Theories of Personality

  1. What are therapeutic models?
    • Framework for organizing thinking about the manifestation, the development, and treatment of disorders
    • Theory attempts to establish scientific method of studying an individual as a living, social being, and contributes a language with which to examine and communicate human action
  2. Freud's personality structure
    • Id - most primative, unconscious activity; impulse driven; goal is to satisfy self; aggressive or sexual
    • Ego - rational part of self, impression of self; logic; present oriented; delays gratification; makes decisions
    • Superego - last to develop; reward and punishment; "should and should not"; moral behavior
    • Overdeveloped superego - feel the need to be perfect; obsessive
    • Underdeveloped superego - sociopathic; reckless; lack of remorse
  3. Freud levels of awareness
    • Conscious - awareness
    • Preconscious - subconscious; info that is not readily in mind but is easily available through conscious effort
    • Unconscious - repressed memories; no conscious awareness; thoughts that cannot easily pull up (i.e. memories of rape, trauma)
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  4. Freud developmental stages
    • Oral (0-1yr) - id based; trust develops (if child has trauma, they may have trust issues as an adult); fixation: passivity, gullibility, dependence
    • Anal (1-3yr) - expulsion and retention phase; control develops and some sense of autonomy; fixation: anal retentiveness (stinginess, rigid thought patterns, OCD)
    • Phallic (3-6yr) - genitals; sexual identity with parent of same sex; lack of successful resolution may result in difficulties with sexual identity and authority figures
    • Latency (6-12yr) - develop competency; growth of ego functions and ability to care about and relate to others; fixation: difficulty identifying with others and in developing social skills, inadequacy, inferiority
    • Genital (12yr+) - develop sexual relationships with opposite sex; develop identity; inability to negotiate this stage can result in difficulties becoming emotionally and financially independent
  5. Erikson vs. Freud
    • Erikson: stressed ego; psychosocial aspects of development; considers life span development; studied healthy people; more present oriented
    • Freud: stressed id and superego; psychosexual aspects of development; personality formed by age of 5; studied neurotic people
  6. Erikson's psychosocial stages
    • Infancy (0 - 1 1/2) - trust vs. mistrust
    • Early childhood (1 1/2 - 3) - autonomy vs. shame and doubt
    • Late childhood (3 - 6) - initiative vs. guilt
    • School age (6 - 12) - industry (competence, ability to work) vs. inferiority
    • Adolescence (12 - 20) - identity vs. role confusion (submission of identity)
    • Early adulthood (20 - 35) - intimacy vs. isolation
    • Middle adulthood (35 - 65) - generativity (ability to give and care for others) vs. self-absorption (inability to grow as a person)
    • Later years (65+) - integrity vs. despair (dissatisfaction with life; denial)
  7. Sullivan theories
    • Interpersonal theorist
    • Study personality in a social setting (relationships); thought that changes or crisis in these relationships is what therapy should be about
    • Needs: satisfactions, security
    • Anxiety: empathetic between child and mother; can be described, observable behaviors; individuals strive to decr anxiety
    • Self system: good-me, bad-me, not-me
    • Security operations: selective inattention, dissociation
  8. Peplau
    • 1948 - wrote first textbook "Interpersonal Relations in Nursing"
    • Believed in nurse-patient relationship, foundation of nursing
    • Emphasized one's own behaviors and beliefs; must have self-awareness before can care for pt
    • 3 phases of interpersonal process:
    • Orientation: establish rapport, set boundaries, scouting phase, assessment
    • Working: interventions, problem-solving, work toward goals
    • Resolution: termination phase, summarize positive things that happened during interaction or any achievement pt has made
  9. Peplau's ideas about nursing
    • Focus is on client
    • Nurse is participant observer not an spectator observer (active role)
    • Nurse has awareness of role
    • Nursing is investigative
    • Nurses use theory
    • Developed process recording
  10. Object relations theory
    • Margaret Mahler
    • Disruption in object relations yields either difficulties bonding to others or difficulties seeing self as separate from others
    • Ex: Pt w/ schizophrenia does not know where they end and where nurse begins
    • Psychologic attachment that people get toward an object or person
  11. Carl Rogers: Humanistic Psychology
    • Mental health is the norm
    • Actualizing tendency
    • Conditional positive regard
    • Neurosis
    • Incongruity
    • Elements of a psychologically healthy person
    • Sees people as good and that they are trying to fulfill their greatest potential
    • Client-centered therapy: non-directive, supportive
    • 3 requirements of therapists:
    • Congruence: non-verbal matches verbal
    • Empathy
    • Respect
  12. Piaget: Stages of cognitive development
    • Sensorimotor - 0 - 2yrs
    • Preoperational - 2 - 7yrs
    • Concrete operations - 7 - 11yrs
    • Formal operations - 11+yrs
    • Describes how cognitive development proceeds from reflex activity to application of logical solutions to problems
    • Before age of 10, children are concrete and have trouble with abstract thinking, so teaching has to be much more concrete and involve modeling.
  13. Piaget: Schema
    • Developed to organize and understand the world
    • Processes used to develop:
    • Assimilation - incorporate new ideas, objects, facts into framework of thoughts and they fit well
    • Accommodation - change schemata to let new behavior fit
  14. Maslow hierarchy
    • Physical health (food, water, O2, etc)
    • Emotional health
    • Mental health (meta-needs, intellectual)
    • Spiritual health
    • If lower needs not met, can't take care of higher needs (self actualization)
  15. Maslow's beliefs
    • Needs are fulfilled by and through other humans
    • A person does the best he can at the time
    • With adequate understandable info, a person will make good decisions
    • Man has a higher nature
  16. Kohlberg theory of moral development
    • Level 1 Preconventional (ages 4-10) - emphasis on external control, avoiding punishment; primarily concerned with self; no empathy; needs role model
    • Level 2 Conventional Role Conformity (ages 10-13) - want to please others and be considered "good"; develop social concern and conscience; don't question rules, just follow them
    • Level 3 Autonomous Moral Principles (after 13, if ever) - acknowledges possibility of conflict between 2 accepted standards and tries to decide between them; acts in accord with internalized standards; sense of morality based on making sense of what society says and if it is just and moral then will follow it
    • Implications for model: can use some transference (if pt in "law & order" phase, may be able to set some rules and they may be more receptive to teaching); can use level of moral pt is in to strengthen teaching
  17. Behaviorists
    • Pavlov - classical conditioning
    • Skinner - operant condition; positive or negative reinforcers (anything that is done that increases or decreases likelihood that behavior happens again; positive - praise, negative - adverse stimuli); extinction - absence of reinforcer to decrease behavior (ignoring behavior; ex: child spitting)
  18. Psychodynamic/psychoanalytic
    • Freud
    • Older technique
    • Not time limited; non-directive
    • Focus on internal experience, defense mechanisms, transference and past relationships
  19. Cognitive therapy
    • Active, directive approach
    • Time limited
    • Goal is to change faulty thinking with correct thinking
    • Therapist helps pt to recognize faulty thinking, feelings behind them, and alternatives
    • Focus on thoughts/cognitions and correcting distortions
  20. Common cognitive distortions
    • All-or-nothing - thinking in black and white, reducing complex outcomes and absolutes
    • Overgeneralization - using a bad outcome as evidence that nothing will ever go right
    • Labeling - form of overgeneralization where characteristic event becomes definitive and results in overly harsh label for self or others
    • Mental filter - focusing on negative detail or bad event and allowing it to taint everything else
    • Disqualifying the positive - maintaining negative view by rejecting info that supports positive view as being irrelevant, inaccurate, or accidental
    • Jumping to conclusions - making negative interpretation despite that there is little or no supporting evidence
    • Mind reading - inferring negative thoughts, responses, motives of others
    • Fortune telling - assuming a negative outcome is inevitable
    • Magnification or minimization - exaggerating importance of something
    • Emotional reasoning - drawing a conclusion based on an emotional state
    • "Should" and "must" statements - rigid self-directives that presume an unrealistic control over external events
    • Personalization - assuming responsibility for external event or situation that was likely outside personal control
  21. Interpersonal therapy
    • Focus on interpersonal relationships
    • Problems: grief, role disputes, role transition, interpersonal deficit
    • Therapist has active and directive role
  22. Behavioral therapy
    • Focus on learning more adaptive behavior
    • Applications: operant condition, modeling, systematic desensitization (slowly get closer to something you fear), aversion therapy, relaxation, assertiveness
    • Therapist has active and directive role
  23. Milieu therapy
    • Structuring of environment in order to promote positive behaviors in health and behavior
    • Clients feel a sense of support from one another
    • Clients not only interact in group, but also between groups and at meals
  24. Basic components of therapeutic milieu
    • Basic physiological needs are met
    • Physical facilities support therapeutic nature of program
    • Some form of self-governance
    • Unit responsibilities
    • Structured program
    • Community and family are included in order to facilitate discharge
  25. Role of psychiatric nurse in milieu
    • SAFETY
    • Participate in interdisciplinary plan of care
    • Ensure physiological needs are met (supervisory liability)
    • Medication administration and monitoring
    • One-one relationship; building trust; responding to needs; modeling
    • Client education
Card Set
Theories of Personality
Psych Exam 3 - Theories of Personality