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THEORIES ON NORMALITY

Lecturer: Anna Josefina Vazquez-Genuino, MD (11-19-2012)


Psychiatry
Edited to Word Format by

4 PERSPECTIVES OF NORMALITY 3) URETHRAL


HEALTH Urethral Erotism
UTOPIA Enuresis
AVERAGE Penis Envy Competiveness, Ambition
PROCESS Pride, Self Competence

6 PRINCIPLES OF EPIGENETIC DEVELOPMENTAL 4) PHALLIC/ OEDIPAL (3-5/6 yrs)


CONCEPTUAL MODEL Castration Anxiety, Penis Envy
1. Stages in fixed & hierarchical sequence Oedipal / Electra complex
2. Stages are interconnected Preceding stage Identification with Parent of Same Sex
lays foundation for next Superego
3. Stage progression may be speeded up, but
cannot skip stage. No short cuts. 5) LATENCY (5/6-11/13 yrs)
4. Each stage equilibrium between demands of Identification w/ Other Figures
environment & capacity of individual to meet Sublimation of Drives
demands successfully Lack Inner Control vs
5. Progression or regression is disruption of Capacity for Mastery, Defined Roles
current equilibrium
6. Fixation, deviation, progression Circular 6) GENITAL (>11/13 yrs)
Reworking of Previous Conflicts
SEPARATION- INDIVIDUATION PROCESS Stable Sense of Identity
(Margaret Mahler) Mutually Satisfying Lasting Non-Incestuous
Relations
1) Normal AUTISTIC Phase (0-4 wks) Integrate Sex & Love
2) Normal SYMBIOTIC Phase (1-5 mos) Self Realization in Work
3) DIFFERENTIATION (5-10 months)
Comparative Scanning PSYCHOSOCIAL STAGES OF LIFE (Erik Erikson)
(+) Stranger Anxiety (8 mos) Each Stage - Turning Points
Transitional Object
Checking Back Pattern (7-8 mos) 1) TRUST VS MISTRUST (0-18 months)
4) PRACTICING (10-16 months) All Needs Satisfied *Trust Others
Love Affair w/ World Cry Elicits Response *Trust Self
Emotional Refuelling Optimism = Present is for the Best, Expects
Low Keyedness Best Outcome
Separation Anxiety (10-18 months) HOPE = To Desire w/ Expectation
5) RAPPROCHEMENT 16-24 months Psychosis, Paranoia, Depression
Development of Language
Fusion vs Isolation, Ambivalence 2) AUTONOMY VS SHAME & DOUBT (1.53 yrs)
Shadowing & Darting Away *Sense of Mastery over Self Self
6) CONSOLIDATION & OBJECT CONSTANCY (24- 36 Confidence
mos) Rigid Control Defeats Attempts at
Object Constancy Independence Doubt Self
No Control Places Child in Physical
PSYCHOSEXUAL STAGES (Sigmund Freud) Danger Shame, Scared
1) ORAL (0-1 yrs) WILL = Regulate Impulses Well
Explore & Feel Mouth, Senses Power Struggle: Parent Child
Oral Erotism vs Oral Aggression Cooperativeness vs Willfullness
Dependence vs Self Reliance Loving Good Will vs Hateful Self Insistence
Over Gratification vs Deprivation Self Expression vs Self Restraint, Meek
Compliance
2) ANAL (1 or 1 - 3 yrs) Paranoid Personality, Impulse Control
Anal Retention vs Expulsion Disorder, Anxiety
Self Determination, Cooperation
Anal Character: Obsessive Compulsive vs 3) INITIATIVE VS GUILT (3-5 Yrs)
Passive Aggressive Allow Child to Decide, Solve Own Problems
Purpose, Ambition
Harsh Criticism/Censure Guilt Ridden,
Overanxious, No Motivation, Phobia,
Conversion, Psychosomatic Disorders

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4) INDUSTRY VS INFERIORITY (5-13 Yrs) 1) SENSORIMOTOR Stage (0- 2 yrs)
Interest in Learning, Mastery of Skills A. Reflexes (0-2 mos)
Enjoyment in Completing Work & Take B. Primary Circular Reaction (2-5 mos)
Pride in Accomplishments C. Secondary Circular Reaction (5-9 mos)
Provide Opportunity to Discover Talents & D. Coordination of Secondary Circular
Praise Competence, Self- Confidence Reaction (9-12 mos)
Parental Expectations too High or Difficult E. Tertiary Circular Reaction (1-1 yrs)
to Please Discouraged, Inferior, Low Self F. Symbolic Thought (1 - 2 yrs)
Esteem Give Up
A. Simple Reflexes at 0-2 mos
5) IDENTITY VS ROLE DIFFUSION (13-21 Yrs) Rooting
Who Am I? Where am I going? How do I fit Sucking
into the scheme of things? Why am I here? Grasp
Allow Freedom to Choose & Decide: Dress, Startle
Music, Friends, Career
Open Communication, Respect Privacy, B. Primary Circular Reaction at 1/2-4/5 mos
Guidance, Withdrawal of Privileges Coordinates Own Body & 5 Senses
FIDELITY = Commitment to Beliefs & Goals Curiosity: Activity, Turns, Reach Out
Psychosis, Schizophrenia, Gender Identity
Disorder, C. Primary Secondary Circular Reaction at
4/5-8/9 mos
6) INTIMACY VS ISOLATION (21-40 Yrs) Anticipate Consequences of Own
Ability to Honor Commitment in Marriage Behavior
even when that requires Sacrifice & Acts Purposefully to Change
Compromise Environment
Vs. Self Interest / Indulgent / Absorbed
LOVE = Generosity of Sharing Self with D. Coordination of Secondary Circular
Others Reaction at 8/9-12 mos
Balance Love & Work Throws Toys
Open /Close
7) GENERATIVITY VS STAGNATION (40-60 Yrs) Intentional Behavior
Raising Children Responsible & Look For Hidden Toy (10 months)
Concerned Citizens Establish Better
Society E. Tertiary Circular Reaction at 1-1 yrs
Passing on Knowledge, Skills, Values- Seeks Out New Experiences
Young Sense of Satisfaction, Fulfilment Produces Novel Behavior Push
Productivity & Creativity Groups, Org, Buttons, Insert Objects in Bottle,
Soc Shake Table to Get Toy
Introspect
CARE = Concern for All, Desire to Help F. Symbolic Thought at 1-2 yrs
Vs. Selfishness, Family Dynasty Visual Image or Mental Symbol of
Mid- Life Crisis: Extramarital Affairs, Words to Signify for Real Objects or
Marital Separation & Divorce, Alcoholism, Events in the Environment
Gambling

8) INTEGRITY VS DESPAIR (> 60 Yrs)


Retirement: Give Position of Authority to Sun = Ball =
Younger Ones, Enjoy Grandchildren &
Gratification from Hobbies Reasoning Use Chair to Get Toy
Retrospect, Prepare for Death
Sense of Satisfaction that Life was 2) Stage of PREOPERATIONAL Thought (2- 7 Yrs)
Productive, Worthwhile Happy A. Substage 1 Symbolic Function at 2-4 Yrs
Vs. Regrets, Not Ready to Die, Depressed B. Substage 2 Intuitive Thought at 4-7 Yrs
WISDOM = Acceptance of Past and that All
that happened was Good A. Substage 1) Symbolic Function at 2-4 Yrs
Egocentrism
COGNITIVE DEVELOPMENT (Jean Piaget) Animism
SCHEMES
ASSIMILATION B. Substage 2) Intuitive Thought at 4-7 Yrs
ACCOMMODATION Centration
ORGANIZATION Cant Grasp Sameness
Defines Words ~ Function
EQUILIBRATION
Phenomenalistic Causality
Stages
A. SENSORIMOTOR
3) Stage of CONCRETE OPERATIONS (7-11 yrs)
B. PRE OPERATIONAL
Serialize, Classify Objects
C. CONCRETE OPERATIONAL
D. FORMAL OPERATIONAL Inductive Reasoning
Reversibility of Processes & Relationships

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II. Stage of END JUSTIFIES the MEANS (6-12
mos)
I want it & I dont care what it takes to
get it
E.g. biting, grabbing, criminals

III. Stage of PUNISHMENT & OBEDIENCE


Orientation (1-3 yrs)
Might is Right
Avoid Physical Punishment, Unquestioning
Deference to Power
Goodness of Action Determined by
Consequence Received
Child Obeys out of Fear of Physical
4) Stage of FORMAL OPERATIONS 11/12 yrs Punishment
Scientific, Logical
Abstract Thinking IV. Stage of INSTRUMENTAL RELATIVISM/
Hypothetical Thinking HEDONISM (3-7 yrs)
Golden Rule: Dont do unto others what
Deductive Reasoning
you would not want others to do to you
Adolescent Egocentrism
You scratch my back, Ill scratch your
1) Imaginary Audience Self
back
Consciousness
Tallion Principle An eye for an eye
2) Personal Fable- Uniqueness,
(Immanent Justice)
Invincibility
Good = What is Beneficial to Me
MORAL DEVELOPMENT
CONVENTIONAL STAGES (Know Good vs Bad, Right
Changes in Thoughts, Feelings, Behaviors vs Wrong)
regarding Standards of Right & Wrong
Intrapersonal Dimension: Regulates ones V. Stage of INTERPERSONAL CONCORDANCE/
Activities When Alone CONFORMITY (7-9 yrs)
Interpersonal Dimension: Regulates Social Good boy/ Nice girl - Conform to Rules
Interaction & Arbitrates Conflict (Gibbs 2003, so as to Please Authority
Walker 1996, Walker & Pitts 1998) Soldier in War Blind Obedience,
Respect for Authority
Good = What is Approved & Dictated by
Those He Loves & Respects

VI. Stage of LAW & ORDER Orientation (9-12 yrs)


I dont want to break any rules
Obeys Rules to Maintain Peace & Social
Order
Complies with his Duty & Responsibility
Morality Dictated by Avoidance of
Dishonor
Good = What is Legal

POST CONVENTIONAL STAGES

VII. Stage of SOCIAL CONTRACT- Legalistic


MORAL DEVELOPMENT (Lawrence Kohlberg) Orientation (1218 yrs)
A. PRE-CONVENTIONAL STAGES Lets decide what is best for us
o Good & Bad Interpreted in Terms of Situation Ethics
External Rewards/ Punishments Realize Relativism of Values &
B. CONVENTIONAL STAGES Impermanence of Rules
o Abide by Certain Internal Standards Voluntary Compliance, Exception to Rules
Dictated by Family, Society, Law Right = Depends on Current
C. POST -CONVENTIONAL STAGES Circumstances
o Recognize Alternative Mores, Explore
Options, Decide on Personal Moral VIII. Stage of UNIVERSAL ETHICAL PRINCIPLES >
Code 18 yrs
Lets decide what is best for everyone
PRE- CONVENTIONAL STAGES Good = Maintains Respect & Dignity for All
Fellowmen, Equality
I. Stage of IMMEDIATE GRATIFICATION (0-6 Right = Self Determined, Autonomous
mos) from Law
I want it now!
e.g. cry, tantrum

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