Concepts of Personality Development Chapter 2 Concepts of Personality Development

Introduction Personality is defined by the DSM-IV-TR as “enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts.”

Introduction (cont.) Life-cycle developmentalists believe that people continue to develop and change throughout life, thereby suggesting the possibility for renewal and growth in adults.

Introduction (cont.) Stages are identified by age. However, personality is influenced by temperament (inborn personality characteristics) and the environment. It is possible for behaviors from an unsuccessfully completed stage to be modified and corrected in a later stage.

Introduction (cont.) Stages overlap, and individuals may be working on tasks from more than one stage at a time. Individuals may become fixed in a certain stage and remain developmentally delayed.

Introduction (cont.) The DSM-IV-TR states that personality disorders occur when personality traits become inflexible and maladaptive, causing either significant functional impairment or subjective distress.

Psychoanalytic Theory – Freud Dr Sigmund Freud 1856-1939 Oldest of eight children Married with 3 girls and 3 boys Physician-Biologist Jewish-anti-religion Based theory on personal experiences Died of cancer of jaw & mouth lifelong cigar chain-smoker

The Structure of Personality Freud believed basic character was formed by age 5 years He organized the structure of the personality into three major components: THE ID —Ruled by the pleasure principle THE EGO — Ruled by the reality principle THE SUPEREGO —Ruled by the moral principle

Id Present at birth Operates to demands of Pleasure Principle - strive to satisfy desires and reduce inner tension Id-driven behaviors are impulsive and may be irrational

Ego Deals with real world Develops between the ages of 4 and 6 months Experiences the reality of the external world, adapt to it, and respond to it.

Superego Develops between age3 and 6 years Initializes the values and morals set forth by primary caregivers Derived from a system of rewards and punishments It is composed of two major components: ego-ideal conscience

Psychoanalytic Theory – Freud (cont.) Topography of the Mind The conscious The preconscious The unconscious

Psychoanalytic Theory – Freud (cont.) Dynamics of the personality Psychic energy: Ego balance between id (impulsive behaviors) and Superego (idealistic behaviors) Cathexis Id invest energy in an object to achieve gratification (e.g., drink alcohol to relieve anxiety) Anticathexis Use of psychic energy by the ego and superego to control id impulses.

Freud’s stages of Personality development ORAL STAGE Related to later mistrust and rejection issues ANAL STAGE Related to later personal power issues PHALLIC STAGE Related to later sexual attitudes LATENCY STAGE A time of socialization GENITAL STAGE Sexual energies are invested in life

Oral Stage: Birth to 18 months Satisfy drive of hunger and thirst by breast or bottle If fixated after weaned: Over Dependency Over Attachment

Anal Stage: 18 months to 3 years Learning independence and control. Id wants pleasure of reducing tension by defecating & urinating Toilet training may have far- reaching effect on the child’s personality: strict and rigid stubborn, stinginess expelling feces in unacceptable manner disorganization, untidiness

Phallic Stage: 3– 6 years Focus on genital organs Emerging sexual gender identity Differences between boys and girls Development of the Oedipus complex (males) and Electra complex (females) Personality fixed by end of this stage

Latency Period 6-12 years of age Time between resolution of Oedipus complex and puberty Usually not possible for sexual urges to be directly expressed Sexual energies are channeled into school and friends Focus on the relationship with the same gender

Genital Stage Adolescence – Adulthood (13-20 years) Normal sexual relations Marriage Child-rearing

Psychoanalytic Theory – Freud (cont.) Relevance to nursing practice Being able to recognize behaviors associated with the id, ego, and superego will assist in the assessment of clients’ developmental level. Understanding the use of ego-defense mechanisms is important in making determinations about maladaptive behaviors and in planning care for clients to assist in creating change.

Interpersonal Theory – Sullivan (1953) Based on the belief that individual behavior and personality development are the direct result of interpersonal relationships Major concepts of this theory Anxiety Satisfaction of needs Interpersonal security Self-system

Interpersonal Theory – Sullivan (cont.) Stages of development Infancy (birth - 18 months) gratification of needs Childhood (18 months – 6 years) learning to experience a delay in personal gratification Juvenile (6 - 9 years) satisfactory peer (GROUP) relationship Preadolescence (9 – 12 years) satisfactory relationship with the same gender Early adolescence (12 – 14 years) satisfactory relationship with the opposite gender Late adolescence (14 – 21 years) develop a lasting, intimate opposite- gender relationship

Interpersonal Theory – Sullivan (cont.) Relevance to nursing practice Relationship development is a major psychiatric nursing intervention. Nurses develop therapeutic relationship with client in an effort to help him generalize this ability to interact successfully with others . Knowledge about the behaviors associated with all levels of anxiety and methods for alleviating anxiety help nurses assist clients in achieving interpersonal security and a sense of well-being.

Theory of Psychosocial Development – Erikson (1963) Based on the influence of social processes on the development of the personality Erikson identified eight stages of development and the major tasks associated with each stage.

Theory of Psychosocial Development – Erikson (cont.) Stages of Development

Theory of Psychosocial Development – Erikson (cont.) Relevance to nursing practice Many individuals with mental health problems are still struggling to achieve tasks from a number of developmental stages. Nurses can plan care to assist these individuals to fulfill these tasks and move on to a higher developmental level.

Theory of Object Relations – Mahler (1975) Based on the separation-individuation process of the infant from the maternal figure (primary caregiver) Stages of development Phase I – The Autistic Phase (birth to 1 month) Phase II – The Symbiotic Phase (1 to 5 months) Phase III - Separation-Individuation (5 to 36 months) Deferentiation ( 5- 10 months) Practicing (10- 16 month) Rapprochment (16- 24 months) Consolidation ( 24- 36 months)

Theory of Object Relations – Mahler (cont.) Relevance to nursing practice Understanding the concepts of Mahler’s theory of object relations assists the nurse in assessing clients’ level of individuation from primary caregivers. The emotional problems of many individuals can be traced to lack of fulfillment of the tasks of separation-individuation.

A Nursing Model – Peplau (1991) Applies interpersonal theory to nurse-client relationship development Correlates the stages of personality development in childhood to stages through which clients advance during the progression of an illness Sees interpersonal experiences as learning situations for nurses to facilitate forward movement in the development of personality

A Nursing Model – Peplau (cont.) Peplau identifies six nursing roles in which nurses function to assist individuals in need of health services: Resource person Counselor Teacher Leader Technical expert Surrogate

A Nursing Model – Peplau (cont.) Four stages of personality development Stage 1 – Learning to count on others Stage 2 – Learning to delay satisfaction Stage 3 – Identifying oneself Stage 4 – Developing skills in participation

A Nursing Model – Peplau (cont.) Relevance to nursing practice Peplau’s model provides nurses with a framework to interact with clients, many of whom are fixed in, or because of illness have regressed to, an earlier level of development. Using nursing roles suggested by Peplau, nurses may facilitate client learning that was not achieved in earlier experiences.