Self Concept, Stress and Adapttion, Death Dying

combined set

Self Concept

How we see ourselves

Mental image of one self

Positive Self-Concept

Those with this are able to develop and maintain better interpersonal relationships, as well as resist psychological and physical illness

1. Self Knowledge

2. Self Expectations

3. Social Self

4. Social Evaluation

Four Dimensions of Self-Concept

Self Knowledge

Dimension of Self-Concept that involves insight into one’s own abilities, nature and limitations

Self Expectations

Dimension of Self-Concept that involves what one expects of themself; may be realistic or unrealistic

Goals and standards for oneself

Social Self

Dimension of Self-Concept that is how one is perceived by others and society

How one thinks others perceives themself

Social Evaluation

Dimension of Self-Concept that is the appraisal of oneself in relation to others, events, or situations

Process of feeling judged or being judged by others

1. Infancy: Trust vs Mistrust

2. Toddlerhood: Autonomy vs Self Doubt

3. Early Childhood: Initiative vs Guilt

4. Early School Years: Industry vs Inferiority

5. Adolescence: Identity vs Role Confusion

6. Early Adulthood: Intimacy vs Isolation

7. Middle-Aged Adults: Generativity vs Stagnation

8. Older Adulthood: Integrity vs Dispair

Erikson’s Stages of Psychosocial Development

Infancy: Trust vs Mistrust

Erikson’s Stage of Psychosocial Development

First stage

(1) Baby feels safe secure and loved; knows needs — food, comfort will be met; builds foundation for future relationships

(2) Anxiety, fear, suspicion if there’s inconsistent care or neglect

Toddlerhood: Autonomy vs Shame and Doubt

Erikson’s Stages of Psychosocial Development

About building independence or self-doubt

Early Childhood: Initiative vs Guilt

Erikson’s Stages of Psychosocial Development

About learning to take (1) or vs feeling (2) for trying

(1) If supportive caregivers encourage curiousity, will lead to (10

(2) If efforts, punished, criticised, dismissed child may feel (2) in trying —> hesitation, fear, failure, or avoiding leadership roles

Early School Years: Industry vs Inferiority

Erikson’s Stages of Psychosocial Development

About developing competence and pride in accomplishments vs feeling (2) and incapable

If efforts met with too much criticism or lack of support, individual may feel inadequate and have low self esteem

Adolescene: Identity vs Role Confusion

Erikson’s Stages of Psychosocial Development

About developing a clear sense of identity vs feeling confused about who you really are

Early Adulthood: Intimacy vs Isolation

Erikson’s Stages of Psychosocial Development

About building deep connections or experiencing loneliness

Middle-Aged Adults: Generativity vs Stagnation

Erikson’s Stages of Psychosocial Development

About creating a legacy and contributing to society or some ppl at this stage may feel unfulfilledness

Older Adults: Integrity vs Dispair

Erikson’s Stages of Psychosocial Development

Looking back with dignity and pride with things done or have feeling of regret of what should have been done

1. Personal Identity

2. Body Image

3. Role Performance

4. Self-Esteem

Components of Self Concept

Personal Identity

Component of Self Concept
Conscious sense of individuality and uniqueness that is continually evolving throughout life

Incs name, gender, race, ethnic origin, etc

Body Image

Component of Self Concept

How an individual perceives the size appearance and functioning of the body and its parts

Both cognitive and affective

Cognitive

Part of Body Image

Knowledge of material being

Affective

Part of Body Image

Feeling related to pain, pleasure, fatigue, and movement

Role Performance

Component of Self Concept

How individual in a particular role behaves in comparison to the behaviors expected of that role

Self Esteem

Component of Self Concept

One’s judgement of their own worth compared to others’ standards and to one’s ideal self

Global Self-Esteem

Type of Self Esteem

How much one likes themselves as a whole

Specific Self-Esteem

Type of Self Esteem

Approval of particular parts of oneself

1. Developmental Stage

2. Family & Culture

3. Stressors

4. Resources

5. History of Success and Failure

6. Illness

Factors Affecting Self Esteem

Loss

Removal, change, or reduction in which something of value (an object, person, situation) is no longer available

1. Actual

2. Perceived

3. Anticipatory

Types of Loss

Actual Loss

Types of Loss

Can be identified by others

Perceived Loss

Types of Loss

Can be experienced by one person, but can’t be verified by others (ex: psychological losses)

Anticipatory

Types of Loss

Experienced before the loss really occurs

1. Aspect of Self

2. External Object

3. Familiar Environment

4. Loved Ones

Sources of Loss

Aspect of Self

Source of Loss

A body part, physiologic function, or psychologic attritbute

External Object

Source of Loss

Money, house

Can be inanimate or animate

Familiar Environment

Source of Loss

Separation from environment and individuals who provide security

Loved One

Source of Loss

Through illness (like Alzheimer’s), divorce, separation, or death

1. Abbreviated Grief

2. Anticipatory Grief

3. Disenfranchised Grief

4. Complicated Grief

Types of Grief Responses

Abbreviated Grief

Type of grief response

Brief and occurs when the lost object or person is not of significant importance or can be replaced quickly by something of equal value

Anticipatory Grief

Type of grief response

Happens before the actual loss, where an individual begins to grieve in advance of the expected event

Reaction when the loss actually happens may become abbreviated

Disenfranchised Grief

Type of grief response

Individuals cannot openly acknowledge or express grief due to societal or cultural constraints

Occurs when losses are considered socially unacceptable or stigmatized or losses are related to secret/non-traditional relationships

Complicated/Unhealthy Grief

Type of grief response

Prolonged and intense form of grief that affects the individual’s ability to function normally

1. Persistent Complex Bereavement Disorder

2. Unresolved or Chronic Grief

3. Inhibited Grief

4. Exaggerated Grief

Types of Complicated Grief

Persistent Complex Bereavement Disorder

Type of Complicated Grief

Lasts for more than 12 mos

Unresolved or Chronic Grief

Type of Complicated Grief

Extended in length and severity

Inhibited Grief

Type of Complicated Grief

Many of the normal symptoms of grief are suppressed and other effects are experienced instead

Exaggerated Grief

Type of Complicated Grief

Dangerous activities used to lessen the pain of grieving

1. Shock & Disbelief

2. Developing Awareness

3. Restitution

4. Resolving the Loss

5. Idealization

6. Outcome Behavior

Engel’s Stages of Grieving

Shock & Disbelief

Engel’s Stages of Grieving

Individual refuses to accept the loss often feeling numb or detached

Accepts situation intellectually but denies it emotionally

Developing Awareness

Engel’s Stages of Grieving

Reality of the loss begins to penetrate consciousness and the individual starts to recognize the full extent of the loss

Anger may occur

Restitution

Engel’s Stages of Grieving

Individual engages in rituals of mourning, like funerals or memorials, to help process and acknowledge the los

Resolving the Loss

Engel’s Stages of Grieving

Individual attempts to deal with the painful void left

Still unable to accept, may accept a more dependent relationship with a support person and talks about memories about lost object

Idealization

Engel’s Stages of Grieving

Individual creates an image of the last person or object that is devoid of undesireable features

Represses all negative and hostile feelings toward lost object m

May feel guilty and remorseful abt past incosiiderate to lost person

Unconsciously internalizes admired qualities of lost object

Reminders of lost object evoke fewer feelings of sadness

Reinvest feeling with others

Outcome Behavior

Engel’s Stages of Grieving

Response to the loss is influenced by various factors such as:

• Importance of lost object

• Source of support

• Degree of dependence on relationship

• Degree of ambivalence toward lost object

• Number and nature of other relationships and previous grief experiences

1. Age

2. Significance of Loss

3. Culture

4. Spiritual Beliefs

5. Gender

6. Socioeconomic Status

7. Support System

8. Cause of Loss or Death

Factors Influencing Loss & Grief Responses

1. Use silence and personal presence along with techniques of therapeutic communication

2. Acknowledge the grief of the client’s family and SO

3. Offer choices that promote client autonomy

4. Provide information regarding how to access community resources

Providing Emotional Support

1. Traditional Signs of Death

2. Cerebral (Higher Brain) Death

3. Persistent Vegetative State

Definitions of Death

Traditional Signs of Death (Heart-Lung Death)

Definition of Death

Cessation of:

• Apical Pulse

• Respirations

• Blood pressure

Cerebral (Higher Brain) Death

Definition of Death

Cerebral cortex is irreversibly destroyed — person must have a permanent loss of the ability to use all brain stem functions and be incapable of consciousness.

May result from severe brain injury or permanent cessation of circulation.

Persistent Vegetative State (PVS)

Definition of Death

Condition where a person has lost cognitive function and awareness, but respiration and circulation remain.

May display facial, eye, and limb movements but do not interact purposefully with their environment.

May partially recover or fully recover, but this is not always the case.

Dr. Cecily Saunders

Founded Hospice Care

Hospice Care

Focuses on the support and care of the dying client with a life expectancy of 6 months or less.

To improve quality of life rather than cure

Palliative Care

• Improves the quality of life of patients and their families facing life-threatening illnesses.

• Prevention and relief of suffering by means of early identification and impeccable treatment and other probs (physical, psychosocial, spiritual)

• Relief fm pain and other distressing symptoms

• Affirms life and regards dying as a normal process.

• Intends neither to hasten nor postpone death.

• Integrates psychological and spiritual aspects of care.

1. Algor Mortis

2. Liver Mortis

3. Rigor Mortis

Post Mortem Physiological Changes

Algor Mortis

Post Mortem Physiological Changes

Cooling of the body that occurs immediately after death and continues for hours

Liver Mortis

Post Mortem Physiological Changes

Blood pools in the lowest parts of the body within 30 mins to 2 hours after death and becomes fixed to 8-12 hours

Once fixed, blood will not move if body is repositioned

Rigor Mortis

Post Mortem Physiological Changes

Stiffening begins 2-4 hours after death, starting in smaller muscles like the jaw and neck and then progressing downwards

Stress

Universal phenomenon; experienced by all individuals (parents, workers, students, etc)

Change in normal balance

Stressor

Event/stimulus causing stress

Coping Mechanisms

Responses to stressors

1. Internal

2. External

3. Developmental

4. Situational

Sources of Stress

Internal Stressors

Source of stress that originates within an individual (like infection or depression)

External Stressors

Source of stress that originates outside (like moving out, death of a loved one, peer pressure)

Developmental Stressors

Source of stress that involves predictable events across life stages

Situational Stressors

Source of stress that are unpredictable and may occur anytime (like death, marriage, divorce, birth, new job, illness)

Impact of events depends on developmental stage (ex: death of a parent affects child more than an adult)

1. Physical

2. Emotional

3. Mental

4. Social

5. Spiritual

Effects of Stress

1. Stimulus-Based Models

2. Selye’s Response-Based Models

   1. General Adaptation Syndrome (GAS)

   2. Local Adaptation Syndrome (LAS)

3. Lazarus’ Transactional Stress Theory

Models of Stress

Stimulus-Based Model

Model of Stress

Defines stress as a ___, life event or set of circumstances that arouses physiological and psychological reactions that may increase the individual’s vulnerability to illness

Selye’s Response-Based Model

Model of Stress

Stress is the nonspecific ___ of the body to any kind of demand made upon it

1. General Adaptation Syndrome (GAS)

2. Local Adaptation Syndrome (LAS)

Selye’s Response-Based Models

General Adaptation Syndrome

Response-Based Model

Stress response is a series of physiological events triggered by stress involving the release of adaptive hormones and changes in body structure and chemical composition

1. Alarm

2. Resistance

3. Exhaustion

Stages of Gas

Alarm

Stage of GAS

Initial response to stress, the body begins to mobilize defenses

Includes Shock & Countershock phases

Shock

Phase in Alarm

Body perceives stress and Sympathetic Nervous System —> Hypothalamus —> Corticotropin-releasing hormone → Pituitary Gland → Adrenocorticotropic hormone (ACTH) → Adrenal Medulla → Catecholamines (epinephrine & norepinephrine)

Countershock Phase

Phase in Alarm

Body reverses the changes form the shock phase as it begins to adapt

Resistance

Stage of GAS

Body attempts to cope with the stressor and limits the impact to the smallest possible area of the body

Exhaustion

Stage of GAS

Body’s ability to adapt is overwhelmed. Prolonged stress can lead to death

Local Adaptation Syndrome

Response-Based Model

Body can also react locally, one organ or a part of the body reacts alone

Lazarus’ Transactional Stress Theory

Model for Stress

Criticizes Stimulus- and response- based models don’t consider ind differences, arguing that neither explains why some and some don’t adapt effectively

Inds and grps vary in their vulnerability, rxn, ints to events

Anxiety

State of mental uneasiness, apprehension, dread, or foreboding or a feeling of helplessness related to an impending or anticipated unidentified threat to self or significant relationships.

1. Mild

2. Moderate

3. Severe

4. Panic

Levels of Anxiety

Mild Anxiety

Level of Anxiety

Slight arousal that enhances perception, learning, and productive abilities

Moderate Anxiety

Level of Anxiety

Increases the arousal to a point where the individual expresses feelings of tension, nervousness or concern. (perception is narrowed; attention is focused)

Severe Anxiety

Level of Anxiety

Consumes most of the individual's energies and requires intervention (perception is further decreased; unable to focus on what is happening.)

Panic

Level of Anxiety

An overpowering, frightening, level of anxiety causing the individual to lose control (distorted perception)

Fear

An emotion or feeling of apprehension aroused by impending or seeming danger, pain, or another perceived threat

Anger

Emotional state consisting of a subjective feeling of animosity or strong displeasure

Constructive

Clearly expressed verbal communication of anger, when the angry individual tells the other individual about the anger and carefully identifies the source, is ____.

Depression

Common reaction to events that seem overwhelming or negative.

Ego Defense Mechanism

Unconscious psychological adaptive mechanisms that develop as the personality attempts to defend itself, establish compromises among conflicting impulses, and calm inner tensions.

Altruism

Emotional conflicts and stressors dealt with by performing helpful service to others that results in satisfaction and pleasure