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Maslovian Approach to Clinical Reasoning Higher Order Needs

Hierarchical
Need
Higher Order Homeostasis Examples of Higher Order Need Perturbations
Safety and Security
Second floor

Note: This is situational
safety rather than
biological or physiological
The (relatively near) future is predictable and
within control of the individual
Unexpected illness or injury
Surgical (whether planned or emergency) outcome
Financial circumstances will continue to remain
adequate to maintain lifestyle
Unanticipated financial needs
Loss of job
Just laws justly administered Arbitrary application of laws or no laws at all (social chaos)
Crime
Sharia law (for females)
Predictable economic system Runaway inflation or deflation
Good public health system Epidemic, contaminated water supply, inadequate disposal of
waste
Access to continuous and dependable supply of
good food
Famine, food inflation, food desert
A safe place to live with reasonable expectation
of privacy
Homelessness
Wide-spread surveillance
Love and
Belongingness
Third floor
Membership within a family offering both
structure and unconditional love
Divorce, desertion (single parent home) addiction of one or
more family members, incest
A supportive circle of friends Rejection by peers, discrimination,
Shared sexual intimacy Infidelity
Pornography
Membership within a group that shares common
origins and ideals (roots)
Societal discrimination (institutionalized segregation)
Antisemitism
Religious persecution
Homophobia
Self-esteem
Fourth floor



Note: This need is expressed
differently in other
A positive body image Disfigurement or loss of function
Earned respect of others Fame or easy notoriety
Contempt of others (deserved or otherwise)
Accomplishment of desired gender roles Loss of status within sexual or familial context
Menopause
Impotence
Job loss of provider
(Eastern) cultures where the
individuals value is his
contribution to the group
Fundamental satisfaction with self and social
status
Inability to accurately measure self-value or status
(depression)
Mastery of specialized knowledge or skills Loss of ability to use skill (disability)
Obsolete knowledge and skill
Retirement (especially if unplanned)
Unemployment
Self-Actualization
Pinnacle

Not a need so much as the
goal to be reached by the
meeting of predicate needs


Master motive of Gestalt Theory
express and activate all the capabilities of the [individual] Carl Rogers
Maslows characteristics of a self-actualized individual
1. More efficient understanding of reality and comfort with it. Recognizes good and evil.
2. Individual accepts his position within the larger context of others and within nature
3. Spontaneity, simplicity, naturalness
4. Interest in problems outside self and compassion for others
5. Thrives with solitude and self-reflection
6. Independence within culture and nature
7. A sense of spiritual enlightenment
8. A feeling of being connected to all of mankind
9. Deep and profound identification/fusion with others. Deep (if few) friendships
10. Democratic impulses that respect the individualism of others
11. Understands the difference between ends and means, good and evil (i.e., no good end is achieved with evil
means)
12. Humor and light-heartedness that does not injure or deprecate others
13. Creative
14. Transcends and objectively evaluates culture
15. Self-satisfaction that never stops striving