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2 PSYCHOANALYTICAL MODEL
2.1 CONSCIOUSNESS
When anxiety becomes too painful, defense mechanisms are used to protect
the ego and diminish anxiety
Excessive use prevent the person from problem solving
They are unconscious but some are within voluntary control
Denial: unconscious refusal to admit an unacceptable idea or behavior
Repression: unconscious and involuntary forgetting of painful ideas, events,
and conflicts
Suppression: conscious exclusion from awareness of anxiety-producing
feelings, ideas, and situations
Rationalization: conscious or unconscious attempts to justify ones feelings or
behaviors
Intellectualization: conscious or unconscious logical explanations without an
affective component
Dissociation: unconscious separation of painful feelings and emotions from an
unacceptable situation, object, or idea
Identification: conscious or unconscious attempt to model oneself after a
respected person
Introjection: unconsciously incorporating values and attitudes of others as if
they were your own
Compensation: consciously covering up for a weakness by overemphasizing
or making up a desirable trait
Sublimation: consciously or unconsciously channeling instinctual drives into
acceptable activities
Reaction formation: conscious behavior that is the exact opposite of an
unconscious feeling
2.3 RELEVANCE
TO NURSING PRACTICE
Nurse must recognize and understand the maladaptive defense mechanisms,
share observations regarding the defense mechanisms, assist the patient to
increase their awareness of using the defense mechanisms, and increase the
use of adaptive behaviors
3 DEVELOPMENTAL MODEL
Eriksons theory: Every person must pass through eight interrelated stages
over the life cycle
Failure to complete a stage results in reduced ability to cope psychologically
Trust vs. Mistrust: (0-18 months) develop realistic trust of self and others
Autonomy vs. Shame (18 months 3 years) developing self-control and
willpower
Initiative vs. Guilt (3-5 years) developing an adequate conscience
Industry vs. Inferiority (6-12 years) sense of competence
Identity vs. Role (12-20 years) confident sense of self
Intimacy vs. Isolation (18-30 years) ability to give and receive love
Generative lifestyle vs. Stagnation (30-65 years) product, constructive,
and creative activity
Integrity vs. Despair (65-death) feelings of self-acceptance
3.1 RELEVANCE
TO NURSING PRACTICE
Patients with psychiatric disorders demonstrate partial mastery of
developmental stages
Nurses conduct assessment on the patients level of function to identify the
degree of mastery of each stage up to the patients age
Assessment reveals issues that need to be addressed while working with the
patient
4 INTERPERSONAL MODEL