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Psychiatric Mental Health Nursing Theoretical
Framework Part I
1.…
Psychiatric Mental Health Nursing Theoretical
Framework Part I
1. Psychoanalytic Theory (Sigmund Freud)
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The focus of the theory is to find the root of unconscious thoughts and feelings that cause the client's anxiety.
Structure of Personality
ID
- it is the source of all psychic energy that contains the primary instincts (sexual & aggression).
- It follows the “pleasure principle” to avoid pain regardless of reality.**
- The Id controls the child, the sociopathic and mentally ill behaviors.
Ego
- It is the objective/rational part of the personality that deals with reality.
- The ego controls actions and perceptions.
- It controls contact with reality.
- Through defense mechanisms, it inhibits primary instinctual drives.
- It acts as a mediator to coordinate
- The mechanisms used by the ego obey the “Reality Principle” and “Secondary Process Thinking (SPT)”.
Levels of Consciousness
Preconscious level
(the largest part, storing repressed memories and instincts).
- the content of the unconscious can be demonstrated through dreams, slips of the tongue or pen, unexplained behavioral responses, jokes, and lapses of memories. It may also emerge during psychotherapy (hypnosis).
- Materials stored in the unconscious have a powerful influence on behavior.
Unconscious level
- That part of the mind on which ideas and reactions are stored and partially forgotten (usually unacceptable and disturbing memories).
- A person can easily and voluntarily become aware if he wants.
Conscious level
- It is concerned with awareness of immediate thoughts, feelings, sensations, and surroundings.
- It is aware of the here and now.
It directs the individual to behave in a rational thoughtful way.
Dynamic Personality
Personality is driven by a limited amount of psychic energy, which originates from the life and death instincts in the Id. This energy is distributed between the Id, Ego, and Superego, and behavior results from the Ego's effort to balance their competing demands.
Fixation
Fixation occurs when a portion of a person's psychic energy remains stuck at an early psychosexual stage due to excessive frustration or gratification. This causes the individual to regress to behaviors characteristic of that stage when under stress, dominating their adult personality.
The Superego
- It is a moral aspect of personality.
- The super-ego always seeks perfection by inhibiting all Id's desires and seeks perfection.
- At a conscious level, it may be regarded as the voice of conscience.
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3. Phallic Stage (3-6 years)
- Good: Successfully resolving the Oedipus/Electra complex leads to healthy identification with the same-sex parent and a strong sense of gender identity.
- Bad: Failure to resolve it can result in sexual identity confusion, relationship problems, and guilt.
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- Defense Mechanisms: Ego's unconscious tools to reduce anxiety (e.g., repression, denial).
These are unconscious mental strategies used by the Ego to protect itself from anxiety and emotional conflict. While they provide short-term relief, overuse can lead to self-deception and mental health problems by distorting reality.
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Psychic Determinism
This is the principle that all behaviors, thoughts, and feelings have a specific, unconscious cause from our past experiences. Nothing in mental life is accidental; even slips of the tongue or dreams are meaningful and reflect unresolved unconscious conflicts.
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