Erikson’s Eight Stages of Development Residency

1. Erikson’s Eight Stages of DevelopmentResidency Jack Rozel, MD, MSL

2. Conflicts of Interest • Research Funding – Alexza, Janssen • Conference/Travel – Alexza, Eli Lilly, Janssen, Wyeth Ayerst • Speakers’ Bureaus – Pennsylvania ACLU • Stock Holdings – Johnson & Johnson, United Health (both sold in 2006)

3. What this is about • Review the 8 stages • Gain some insight into your own experience • Think about how you can help other people through their stages

4. Another Conflict of Interest

9. 1. Trust v MistrustBirth to 18 Months • Ego Development Outcome • Trust v Mistrust • Strength • Drive & Hope • Significant Relationship • Significant & Constant Caregiver • (Often the Mom)

11. 1. Trust v Mistrust • Two responses by my chief residents • “Fred” – I’m Looking into it • Anne – Venting or problem solving • Reward and positively reinforce the positive traits

12. 2. Autonomy v Shame18 Months to 36 Months • Ego Development Outcome • Autonomy v Shame • Strength • Self-control, Courage and Will • Significant Relationship • Parents

13. 2. Autonomy v Shame • Night of the three DKAs • But Yi-Chen was always there

15. 3. Initiative v Guilt3 to 5 years • Ego Development Outcome • Initiative v Guilt • Strength • Purpose • Significant Relationship • Basic family unit

16. 3. Initiative v Guilt3 to 5 years • Seema – You should be house staff president and make that a central issue! • “Ned” – I want you on a committee to look at that • Coach, don’t do

18. 4. Industry v Inferiority6 to 12 years • Ego Development Outcome • Industry v Inferiority • Strength • Method & Competence • Significant Relationship • School and neighborhood • Parents no longer the complete authority

19. 4. Industry v Inferiority6 to 12 years • The 10 PM Code • The perfectly balanced WPIC Lifestyle

21. 5. Identity v Role Confusion12 to 18 years • Ego Development Outcome • Identity v Role Confusion • Strength • Devotion and Fidelity • Significant Relationship • Peer groups

22. 5. Identity v Role Confusion • Child Psychiatry • Forensic Psychiatry • Law school • Medical Ethics • Emergency psychiatry • Health care administration • Public policy • Education

24. 6. Intimacy & Solidarity v Isolation18 to 35 years • Ego Development Outcome • Intimacy & Solidarity v Isolation • Strength • Affiliation and Love • Significant Relationship • Partners, Lovers & Friends

25. 6. Intimacy & Solidarity v Isolation • This one really matches! • Collaboration across disciplines • The end of adolescence

27. 7. Generativity v Self-absorption or Stagnation35 to 65 years • Ego Development Outcome • Generativity v Self Absorption or Stagnation • Strength • Production and Care • Significant Relationship • Family, Workplace & Community

28. 7. Generativity v Self-absorption or Stagnation • Career planning • Research? • Private practice or academics? • Clinical, forensic or law enforcement? • US or International? • Big money or quality of life now?

30. 8. Integrity v Despair65 years to death • Ego Development Outcome • Integrity v Despair • Strength • Wisdom • Significant Relationship • With all mankind

31. 8. Integrity v Despair Every man must decide whether he will walk in the light of creative altruism or in the darkness of destructive selfishness. This is the judgment. Life's most persistent and urgent question is: what are you doing for others?

33. Thank you!