PSYT 209 Test 4

~personality development, personality DOs, defense mechanisms, patient ed

what is personality?

Basically, personality is the characteristic patterns of thoughts, feelings, and behaviors that make a person unique.

personality definitions

• The combination of character, behavior, temperamental, emotion, and mental traits that are unique to each specific individual.

• American Psychological Association (2017)- “The characteristic patterns of thinking, feeling, and behaving that define individual differences and clarify how the various parts of a person come together as a whole.”

• DSM-5- enduring patterns of perceiving, relating to, & thinking about the environment and oneself.

• Occurs in response to- heredity (genetics), temperament, experiential learning, social interactions, environment, and more!

personality is expressed _

through behavior

Freud’s Theories

Sigmund Freud (1856-1939) was one of the first to identify stages of personality development- how we get our personalities.

His psychoanalytical Theory says the personality is made up of 3 parts:

• the Id, Ego, and Superego

• These 3 components ‘interact’ with each other in our mind

The 3 parts have different functions and features~ Psychoanalytical Theory

• The Id- instinctual drives that seek to satisfy needs and achieve immediate gratification; “Pleasure Principle”.

• The Ego- rational self, mediator between ID and Superego; “reality Principle”.

• The Superego- internalizes learned values and morals; our conscience formed R/T bad behavior; “perfection Principle”.

Freud’s Homer

Id

• primitive features that are driven by an unconscious need for pleasure (pleasure principle). Present at birth. Displays itself as selfish and demands gratification.

Ego

• develops around the age of 2 and focuses on the reality principle. It reduces conflict between id and superego by implementing defense mechanisms.

Superego

• develops around the age of 5. It’s our internal morals (morality principle) that we learn from our same-sex parent, that punishes our ego for any wrong through guilt.

The ID

Present at birth, primitive

Instinctive, selfish, unlearned

Operates on the “Pleasure Principle”

If uncontrolled, may erupt into conscious forms of fantasies, or overt behavior.
(Antisocial, lawlessness, rape.)

EGO

Formed between 4 and 6 months

Portion lies within the conscious mind

Operates on the “Reality Principle”

Mediates between the Id and Superego

A strong Ego will integrate all three

A weak Ego disintegrates and results in developing mental illness

the Superego

Develops between 3 and 6 years

Blindly rigid

Strictly moralistic

As unrelenting as the Id

Represents moral and social values

Supervises the Ego–“Perfection Principle”

Ego-Ideal~ components of superego

develops through “rewards” for “good behavior” and becomes part of our value system.

Conscience~ components of superego

develops out of punishment for “bad behavior” and creates guilt, anxiety, and shame.

cathexis

when the Id puts energy in to getting what it wants.

anti-cathexis

when the Ego & Superego use energy to control the Id.

libido

the drive to fulfill basic physiological needs (hunger, thirst, sex)

cathexis; anti-cathexis; libido~ example

when you’re hungry you might see food in your mind= Cathexis; the Id wants to eat.

Anti-cathexis removes this picture if you’re dieting.

Freud picture the mind as having 3 parts:

• conscious mind

• preconscious mind

• unconscious mind

Conscious~ structures of the mind

Includes all memories that remain within the individual’s awareness- memories that are easy to recall like what you had for breakfast or the last movie you saw.

Controlled by the Ego.

Directs the individual as he/she behaves in a rational way.

Conscious - smallest of the three areas.

Pre-conscious or sub-conscious~ structures of the mind

includes all memories not in present awareness, but can be readily recalled, like your first grade teacher or your favorite song when you were 13.

Freud believed this suppressed unpleasant memories and unacceptable thoughts from reaching the conscious level.

Thought to be under the control of the Super-Ego.

Unconscious~ structures of the mind

Includes all memories & feelings that one has experienced, but cannot bring to conscious awareness.

Rarely aware of un-conscious mind, but material here can influence behavior.

Can only be retrieved through hypnosis, psychoanalysis, Na+ Amytal (a drug), dreams.

Unconscious - largest of the three areas

topography of the mind

Freud viewed the 3 levels of consciousness as an iceberg- our current memories are above water (the tip) but the majority of our memories are below, out of reach; the largest part.

Freud’s Psychosexual Theory

Freud believed the formation of the personality took place through 5 stages of Psychosexual Development.

His psychosexual Theory outlines what happens in the first five years of life.

If the child is successful at tasks or has positive experiences during this time, ‘normal’ development happens. If not, there will be problems in adulthood.

Freud’s oral stage

(0-18 months)- behavior is directed by the Id.

Goal is immediate gratification of needs.

A sense of security and ability to trust others develops when basic needs met.

Example: baby hungry, mom feeds, baby trusts.

Or- baby hungry, no food, baby not happy; no trust/security developed on when next meal is.

Freud’s anal Stage

(18 months - 3 years) – learning independence and control, with focus on excretory functions. Toilet training can effect values and personality.

Freud’s phallic Stage

(3-6 years) - focus of energy shifts to genital area. Pleasure in sexual self or group-exploratory play. identification with same-sex parent.

Freud’s latency Stage

(6-12 years) - focus changes from egocentrism to more interest in group activities, learning, and socialization with peers (mostly same gender).

Freud’s Genital Stage

(13-20 years) - reawakening of libido with maturing of sexual organs. Focus on relationships with opposite sex, preparations for selecting a mate, and behaviors acceptable by societal norms.

SULLIVAN’S THEORY

Harry Stack Sullivan (1892-1949)

Interpersonal Theory:

Personality results through interpersonal relationships, social interactions.

All human interaction is goal directed between satisfaction and security.

(“good me”= self contentment; “bad me” = self discomfort; “not me”= intense anxiety)

Infancy~ Sullivan’s Developmental Stages

(0-18 months) - gratification of needs through interaction with others

Childhood~ Sullivan’s Developmental Stages

(18 months to 6 years) - learns about delayed gratification. Uses language to communicate needs when interacting with others

Juvenile~ Sullivan’s Developmental Stages

(6 to 9 years) – formation of relationships with peers through competition, cooperation, and compromise

Preadolescence~ Sullivan’s Developmental Stages

(9 to 12 years) - develops relationships with friends of same gender.

Early Adolescence~ Sullivan’s Developmental Stages

(12 to 14 years) - struggling with sense of identity; develop relationships with opposite gender.

Late Adolescence~ Sullivan’s Developmental Stages

(14 to 21 years) - formation of lasting, intimate relationship; independence.

Adult~ Sullivan’s Developmental Stages

(21 & older) - maintains balance and involvement between self & community

ERIKSON’S THEORY

Erik Erikson (1963)

Psychosocial - development of personality is influenced through social processes.

Eight Stages In The Life Cycle of man.

If individual masters tasks in each stage, then they are well integrated.

If individual has trouble mastering tasks at an early stage, then it’s more difficult to master succeeding tasks.

Infancy~ Erikson’s Developmental Stages

(0 - 18 months) - Trust vs Mistrust

develop basic trust in mothering figure and be able to generalize it to others.

Early Childhood~ Erikson’s Developmental Stages

(18 months - 3 years) - Autonomy vs Shame and Doubt

gain some self-control and independence.

Lack of self confidence and pride when fails to complete tasks.

Late Childhood~ Erikson’s Developmental Stages

(3 years - 6 years) - Initiative vs Guilt

develop a sense of purpose and ability to initiate and direct own activities

School Age~ Erikson’s Developmental Stages

(6 years - 12 years) - Industry vs Inferiority

achieve a sense of self-confidence by learning, competing, performing successfully, and receiving recognition from others & peers

Adolescence~ Erikson’s Developmental Stages

(12 years - 20 years) - Identity vs Role Confusion

establish identity, place in society, emotional stability

Young Adulthood~ Erikson’s Developmental Stages

(20years - 30 years) - Intimacy vs Isolation

goal- form an intense, lasting relationship or a commitment to another person, cause, institution, or creative effort

Adulthood~ Erikson’s Developmental Stages

(30 years - 65 years) - Generativity vs Stagnation

achieve the life goals established for oneself and consider future generations

Old Age~ Erikson’s Developmental Stages

(65 years - death) - Ego Integrity vs Despair

review one’s life and derive meaning from both positive and negative events, while achieving a positive sense of self-worth

PIAGET’S THEORY

Jean Piaget (1896 – 1980)

Cognitive Development Theory

Cognition= “thinking skills”- language, calculation, reasoning, perception, memory, judgement, imagination.

Human intelligence is an extension of biological adaptation- progression of “logical organization”.

Sensorimotor~ Piaget’s Stages

(0 - 2 years)

Increased mobility and awareness

Development of a sense of self as separate from environment

Concept of “object permanence” (things you see don’t disappear/ leave) emerges as ability to form mental images evolves

Preoperational~ Piaget’s Stages

(2 years - 6 years)

Learning to express self with language

Characterized by egocentrism

Development of understanding of symbolic gestures (book= story time)

Achievement of object permanence

Concrete Operations~ Piaget’s Stages

(6 years - 12 years)

Learning to apply logic to thinking

Development of understanding of reversibility and spatiality

Learning to differentiate and classify

Increased socialization and application of rules

Concept of “lawful self”- rule conscious.

Formal Operations~ Piaget’s Stages

(12 years - 15 years)

Learning to think and reason in abstract terms

Making and testing hypotheses

Capability of logical thinking and reasoning expand and are refined

Cognitive maturity achieved- the capability to perform mental operations of adulthood

personality development

Understanding mental health and mental illness depends largely upon understanding the process through which human beings develop, emotionally and cognitively.

Sigmund Freud/Defense mechanisms

Sigmund Freud (1856-1939) noted a number of ego defenses in his written works. He called these Defense Mechanisms.

His daughter Anna Freud (1895-1982) developed these ideas and added more of her own.

Defense Mechanisms

Defense mechanisms are psychological strategies that are unconsciously used to protect a person from anxiety and stress arising from unacceptable thoughts or feelings.

Stress

“An environmental event that produces a physiological response”.

“A condition in which the human system responds to input that has disturbed it’s steady state”.

“A relationship between the person and the environment that is appraised by the person as taxing or exceeding his/her resources and endangering his/her well-being”.

Anxiety

“Vague sense of impending doom”

“An apprehension or sense of dread with no basis in reality”

“Diffuse apprehension”

“Heightened and persistent inner tension”

Normal Anxiety

realistic apprehension of a previously un-encountered situation that has symbolic meaning

Pathological Anxiety

response to feelings, thoughts, wishes, desires, that if conscious would be unacceptable to the individual. Results from prolong, intense anxiety and poor coping skills

Levels or Degrees of Anxiety

• Mild

• Moderate

• Severe

• Panic

All levels will have physiological symptoms. These usually get worse as the anxiety level goes up.

MILD~ Levels or Degrees of Anxiety

Seldom a problem; associated with the tension of day-to-day living

Awareness of the environment is heightened.

Symptoms (Sx.)- HR, BP, respirations may increase a bit.

Moderate~ Levels or Degrees of Anxiety

The perceptual field diminishes. Focus on immediate concerns.

Client is less alert to environment.

Attention span and ability to concentrate decrease

Muscular tension and restlessness may be evident. Pounding heart, perspiration, stomach discomfort. BP, HR, sweating incrs.

Severe~ Levels or Degrees of Anxiety

perceptual field greatly reduced

Connection between details is diminished

Physical symptoms may be evident- Headache (HA), Nausea, Dizziness, feelings of Dread.

Panic

The most severe state. Frightening to the point of paralyzing.

Distorted perceptions

May be a loss of contact with reality

Decreased ability to communicate/ relate/ function with others.

HR, BP, pulse, sweat, and respirations will be very high.

Factors affecting Stress and Anxiety

Predisposing Factors - biological make-up, psychological and sociocultural characteristics

Precipitating Factors - events, perception of those events, situations, feelings

Responses to Stress and Anxiety

• “Fight or Flight”

• Physiological - increased heart rate & respirations, dry mouth, nausea, increase in B/P, loss of appetite

• Behavioral - tremors, restlessness, lack of coordination

• Cognitive - attention affected, altered thoughts

• Affective - anger, crying

• Acting Out
  Overtly - angry outbursts, etc.
  Covertly - passive-aggressive behavior

• Withdraw - sleeping, getting away

• Somatization - headache, nausea, etc.

Adaptations~ Defense Mechanisms

Coping Mechanisms - operate in the conscious

Ego Defense Mechanisms - mostly operate in the unconscious

Short-term Coping Mechanisms

are conscious maneuvers focused on the anxiety itself, rather than on the source.

• Designed to effect a relatively immediate relief from the anxiety

• eating

• exercise, meditation, relaxation

• withdrawing, sleeping

Long-term Coping Mechanisms

characterized by efforts to address the source of the anxiety.

More functional than short-term mechanisms, and provide individual with patterns of behavior that increase self-esteem.

Education - classes; therapy

Ego Defense Mechanisms

• Sigmund Freud: the Ego= the reality component of the personality

• The Ego has some tools it can use in its job as the mediator, tools that help defend the Ego.

• These are called Ego Defense Mechanisms or Defenses.

• Used by the Ego as a protective device to relieve mild to moderate anxiety

• Some are more adaptive than others.

• Can become maladaptive, can distort reality.

Compensation~ Ego Defense Mechanisms

Covering up a real or perceived weakness by emphasizing a trait one considers more desirable.

Prestige seems to be one of the fundamental needs of the individual.

May lead to greater efforts.

Example: non-athlete builds brain

Denial~ Ego Defense Mechanisms

Refusing to acknowledge the existence of a real situation, or the feelings associated with it.

Example: alcoholics self- medicate daily; MD gives bad news but tell others there’s no problem.

Displacement~ Ego Defense Mechanisms

The transfer of feelings from the actual object to another object that is considered less threatening or that is neutral.

Example: A patient (pt.) is mad at MD but mean to everyone else.

Identification~ Ego Defense Mechanisms

An attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires.~ conscious

Example: A sick teenager becomes a doctor.

Introjection~ Ego Defense Mechanisms

Integrating the beliefs and values of another individual into one’s own ego structure.~ unconscious

Example: Children learn from parents.

Isolation~ Ego Defense Mechanisms

Separating a thought or memory from the feeling, tone, or emotion associated with it.

Example: pt. describing abuse and showing no emotion.

Projection~ Ego Defense Mechanisms

Attributing feelings or impulses unacceptable to one’s self, to another person.

Used by paranoid patients.

Example: pt. likes you, but says you like him.

Rationalization~ Ego Defense Mechanisms

Attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors.

Example: “I drink alcohol to cope”; “No one else studied.”

Reaction Formation~ Ego Defense Mechanisms

Preventing unacceptable or undesirable thoughts or behaviors from being expressed, by exaggerating opposite thoughts or types of behaviors.

Example: RN hates nursing but tells others it’s a great job.

Regression~ Ego Defense Mechanisms

Retreating in response to stress to an earlier level of development, and the comfort measures associated with that level of functioning.

Example: When feeling sick or sad, a child drinks from a bottle rather than a cup.

Repression~ Ego Defense Mechanisms

Involuntarily blocking unpleasant feelings and experiences from one’s awareness.~ unconsciously suppress impulses

Unconsciously done.

Experiences involving guilt, shame, or lowering of self-esteem are particularly likely to be repressed.

Example: An accident victim’s thoughts of the accident are blocked.

Sublimation~ Ego Defense Mechanisms

Re-channeling of drives or impulses that are personally or socially unacceptable into activities that are constructive or acceptable.

Example: A mom supports MADD when child killed by drunk driver.

Suppression~ Ego Defense Mechanisms

The voluntary blocking of unpleasant feelings and experiences from one’s awareness.~ consciously deny impulses

Only ego defense mechanism that aware of when using it.

Example: “I don’t want to think of State Boards right now.”

Undoing~ Ego Defense Mechanisms

Symbolically negating or canceling out an experience that one finds intolerable.

Example: Yelling at someone, then giving them a gift to make it better.

Result of Ego Defense Mechanisms~ Ego Defense Mechanisms

Can be healthy; used consciously/uncons., to protect ego.

Relieve mild to moderate anxiety.

The lack of these defenses, or the inability to use them effectively, can often lead to problems in life.

People sometimes employ the defenses at the wrong time or overuse them.

Personality

DSM-5- enduring patterns of perceiving, relating to, & thinking about the environment and oneself.

Temperament

A set of inborn personality characteristics that influence an individual’s manner of reacting to the environment, and ultimately influences his or her developmental progression.

~ Personality also includes someone’s temperament and traits.

Personality Traits

qualities of behavior that make the person unique. These are characteristics which a person is born with or develops early in life. It influences the way he or she perceives and relates to the environment and are stable over time.

A Disorder can develop when these traits, or behaviors, become inflexible and maladaptive.

Personality Trait Examples

Openness

Conscientiousness

Extraversion

Agreeableness

Neuroticism

Morals and Values:

are developed through primary caregivers and internalized by the super-ego between ages of 3 and 6 years of age.

Freud- Phallic stage

Erikson-Late Childhood (Initiative vs Guilt)

Where do personality disorders come from?~ Etiology of Personality Disorders

• Family Dynamics- member interactions

• Neurobiology- brain physiology

• Intrapersonal Factors- traits, temperament

• Genetics- DNA

• (‘intrapersonal’= within the person)

• (‘interpersonal’= involving 2 or more people)

Personality Disorder

Pervasive and inflexible pattern of behavior demonstrating unhealthy characteristics that limit the individual’s ability to function in society.

The presence of a personality disorder is most clearly indicated by a persistent maladaptive response pattern that is stable over the lifetime.

Personality Disorder Characteristics

• Lead to significant distress or impairment in social, occupational, or other important areas of functioning.

• Do not emerge in response to specific, situational stressors.

• Become recognizable in adolescence or early adult hood.

• are inflexible and maladaptive responses to stress.

• include difficulty with interpersonal relationships.

• have the capacity to evoke negative feelings in others.

• do not interfere with intellect. A person with a PD can still read, write, and do math.

A~ DSM 5 PD General Diagnostic Criteria

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two or more of the following ways:

1. Cognition

2. Affectivity

3. Interpersonal Functioning

4. Impulse Control

B~ DSM 5 PD General Diagnostic Criteria

The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

Pervasive= everywhere

C~ DSM 5 PD General Diagnostic Criteria

The enduring pattern leads to clinical significant distress or impairment in social, occupational, or other important areas of functioning.

D~ DSM 5 PD General Diagnostic Criteria

The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.

E~ DSM 5 PD General Diagnostic Criteria

The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. (not caused by other illness)

F~ DSM 5 PD General Diagnostic Criteria

The enduring pattern is not due to physiological effects of substance abuse, or medical condition.

Boundary

defines the level of interaction between individuals and members of subsystems

Ego Dystonic

pertaining to something repulsive to the individual’s self-image. (OCD- one understands the need to change Bx.)

Ego Syntonic

pertaining to something that is consistent with the individual’s self-image. (anorexia- one is fine with Bx. of not eating).

Manipulation

to influence or manage shrewdly or deviously for personal gain.

Projection

attributing one’s own feelings, attitudes, or desires on to others.