Copyright © 2002 by W. B. Saunders Company. All rights reserved. Chapter 13 Understanding Anxiety and Anxiety Defenses Menu F
Copyright © 2002 by W. B. Saunders Company. All rights reserved. Anxiety vs. Fear ANXIETY Reaction to an unspecified danger FEAR Reaction to a specific danger Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Anxiety operationally defined 13-3 (Fig. 13-1) Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Perceptual field heightened l Grasps what is happening l Identifies disturbing things l Can work toward a goal l Can examine alternatives l Experiences slight discomfort l Restlessness, irritability l Mild tension relieving behaviors l Perceptual field heightened l Grasps what is happening l Identifies disturbing things l Can work toward a goal l Can examine alternatives l Experiences slight discomfort l Restlessness, irritability l Mild tension relieving behaviors Mild Anxiety Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Perceptual field narrows l Selective inattention l Needs to have things pointed out l Problem solving ability moderately impaired l Benefits from guidance l Shaky voice, concentration difficult l Sympathetic nervous system symptoms l Somatic complaints l Perceptual field narrows l Selective inattention l Needs to have things pointed out l Problem solving ability moderately impaired l Benefits from guidance l Shaky voice, concentration difficult l Sympathetic nervous system symptoms l Somatic complaints Moderate Anxiety Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Perceptual field greatly reduced l Attention scattered l Self-absorbed l Can’t attend to events or see connections l Perceptions distorted l Feelings of dread/doom l Sympathetic nervous system symptoms l Confusion, purposeless activity l Perceptual field greatly reduced l Attention scattered l Self-absorbed l Can’t attend to events or see connections l Perceptions distorted l Feelings of dread/doom l Sympathetic nervous system symptoms l Confusion, purposeless activity Severe Anxiety Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Unable to focus on environment l Terror, emotional paralysis l Hallucinations/delusions l Muteness, severe withdrawal l Immobility or extreme agitation, severe shakiness l Disorganized, irrational thinking l Unintelligible speech l Sleeplessness l Unable to focus on environment l Terror, emotional paralysis l Hallucinations/delusions l Muteness, severe withdrawal l Immobility or extreme agitation, severe shakiness l Disorganized, irrational thinking l Unintelligible speech l Sleeplessness Panic Level Anxiety Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Manage conflict and affect l Are relatively unconscious l Are discrete from one another l Are often hallmarks of psychiatric syndromes l Are reversible l Are adaptive as well as pathological l Manage conflict and affect l Are relatively unconscious l Are discrete from one another l Are often hallmarks of psychiatric syndromes l Are reversible l Are adaptive as well as pathological Defenses against Anxiety Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Sublimation 13-9 Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Humor Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Suppression Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Compensation Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Introjection Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Identification Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Repression Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Displacement Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Reaction Formation Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Somatization Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Undoing Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Rationalization Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Regression Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Projection Menu FB
Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Denial Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Help identify anxiety and antecedents to anxiety l Anticipate anxiety-provoking situations l Demonstrate interest l Encourage talk about feelings and concerns l Keep communication open l Use clarification to understand l Encourage problem solving l Use role playing, modeling l Explore behaviors used in past l Provide outlets for excess energy l Help identify anxiety and antecedents to anxiety l Anticipate anxiety-provoking situations l Demonstrate interest l Encourage talk about feelings and concerns l Keep communication open l Use clarification to understand l Encourage problem solving l Use role playing, modeling l Explore behaviors used in past l Provide outlets for excess energy Interventions: Mild to Moderate Anxiety Menu FB
Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Maintain calm manner l Remain with client l Minimize environmental stimuli l Use clear, simple statements and repetition l Low pitched voice; speak slowly l Reinforce reality if distortions occur l Listen for themes l Meet physical and safety needs l Set verbal limits/physical limits l Assess need for medication or seclusion l Maintain calm manner l Remain with client l Minimize environmental stimuli l Use clear, simple statements and repetition l Low pitched voice; speak slowly l Reinforce reality if distortions occur l Listen for themes l Meet physical and safety needs l Set verbal limits/physical limits l Assess need for medication or seclusion Interventions: Severe to Panic Anxiety Menu B