1. Understanding Anxiety and Anxiety Defenses
Chapter 13
Understanding Anxiety and Anxiety Defenses
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2. Stress Leads to Anxiety
Produced by change in environment
Individual perceives change as
Challenging
Threatening
Damaging
Stress leads to a variety of psychological responses
Anxiety the most common response
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3. Anxiety Versus Fear Anxiety has an unknown or unrecognized source.
Feeling of apprehension, uneasiness, uncertainty, or dread
Dysfunctional behavior often an attempt to reduce anxiety.
Fear is a reaction to a specific threat.
Body reacts similarly to both anxiety and fear.
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4. Categories of Anxiety Normal anxiety Acute or state anxiety
Healthy life force necessary for survival
Acute or state anxiety
Crisis threatens sense of security
Chronic or trait anxiety
Long-term anxiety
May take the form of chronic fatigue, insomnia, discomfort in relationships or poor job performance
Overwhelming anxiety may be repressed (placed out of awareness) and then be expressed behaviorally.
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5. Four Levels of Anxiety Mild Moderate Severe Panic
Peplau considered anxiety as one of the most significant concepts in psychiatric nursing and developed an anxiety model to guide nursing interventions. She described the effects of the different levels of anxiety (mild, moderate, severe, and panic levels) on perception and learning. Nursing interventions were aimed at lowering the patient’s anxiety level in order to improve the patient’s ability to think and function (text, p.24).
Keep in mind that the boundaries between the different levels of anxiety are not always clear and distinctive and characteristic behaviors often overlap.
Mild anxiety: Normal everyday experience
Moderate anxiety: Perceptual field narrows, selective inattention
Severe anxiety: Learning and problem-solving impossible
Panic: Disturbed behavior
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6. Interventions Mild to moderate anxiety
Help client focus and problem-solve
Severe to panic level of anxiety
Focus on client safety and the safety of others
Provide for physical needs
Review tables 13-2 and 13-3 on pages 215 and 216 of the text.
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7. Five Properties of Defense Mechanisms
1. Manage conflict and affect
2. Relatively unconscious
3. Discrete from one another
4. Often hallmarks of psychiatric syndromes, but reversible
5. Adaptive as well as pathological
Defense mechanisms protect individuals from overwhelming anxiety. When experiencing high anxiety, people may become less flexible in their use of defense mechanisms and resort to more primitive or immature defense mechanisms.
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8. Defense Mechanisms
All defense mechanisms can be used in an adaptive or maladaptive manner except sublimation and altruism (always healthy).
Whether the use of a particular defense mechanism is adaptive or maladaptive is determined by its frequency, intensity, and duration of use.
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9. Sublimation
Review the various defense mechanisms described on pages of your textbook.
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10. Humor
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11. Suppression
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12. Compensation
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13. Introjection
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14. Identification
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15. Repression
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16. Displacement
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17. Reaction Formation
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18. Somatization
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19. Undoing
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20. Rationalization
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21. Regression
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22. Projection
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23. Denial
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