Chapter 2: Theories and Therapies

Vocabulary-style flashcards covering major theories and therapies in Chapter 2 notes.

Freud's Levels of Awareness

Conscious: material you are aware of; Preconscious: retrievable with effort; Unconscious: repressed memories and urges.

Id

Unconscious, impulsive part of personality; seeks immediate gratification; pleasure principle; cannot problem-solve.

Ego

Rational part; reality testing; mediator between id and external world; problem solver across conscious, preconscious, and unconscious.

Superego

Moral component; conscience and ego ideal; strives for perfection; guilt when standards are not met.

Defense mechanisms

Unconscious processes that deny, distort, or falsify reality to reduce anxiety.

Freud's Psychosexual Stages

Oral, Anal, Phallic, Latency, Genital; each with specific conflicts and developmental tasks.

Oral stage (0-1 year)

Satisfaction from oral activities; trust development; ego development begins.

Anal stage (1-3 years)

Satisfaction from anal region; control over impulses; toilet training.

Phallic stage (3-6 years)

Oedipus/Electra conflicts; development of sexual identity with same-sex parent; early superego development.

Latency stage (6-12 years)

Growth of ego functions; focus on school and friendships; sexual feelings repressed.

Genital stage (12+ years)

Maturation of sexual identity; mature sexual and intimate relationships; focus on love and work.

Transference

Unconscious feelings toward a health care worker originating from childhood relationships.

Countertransference

Therapist's unconscious emotional reactions toward the patient.

Classical Psychoanalysis

Traditional Freudian approach: free association, dream analysis, recognition of defenses; includes transference.

Psychodynamic Therapy

Newer psychoanalytic model; focus on here-and-now; more therapist-patient interaction; suitable for motivated clients.

Interpersonal Theory (Peplau)

Nurse as participant-observer; focus on interpersonal relationships; anxiety reduction enhances thinking.

Security operations

Measures used to reduce anxiety and protect self-esteem.

Self-system

All security operations used to defend against anxiety and maintain self-esteem.

Interpersonal Therapy applications

Most effective for grief/loss, interpersonal disputes, and role transitions.

Behavioral therapy

Focuses on observable behavior changes; not always requiring insight; used for specific problems.

Modeling

Therapist demonstrates a behavior for the patient to imitate.

Operant conditioning

Use of positive reinforcement to increase desired behaviors.

Exposure therapy

Facing feared situations in a safe environment to reduce anxiety.

Aversion therapy

Pairing a target behavior with a negative stimulus to extinguish it.

Biofeedback

Gaining awareness and control over physiological responses to stress.

Cognitive theory

Thoughts influence feelings and actions; irrational beliefs and automatic thoughts.

Rational-emotive therapy

Identify and challenge distorted beliefs; replace with realistic thoughts to reduce symptoms.

Cognitive Behavioral Therapy

CBT; identify cognitive distortions and restructure thinking; goal-oriented.

All-or-nothing thinking

Viewing outcomes in absolutes (black-and-white thinking).

Overgeneralization

A single negative event becomes a universal rule.

Mental filter

Focusing on negative detail while ignoring positives.

Disqualifying the positive

Rejecting positive information as irrelevant or invalid.

Jumping to conclusions

Mind-reading or fortune-telling about others' thoughts or outcomes.

Magnification/minimization

Exaggerating negatives or minimizing positives.

Should statements

Rigid self- and other-directed demands; perfectionistic expectations.

Emotional reasoning

Believing something is true because it feels true.

Trauma-focused CBT (TF-CBT)

CBT adapted for trauma; addresses sexual abuse trauma; includes caregivers; shorter-term.

Dialectical Behavior Therapy (DBT)

Integrates CBT with mindfulness and skills for emotional regulation; long-term therapy.

Maslow's Hierarchy of Needs

Physiological, safety, love/belonging, esteem, self-actualization, self-transcendence; motivation rises as lower needs are met.

Self-Actualization

Becoming who one is capable of; accurate reality perception; spontaneity; mission-focused living.

Self-Transcendence

Going beyond self-interest to connect with larger meanings or others.

Biological Model

Focus on neurological, chemical, biological, genetic factors; also considers social/environmental influences.

Pharmacotherapy

Use of medications to treat psychiatric illness.

Brain stimulation therapies

ECT, rTMS, VNS, and DBS used to modulate brain activity.

Piaget's cognitive development (general)

From sensorimotor to formal operational stages; interaction with environment builds knowledge.

Erikson's eight stages

Eight psychosocial stages from Trust vs Mistrust to Integrity vs Despair; each with a developmental task.

Kohlberg's stages

Moral development through three levels: preconventional, conventional, and postconventional.

Ethics of Care (Gilligan)

Moral reasoning centered on relationships and care for others; critiques Kohlberg.

Mahler object relations

Early relationships shape self and later relationships; separation-individuation; good-enough parenting.

Developmental theories (nursing implications)

Developmental perspectives guide assessment and inform which interventions are most effective.