflict.
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENT RELATIONSHIPThe nurse slowly works on decision making with thepatient to increase responsibility for self in daily living.The patient needs assistance with managing anxietybecause it will increase as the patient assumes moreresponsibility for self.Assertiveness is an important area of the nurse’steaching.Verbalization of feelings and ways to cope with themare essential
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENT RELATIONSHIPHelping clients to identify their strengths and needs.Cognitive restructuring is a useful technique forunderstanding what lies behind negative moodsThe nurse may also need to teach problem solvingand decision making and help clients apply them todaily life.
Patients with the avoidant personality disorder aretimid, socially uncomfortable and withdrawn.They feel inadequate and are hypersensitive tocriticism.Desire relationship but need to be certain of beingliked before making social contacts.To keep their anxiety at a minimal level, theseindividuals avoid situations in which they might bedisappointed or rejected.
When interacting with someone, thisperson sounds uncertain and lacks selfconfidence and also is afraid to askquestions or speak up in public,withdraws from social support, andconveys helplessness.
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENT RELATIONSHIPThe nurse helps the patient gradually confront his orher fears.Discussing the patient’s feelings and fears beforenad after doing something that he or she is afraid to dois an essential part of the relationship.The nurse supports and directs the patient inaccomplishing small goals.Helping the patient to be assertive and developsocial skills is necessary.
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENT RELATIONSHIPBecause of the patient’s anxiety, relaxationtechniques are taught to enable the person to besuccessful in interactions.The nurse will give positive feedback to the patientfor any real success and for any attempts to engage ininteractions with others to promote self esteem.
They are perfectionist and inflexible. They are strict and often set standards forthemselves that are too high; thus their work isnever good enough. They are preoccupied with rules, trivial details, andprocedures. They find it difficult to express warmth or tenderemotions.
There is little give-and-take intheir interactions with others,and they are rigid, controllingand cold. They are serious about all oftheir activities, so having funor experiencing pleasure isdifficult. They are afraid of makingmistakes, they can beindecisive or will put offdecisions until all the factshave been obtained.
UNIQUE CAUSES:HereditaryEarly parent-child relationshiparound issues of autonomy, controland authority.
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENT RELATIONSHIPThe nurse needs to support the patients in exploringhis or her feelings and in attempting new experiencesand situations.The nurse helps the patient with decision makingand encourage follow -through behavior.At times, there’s a need to confront the patient’sprocrastination and intellectualization.
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENT RELATIONSHIPThe nurse teaches the patient the importanceof leisure activities and exploring interests in thearea.Teaching the patient that he or she is humanand that it is all right to make mistakes helpsdecrease irrational beliefs about the necessityto be perfect.
Similar behavior characteristics as clients withmajor depression (e.g. moodiness, brooding,joylessness, pessimism) They view the pessimism as being “realistic”regardless of positive outcome in a given situation. They express persistent unhappiness,cheerlessness, and hopeless regardless of thesituation. They consider pleasure and enjoyment a sin.
They use their misery to gain the love andadmiration of others. Clients may repress or not express anger Self criticism Self esteem is quite low They prefer to follow others rather than be aleaders in any work or social situations.
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENTRELATIONSHIPAssess whether there is risk fromself harmEncouraging the client to becomeinvolved in activities or engagedwith others provides opportunitiesto interrupt the cyclical, negativethought patterns.Giving factual feedback ratherthan general praise.
Passive-aggressivepersonality disorder ischaracterized by a negativeattitude and a pervasivepattern of passive resistanceto demands for adequatesocial and occupationalperformance.APA, 2000
These clients may appear cooperative, eveningratiating, or sullen and withdrawn depending onthe circumstances Changing of moods (easily upset or offended) There is a pervasive attitude that is negative, sullen,and defeatist Clients perceive and anticipate difficulties anddisappointments where none exist Impaired in making judgment and decisions Insight is also limited; blaming others for their ownfeeling & misfortune
May complain they are misunderstood by others andmay report feeling of cheated, victimized and exploitedAvoiding responsibilitiesThey show the following traits:PessimisticProcrastinationStubbornnessIntentional inefficiencyForgetfulnessDependency
CAUSES:DOMINANT rigidfatherOral CharacterFear of rejectionwhen exhibitingaggressive behavior
TAKE NOTE: This individuals harbor feelings ofhostility but are afraid to express them due tofear of rejection and retaliation. Thus, theyexpress hostility passively. Frequently, theyagree to perform tasks they do not want toperform and subtly undermine completion ofthe tasks.
PSYCHOTHERAPEUTICMANAGEMENTNURSE-PATIENT RELATIONSHIPEncourage to express feelings directlyespecially angerHelp them examine the relationship betweenfeelings and subsequent actionsMethods such as having the client writeabout the feelings or role play are effective
Persons with this personality has rapidlychanging moods that alternate between high-spirited buoyancy alternates, and gloom andpessimism.Each mood tend to last for a week or longer andoccur for no apparent reason or identifiable cause.They manifest sign and symptoms of bipolardisorder but in subtle form.Considered a temperament that characterizesmany gifted and creative people