Psych Chap 2: Relevant theories and therapies for nursing Practice (24-43)

Catharatic method of therapy (freud)

talk therapy "getting things off our chests" Evolved into "free association" which requires full and honest disclosure of thoughts and feelings as they come to mind

Three levels of Psychological awareness (freud)

Conscious, preconscious, and unconscious

Conscious:

tip of the iceberg, contains perceptions, memories, thoughts, tntasies and feelings that the person is aware of at any one time.

Preconscious

Just below the surface of awareness, contains material that can be retrieved rather easily through conscious effort (memories, stored knowledge etc)

Unconscious

Includes all repressed memories, passions, and unacceptable urges lying deep below the surface. (fears, violent motives, irrational wishes, shameful experiences, selfish needs Immoral urges, unacceptable sexual desires.

Personality structure (Freud)

interactive systems of the personality: the id, ego and superego.

Ego (Develops by 4th or 5th month of life)

Problem solver and reality tester, it develops because of the needs, wishes and demands of the id. (tells id, you have to delay gratification for right now)

Id (develops at birth)

the source of all drives, instincts reflexes, needs etc. Lacks the ability to problem solve, is not logical and operates according to pleasure.

Superego (last portion of personality to develop)

represents the moral component of personality. consists of the conscience (all the should nots internalized from parents) Represents the ideal rather than the real, it seeks perfection.

Defense mechanisms (26)

ego develops to ward off anxiety by preventing conscious awareness of threatening feelings. 2 features: (1) They all (except supression) operate on an unconscious level (2) they deny, falsify, or distort reality to make it less theratening.

Freuds Psychosexual stages of development (27)

(pg 27) Oral (0-1 year), Anal (1-3yr), Phallic (3-6yr), Latency, (6-12), genital (12 and up)

Transference

Develops when the patient experiences feelings toward the nurse or therapist that were originally held toward significant others in his or her life.

Countertransference

Is the healthcare workers unconscioius, personal response to the patient.

Erikson's Eight stages of development (29)

Infancy (0-1 1/2 yr), Early childhood (1 1/2 - 3 yr), Late childhood (3-6yr), School age (6-12), Adolescence (12-20 yr), Early adulthood (20-35), Middle adulthood (35-65) later years (65 to death)

Anxiety as defined by sullivan

any painful feeling or emotion that arises from social insecurity or prevents biological needs from being satisfied.

Security operations (sullivan)

to describe measures the individual employs to reduce anxiety and enhance security.

Self system (Sullivan)

Collectively, all the security operations an individual uses to defend against anxiety and ensure self-esteem.

Interpersonal psychotherapy

The goal is to reduce or eliminate psychiatric symptoms (depression) by imporving interpersonal functioning and satisfacction with social relationships.

interpersonal psychotherapy: Four types of problem areas identified

Grief, role disputes, role transition, interpersonal deficit.

Conditioning

involves pairing a behavior with a condition that reinforces or diminishes the behavior's occurrence.

classic conditioning (32)

learning to associate two stimuli, even unrelated stimuli, beyond the organism's control; involuntary; neutral stimulus can be made to trigger an unconditioned stimulus; Pavlov's dog salivation experiment (ex. dogs salivate at tone)

Operant conditioning (33)

conditioning in which an operant response is brought under stimulus control by virtue of presenting reinforcement contingent upon the occurrence of the operant response

Extinction (33)

absence of reinforcement decreases behavior by withholding a reward that has become habitual.

Behavioral therapy (33)

Based on the assumption that changes in maladaptive behavior can occur without insight into the underlying cause. four types: modeling, operant conditioning, systematic desensitization, and aversion therapy