Chapter 3 Personality Theory

1. Chapter 3 Personality Theory

2. Personality-relatively stable way a person feels, thinks, behaves Individualized psychosocial traits and characteristics Key influences form the personality Unconscious aspects Identity, biology, conditioning Cognitive dimension Specific traits, skills, and predispositions Spiritual dimension Interactions Development of Personality

3. Psychotherapists adhere to different theories, depending on the principle of personality studied Different approaches to treatment Personality theory in the early 20th century focused on one principle Freud, Skinner Personality Theory

4. Modern theories approach personality more holistically Many interacting parts and influences shape personality Personality Theory

5. Sigmund Freud – early 20th century Focus on finding root of unconscious thoughts and feelings that cause anxiety Free association Dream analysis – clues to unconscious mind Id, ego, superego Psychoanalytic Theory

6. Theory of development – psychosexual development Oral, anal, phallic, latency, and genital All behavior motivated and defense mechanisms are still considered valid Psychoanalytic Theory

7. Defense Mechanisms

8. Defense Mechanisms

9. Dream analysis Free association Interpretation of behavior Understand reason for anxiety to resolve conflicts Very limited practice Psychotherapy by Psychoanalysts

10. Defense mechanisms help nurses understand behavior – their own and their clients Behavior associated with defense mechanisms is either adaptive or maladaptive Nurses should point out maladaptive behavior and discuss adaptive options Nursing Implications

11. Carl Jung – analytic psychology Conscious ego, personal conscious, collective unconscious Culture plays an important role in personality development Individual motives and goals more important than sexual urges Alfred Adler Need for autonomy and control Inferiority complex Effects of birth order on personality development Ego Theorists

12. Karen Horney Disproved Freud’s theory of penis envy Women motivated by desire to have qualities associated with maleness Basic anxiety – child’s fear of being helpless and alone Passive, aggressive or withdrawn style of personality related to how children were treated Form the foundation of modern child-rearing practices Ego Theorists

13. Erik Erikson - psychosocial development Eight stages of development Each stage represents a conflict to be overcome called a developmental task Must overcome conflict in one stage before moving to the next Margaret Mahler – object relations theory Focus on separation-individualism Total dependence, ambivalence, separate individual or object Ego Theorists

16. Goal is to establish increasing levels of independence by assisting ego or self to overcome developmental obstacles Client talks to therapist and works to develop insight into reasons for anxiety Emphasis on clients studying own stories to understand own motivations and self-concept Play therapy used with children Psychotherapy By Ego Theorists

17. Erikson’s theory widely used in nursing Assessing clients developmental level Identifying developmental needs Planning nursing interventions to promote development Understand client’s priority concerns Understand client’s motivation for learning Nursing Implications

18. Believe people are born with certain predispositions and abilities affecting personality Response to stress, susceptibility to developing mental disorders, how they act and feel caused by genetic, chemical, and physiological forces Biological Theories

19. Hans Eysenck People with low level of brain arousal, seek stimulation - called extroverts People with higher level of CNS stimulation shy from stimulation – introverts Twin study for nature vs. nurture controversy Danger of accepting this theory is it negates personal responsibility and denies control over behavior Most biological theorists believe environment factors also involved Biological Theorists

20. Psychopharmacology is best evidence that biology affects thinking and behavior Drugs affect function of neurotransmitters Effectiveness of medication therapy has been a great breakthrough in quality of life of mentally ill Drugs do not help everyone Not completely cured by them Individuals respond differently to drugs Other approaches are also effective Therapeutic Perspective

21. Nurses collaborate with physicians who prescribe psychotropic drugs Nurses administer medications, monitor client response, and teach client to manage medications at home Holistic approach Nursing Implications

22. Attempt to summarize and predict human behavior by identifying universal personality traits Friedman and Schustack – Big Five Extroversion Agreeableness Conscientiousness Emotional stability Openness Trait Theories

23. Used to understand client’s abilities and uniqueness Personality styles and skills can be tested Therapist determines which characteristics are modifiable and which are not Counsel client how to act on problematic traits subject to change Goals and skills are subject to change, basic temperament is not Psychotherapy By Trait Theorists

24. Use information that some traits are innate to basic disposition and goals are modifiable to help people plan realistic goals Use knowledge that personality traits are constant as basis for understanding individual client variations and learning needs Nursing Implications

25. Behaviorist theories based on idea behavior persists if it is positively reinforced Personality shaped by life experiences Therapy includes planning and practicing new behavior reinforced so it continues Pavlov – classical conditioning Skinner – operant conditioning Behaviorists Theories

26. Behavioral therapy – training approach to changing behavior Nursing implications – provide positive reinforcement when client displays desirable health behaviors or use relaxation training Behaviorists Theories

27. Cognition – mental process by which knowledge is acquired and processed Gestalt theory – the complex pattern or arrangement of an experience is its essence Main ideas Human beings seek meaning in their lives People organize the stimuli we receive into perceptions that have meaning to us Complex experiences are more than the sum of their parts Cognitive Theories of Personality

28. Jean Piaget - cognitive development theory Four stages of intellectual development Sensorimotor state (0-2 years) Preoperational stage (2-7 years) Concrete operations stage (7-11 years) Formal operations stage (11-15 years) Cognitive Theorists

29. Howard Gardner – theory of multiple intelligences Vary in multiple ways of knowing about the world Language, logical-mathematical analysis Spatial representation, musical thinking Bodily kinesthetic intelligence, understanding self and others, naturalistic Cognitive Theorists

30. Albert Bandura – social learning theory Not all behavior explained by stimulus-response terms Psychological functioning result of interaction between personal attributes and environmental conditions Observational learning Studied how children learn aggressive behavior Self-efficacy Cognitive Theorists

31. Human perception and human cognition at the center of being human Not interested in unconscious or emotional motivations for behaviors Goal – rational decision making through understanding thought processes Cognitive Psychotherapy

32. Focus on overall general meanings of client situations and behaviors Role playing may be used Gestalt Therapy

33. Nurses frequently use cognitive approach Gain client’s cooperation Collaborate with planning goals Client teaching Emphasize how client will use information to promote self care Empowers people to actively participate in treatment Knowledge of cognitive development important Nursing Implications

34. Cognitive therapy Correcting errors in client’s thinking Promoting a positive sense of self-efficacy Role model healthy behavior Encourage desirable behavior Discourage undesirable behavior Allow clients to talk about feelings related to behavior change Create situations for clients to have positive experience with health-promoting behaviors Nursing Implications

35. Seeks the meaning of life or human existence Viktor Frankl – logotherapy Emphasis on personal choice and magnitude of love Existential and Humanistic Theories

36. Carl Rogers – client-centered therapy Focus on personal worth and essential role of human values Emphasized personal, subjective, and experiential aspects of human existence Client, not therapist, best able to understand the problem and what will help Existential and Humanistic Theories

37. Focus on human needs and most highly evolved state of human development Maslow’s hierarchy Abraham Maslow

38. Figure 3.7Maslow’s hierarchy of needs. Source: Craig, G. J. (2002). Human development,9e. Upper Saddle River: Prentice Hall. p. 474, figure 14-2.

39. Open and accepting attitude by therapist Encourages self-knowledge and authenticity in relationships Goals of therapy – overcome crisis of discovering meaning in life and finding self-actualization, love, and dignity Group therapy often used Encourage creative expression Encourage public service to combat alienation Client takes responsibility for own behavior Humanistic Psychotherapy

40. Humanism is an excellent foundation for nursing care Provide holistic, nonjudgmental care to every client Provide unconditional positive regard Respect diverse cultural backgrounds Nursing Implications

41. Consider clients to be active participants in care Maslow’s hierarchy provides nurses with basis for prioritizing client needs and nursing interventions Nursing Implications

42. Harry Stack Sullivan Personality determined by interpersonal situations Society is cause of people’s problems People learn from experiences and change how they react Interpersonal Theories

43. Hildegard Peplau Mental health nurse theorist Identified psychiatric-mental health nursing as essential part of general nursing and a specialty Proposed nurse-client relationship as foundation for nursing practice Interpersonal Theories

44. Help client develop trusting relationships Client shares anxieties Therapist uses empathy to perceive client’s feelings and use relationship as corrective interpersonal experience Client-therapist relationship helps develop feelings of security and relieve anxiety Interpersonal Psychotherapy

45. Three phases of nurse-client relationship: Orientation Working Resolution or termination Careful problem-solving approach to treatment Nursing Implications

46. Personality test – Choose the shape you most relate to and read what the test reveals about you. 10 Personality tests – Take the old and the new shorter version of the IPIP New PI personality test. Compare the differences between the two. Resources