1. Copyright © 2002 by W. B. Saunders Company. All rights reserved. Chapter 13 Understanding Anxiety and Anxiety Defenses Menu F

2. 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

3. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Anxiety operationally defined 13-3 (Fig. 13-1) Menu FB

4. 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

5. 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

6. 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

7. 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

8. 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

9. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Sublimation 13-9 Menu FB

10. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Humor 13-10 Menu FB

11. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Suppression 13-11 Menu FB

12. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Compensation 13-12 Menu FB

13. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Introjection 13-13 Menu FB

14. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Identification 13-14 Menu FB

15. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Repression 13-15 Menu FB

16. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Displacement 13-16 Menu FB

17. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Reaction Formation 13-17 Menu FB

18. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Somatization 13-18 Menu FB

19. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Undoing 13-19 Menu FB

20. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Rationalization 13-20 Menu FB

21. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Regression 13-21 Menu FB

22. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Projection 13-22 Menu FB

23. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Denial 13-23 Menu FB

24. 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

25. 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