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Copyright © 2014. F.A. Davis Company Mental Health and Mental Illness Chapter 1
Copyright © 2014. F.A. Davis Company • The concepts of mental health and mental illness are culturally defined. • Individuals experience both physical and psychological responses to stress. • ‫يتم‬ ‫تعريف‬ ‫مفاهيم‬ ‫الصحة‬ ‫العقلية‬ ‫واألمراض‬ ‫العق‬ ‫لية‬ ‫ثقافيا‬ . • ‫يواجه‬ ‫األفراد‬ ‫استجابات‬ ‫جسدية‬ ‫ونفسية‬ ‫للتوتر‬ . Introduction
Copyright © 2014. F.A. Davis Company Maslow identified: • A “hierarchy of needs” • Self-actualization as fulfillment of one’s highest potential • ‫حدد‬ ‫ماسلو‬ : • ‫أ‬ " ‫التسلسل‬ ‫الهرمي‬ ‫لالحتياجات‬ " • ‫تحقيق‬ ‫الذات‬ ‫كتحقيق‬ ‫لواحد‬ ' ‫أعلى‬ ‫اإلمكانات‬ • Mental Health
Copyright © 2014. F.A. Davis Company Mental Health is defined as “The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms.” ‫الصحة‬ ‫النفسية‬ ‫يعرف‬ ‫ب‬ " ‫التكيف‬ ‫الناجح‬ ‫مع‬ ‫الضغوطات‬ ‫من‬ ‫البيئ‬ ‫ة‬ ‫الداخلية‬ ‫أو‬ ‫الخارجية‬ ، ‫بدليل‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫ا‬ ‫لتي‬ ‫تتناسب‬ ‫مع‬ ‫عمره‬ ‫وتتوافق‬ ‫مع‬ ‫األعراف‬ ‫المحلية‬ ‫والثقافية‬ ." Mental Health (cont’d)
Copyright © 2014. F.A. Davis Company Mental Illness is defined as “Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individual’s social, occupational, or physical functioning.” ‫مرض‬ ‫عقلي‬ ‫يعرف‬ ‫ب‬ " ‫االستجابات‬ ‫غير‬ ‫القادرة‬ ‫على‬ ‫التكيف‬ ‫مع‬ ‫الضغوطات‬ ‫من‬ ‫البيئة‬ ‫الداخلية‬ ‫أو‬ ‫الخارجية‬ ، ‫والتي‬ ‫يتضح‬ ‫من‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫التي‬ ‫ال‬ ‫تتوافق‬ ‫مع‬ ‫المعايير‬ ‫المحلية‬ ‫والثقافية‬ ‫وتتداخل‬ ‫مع‬ ‫'الفرد‬ ‫األداء‬ ‫االجتماعي‬ ‫أو‬ ‫المهني‬ ‫أو‬ ‫الجسدي‬ ." Mental Illness
Copyright © 2014. F.A. Davis Company Horwitz describes cultural influences that affect how individuals view mental illness, which include: – Incomprehensibility: the inability of the general population to understand the motivation behind the behavior – Cultural relativity: the “normality” of behavior is determined by the culture • ‫يصف‬ ‫هورويتز‬ ‫التأثيرات‬ ‫الثقافية‬ ‫التي‬ ‫تؤثر‬ ‫على‬ ‫كيفية‬ ‫رؤية‬ ‫األفراد‬ ‫لألمراض‬ ‫العقلية‬ ، ‫والتي‬ ‫تشمل‬ : – ‫عدم‬ ‫الفهم‬ : ‫عدم‬ ‫قدرة‬ ‫عامة‬ ‫الناس‬ ‫على‬ ‫فهم‬ ‫الدافع‬ ‫وراء‬ ‫هذا‬ ‫السلوك‬ – ‫ثقافية‬ ‫النسبية‬ : ‫ال‬ " ‫الحياة‬ ‫الطبيعية‬ " ‫السلوك‬ ‫تحدده‬ ‫الثقافة‬ Mental Illness (cont’d)
Copyright © 2014. F.A. Davis Company PHYSICAL AND PSYCHOLOGIAL RESPONSES TO STRESS
Copyright © 2014. F.A. Davis Company • Hans Selye defined stress as “the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system.” • “Fight-or-flight” syndrome • ‫ف‬ّ‫عر‬ ‫هانز‬ ‫سيلي‬ ‫التوتر‬ ‫بأنه‬ " ‫الحالة‬ ‫التي‬ ‫تتجلى‬ ‫في‬ ‫متالزمة‬ ‫محددة‬ ‫تتكون‬ ‫من‬ ‫جميع‬ ‫التغيرات‬ ‫المستحثة‬ ‫بشكل‬ ‫غير‬ ‫محدد‬ ‫داخل‬ ‫ال‬ ‫نظام‬ ‫البيولوجي‬ ." • " ‫المكافحة‬ ‫أو‬ ‫الهروب‬ " ‫متالزمة‬ Physical Responses
Copyright © 2014. F.A. Davis Company Selye’s General Adaptation Syndrome 1. Alarm reaction stage: During this stage, the physiological responses of the fight or flight syndrome are initiated. 2. Stage of resistance: -The individual uses the physiological responses of the first stage as a defense in attempt to adapt to the stressor. -If adaptation occurs, the third stage is prevented or delayed. Physiological symptoms may disappear. Physical Responses (cont’d)
Copyright © 2014. F.A. Davis Company ‫سيلي‬ '- ‫متالزمة‬ ‫التكيف‬ ‫العامة‬ .1 ‫مرحلة‬ ‫رد‬ ‫فعل‬ ‫اإلنذار‬ : ‫خالل‬ ‫هذه‬ ‫المرحلة‬ ، ‫تبدأ‬ ‫االستجابات‬ ‫الفسيولوجية‬ ‫لمتالزمة‬ ‫القتال‬ ‫أو‬ ‫الهر‬ ‫وب‬ . 2. ‫مرحلة‬ ‫المقاومة‬ : - ‫يستخدم‬ ‫الفرد‬ ‫االستجابات‬ ‫الفسيولوجية‬ ‫للمرحلة‬ ‫األولى‬ ‫كدفاع‬ ‫في‬ ‫م‬ ‫حاولة‬ ‫للتكيف‬ ‫مع‬ ‫الضغوطات‬ . - ‫في‬ ‫حالة‬ ‫حدوث‬ ‫التكيف‬ ‫يتم‬ ‫منع‬ ‫أو‬ ‫تأخير‬ ‫المرحلة‬ ‫الثالثة‬ . ‫قد‬ ‫تختفي‬ ‫األعراض‬ ‫الفسيولوجية‬ . ‫االستجابات‬ ‫الجسدية‬ ( ‫تابع‬ )
Copyright © 2014. F.A. Davis Company Selye’s General Adaptation Syndrome 3- Stage of exhaustion: -This stage occurs when there is a prolonged exposure to the stressor. -The adaptive energy is depleted, and the individual can no longer draw from the resources for adaptation described in the first two stages. -Diseases of adaptation (e.g., headaches, mental disorders, coronary artery disease, ulcers, colitis) may occur. -Without intervention for reversal, exhaustion and even death may occur Physical Responses (cont’d)
Copyright © 2014. F.A. Davis Company ‫سيلي‬ '- ‫متالزمة‬ ‫التكيف‬ ‫العامة‬ 3- ‫مرحلة‬ ‫اإلرهاق‬ : - ‫تحدث‬ ‫هذه‬ ‫المرحلة‬ ‫عندما‬ ‫يكون‬ ‫هناك‬ ‫تعرض‬ ‫طويل‬ ‫للضغط‬ . - ‫استنفاد‬ ‫طاقة‬ ‫التكيف‬ ، ‫ولم‬ ‫يعد‬ ‫الفرد‬ ‫قادرا‬ ‫على‬ ‫االستفادة‬ ‫من‬ ‫موارد‬ ‫التكيف‬ ‫الموص‬ ‫وفة‬ ‫في‬ ‫األولين‬ ‫مراحل‬ . - ‫أمراض‬ ‫التكيف‬ ( ‫مثل‬ ‫الصداع‬ ‫والذهنية‬ ‫قد‬ ‫تحدث‬ ‫اضطرابات‬ ، ‫مرض‬ ‫الشريان‬ ‫التاجي‬ ، ‫القرحة‬ ، ‫التهاب‬ ‫القولون‬ ). - ‫بدون‬ ‫التدخل‬ ‫للعكس‬ ‫قد‬ ‫يحدث‬ ‫اإلرهاق‬ ‫وحتى‬ ‫الموت‬ ‫االستجابات‬ ‫الجسدية‬ ( ‫تابع‬ )
Copyright © 2014. F.A. Davis Company • Anxiety and grief have been described as two major, primary psychological response patterns to stress. • A variety of thoughts, feelings, and behaviors are associated with each of these response patterns. • Adaptation is determined by the extent to which the thoughts, feelings, and behaviors interfere with an individual’s functioning. • ‫قلق‬ ‫و‬ ‫حزن‬ ‫تم‬ ‫وصفهما‬ ‫على‬ ‫أنهما‬ ‫نمطان‬ ‫رئيسيان‬ ‫لالستجابة‬ ‫النفسية‬ ‫األولية‬ ‫لل‬ ‫توتر‬ . • ‫ترتبط‬ ‫مجموعة‬ ‫متنوعة‬ ‫من‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫بكل‬ ‫نمط‬ ‫من‬ ‫أنماط‬ ‫االس‬ ‫تجابة‬ ‫هذه‬ . • ‫يتم‬ ‫تحديد‬ ‫التكيف‬ ‫من‬ ‫خالل‬ ‫مدى‬ ‫تداخل‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫مع‬ ‫الفرد‬ ' ‫يعمل‬ . Psychological Responses
Copyright © 2014. F.A. Davis Company Anxiety • A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness • Extremely common in our society • Mild anxiety is adaptive and can provide motivation for survival • ‫قلق‬ • ‫خوف‬ ‫منتشر‬ ‫غامض‬ ‫بطبيعته‬ ‫ويرتبط‬ ‫بمشاعر‬ ‫عدم‬ ‫اليقين‬ ‫والعجز‬ • ‫شائع‬ ‫ًا‬‫د‬‫ج‬ ‫في‬ ‫مجتمعنا‬ • ‫القلق‬ ‫المعتدل‬ ‫هو‬ ‫تكيف‬ ‫ويمكن‬ ‫أن‬ ‫يوفر‬ ‫الدافع‬ ‫للبقاء‬ ‫على‬ ‫قيد‬ ‫الح‬ ‫ياة‬ Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company Peplau’s Four Levels of Anxiety – Mild: seldom a problem – Moderate: perceptual field diminishes – Severe: – perceptual field is so diminished – Attention span is extremely limited, and the individual has much difficulty completing even the simplest task – Panic: – In this most intense state of anxiety, the individual is unable to focus on even one detail within the environment. – Misperceptions are common, and a loss of contact with reality may occur Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company ‫بيبالو‬ ' ‫أربعة‬ ‫مستويات‬ ‫من‬ ‫القلق‬ – ‫خفيف‬ : ‫نادرا‬ ‫ما‬ ‫تكون‬ ‫مشكلة‬ – ‫معتدل‬ : ‫يتضاءل‬ ‫المجال‬ ‫اإلدراكي‬ – ‫شديد‬ : – ‫المجال‬ ‫اإلدراكي‬ ‫يتضاءل‬ ‫للغاية‬ – ‫مدى‬ ‫االنتباه‬ ‫محدود‬ ‫للغاية‬ ، ‫ويواجه‬ ‫الفرد‬ ‫صعوبة‬ ‫كبيرة‬ ‫في‬ ‫إكمال‬ ‫أبسط‬ ‫المهام‬ – ‫ذعر‬ : – ‫في‬ ‫هذه‬ ‫الحالة‬ ‫الشديدة‬ ‫من‬ ‫القلق‬ ، ‫ال‬ ‫يتمكن‬ ‫الفرد‬ ‫من‬ ‫التركيز‬ ‫حتى‬ ‫على‬ ‫تفصيل‬ ‫و‬ ‫احد‬ ‫داخل‬ ‫البيئة‬ . – ‫المفاهيم‬ ‫الخاطئة‬ ‫شائعة‬ ، ‫وقد‬ ‫يحدث‬ ‫فقدان‬ ‫االتصال‬ ‫بالواقع‬ ‫االستجابات‬ ‫النفسية‬ ( ‫تابع‬ )
Copyright © 2014. F.A. Davis Company Behavioral Adaptation Responses to Anxiety • At the mild level, individuals employ various coping mechanisms to deal with stress. A few of these include eating, drinking, sleeping, physical exercise, smoking, crying, laughing, and talking to persons with whom they feel comfortable. – ‫استجابات‬ ‫التكيف‬ ‫السلوكي‬ ‫للقلق‬ • ‫على‬ ‫المستوى‬ ‫المعتدل‬ ، ‫يوظف‬ ‫األفراد‬ • ‫آليات‬ ‫التكيف‬ ‫المختلفة‬ ‫للتعامل‬ ‫مع‬ ‫التوتر‬ . ‫عدد‬ ‫قليل‬ ‫من‬ ‫هذه‬ ‫تشمل‬ ‫يتناول‬ ‫الطعام‬ ، • ‫الشرب‬ ، ‫النوم‬ ، ‫ممارسة‬ ‫الرياضة‬ ‫البدنية‬ ، • ‫التدخين‬ ‫والبكاء‬ ‫والضحك‬ ‫والتحدث‬ ‫مع‬ ‫األشخاص‬ ‫الذين‬ ‫يشعرون‬ ‫بالراحة‬ ‫معهم‬ . Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company Psychological Responses (cont’d) • At the mild to moderate level, the ego calls on defense mechanisms for protection (table1-1) page.9, such as – Compensation – Denial – Displacement – Intellectualization – Rationalization – Reaction formation – Regression – Repression – Sublimation – Suppression – Undoing – ‫تعويض‬ – ‫إنكار‬ – ‫اإلزاحة‬ – ‫الفكر‬ – ‫ترشيد‬ – ‫تشكيل‬ ‫رد‬ ‫الفعل‬ – ‫تراجع‬ – ‫قمع‬ – ‫تسامي‬ – ‫إخماد‬ – ‫تراجع‬
Copyright © 2014. F.A. Davis Company
Copyright © 2014. F.A. Davis Company • Anxiety at the moderate to severe level that remains unresolved over an extended period can contribute to a number of physiological disorders, e.g., migraine headaches, irritable bowel syndrome, and cardiac arrhythmias. • Extended periods of repressed severe anxiety can result in psychoneurotic patterns of behaving, e.g., anxiety disorders and somatoform disorders. • ‫القلق‬ ‫في‬ ‫مستوى‬ ‫معتدل‬ ‫إلى‬ ‫شديد‬ ‫التي‬ ‫تبقى‬ ‫دون‬ ‫حل‬ ‫على‬ ‫مدى‬ ‫فترة‬ ‫طويلة‬ ‫يم‬ ‫كن‬ ‫أن‬ ‫تساهم‬ ‫في‬ ‫عدد‬ ‫من‬ ‫االضطرابات‬ ‫الفسيولوجية‬ ، ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫الصداع‬ ‫النصفي‬ ، ‫و‬ ‫متالزمة‬ ‫القولون‬ ‫العصبي‬ ، ‫وعدم‬ ‫انتظام‬ ‫ضربات‬ ‫القلب‬ . • ‫فترات‬ ‫ممتدة‬ ‫من‬ ‫القمع‬ ‫شديد‬ ‫يمكن‬ ‫أن‬ ‫يؤدي‬ ‫القلق‬ ‫إلى‬ ‫أنماط‬ ‫سلوكية‬ ‫عصبية‬ ‫نفس‬ ‫ية‬ ، ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫اضطرابات‬ ‫القلق‬ ‫واالضطرابات‬ ‫الجسدية‬ . Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company • Extended periods of functioning at the panic level of anxiety may result in psychotic behavior. • Examples of psychotic disorders include schizophrenia, schizoaffective disorders, and delusional disorders. • ‫فترات‬ ‫ممتدة‬ ‫من‬ ‫العمل‬ ‫في‬ ‫مستوى‬ ‫الذعر‬ ‫من‬ ‫القلق‬ ‫قد‬ ‫يؤدي‬ ‫إلى‬ ‫سلوك‬ ‫ذهاني‬ . • ‫تشمل‬ ‫أمثلة‬ ‫االضطرابات‬ ‫الذهانية‬ ‫الفصام‬ ، ‫واالضطرابات‬ ‫الفصامي‬ ‫ة‬ ‫العاطفية‬ ، ‫واالضطرابات‬ ‫الوهمية‬ . Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company Grief • The subjective state of emotional, physical, and social responses to the loss of a valued entity. • The loss may be real or perceived. • Elisabeth Kübler-Ross – 5 Stages of Grief  Denial  Anger  Bargaining  Depression  Acceptance Psychological Responses (cont’d) – 5 ‫مراحل‬ ‫الحزن‬  ‫إنكار‬  ‫الغضب‬  ‫مساومة‬  ‫اكتئاب‬  ‫قبول‬
Copyright © 2014. F.A. Davis Company Stage 1—Denial: This is a stage of shock and disbelief. The response may be one of “No, it can’t be true!” The reality of the loss is not acknowledged. • ‫المرحلة‬ 1— ‫إنكار‬ : • ‫هذه‬ ‫مرحلة‬ ‫الصدمة‬ ‫وعدم‬ ‫التصديق‬ . ‫قد‬ ‫يكون‬ ‫الرد‬ ‫كالتالي‬ : " ‫ال‬ ، ‫ال‬ ‫يمكن‬ ‫أن‬ ‫يكون‬ ‫هذا‬ ‫ا‬ً‫ح‬‫صحي‬ !" ‫ولم‬ ‫يتم‬ ‫االعتراف‬ ‫بحقيقة‬ ‫الخسارة‬ . Stage 2—Anger: “Why me?” and “It’s not fair! "are comments often expressed during the anger stage. Envy and resentment toward individuals not affected by the loss are common. • ‫المرحلة‬ 2— ‫الغضب‬ : • " ‫لماذا‬ ‫أنا‬ ‫؟‬ " ‫و‬ " ‫هذا‬ ‫ليس‬ ً ً‫ال‬‫عد‬ ! " ‫هي‬ ‫التعليقات‬ ‫التي‬ ‫يتم‬ ‫التعبير‬ ‫عنها‬ ‫ا‬ً‫ب‬‫غال‬ ‫خالل‬ ‫مرحلة‬ ‫الغضب‬ . • ‫الحسد‬ ‫واالستياء‬ ‫تجاه‬ ‫األفراد‬ ‫الذين‬ ‫لم‬ ‫يتأثروا‬ ‫بالخسارة‬ ‫أمر‬ ‫شائع‬ . 5 Stages of Grief
Copyright © 2014. F.A. Davis Company Stage 3—Bargaining: During this stage, which is usually not visible or evident to others, a “bargain” is made with God in an attempt to reverse or postpone the loss. Stage 4—Depression: During this stage, the full impact of the loss is experienced. The sense of loss is intense, and feelings of sadness and depression prevail. This stage differs from pathological depression in that it represents advancement toward resolution rather than the fixation in an earlier stage of the grief process. 5 Stages of Grief
Copyright © 2014. F.A. Davis Company ‫المرحلة‬ 3— ‫مساومة‬ : ‫خالل‬ ‫هذه‬ ‫المرحلة‬ ، ‫والتي‬ ‫عادة‬ ‫ما‬ ‫تكون‬ ‫غير‬ ‫مرئية‬ ‫أو‬ ‫واضحة‬ ‫لآلخرين‬ ، ‫ي‬ ‫تم‬ ‫عقد‬ " ‫صفقة‬ " ‫مع‬ ‫هللا‬ ‫في‬ ‫محاولة‬ ‫لعكس‬ ‫الخسارة‬ ‫أو‬ ‫تأجيلها‬ . ‫المرحلة‬ 4— ‫اكتئاب‬ : ‫خالل‬ ‫هذه‬ ‫المرحلة‬ ، ‫يتم‬ ‫تجربة‬ ‫التأثير‬ ‫الكامل‬ ‫للخسارة‬ . ‫ويكون‬ ‫اإلحساس‬ ‫بالخسارة‬ ‫ًا‬‫د‬‫شدي‬ ، ‫وتسود‬ ‫مشاعر‬ ‫الحزن‬ ‫واالكتئاب‬ . ‫تختلف‬ ‫هذه‬ ‫المرحلة‬ ‫عن‬ ‫االكتئاب‬ ‫المرضي‬ ‫من‬ ‫حيث‬ ‫أنها‬ ‫تمثل‬ ‫التقدم‬ ‫ن‬ ‫حو‬ ‫الحل‬ ً ً‫ال‬‫بد‬ ‫من‬ ‫التثبيت‬ ‫في‬ ‫مرحلة‬ ‫مبكرة‬ ‫من‬ ‫عملية‬ ‫الحزن‬ . 5 ‫مراحل‬ ‫الحزن‬
Copyright © 2014. F.A. Davis Company stage 5—Acceptance: *The final stage brings a feeling of peace regarding the loss that has occurred. *It is a time of quiet expectation and resignation. *The focus is on the reality of the loss and its meaning for the individuals affected • ‫س‬ ‫العالمة‬ 5— ‫قبول‬ : • * ‫المرحلة‬ ‫النهائية‬ ‫تجلب‬ ‫الشعور‬ ‫بالسالم‬ ‫تجاه‬ ‫الخسارة‬ ‫التي‬ ‫حدثت‬ . • * ‫إنه‬ ‫وقت‬ ‫التوقع‬ ‫الهادئ‬ ‫واالستسالم‬ . * ‫يتم‬ ‫التركيز‬ ‫على‬ ‫حقيقة‬ ‫الخسارة‬ ‫ومعن‬ ‫اها‬ ‫لألفراد‬ ‫المتضررين‬ 5 Stages of Grief
Copyright © 2014. F.A. Davis Company • Anticipatory grief: the experiencing of the grief process before the actual loss occurs. • Resolution: length of the grief process is entirely individual. It can last from a few weeks to years. It is influenced by a number of factors. • ‫الحزن‬ ‫المتوقع‬ : ‫تجربة‬ ‫عملية‬ ‫الحزن‬ ‫قبل‬ ‫حدوث‬ ‫الخسارة‬ ‫الفعلية‬ . • ‫دقة‬ : ‫طول‬ ‫عملية‬ ‫الحزن‬ ‫فردية‬ ‫ا‬ً‫م‬‫تما‬ . ‫ويمكن‬ ‫أن‬ ‫تستمر‬ ‫من‬ ‫بضعة‬ ‫أسابيع‬ ‫إلى‬ ‫سنوات‬ . ‫يتأثر‬ ‫بعدد‬ ‫من‬ ‫العوامل‬ . Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company – The experience of guilt for having had a “love-hate” relationship with the lost entity. Guilt often lengthens the grieving process. – Anticipatory grieving is thought to shorten the grief response when the loss actually occurs. – The length of the grief response is often extended when an individual has experienced a number of recent losses and when he or she is unable to complete one grieving process before another one begins. – ‫تجربة‬ ‫الشعور‬ ‫بالذنب‬ ‫ألنه‬ ‫كان‬ ‫لديك‬ " ‫حب‬ ‫كره‬ " ‫العالقة‬ ‫مع‬ ‫الكيان‬ ‫المفقود‬ . ‫ا‬ً‫ب‬‫غال‬ ‫ما‬ ‫يؤدي‬ ‫الشعور‬ ‫بالذنب‬ ‫إلى‬ ‫إطالة‬ ‫عملية‬ ‫الحزن‬ . – ‫عتقد‬ُ‫ي‬ ‫أن‬ ‫الحزن‬ ‫االستباقي‬ ‫يقلل‬ ‫من‬ ‫استجابة‬ ‫الحزن‬ ‫عند‬ ‫حدوث‬ ‫الخسارة‬ ‫ب‬ ‫الفعل‬ . – ‫ا‬ً‫ب‬‫غال‬ ‫ما‬ ‫يمتد‬ ‫طول‬ ‫االستجابة‬ ‫للحزن‬ ‫عندما‬ ‫يتعرض‬ ‫الفرد‬ ‫لعدد‬ ‫من‬ ‫الخسائر‬ ‫األخيرة‬ ‫وعندما‬ ‫يكون‬ ‫غير‬ ‫قادر‬ ‫على‬ ‫إكمال‬ ‫عملية‬ ‫حزن‬ ‫واحدة‬ ‫قبل‬ ‫أن‬ ‫تبدأ‬ ‫عملية‬ ‫حزن‬ ‫أخر‬ ‫ى‬ . Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company • Resolution of the grief response is thought to occur when an individual can look back on the relationship with the lost entity and accept both the pleasures and the disappointments of the association. • ‫عتقد‬ُ‫ي‬ ‫أن‬ ‫حل‬ ‫استجابة‬ ‫الحزن‬ ‫يحدث‬ ‫عندما‬ ‫يتمكن‬ ‫الفرد‬ ‫من‬ ‫الن‬ ‫ظر‬ ‫إلى‬ ‫الوراء‬ ‫في‬ ‫العالقة‬ ‫مع‬ ‫الكيان‬ ‫المفقود‬ ‫وقبول‬ ‫كل‬ ‫من‬ ‫ملذات‬ ‫وخيب‬ ‫ات‬ ‫األمل‬ ‫في‬ ‫االرتباط‬ . Psychological Responses (cont’d)
Copyright © 2014. F.A. Davis Company Maladaptive Grief Responses – Prolonged response – Delayed/inhibited response – Distorted response Psychological Responses (cont’d) ‫استجابات‬ ‫الحزن‬ ‫غير‬ ‫التكيفي‬ ‫ة‬ – ‫استجابة‬ ‫مطولة‬ – ‫تأخر‬ / ‫منع‬ ‫االستجابة‬ – ‫استجابة‬ ‫مشوهة‬
Copyright © 2014. F.A. Davis Company 1- The prolonged response is characterized by an intense preoccupation with memories of the lost entity for many years after the lost has occurred • 1- ‫اال‬ ‫ستجابة‬ ‫طويلة‬ ‫يتميز‬ ‫ب‬ • ‫االنشغال‬ ‫الشديد‬ ‫بذكريات‬ ‫الكيان‬ ‫المفقود‬ ‫لسنوات‬ ‫عديدة‬ ‫بعد‬ ‫حدو‬ ‫ث‬ ‫الفقد‬ Behaviors associated with the stages of denial or anger are manifested. - ‫ظهور‬ ‫السلوكيات‬ ‫المرتبطة‬ ‫بمراحل‬ ‫اإلنكار‬ ‫أو‬ ‫الغضب‬ . Maladaptive Grief Responses
Copyright © 2014. F.A. Davis Company 2- In the delayed or inhibited response, the individual becomes fixed in the denial stage of the grieving process. The anxiety disorders are experienced in this response (e.g., phobias, hypochondriasis) or sleeping and eating disorders (e.g., insomnia, anorexia) may be evident. • 2- ‫في‬ ‫تأخر‬ ‫االستجابة‬ ‫أو‬ ‫تثبيطها‬ ، ‫يصبح‬ ‫الفرد‬ ً ً‫ا‬‫ثابت‬ ‫في‬ ‫مرحلة‬ ‫ا‬ ‫إلنكار‬ ‫من‬ ‫عملية‬ ‫الحزن‬ . • ‫تظهر‬ ‫اضطرابات‬ ‫القلق‬ ‫في‬ ‫هذه‬ ‫االستجابة‬ ( ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫الرهاب‬ ، ‫الوسواس‬ ‫المرضي‬ ) ‫أو‬ ‫اضطرابات‬ ‫النوم‬ ‫واألكل‬ • ( ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫األرق‬ ، ‫فقدان‬ ‫الشهية‬ ) ‫قد‬ ‫يكون‬ ‫واضحا‬ . Maladaptive Grief Responses
Copyright © 2014. F.A. Davis Company • 3- distorted response: • The individual is fixed in the anger stage of grieving. • all the behaviors associated with grieving, such as helplessness, hopelessness, sadness, anger, and guilt, are exaggerated out of proportion to the situation. • The individual is unable to function in normal activities of daily living. • Pathological depression is a distorted grief response. • 3- ‫االستجابة‬ ‫المشوهة‬ : • ‫يثبت‬ ‫الفرد‬ ‫في‬ ‫مرحلة‬ ‫الغضب‬ ‫والحزن‬ . • ‫جميع‬ ‫السلوكيات‬ ‫المرتبطة‬ ‫بالحزن‬ ، ‫مثل‬ ‫العجز‬ ‫واليأس‬ ‫والحزن‬ ‫والغضب‬ ‫والشعور‬ ‫ب‬ ‫الذنب‬ ، ‫يتم‬ ‫تضخيمها‬ ‫بشكل‬ ‫ال‬ ‫يتناسب‬ ‫مع‬ ‫الموقف‬ . • - ‫عدم‬ ‫قدرة‬ ‫الفرد‬ ‫على‬ ‫القيام‬ ‫باألنشطة‬ ‫الطبيعية‬ ‫للحياة‬ ‫اليومية‬ . • ‫االكتئاب‬ ‫المرضي‬ ‫هو‬ ‫استجابة‬ ‫مشوهة‬ ‫للحزن‬ . Maladaptive Grief Responses
Copyright © 2014. F.A. Davis Company Thanks

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lect. 1 mental health and mental illness (2).ppt

  • 1. Copyright © 2014. F.A. Davis Company Mental Health and Mental Illness Chapter 1
  • 2. Copyright © 2014. F.A. Davis Company • The concepts of mental health and mental illness are culturally defined. • Individuals experience both physical and psychological responses to stress. • ‫يتم‬ ‫تعريف‬ ‫مفاهيم‬ ‫الصحة‬ ‫العقلية‬ ‫واألمراض‬ ‫العق‬ ‫لية‬ ‫ثقافيا‬ . • ‫يواجه‬ ‫األفراد‬ ‫استجابات‬ ‫جسدية‬ ‫ونفسية‬ ‫للتوتر‬ . Introduction
  • 3. Copyright © 2014. F.A. Davis Company Maslow identified: • A “hierarchy of needs” • Self-actualization as fulfillment of one’s highest potential • ‫حدد‬ ‫ماسلو‬ : • ‫أ‬ " ‫التسلسل‬ ‫الهرمي‬ ‫لالحتياجات‬ " • ‫تحقيق‬ ‫الذات‬ ‫كتحقيق‬ ‫لواحد‬ ' ‫أعلى‬ ‫اإلمكانات‬ • Mental Health
  • 4. Copyright © 2014. F.A. Davis Company Mental Health is defined as “The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms.” ‫الصحة‬ ‫النفسية‬ ‫يعرف‬ ‫ب‬ " ‫التكيف‬ ‫الناجح‬ ‫مع‬ ‫الضغوطات‬ ‫من‬ ‫البيئ‬ ‫ة‬ ‫الداخلية‬ ‫أو‬ ‫الخارجية‬ ، ‫بدليل‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫ا‬ ‫لتي‬ ‫تتناسب‬ ‫مع‬ ‫عمره‬ ‫وتتوافق‬ ‫مع‬ ‫األعراف‬ ‫المحلية‬ ‫والثقافية‬ ." Mental Health (cont’d)
  • 5. Copyright © 2014. F.A. Davis Company Mental Illness is defined as “Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individual’s social, occupational, or physical functioning.” ‫مرض‬ ‫عقلي‬ ‫يعرف‬ ‫ب‬ " ‫االستجابات‬ ‫غير‬ ‫القادرة‬ ‫على‬ ‫التكيف‬ ‫مع‬ ‫الضغوطات‬ ‫من‬ ‫البيئة‬ ‫الداخلية‬ ‫أو‬ ‫الخارجية‬ ، ‫والتي‬ ‫يتضح‬ ‫من‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫التي‬ ‫ال‬ ‫تتوافق‬ ‫مع‬ ‫المعايير‬ ‫المحلية‬ ‫والثقافية‬ ‫وتتداخل‬ ‫مع‬ ‫'الفرد‬ ‫األداء‬ ‫االجتماعي‬ ‫أو‬ ‫المهني‬ ‫أو‬ ‫الجسدي‬ ." Mental Illness
  • 6. Copyright © 2014. F.A. Davis Company Horwitz describes cultural influences that affect how individuals view mental illness, which include: – Incomprehensibility: the inability of the general population to understand the motivation behind the behavior – Cultural relativity: the “normality” of behavior is determined by the culture • ‫يصف‬ ‫هورويتز‬ ‫التأثيرات‬ ‫الثقافية‬ ‫التي‬ ‫تؤثر‬ ‫على‬ ‫كيفية‬ ‫رؤية‬ ‫األفراد‬ ‫لألمراض‬ ‫العقلية‬ ، ‫والتي‬ ‫تشمل‬ : – ‫عدم‬ ‫الفهم‬ : ‫عدم‬ ‫قدرة‬ ‫عامة‬ ‫الناس‬ ‫على‬ ‫فهم‬ ‫الدافع‬ ‫وراء‬ ‫هذا‬ ‫السلوك‬ – ‫ثقافية‬ ‫النسبية‬ : ‫ال‬ " ‫الحياة‬ ‫الطبيعية‬ " ‫السلوك‬ ‫تحدده‬ ‫الثقافة‬ Mental Illness (cont’d)
  • 7. Copyright © 2014. F.A. Davis Company PHYSICAL AND PSYCHOLOGIAL RESPONSES TO STRESS
  • 8. Copyright © 2014. F.A. Davis Company • Hans Selye defined stress as “the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system.” • “Fight-or-flight” syndrome • ‫ف‬ّ‫عر‬ ‫هانز‬ ‫سيلي‬ ‫التوتر‬ ‫بأنه‬ " ‫الحالة‬ ‫التي‬ ‫تتجلى‬ ‫في‬ ‫متالزمة‬ ‫محددة‬ ‫تتكون‬ ‫من‬ ‫جميع‬ ‫التغيرات‬ ‫المستحثة‬ ‫بشكل‬ ‫غير‬ ‫محدد‬ ‫داخل‬ ‫ال‬ ‫نظام‬ ‫البيولوجي‬ ." • " ‫المكافحة‬ ‫أو‬ ‫الهروب‬ " ‫متالزمة‬ Physical Responses
  • 9. Copyright © 2014. F.A. Davis Company Selye’s General Adaptation Syndrome 1. Alarm reaction stage: During this stage, the physiological responses of the fight or flight syndrome are initiated. 2. Stage of resistance: -The individual uses the physiological responses of the first stage as a defense in attempt to adapt to the stressor. -If adaptation occurs, the third stage is prevented or delayed. Physiological symptoms may disappear. Physical Responses (cont’d)
  • 10. Copyright © 2014. F.A. Davis Company ‫سيلي‬ '- ‫متالزمة‬ ‫التكيف‬ ‫العامة‬ .1 ‫مرحلة‬ ‫رد‬ ‫فعل‬ ‫اإلنذار‬ : ‫خالل‬ ‫هذه‬ ‫المرحلة‬ ، ‫تبدأ‬ ‫االستجابات‬ ‫الفسيولوجية‬ ‫لمتالزمة‬ ‫القتال‬ ‫أو‬ ‫الهر‬ ‫وب‬ . 2. ‫مرحلة‬ ‫المقاومة‬ : - ‫يستخدم‬ ‫الفرد‬ ‫االستجابات‬ ‫الفسيولوجية‬ ‫للمرحلة‬ ‫األولى‬ ‫كدفاع‬ ‫في‬ ‫م‬ ‫حاولة‬ ‫للتكيف‬ ‫مع‬ ‫الضغوطات‬ . - ‫في‬ ‫حالة‬ ‫حدوث‬ ‫التكيف‬ ‫يتم‬ ‫منع‬ ‫أو‬ ‫تأخير‬ ‫المرحلة‬ ‫الثالثة‬ . ‫قد‬ ‫تختفي‬ ‫األعراض‬ ‫الفسيولوجية‬ . ‫االستجابات‬ ‫الجسدية‬ ( ‫تابع‬ )
  • 11. Copyright © 2014. F.A. Davis Company Selye’s General Adaptation Syndrome 3- Stage of exhaustion: -This stage occurs when there is a prolonged exposure to the stressor. -The adaptive energy is depleted, and the individual can no longer draw from the resources for adaptation described in the first two stages. -Diseases of adaptation (e.g., headaches, mental disorders, coronary artery disease, ulcers, colitis) may occur. -Without intervention for reversal, exhaustion and even death may occur Physical Responses (cont’d)
  • 12. Copyright © 2014. F.A. Davis Company ‫سيلي‬ '- ‫متالزمة‬ ‫التكيف‬ ‫العامة‬ 3- ‫مرحلة‬ ‫اإلرهاق‬ : - ‫تحدث‬ ‫هذه‬ ‫المرحلة‬ ‫عندما‬ ‫يكون‬ ‫هناك‬ ‫تعرض‬ ‫طويل‬ ‫للضغط‬ . - ‫استنفاد‬ ‫طاقة‬ ‫التكيف‬ ، ‫ولم‬ ‫يعد‬ ‫الفرد‬ ‫قادرا‬ ‫على‬ ‫االستفادة‬ ‫من‬ ‫موارد‬ ‫التكيف‬ ‫الموص‬ ‫وفة‬ ‫في‬ ‫األولين‬ ‫مراحل‬ . - ‫أمراض‬ ‫التكيف‬ ( ‫مثل‬ ‫الصداع‬ ‫والذهنية‬ ‫قد‬ ‫تحدث‬ ‫اضطرابات‬ ، ‫مرض‬ ‫الشريان‬ ‫التاجي‬ ، ‫القرحة‬ ، ‫التهاب‬ ‫القولون‬ ). - ‫بدون‬ ‫التدخل‬ ‫للعكس‬ ‫قد‬ ‫يحدث‬ ‫اإلرهاق‬ ‫وحتى‬ ‫الموت‬ ‫االستجابات‬ ‫الجسدية‬ ( ‫تابع‬ )
  • 13. Copyright © 2014. F.A. Davis Company • Anxiety and grief have been described as two major, primary psychological response patterns to stress. • A variety of thoughts, feelings, and behaviors are associated with each of these response patterns. • Adaptation is determined by the extent to which the thoughts, feelings, and behaviors interfere with an individual’s functioning. • ‫قلق‬ ‫و‬ ‫حزن‬ ‫تم‬ ‫وصفهما‬ ‫على‬ ‫أنهما‬ ‫نمطان‬ ‫رئيسيان‬ ‫لالستجابة‬ ‫النفسية‬ ‫األولية‬ ‫لل‬ ‫توتر‬ . • ‫ترتبط‬ ‫مجموعة‬ ‫متنوعة‬ ‫من‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫بكل‬ ‫نمط‬ ‫من‬ ‫أنماط‬ ‫االس‬ ‫تجابة‬ ‫هذه‬ . • ‫يتم‬ ‫تحديد‬ ‫التكيف‬ ‫من‬ ‫خالل‬ ‫مدى‬ ‫تداخل‬ ‫األفكار‬ ‫والمشاعر‬ ‫والسلوكيات‬ ‫مع‬ ‫الفرد‬ ' ‫يعمل‬ . Psychological Responses
  • 14. Copyright © 2014. F.A. Davis Company Anxiety • A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness • Extremely common in our society • Mild anxiety is adaptive and can provide motivation for survival • ‫قلق‬ • ‫خوف‬ ‫منتشر‬ ‫غامض‬ ‫بطبيعته‬ ‫ويرتبط‬ ‫بمشاعر‬ ‫عدم‬ ‫اليقين‬ ‫والعجز‬ • ‫شائع‬ ‫ًا‬‫د‬‫ج‬ ‫في‬ ‫مجتمعنا‬ • ‫القلق‬ ‫المعتدل‬ ‫هو‬ ‫تكيف‬ ‫ويمكن‬ ‫أن‬ ‫يوفر‬ ‫الدافع‬ ‫للبقاء‬ ‫على‬ ‫قيد‬ ‫الح‬ ‫ياة‬ Psychological Responses (cont’d)
  • 15. Copyright © 2014. F.A. Davis Company Peplau’s Four Levels of Anxiety – Mild: seldom a problem – Moderate: perceptual field diminishes – Severe: – perceptual field is so diminished – Attention span is extremely limited, and the individual has much difficulty completing even the simplest task – Panic: – In this most intense state of anxiety, the individual is unable to focus on even one detail within the environment. – Misperceptions are common, and a loss of contact with reality may occur Psychological Responses (cont’d)
  • 16. Copyright © 2014. F.A. Davis Company ‫بيبالو‬ ' ‫أربعة‬ ‫مستويات‬ ‫من‬ ‫القلق‬ – ‫خفيف‬ : ‫نادرا‬ ‫ما‬ ‫تكون‬ ‫مشكلة‬ – ‫معتدل‬ : ‫يتضاءل‬ ‫المجال‬ ‫اإلدراكي‬ – ‫شديد‬ : – ‫المجال‬ ‫اإلدراكي‬ ‫يتضاءل‬ ‫للغاية‬ – ‫مدى‬ ‫االنتباه‬ ‫محدود‬ ‫للغاية‬ ، ‫ويواجه‬ ‫الفرد‬ ‫صعوبة‬ ‫كبيرة‬ ‫في‬ ‫إكمال‬ ‫أبسط‬ ‫المهام‬ – ‫ذعر‬ : – ‫في‬ ‫هذه‬ ‫الحالة‬ ‫الشديدة‬ ‫من‬ ‫القلق‬ ، ‫ال‬ ‫يتمكن‬ ‫الفرد‬ ‫من‬ ‫التركيز‬ ‫حتى‬ ‫على‬ ‫تفصيل‬ ‫و‬ ‫احد‬ ‫داخل‬ ‫البيئة‬ . – ‫المفاهيم‬ ‫الخاطئة‬ ‫شائعة‬ ، ‫وقد‬ ‫يحدث‬ ‫فقدان‬ ‫االتصال‬ ‫بالواقع‬ ‫االستجابات‬ ‫النفسية‬ ( ‫تابع‬ )
  • 17. Copyright © 2014. F.A. Davis Company Behavioral Adaptation Responses to Anxiety • At the mild level, individuals employ various coping mechanisms to deal with stress. A few of these include eating, drinking, sleeping, physical exercise, smoking, crying, laughing, and talking to persons with whom they feel comfortable. – ‫استجابات‬ ‫التكيف‬ ‫السلوكي‬ ‫للقلق‬ • ‫على‬ ‫المستوى‬ ‫المعتدل‬ ، ‫يوظف‬ ‫األفراد‬ • ‫آليات‬ ‫التكيف‬ ‫المختلفة‬ ‫للتعامل‬ ‫مع‬ ‫التوتر‬ . ‫عدد‬ ‫قليل‬ ‫من‬ ‫هذه‬ ‫تشمل‬ ‫يتناول‬ ‫الطعام‬ ، • ‫الشرب‬ ، ‫النوم‬ ، ‫ممارسة‬ ‫الرياضة‬ ‫البدنية‬ ، • ‫التدخين‬ ‫والبكاء‬ ‫والضحك‬ ‫والتحدث‬ ‫مع‬ ‫األشخاص‬ ‫الذين‬ ‫يشعرون‬ ‫بالراحة‬ ‫معهم‬ . Psychological Responses (cont’d)
  • 18. Copyright © 2014. F.A. Davis Company Psychological Responses (cont’d) • At the mild to moderate level, the ego calls on defense mechanisms for protection (table1-1) page.9, such as – Compensation – Denial – Displacement – Intellectualization – Rationalization – Reaction formation – Regression – Repression – Sublimation – Suppression – Undoing – ‫تعويض‬ – ‫إنكار‬ – ‫اإلزاحة‬ – ‫الفكر‬ – ‫ترشيد‬ – ‫تشكيل‬ ‫رد‬ ‫الفعل‬ – ‫تراجع‬ – ‫قمع‬ – ‫تسامي‬ – ‫إخماد‬ – ‫تراجع‬
  • 19. Copyright © 2014. F.A. Davis Company
  • 20. Copyright © 2014. F.A. Davis Company • Anxiety at the moderate to severe level that remains unresolved over an extended period can contribute to a number of physiological disorders, e.g., migraine headaches, irritable bowel syndrome, and cardiac arrhythmias. • Extended periods of repressed severe anxiety can result in psychoneurotic patterns of behaving, e.g., anxiety disorders and somatoform disorders. • ‫القلق‬ ‫في‬ ‫مستوى‬ ‫معتدل‬ ‫إلى‬ ‫شديد‬ ‫التي‬ ‫تبقى‬ ‫دون‬ ‫حل‬ ‫على‬ ‫مدى‬ ‫فترة‬ ‫طويلة‬ ‫يم‬ ‫كن‬ ‫أن‬ ‫تساهم‬ ‫في‬ ‫عدد‬ ‫من‬ ‫االضطرابات‬ ‫الفسيولوجية‬ ، ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫الصداع‬ ‫النصفي‬ ، ‫و‬ ‫متالزمة‬ ‫القولون‬ ‫العصبي‬ ، ‫وعدم‬ ‫انتظام‬ ‫ضربات‬ ‫القلب‬ . • ‫فترات‬ ‫ممتدة‬ ‫من‬ ‫القمع‬ ‫شديد‬ ‫يمكن‬ ‫أن‬ ‫يؤدي‬ ‫القلق‬ ‫إلى‬ ‫أنماط‬ ‫سلوكية‬ ‫عصبية‬ ‫نفس‬ ‫ية‬ ، ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫اضطرابات‬ ‫القلق‬ ‫واالضطرابات‬ ‫الجسدية‬ . Psychological Responses (cont’d)
  • 21. Copyright © 2014. F.A. Davis Company • Extended periods of functioning at the panic level of anxiety may result in psychotic behavior. • Examples of psychotic disorders include schizophrenia, schizoaffective disorders, and delusional disorders. • ‫فترات‬ ‫ممتدة‬ ‫من‬ ‫العمل‬ ‫في‬ ‫مستوى‬ ‫الذعر‬ ‫من‬ ‫القلق‬ ‫قد‬ ‫يؤدي‬ ‫إلى‬ ‫سلوك‬ ‫ذهاني‬ . • ‫تشمل‬ ‫أمثلة‬ ‫االضطرابات‬ ‫الذهانية‬ ‫الفصام‬ ، ‫واالضطرابات‬ ‫الفصامي‬ ‫ة‬ ‫العاطفية‬ ، ‫واالضطرابات‬ ‫الوهمية‬ . Psychological Responses (cont’d)
  • 22. Copyright © 2014. F.A. Davis Company Grief • The subjective state of emotional, physical, and social responses to the loss of a valued entity. • The loss may be real or perceived. • Elisabeth Kübler-Ross – 5 Stages of Grief  Denial  Anger  Bargaining  Depression  Acceptance Psychological Responses (cont’d) – 5 ‫مراحل‬ ‫الحزن‬  ‫إنكار‬  ‫الغضب‬  ‫مساومة‬  ‫اكتئاب‬  ‫قبول‬
  • 23. Copyright © 2014. F.A. Davis Company Stage 1—Denial: This is a stage of shock and disbelief. The response may be one of “No, it can’t be true!” The reality of the loss is not acknowledged. • ‫المرحلة‬ 1— ‫إنكار‬ : • ‫هذه‬ ‫مرحلة‬ ‫الصدمة‬ ‫وعدم‬ ‫التصديق‬ . ‫قد‬ ‫يكون‬ ‫الرد‬ ‫كالتالي‬ : " ‫ال‬ ، ‫ال‬ ‫يمكن‬ ‫أن‬ ‫يكون‬ ‫هذا‬ ‫ا‬ً‫ح‬‫صحي‬ !" ‫ولم‬ ‫يتم‬ ‫االعتراف‬ ‫بحقيقة‬ ‫الخسارة‬ . Stage 2—Anger: “Why me?” and “It’s not fair! "are comments often expressed during the anger stage. Envy and resentment toward individuals not affected by the loss are common. • ‫المرحلة‬ 2— ‫الغضب‬ : • " ‫لماذا‬ ‫أنا‬ ‫؟‬ " ‫و‬ " ‫هذا‬ ‫ليس‬ ً ً‫ال‬‫عد‬ ! " ‫هي‬ ‫التعليقات‬ ‫التي‬ ‫يتم‬ ‫التعبير‬ ‫عنها‬ ‫ا‬ً‫ب‬‫غال‬ ‫خالل‬ ‫مرحلة‬ ‫الغضب‬ . • ‫الحسد‬ ‫واالستياء‬ ‫تجاه‬ ‫األفراد‬ ‫الذين‬ ‫لم‬ ‫يتأثروا‬ ‫بالخسارة‬ ‫أمر‬ ‫شائع‬ . 5 Stages of Grief
  • 24. Copyright © 2014. F.A. Davis Company Stage 3—Bargaining: During this stage, which is usually not visible or evident to others, a “bargain” is made with God in an attempt to reverse or postpone the loss. Stage 4—Depression: During this stage, the full impact of the loss is experienced. The sense of loss is intense, and feelings of sadness and depression prevail. This stage differs from pathological depression in that it represents advancement toward resolution rather than the fixation in an earlier stage of the grief process. 5 Stages of Grief
  • 25. Copyright © 2014. F.A. Davis Company ‫المرحلة‬ 3— ‫مساومة‬ : ‫خالل‬ ‫هذه‬ ‫المرحلة‬ ، ‫والتي‬ ‫عادة‬ ‫ما‬ ‫تكون‬ ‫غير‬ ‫مرئية‬ ‫أو‬ ‫واضحة‬ ‫لآلخرين‬ ، ‫ي‬ ‫تم‬ ‫عقد‬ " ‫صفقة‬ " ‫مع‬ ‫هللا‬ ‫في‬ ‫محاولة‬ ‫لعكس‬ ‫الخسارة‬ ‫أو‬ ‫تأجيلها‬ . ‫المرحلة‬ 4— ‫اكتئاب‬ : ‫خالل‬ ‫هذه‬ ‫المرحلة‬ ، ‫يتم‬ ‫تجربة‬ ‫التأثير‬ ‫الكامل‬ ‫للخسارة‬ . ‫ويكون‬ ‫اإلحساس‬ ‫بالخسارة‬ ‫ًا‬‫د‬‫شدي‬ ، ‫وتسود‬ ‫مشاعر‬ ‫الحزن‬ ‫واالكتئاب‬ . ‫تختلف‬ ‫هذه‬ ‫المرحلة‬ ‫عن‬ ‫االكتئاب‬ ‫المرضي‬ ‫من‬ ‫حيث‬ ‫أنها‬ ‫تمثل‬ ‫التقدم‬ ‫ن‬ ‫حو‬ ‫الحل‬ ً ً‫ال‬‫بد‬ ‫من‬ ‫التثبيت‬ ‫في‬ ‫مرحلة‬ ‫مبكرة‬ ‫من‬ ‫عملية‬ ‫الحزن‬ . 5 ‫مراحل‬ ‫الحزن‬
  • 26. Copyright © 2014. F.A. Davis Company stage 5—Acceptance: *The final stage brings a feeling of peace regarding the loss that has occurred. *It is a time of quiet expectation and resignation. *The focus is on the reality of the loss and its meaning for the individuals affected • ‫س‬ ‫العالمة‬ 5— ‫قبول‬ : • * ‫المرحلة‬ ‫النهائية‬ ‫تجلب‬ ‫الشعور‬ ‫بالسالم‬ ‫تجاه‬ ‫الخسارة‬ ‫التي‬ ‫حدثت‬ . • * ‫إنه‬ ‫وقت‬ ‫التوقع‬ ‫الهادئ‬ ‫واالستسالم‬ . * ‫يتم‬ ‫التركيز‬ ‫على‬ ‫حقيقة‬ ‫الخسارة‬ ‫ومعن‬ ‫اها‬ ‫لألفراد‬ ‫المتضررين‬ 5 Stages of Grief
  • 27. Copyright © 2014. F.A. Davis Company • Anticipatory grief: the experiencing of the grief process before the actual loss occurs. • Resolution: length of the grief process is entirely individual. It can last from a few weeks to years. It is influenced by a number of factors. • ‫الحزن‬ ‫المتوقع‬ : ‫تجربة‬ ‫عملية‬ ‫الحزن‬ ‫قبل‬ ‫حدوث‬ ‫الخسارة‬ ‫الفعلية‬ . • ‫دقة‬ : ‫طول‬ ‫عملية‬ ‫الحزن‬ ‫فردية‬ ‫ا‬ً‫م‬‫تما‬ . ‫ويمكن‬ ‫أن‬ ‫تستمر‬ ‫من‬ ‫بضعة‬ ‫أسابيع‬ ‫إلى‬ ‫سنوات‬ . ‫يتأثر‬ ‫بعدد‬ ‫من‬ ‫العوامل‬ . Psychological Responses (cont’d)
  • 28. Copyright © 2014. F.A. Davis Company – The experience of guilt for having had a “love-hate” relationship with the lost entity. Guilt often lengthens the grieving process. – Anticipatory grieving is thought to shorten the grief response when the loss actually occurs. – The length of the grief response is often extended when an individual has experienced a number of recent losses and when he or she is unable to complete one grieving process before another one begins. – ‫تجربة‬ ‫الشعور‬ ‫بالذنب‬ ‫ألنه‬ ‫كان‬ ‫لديك‬ " ‫حب‬ ‫كره‬ " ‫العالقة‬ ‫مع‬ ‫الكيان‬ ‫المفقود‬ . ‫ا‬ً‫ب‬‫غال‬ ‫ما‬ ‫يؤدي‬ ‫الشعور‬ ‫بالذنب‬ ‫إلى‬ ‫إطالة‬ ‫عملية‬ ‫الحزن‬ . – ‫عتقد‬ُ‫ي‬ ‫أن‬ ‫الحزن‬ ‫االستباقي‬ ‫يقلل‬ ‫من‬ ‫استجابة‬ ‫الحزن‬ ‫عند‬ ‫حدوث‬ ‫الخسارة‬ ‫ب‬ ‫الفعل‬ . – ‫ا‬ً‫ب‬‫غال‬ ‫ما‬ ‫يمتد‬ ‫طول‬ ‫االستجابة‬ ‫للحزن‬ ‫عندما‬ ‫يتعرض‬ ‫الفرد‬ ‫لعدد‬ ‫من‬ ‫الخسائر‬ ‫األخيرة‬ ‫وعندما‬ ‫يكون‬ ‫غير‬ ‫قادر‬ ‫على‬ ‫إكمال‬ ‫عملية‬ ‫حزن‬ ‫واحدة‬ ‫قبل‬ ‫أن‬ ‫تبدأ‬ ‫عملية‬ ‫حزن‬ ‫أخر‬ ‫ى‬ . Psychological Responses (cont’d)
  • 29. Copyright © 2014. F.A. Davis Company • Resolution of the grief response is thought to occur when an individual can look back on the relationship with the lost entity and accept both the pleasures and the disappointments of the association. • ‫عتقد‬ُ‫ي‬ ‫أن‬ ‫حل‬ ‫استجابة‬ ‫الحزن‬ ‫يحدث‬ ‫عندما‬ ‫يتمكن‬ ‫الفرد‬ ‫من‬ ‫الن‬ ‫ظر‬ ‫إلى‬ ‫الوراء‬ ‫في‬ ‫العالقة‬ ‫مع‬ ‫الكيان‬ ‫المفقود‬ ‫وقبول‬ ‫كل‬ ‫من‬ ‫ملذات‬ ‫وخيب‬ ‫ات‬ ‫األمل‬ ‫في‬ ‫االرتباط‬ . Psychological Responses (cont’d)
  • 30. Copyright © 2014. F.A. Davis Company Maladaptive Grief Responses – Prolonged response – Delayed/inhibited response – Distorted response Psychological Responses (cont’d) ‫استجابات‬ ‫الحزن‬ ‫غير‬ ‫التكيفي‬ ‫ة‬ – ‫استجابة‬ ‫مطولة‬ – ‫تأخر‬ / ‫منع‬ ‫االستجابة‬ – ‫استجابة‬ ‫مشوهة‬
  • 31. Copyright © 2014. F.A. Davis Company 1- The prolonged response is characterized by an intense preoccupation with memories of the lost entity for many years after the lost has occurred • 1- ‫اال‬ ‫ستجابة‬ ‫طويلة‬ ‫يتميز‬ ‫ب‬ • ‫االنشغال‬ ‫الشديد‬ ‫بذكريات‬ ‫الكيان‬ ‫المفقود‬ ‫لسنوات‬ ‫عديدة‬ ‫بعد‬ ‫حدو‬ ‫ث‬ ‫الفقد‬ Behaviors associated with the stages of denial or anger are manifested. - ‫ظهور‬ ‫السلوكيات‬ ‫المرتبطة‬ ‫بمراحل‬ ‫اإلنكار‬ ‫أو‬ ‫الغضب‬ . Maladaptive Grief Responses
  • 32. Copyright © 2014. F.A. Davis Company 2- In the delayed or inhibited response, the individual becomes fixed in the denial stage of the grieving process. The anxiety disorders are experienced in this response (e.g., phobias, hypochondriasis) or sleeping and eating disorders (e.g., insomnia, anorexia) may be evident. • 2- ‫في‬ ‫تأخر‬ ‫االستجابة‬ ‫أو‬ ‫تثبيطها‬ ، ‫يصبح‬ ‫الفرد‬ ً ً‫ا‬‫ثابت‬ ‫في‬ ‫مرحلة‬ ‫ا‬ ‫إلنكار‬ ‫من‬ ‫عملية‬ ‫الحزن‬ . • ‫تظهر‬ ‫اضطرابات‬ ‫القلق‬ ‫في‬ ‫هذه‬ ‫االستجابة‬ ( ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫الرهاب‬ ، ‫الوسواس‬ ‫المرضي‬ ) ‫أو‬ ‫اضطرابات‬ ‫النوم‬ ‫واألكل‬ • ( ‫على‬ ‫سبيل‬ ‫المثال‬ ، ‫األرق‬ ، ‫فقدان‬ ‫الشهية‬ ) ‫قد‬ ‫يكون‬ ‫واضحا‬ . Maladaptive Grief Responses
  • 33. Copyright © 2014. F.A. Davis Company • 3- distorted response: • The individual is fixed in the anger stage of grieving. • all the behaviors associated with grieving, such as helplessness, hopelessness, sadness, anger, and guilt, are exaggerated out of proportion to the situation. • The individual is unable to function in normal activities of daily living. • Pathological depression is a distorted grief response. • 3- ‫االستجابة‬ ‫المشوهة‬ : • ‫يثبت‬ ‫الفرد‬ ‫في‬ ‫مرحلة‬ ‫الغضب‬ ‫والحزن‬ . • ‫جميع‬ ‫السلوكيات‬ ‫المرتبطة‬ ‫بالحزن‬ ، ‫مثل‬ ‫العجز‬ ‫واليأس‬ ‫والحزن‬ ‫والغضب‬ ‫والشعور‬ ‫ب‬ ‫الذنب‬ ، ‫يتم‬ ‫تضخيمها‬ ‫بشكل‬ ‫ال‬ ‫يتناسب‬ ‫مع‬ ‫الموقف‬ . • - ‫عدم‬ ‫قدرة‬ ‫الفرد‬ ‫على‬ ‫القيام‬ ‫باألنشطة‬ ‫الطبيعية‬ ‫للحياة‬ ‫اليومية‬ . • ‫االكتئاب‬ ‫المرضي‬ ‫هو‬ ‫استجابة‬ ‫مشوهة‬ ‫للحزن‬ . Maladaptive Grief Responses
  • 34. Copyright © 2014. F.A. Davis Company Thanks