EXISTENTIAL & PSYCHOANALYTICAL MODEL IN PSYCHIATRY

1. CONCEPTUAL MODELS
EXISTENTIAL MODEL &
PSYCHOANALYTICAL MODEL
PREPARED BY
Mrs. Divya Pancholi
M.Sc. (Psychiatric Nursing)
Assistant Professor
SSRCN, Vapi

2. INTRODUCTION
‘Model is an organized complex
body of knowledge such as
concepts related to human
behavior.’

3. The recognized conceptual models that are
used in psychiatric nursing are:
Medical model
Nursing model
Statistical model
Communication model
Social model
Existential model
Psychoanalytical model
Behavioral model
Interpersonal model

4. TERMINOLOGY
THEORY- A theory is a set of concepts, definitions,
relationships and assumptions or propositions that
project/explain a systematic view of phenomena.
The theory explains how these elements are uniquely
related in the phenomena.
CONCEPTS- Mental formulations of an object or an
event which will come from individual perceptual
experience, e.g. ideas, mental images, etc. which
describes phenomena.

5. CONTI…
DEFINITION- It conveys the general meaning of the
concepts in a manner that fits the theory. It also
describes the activity necessary to measure the
constructs, relationships or variables.
ASSUMPTIONS- Statements that describes factual
concepts, statements that determine the nature,
definitions, purpose, relationships and structure of the
theory.
PHENOMENON- Aspects of reality that can be
consciously sensed or experienced, phenomena are apart
of the domain of discipline.

6. 1. EXISTENTIAL MODEL
Satre, Heidegger and Kierkegaard are
the philosophers of existential model.
The theory focuses on person’s present
experience provide less attention to the
person’s past.

7. EXISTENTIAL VIEW OF BEHAVIORAL
DEVIATION
Behavior deviations will occur
If the individual is out of touch with him or
his environment or when he poses self-
imposed restrictions or inhibitors.
When individual is not free to choose from
among alternative behavior.
When the individual avoids socially
acceptable and responsible behavior.

8. MANIFESTATIONS
• Helplessness
• Sadness
• Lonely/aloof
• Self-criticism
• Lack of self -awareness
• Prevents participating in authentic and
rewarding relationships with others

9. CONTI…
• Surrenders to the demand of others.
• Psychiatric clients lost the values which gives
meaning for the existence; the world is absurd,
gives invalid demands.
• Lacks of commitment
• Hazy identity
• Sense of unreality
• Will not accept the painful realities of life
• Altered sense of time

10. EXISTENTIAL THERAPEUTIC
PROCESS
The therapeutic process assumes that the patient
must be able to choose freely from what life has
to offer.
 The therapeutic goal is to return the patient to an
authentic awareness of his being. The existential
therapeutic process focuses on the encounter.
The client is helped to accept and understand his
past, to live present and to look forward to the
future.

11. ROLE OF EXISTENTIAL
THERAPIST
Therapist acts as a guide, director and role model
Provides warmth and caring, give values to the clients.
Helps the client to find his way from the alienation of
madness to the relatedness of full life.
Therapist points out the areas where the client has to
consider change.
Treats the client as an adult, encourages hope and trust.

12. ROLE OF CLIENT
Client is active in therapy.
Client must be open and honest; ready for
change.
Accepts responsibility for his behavior.
Works toward the challenges kept by the
therapist.

13. PSYCHOANALYTICAL MODEL
 Given by Sigmund Freud.
 It is based on the concept of intrapsychic conflict within
the individual.
Psycho analysis system was presented both theoretical
and practical side.
 On the theoretical side, it presented a theory to
understand and explain the human psyche and
On the practical side, it studies human behavior and also
as a therapy to treat mentally ill.

14. DEFINTION
It is defined as a psychological
theory of mind and personality
development based on concept of
‘intrapsychic conflict’

15. BASIC CONCEPTS
1. PSYCHIC ENERGY/ PSYCHIC DETERMINISM:
The human organism is a complicated energy system
deriving from all the instincts or desires or needs
fulfillment. The form of energy which operates the three
systems of personality is called as ‘psychic energy’.
 It performs psychological work, i.e. thinking,
perceiving, recalling, reasoning and analyzing etc. no
mental activity or behavior is a random, accidental or
meaningless, unless it is caused by abnormal behavior.

16. 2. INSTINCTS/DRIVES:
An instinct is the mental representative of a bodily
need.
Freud used the word instinct in his theories as the
energy of all the life instincts. I.e. libido. It is a sum
of psychic energy which imparts direction to
psychological processes.
The aim of an instinct is the fulfilled, the individual
will get psychological and physiological satisfaction
and the source of that instinct is eliminated, e.g.
hunger drive.

17. CONTI…
3. CATHEXIS:
Utilization of energy in the image of an object or in
discharge action upon an object that will satisfy an
instinct is called as, ‘cathexis’. The total energy of the id,
is utilized in object-cathexis.
4. ANTI- CATHEXIS:
The urging forces are to satisfy instinct, ‘cathexis’ and
The checking forces are ‘anti-cathexis’.
The ego and super ego possess anti-cathexis. Ego and super
ego checks the actions of id with their own forces.

18. THE STRUCTURAL THEORY OF MIND
In 1923, Sigmund Freud
ID
The id is the locus of the instinctual drives- the
“pleasure principle”.
present at birth.
 it is totally unconscious, containing the basic drives
and instincts concerned with survival, sexual drive and
aggression.
The only urge of this drive is immediate gratification.

19. CONTI…
EGO
 Ego is primarily determined and guided by the “reality
principle’.
 It is immediacy between three set of forces i.e. the
instinctive, irrational demands of the id, realities of the
external world and the ethical, moral demands of the
super ego.
 Ego maintains a balance between id and super ego on
one hand and the reality on the other.

20. CONTI…
SUPER EGO
• Super ego referred to as a perfection principle.
• It consists of punitive con-science and non-punitive
conscience; both derive form the effect of parental influence
on the ego.
• The parental influences not only include the effect of actual
parents but also of the important people in the surrounding
environment.
• Fear of punishment and a desire for approval cause the child
to identify himself with the moral percepts of parents.

21. • The open criticism, prohibitions, guilt arousing
statements and punishments are introjected as
conscience.
• Super ego develops in the five years of age of
the child, it is idealistic in nature and perfection
is its goal.
• On the other hand, the approvals and rewards
become introjected as the ego ideal.
• Super ego is also furnished with the power to
reward or to punish.

24. BEHAVIORAL EXAMPLES
ID EGO SUPER EGO
“I found this
wallet; I will keep
the money.”
– “I already have
money. This
money doesn’t
belong to me.
Maybe the person
who owns this
wallet doesn’t
have any money”.
– “It is never
right to take
something that
doesn’t belong to
you”.

25. THEORIES OF MIND /
TOPOGRAPHIC THEORY OF
MIND

27. THE THEORY OF
PSYCHOSEXUAL
DEVELOPMENT

28. STAGE AGE MAJOR DEVELOPMENTAL
TASK
ABNORMALITY
Oral Birth to 18
months
Relief from anxiety through
oral gratification of needs
Dependent
personality traits,
schizophrenia,
severe mood
disorders, and
alcohol
dependence
syndrome and
drug dependence
behavior.
Anal 18 months
to 3 years
Learning independence and
control, with focus on the
excretory function
To obsessive
compulsive
personality traits
and obsessive
compulsive
disorder.

29. STAGE AGE MAJOR DEVELOPMENTAL
TASK
ABNORMALITY
Phallic 3 to 6
years
Identification with parent of
same gender, development
of sexual identity
focus on genital organs
Sexual deviations,
sexual dysfunction
and neurotic
disorders.
Latency 6 to 12
years
Sexuality repressed, focus on
relationships with same-
gender peers
Neurotic disorders.
Genital 13 to 20
years
Libido reawakened as genital
organs mature
focus on relationships with
members of the opposite
gender.
Neurotic disorders.

30. ROLE OF THE PATIENT AND THE
PSYCHOANALYST
 The client is an active participant, freely revealing all thoughts
and feelings exactly as they occurred and describing the dreams.
 The psychoanalyst is a shadow person; he will not reveal any
personal issues in order to allow the transference process.
 The analyst usually conducts the therapeutic session outside the
direct line of the vision of the client, so that non-verbal responses do
not influence the client’s verbalizations.
 Verbal responses are brief, so that it will not interfere with
associative flow.
 By termination of therapy the patient will be able to view the analyst
realistically as another adult having worked through his conflicts and
dependency needs.