Psychosocial Theories and Therapy

Hysteria

a diagnosis in the 1800s used for symptoms that looked neurological (paralysis, blindness, seizures, fainting, numbness, pain) without a clear physical/medical cause.

Franz Anton Mesmer (1734-1815)

Believed that the planets influence health through a force he called animal magnetism. People had a "universal magnetic fluid" that affected well-being. He thought healing happened by restoring the flow of this "magnetic fluid,"

Mesmerism

early predecessor to hypnosis

Jean Charcot (1825-1893)

Was influential and treated hysteria as a neurological condition.

Hippolyte-Marie Bernheim (1840-1919)

Ambroise-Auguste Liébeault (1823-1904)

Believed that Hysteria was nothing more than a form of self-hypnosis. People could unconsciously "suggest" symptoms to themselves (not faking—more like an automatic mental process).

Psychoanalytic

Developmental

Interpersonal

Humanistic

Behavioral

Existential

Major Types of Psychosocial Theories

Psychoanalytic

Focuses on unconscious processes, early life experiences, and inner conflicts.

Developmental

Explains behavior and mental health based on stages of growth and maturation

Interpersonal

Emphasizes social relationships and communication in influencing mental health.

Humanistic

Focuses on personal growth, self-actualization, and the human potential for change.

Behavioral

Views behavior as learned; therapy focuses on conditioning and reinforcement.

Existential

Addresses human existence, meaning, freedom, and responsibility in mental health.

Sigmund Freud

Father of Psychoanalysis. Theory is deterministic: all human behavior has a cause and can be explained. Believed that repressed sexual impulses and desires drive much human behavior.

Psychodynamic theory

pioneered by Sigmund Freud and Josef Breuer, asserts that human behavior is driven by unconscious, often repressed, childhood memories, traumas, and innate biological drives. emphasizes the "talking cure" (Catharsis) to make the unconscious conscious, resolving conflicts between the id, ego, and superego.

Id, Ego, Superego

Personality Components

Id

Innate, basic desires: pleasure-seeking, aggression, sexual impulses. Seeks instant gratification; impulsive, unthinking, ignores rules.

Superego

Moral and ethical standards, societal and parental expectations. Opposes the id; enforces self-control and discipline.

Ego

Mediator between id and superego. Represents mature, adaptive behavior for functioning successfully in the world

Conscious, preconscious, unconscious

Levels of Awareness

Conscious

Thoughts, perceptions, emotions currently in awareness.

Preconscious

Thoughts and emotions not in immediate awareness, but can be recalled with effort.

Unconscious

Thoughts and feelings outside awareness yet motivate behavior.

Includes most defense mechanisms and instinctual drives.

Freudian Slip

A slip of the tongue revealing subconscious feelings or thoughts.

Dream analysis, Free association, Transference

Psychodynamic Techniques

Freud's Dream Analysis

Dreams reflect the subconscious mind and have symbolic meaning.

Latent content

symbolic meaning of dream

Manifest content

according to Freud, the remembered story line of a dream

Free Association

Therapist says a word; client responds immediately with first thought. Reveals subconscious or repressed thoughts and feelings.

Transference

Occurs when the client unconsciously displaces feelings or attitudes from past relationships onto the therapist. Patterns are automatic and unconscious.

Countertransference

Occurs when the therapist unconsciously projects past feelings or attitudes onto the client.

Compensation

Overachieving in one area to offset deficiencies in another

Conversion

Emotional conflict expressed as a physical symptom

Denial

Refusal to acknowledge reality

Displacement

Directing emotions to a less threatening target

Dissociation

Temporary alteration in consciousness or identity

Fixation

Immobility in a developmental stage

Identification

Adopting traits of someone admired

Intellectualization

Separating facts from emotions

Introjection

Accepting others' beliefs as your own

Projection

Attributing unacceptable thoughts to others

Rationalization

Justifying behavior to avoid guilt or anxiety

Reaction Formation

Acting opposite to true feelings

Regression

Reverting to an earlier developmental stage

Repression

Blocking painful thoughts from consciousness

Resistance

Avoiding processing anxiety-provoking information

Sublimation

Channeling unacceptable impulses into acceptable activity

Substitution

Replacing desired gratification with a more available one

Suppression

Consciously putting aside unacceptable thoughts

Undoing

Making amends for unacceptable behavior through acceptable actions

EROS (Life Instincts)

Represents the life drive: survival, growth, connection, creativity. linked to libido because it motivates people to seek pleasure and maintain life.

THANATOS (Death Instinct)

Represents the death drive: aggression, destruction, self-harm tendencies (in Freud's view). Can either be directed inward or outward

Oral (Birth - 18 months)

Id present at birth; ego begins to develop gradually. Focuses on Mouth, lips, tongue; biting & sucking

Anal (18 - 36 months)

Voluntary sphincter control acquired (toilet training). If fixation happens: Anal-retentive traits: perfectionistic, rigid, controlling Anal-expulsive traits: messy, impulsive, careless

Phallic / Oedipal

Genital focus; penis as organ of interest. If fixation happens: issues with confidence, identity, relationships, attention-seeking, guilt

Latency Period

psychosexual stage in which sexual feelings are dormant. Resolution of Oedipal complex; formation of superego; focus on school, sports

Genital period

Puberty through adulthood. Re-emergence of sexual urges. However, now these urges can be channeled into adult sexuality.

Erik Erikson

Expanded Freud's work by focusing on social and psychological development across the lifespan. Each stage involves a life task, which when successfully completed, results in a virtue that contributes to overall mental health and well-being.

Infant (0-18 months) | Learn world is safe; needs met | Hope

Trust vs. Mistrust — Age, life task, virtue?

Toddler (18-36 months) | Control & independence | Will

Autonomy vs. Shame & Doubt — Age, life task, virtue?

Preschool (3-5 years) | Develop conscience; manage conflict/anxiety | Purpose

Initiative vs. Guilt — Age, life task, virtue?

School-age (6-12 years) | Confidence & competence in abilities | Competence

Industry vs. Inferiority — Age, life task, virtue?

Adolescence (12-18 years) | Form personal identity/sense of self | Fidelity

Identity vs. Role Confusion — Age, life task, virtu

Young Adult (19-40 years) | Build adult relationships/attachments | Love

Intimacy vs. Isolation — Age, life task, virtue?

Middle Adult (40-65 years) | Productivity; contribute to next generation | Care

Generativity vs. Stagnation — Age, life task, virtue?

Maturity (65+ years) | Reflect with acceptance/satisfaction | Wisdom

Ego Integrity vs. Despair — Age, life task, virtue?

Jean Piaget

Explored how intelligence and cognitive functioning develop in children, emphasizing that biologic maturation drives cognitive growth. Children progress through stages, with each stage representing higher cognitive abilities than the previous.

Sensorimotor

birth to 2 years, Develops sense of self separate from environment. Earns object permanence (objects exist even when out of sight). Begins forming mental images

Preoperational

2-6 years. - Develops language and symbolic thought - Understands meaning of gestures - Begins classifying objects

Concrete Operations

6-12 years. Begins logical thinking - Understands reversibility and spatial relationships. Applies rules but thinking is still concrete

Formal Operations

12-15 years and beyond. Abstract and hypothetical reasoning, Advanced logical thinking and problem-solving - Cognitive maturity achieved

Harry Stack Sullivan.

emphasized the importance of interpersonal relationships in personality development and mental health. He believed Inadequate or unsatisfying relationships produce anxiety, which underlies most emotional problems.

Prototaxic

Brief, unconnected experiences; no relation between events

Parataxic

Experiences are connected in sequence but illogical; interpreted as coincidence

Syntaxic

Experiences analyzed within context of environment; logical and coherent thinking

Infancy

Childhood

Juvenile

Preadolescence

Adloscence

Sullivan's Five Life Stages

Infancy (Birth-onset of language)

Needs: bodily contact, tenderness. Mode: prototaxic - Primary zones: oral & anal - Met needs which are intentional, makes sense of well-being; unmet needs → anxiety/dread

Childhood (Language-5 years)

Parents as source of praise & acceptance. Mode: shift to parataxic (connects experiences in sequence) - Primary zone: anal - Gratification → positive self-esteem; anxiety → self-defeating behaviors

Juvenile (5-8 years )

Mode: beginning of syntaxic (analyzing self & others) - Learning to negotiate needs - Severe anxiety → controlling/restrictive behaviors

Preadolescence (8-12 years)

- Genuine intimacy with same-sex friends - Shift from family satisfaction to peer attachment - Syntaxic mode predominates - Capacity for attachment, collaboration, and love develops

Adolescence (Puberty-adulthood)

- Need for sharing relationship with opposite sex - Social experimentation - Consolidation of self-esteem or self-ridicule - Focus expands to values, career, and social concerns

Hildegard Peplau: Therapeutic Nurse-Patient Relationship

Built on Sullivan's interpersonal theories. Nurse functions as a participant observer. Focuses on relationship between nurse and patient to promote healing. Relationship progresses through four phases.

Orientation, Identification, Exploitation, Resolution

Phases of the Nurse-Patient Relationship

Orientation

- Patient's problems and needs are clarified

- Patient asks questions

- Hospital routines and expectations explained

- Patient harnesses energy toward problem-solving

- Nurse elicits full patient participation

Identification

- Patient responds to persons perceived as helpful

- Expresses feelings

- Feels stronger

- Works interdependently with nurse

- Roles of both nurse and patient clarified

Exploitation

- Patient makes full use of available services

- Goals such as going home and returning to work emerge

- Behavior fluctuates between dependence and independence

Resolution

- Patient gives up dependent behavior

- No longer needs professional services

- Assumes power to meet own needs and set new goals

Mild anxiety

Sharpened senses; alert; able to solve problems and learn effectively

Moderate anxiety

Perceptual field narrowed to immediate task; can be redirected; learning possible with assistance

Severe anxiety

Perceptual field greatly reduced to scattered details; cannot solve problems or learn independently

Panic anxiety

Perceptual field reduced to self; distorted perceptions; loss of rational thought; delusions or hallucinations possible