Theories of Personality

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

• Id - most primative, unconscious activity; impulse driven; goal is to satisfy self; aggressive or sexual EX: I want the cookie
• Ego - rational part of self, impression of self; logic; present oriented; delays gratification; makes decisions EX: I will decided if I want the cookie or not
• Superego - last to develop; reward and punishment; "should and should not"; moral behavior EX: I shouldn't have the cookie

Overdeveloped superego - feel the need to be perfect; obsessive

Underdeveloped superego - sociopathic; reckless; lack of remorse

• 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)
• 

• Oral (0-1yr) - id based; trust develops
• Anal (1-3yr) - control develops
• Phallic (3-6yr) - sexual identity and the beginning of superego
• Latency (6-12yr) - develop competency
• Genital (12yr+) - develop sexual relationships

• Erikson: stressed ego; psychosocial aspects of development; considers life span development; studied healthy people
• Freud: stressed id; psychosexual aspects of development; personality formed by age of 5; studied neurotic people

• 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)

• Orientation: establish rapport, set boundaries, scouting phase, assessment
• Working: interventions/problem-solving, work toward goals
• Resolution: summarize positive things that happened during interaction or any achievement pt has made

• Focus is on client
• Nurse is a participant observer not an spectator observer (active role)
• Nurse has awareness of role
• Nursing is investigative
• Nurses use theory
• Developed process recording

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

• 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

• Congruence: non-verbal matches verbal
• Empathy
• Respect

• Sensorimotor - 0 - 2yrs
• Preoperational - 2 - 7yrs
• Concrete operations - 7 - 11yrs
• Formal operations - 11+yrs

Developed to organize and understand the world

• Assimilation - incorporate new ideas, objects, facts into framework of thoughts and they fit well
• Accommodation - change schemata to let new behavior fit

• Physical health (food, water, O2, etc)
• Emotional health (love, esteem)
• Mental health (meta-needs, intellectual)
• Spiritual health
• If lower needs not met, can't take care of higher needs (self actualization)

• 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

• Level 1 Preconventional (ages 4-10) - emphasis on external control, avoiding punishment
• Level 2 Conventional Role Conformity (ages 10-13) - want to please others and be considered "good"; develop social concern and conscience
• 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

• Pavlov - classical conditioning
• Skinner - operant condition; positive or negative reinforcers

• Freud
• Older technique
• Not time limited; non-directive
• Focus on internal experience, defense mechanisms, transference and past relationships

• 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

• 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

• Focus on interpersonal relationships
• Problems: grief, role disputes, role transition, interpersonal deficit
• Therapist has active and directive role

• 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

• 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

• 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

• 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