Existential & psychoanalytical model

EXISTENTIAL & PSYCHOANALYTICAL MODEL IN PSYCHIATRY

1. CONCEPTUAL MODELS EXISTENTIAL MODEL & PSYCHOANALYTICAL MODEL   PREPARED BY Mrs. Divya Pancholi M.Sc. (Psychiatric Nursing) Assistant Professor SSRCN, Vapi

2. INTRODUCTION   ‘ Model is an organized complex body of knowledge such as concepts related to human behavior.’

3. The recognized conceptual models that are used in psychiatric nursing are: Medical model Nursing model Statistical model Communication model Social model Existential model Psychoanalytical model Behavioral model Interpersonal model

4. TERMINOLOGY THEORY - A theory is a set of concepts, definitions, relationships and assumptions or propositions that project/explain a systematic view of phenomena . The theory explains how these elements are uniquely related in the phenomena. CONCEPTS- Mental formulations of an object or an event which will come from individual perceptual experience, e.g. ideas, mental images, etc. which describes phenomena.

5. CONTI… DEFINITION- It conveys the general meaning of the concepts in a manner that fits the theory. It also describes the activity necessary to measure the constructs, relationships or variables. ASSUMPTIONS- Statements that describes factual concepts, statements that determine the nature, definitions, purpose, relationships and structure of the theory. PHENOMENON- Aspects of reality that can be consciously sensed or experienced, phenomena are apart of the domain of discipline.

6. 1. EXISTENTIAL MODEL Satre , Heidegger and Kierkegaard are the philosophers of existential model. The theory focuses on person’s present experience provide less attention to the person’s past.

7. EXISTENTIAL VIEW OF BEHAVIORAL DEVIATION Behavior deviations will occur If the individual is out of touch with him or his environment or when he poses self-imposed restrictions or inhibitors. When individual is not free to choose from among alternative behavior. When the individual avoids socially acceptable and responsible behavior.

8. MANIFESTATIONS Helplessness Sadness Lonely/aloof Self-criticism Lack of self -awareness Prevents participating in authentic and rewarding relationships with others

9. CONTI… Surrenders to the demand of others. Psychiatric clients lost the values which gives meaning for the existence; the world is absurd, gives invalid demands. Lacks of commitment Hazy identity Sense of unreality Will not accept the painful realities of life Altered sense of time

10. EXISTENTIAL THERAPEUTIC PROCESS The therapeutic process assumes that the patient must be able to choose freely from what life has to offer. The therapeutic goal is to return the patient to an authentic awareness of his being. The existential therapeutic process focuses on the encounter. The client is helped to accept and understand his past, to live present and to look forward to the future.

11. ROLE OF EXISTENTIAL THERAPIST Therapist acts as a guide, director and role model Provides warmth and caring, give values to the clients. Helps the client to find his way from the alienation of madness to the relatedness of full life. Therapist points out the areas where the client has to consider change. Treats the client as an adult, encourages hope and trust.

12. ROLE OF CLIENT Client is active in therapy. Client must be open and honest; ready for change. Accepts responsibility for his behavior. Works toward the challenges kept by the therapist.

13. PSYCHOANALYTICAL MODEL Given by Sigmund Freud . It is based on the concept of intrapsychic conflict within the individual. Psycho analysis system was presented both theoretical and practical side. On the theoretical side, it presented a theory to understand and explain the human psyche and On the practical side , it studies human behavior and also as a therapy to treat mentally ill.

14. DEFINTION It is defined as a psychological theory of mind and personality development based on concept of ‘ intrapsychic conflict’

15. BASIC CONCEPTS 1. PSYCHIC ENERGY/ PSYCHIC DETERMINISM : The human organism is a complicated energy system deriving from all the instincts or desires or needs fulfillment. The form of energy which operates the three systems of personality is called as ‘psychic energy’. It performs psychological work, i.e. thinking, perceiving, recalling, reasoning and analyzing etc. no mental activity or behavior is a random, accidental or meaningless, unless it is caused by abnormal behavior. 

16. 2. INSTINCTS/DRIVES : An instinct is the mental representative of a bodily need. Freud used the word instinct in his theories as the energy of all the life instincts. I.e. libido. It is a sum of psychic energy which imparts direction to psychological processes. The aim of an instinct is the fulfilled, the individual will get psychological and physiological satisfaction and the source of that instinct is eliminated, e.g. hunger drive.

17. CONTI… 3. CATHEXIS : Utilization of energy in the image of an object or in discharge action upon an object that will satisfy an instinct is called as, ‘cathexis’. The total energy of the id, is utilized in object-cathexis. 4. ANTI- CATHEXIS: The urging forces are to satisfy instinct, ‘ cathexis ’ and The checking forces are ‘anti- cathexis ’. The ego and super ego possess anti- cathexis . Ego and super ego checks the actions of id with their own forces. 

18. THE STRUCTURAL THEORY OF MIND In 1923, Sigmund Freud ID The id is the locus of the instinctual drives- the “pleasure principle”. present at birth. it is totally unconscious, containing the basic drives and instincts concerned with survival, sexual drive and aggression. The only urge of this drive is immediate gratification.

19. CONTI… EGO Ego is primarily determined and guided by the “reality principle’ . It is immediacy between three set of forces i.e. the instinctive, irrational demands of the id, realities of the external world and the ethical, moral demands of the super ego. Ego maintains a balance between id and super ego on one hand and the reality on the other.

20. CONTI… SUPER EGO Super ego referred to as a perfection principle. It consists of punitive con-science and non-punitive conscience ; both derive form the effect of parental influence on the ego. The parental influences not only include the effect of actual parents but also of the important people in the surrounding environment. Fear of punishment and a desire for approval cause the child to identify himself with the moral percepts of parents.

21. The open criticism, prohibitions, guilt arousing statements and punishments are introjected as conscience. Super ego develops in the five years of age of the child, it is idealistic in nature and perfection is its goal. On the other hand, the approvals and rewards become introjected as the ego ideal . Super ego is also furnished with the power to reward or to punish.

22. BEHAVIORAL EXAMPLES ID EGO SUPER EGO “I found this wallet; I will keep the money.” – “I already have money. This money doesn’t belong to me. Maybe the person who owns this wallet doesn’t have any money”. – “It is never right to take something that doesn’t belong to you”.  

23. THEORIES OF MIND / TOPOGRAPHIC THEORY OF MIND

24. THE THEORY OF PSYCHOSEXUAL DEVELOPMENT

25. STAGE AGE MAJOR DEVELOPMENTAL TASK ABNORMALITY   Oral Birth to 18 months Relief from anxiety through oral gratification of needs   Dependent personality traits, schizophrenia, severe mood disorders, and alcohol dependence syndrome and drug dependence behavior.   Anal 18 months to 3 years Learning independence and control, with focus on the excretory function   To obsessive compulsive personality traits and obsessive compulsive disorder.    

26. STAGE AGE MAJOR DEVELOPMENTAL TASK ABNORMALITY   Phallic 3 to 6 years Identification with parent of same gender, development of sexual identity focus on genital organs Sexual deviations, sexual dysfunction and neurotic disorders.     Latency 6 to 12 years Sexuality repressed, focus on relationships with same-gender peers   Neurotic disorders.   Genital 13 to 20 years Libido reawakened as genital organs mature focus on relationships with members of the opposite gender.   Neurotic disorders.  

27. ROLE OF THE PATIENT AND THE PSYCHOANALYST The client is an active participant , freely revealing all thoughts and feelings exactly as they occurred and describing the dreams. The psychoanalyst is a shadow person; he will not reveal any personal issues in order to allow the transference process. The analyst usually conducts the therapeutic session outside the direct line of the vision of the client , so that non-verbal responses do not influence the client’s verbalizations. Verbal responses are brief, so that it will not interfere with associative flow. By termination of therapy the patient will be able to view the analyst realistically as another adult having worked through his conflicts and dependency needs.