4 PERSPECTIVES OF NORMALITY 1. Health • Normality as health—no signs and symptoms, there is no psychiatric signs and symptoms.

Absence of psychiatric disorder or disease indicates the person is healthy and normal. 2. Utopia • Refers to the fact that normal means being able to achieve the optimal level of functioning. You have no hang-ups, even though you don’t have any signs of disease or disorder. It’s like the ideal setup of who you are.. Which is in a way according to Freud, is fiction because there is no perfect state of mental health. Utopia is the ideal functioning of the human being or person both in terms of work and social functioning. 3. Average • Refers to like a bell curve, a mathematical, middle range, the normal. 4. Process • Refers to the fact that normality is like an on going process, continuous equilibrium disequilibrium. That every stage in one development, there is a certain price that would have to be the result... So it’s an on going thing. What could be normal for an infant could not be normal for an adult. 6 PRINCIPLES OF EPIGENETIC DEVELOPMENTAL CONCEPTUAL MODEL (1) Stages are fixed and hierarchical in sequence. (2) Stages are interconnected. One stage precedes another and each preceding stage lays the foundation of the next stage. (3) Stage progression may be speeded up but can’t skip stage. • We have to go through each stage. We cannot skip a stage. One stage builds up on the next stage. (4) Each stage—equilibrium between demands of environment and capacity of individual meet demands successfully. • Each stage indicates equilibrium between the demands on the environment and the capacity of the individual to meet those demands successfully--Nature vs. Nurture. There is a toss between the person’s biological makeup, genetic traits inherited, intellectual and physical capacity, and how your parents brought you up. There is an interaction

between the two that will determine successfully you will resolve the conflict of this stage and proceed on to the next stage. (5) Progression or regression is disruption of current equilibrium. • Even if you really attain a certain stage, depending on your age, there is still a possibility that we can regress to an earlier stage under a lot of stress, or when ill, even in adults when they’re Ill they can start acting like a baby, they would want their spouse to feed them, never to leave them alone like a child, they sort of regress in a way. (6) Fixation, deviation, progression--circular • Fixation is possible, which is like over deprivation or over gratification at a particular stage, you end up stuck at that particular stage although in a way you go to the next stages because that’s part of normality, part of growth and development… but you’re going to be somewhat handicapped already because majority of your pleasure comes from an earlier stage.. We sort of prefer to stay at that particular stage like we have children who continue to thumb suck even up to when they’re 13 or older. Or there are other manifestations of being fixated: Nail biting, drinking alcohol… so there can be fixations, deviations—if we are not able to resolve the conflict. We can progress, regress, it is not a linear movement. SEPARATION- INDIVIDUATION PROCESS Margaret Mahler (1) Normal AUTISTIC (Phase 0-4 weeks) • First month of a child’s life. Autistic in a sense that it does not really matter whether the mother is the one taking care of the baby, the father, or a complete stranger. For as long as the baby gets what he needs, eat on time, diapers changed, carried when crying.. (2) Normal SYMBIOTIC (Phase 1-5 months) • When infants have some sense that there is another person outside himself, addressing his needs. In a way he begins to recognize the characteristics of the primary care giver or the mother. He still thinks that he and the mother is one entity.

(3) DIFFERENTIATION (5-10 months) • Comparative scanning (1) Further recognition of the differences between familiar and unfamiliar. Mother’s face being the familiar and others who are not as familiar… Mother refers to the primary caregiver. May be the father, yaya, aunt or who ever provides but they are beginning to compare the faces, who is more familiar to recognize the mother more clearly. That’s why we end up having stranger anxiety. • (+) Stranger anxiety at 8 months old • Transitional object (1) Transitional object represents the mother— especially when mother is not around… Bear, blanket, rag doll. If they hold that transitional object, they can still feel comfortable because they have their transitional object with them. • Checking back pattern (7-8 months) (1) Checking back pattern indicates when the infant is able to crawl, he realizes he can distance himself with his mother, he realizes he can be separate a bit with his mother... And that in a way scares the baby so he checks back… Crawling away and at the same time checking if the mother is still there. (4) PRACTICING (10 to 16 months) • Love affair with the world (1) When infants are already beginning to walk around a bit further, go out of the crib to explore the environment.. Move around, touch things outside of his crib.. They begin to manipulate all these things: put them in the mouth, touching them, poking fingers in the hole.. Practicing their skill of walking and manipulating things. • Emotional refuelling (1) Like a car after you travel, you have to come

back to gas station to refill. Baby has to come back to mother after exploring the environment. Go back to mother to have emotional refuelling, baby is looking for some appreciation that he is back.. Either a hug or a kiss. It’s important for the mother to be still around even when the child is exploring and not to be over-bearing, not allowing the child to move around—not being able to practice their motor skills. • Low keyedness (1) When the mother is not around, the child’s attention and motor movement are a bit toned down or slower, not as alert and interested of what’s going on. He’s watchful of when the mother is going back. Even if the sister of visitor is entertaining with him, he’s not interested because he’s anticipating the mother’s return. • Separation anxiety at 1- to 18 months (5) REAPPROACHMENT (16 to 24 months) • Development of language (1) 1 year old– 1 word like mama or papa.. 1 ½ year the toddler is able to utter phrases.. By 3 years old, they must be able to say complete sentences.. (Minimum limit for development of language). Time when there is a lot of language filled developing, identifying words, body parts.. Identifying simple commands. • Fusion vs. isolation, ambivalence • Shadowing and darting away (1) They still continue to have interest on what’s going on outside mother son relationship. On the other hand, they still want to go back to their mother.. Keep tract on what the mother is doing and their whereabouts. If the mother sees the baby following around, baby may tend to push away

the mother.. “Urongsulong” treatment. Best thing to do is to follow the lead of the child, let him do what he wants to do, let the child take the initiative to hug you.. To prevent the borderline personality disorders– people who are very clingy with relationships, difficulty accepting break ups to the point where they try to manipulate the person by either attempting suicide or doing something drastic so that the other person would not break up with them. (6) CONSOLIDATION AND OBJECT CONSTANCY (16 to 24 months) • Last stage. • Ability of finally determine that he is a separate entity from a mother. Terrible twos– child is asserting what he wants, rather than what the mother wants so it’s much clearer to him that he is a separate person.. He knows he has his own mind; he can say no to the mother and not obey. • Stage wherein they develop object constancy. Even if the mother is not there, he knows that she still exists. Even if she is not around, he can remember her as a consoling idea or concept in his mind, and therefore he is assured that she will still be there to love and take care of him. • Example: At 3 years old, we can actually allow the child to go to preschool because they can tolerate longer separations now. PSYCHOSEXUAL STAGES Sigmund Freud Oral (0-1 ½ years) • Explore and feel—mouth, senses o Activities centred on the mouth, both pleasurable and aggressive activities. Examples: feeding, sucking. Explore the world by putting things in the mouth. In a way, we have to allow them to explore the world through their mouth because if we don’t they might continue to explore it later on because they were never satisfied orally speaking. They check out the texture: hard or soft.. Soft or sweet.

Oral erotism vs. oral aggression o Physical development of an infant that initiates oral aggression:  Around 6 months, we have our first toothstart of biting; Once they have a tooth, they can now start biting.. Practical use of weaning the child from the breast of the mother to the bottle. Biting as a form of pleasure. 2 drives that freud thinks we all have: (1) Sexual (2) Aggressive. o In the oral stage, sexual pleasure comes from the mouth, gain pleasure from sucking.. Aggressive pleasure from biting later on. People who would enjoy hurting other people… Oral aggression: biting, chewing, spitting, crying. Dependence vs. self reliance o With successful resolution of oral face, we should be able to depend on other people to the extent that we are comfortable enough to be dependent on others and at the same time have some self-reliance with whatever you are able to do. Dependent just enough, and self-reliant to a certain degree. Over gratification vs. deprivation o This really depends on how parents bring up their kids. Some parents continue to feed their child up to 8 years old, child will never get over this phase, children become too dependent and never learn to be self-reliant. It is important for parents to know such expected developmental milestones.. When does the child learn how to walk.. Feed themselves.. Etc. So that we can facilitate development rather than persist infancy in their adulthood. o Over gratification of oral pleasure or needs like some parents continue to allow their child to drink milk from bottle from beyond 2 years of age, we end up continuing to gain pleasure from the mouth like smoking, drinking alcohol,


taking drugs, nail biting, thumb-sucking, shouting, over-eating or almost any kind of addiction are manifestations of continued wish for oral gratification or oral deprivation to run after satisfaction from the mouth. Oral characters: People who are very dependent, they tend to give in to whatever people demand of them, dependent type of personality disorder, they always need people to rely to boost their self-esteem, depression and psychosis may be due to oral deprivation ◊ depression as hopeless case not satisfied as an individual. Filipinos are orally gratified, may be reflected that we are not matured as a nation.

Another form of anal erotism is when we hoard things, accumulate a lot of material riches and goods.. Or the ones who are very frugal. • • Self determination, cooperation Anal character: Obsessive compulsive vs. Passive aggressive

ANAL (1 or 1 ½ to 3 years old) • Anal retention vs. Expulsion o Physical development: increased control over the sphincters. Neuromuscular development is progressive, therefore we can now have the option to either retain or to let go of the feces. Training the child at 6 months is not possible because comprehension and form of communication is not yet developed. o Feces from a child’s point of view are like gifts to the parents, they have the option to either retain this according to the parents want.. Or they can also gain pleasure in releasing the feces in the wrong places.. That is their way of expressing their aggression towards the parent. It’s a time wherein the child pushes for independence, determining when he wants to release the feces. It’s his decision. Battle between what the parents want and what the child wants. Must have just the right amount of training and strictness. We become fixated in this phase If we have very strict training, we end up having obsessive-compulsive in a way (neat freak, orderly, comes on time) or too passive aggressive, to show aggression in a passive way. If parents are to lax: we end up being a messy child.

URETHRAL Not part of Freud’s work. Transitional stage between the anal and phallic stage. Gain pleasure either by retaining the urine or releasing. Issue is the act of physical pleasure of releasing it. • Urethral erotism • Enuresis • Penis envyCompetiveness, ambition o Penis envy: Kids at this stage begin to compare their genitals; Girls and boys see their anatomical differences in terms of their reproductive system. Girls in a way envy what the boys have, leading the female to strive to be like the males. The female manifests their penis envy by competing in activities where the male population dominates. • Pride, self-competence o Their ability to control urination gives them an amount of pride in themselves, that they have self-control already. PHALLIC/OEDIPAL (3 to 5/6 years old) Source of pleasure comes from penis and clitoris for male and female, respectively. Children at this point are able to discover that it’s pleasurable to manipulate or rub their genital just only for mere physical pleasure. Castration anxiety, penis envy o Castration anxiety, manifested when boy has to give up his love for his mother. Manifested in a child when a child gets very afraid like it’s going to be the death of them. Sexual drive is sublimated through creative activities, drawing, painting, dancing, writing poetry. Aggressive drive may be seen through sports and in academics. There is a possibility for child to identify with other figures such as politicians, artists, even cartoons. Oedipa/ electra complex

o Oedipal complex for male, electra complex for female. The child falls in love with their parents of their opposite sex. Daughter tends to have a close relationship with the father, and vice-versa. Inability to resolve oedipal complex results to sexual perversion, gender identity disorder, exhibitionism, paedophilia, o To resolve the oedipal/ electra complex. Give up your rivalry with your parent with the same sex. Try to identify with the father, and try to attract a woman similar to your mother later on. Sometimes, when you get married, you married someone like your mom or your dad. It is advisable for parents to have their own room. So as to prevent condoning the oedipal complex. Identification with parent of same sex o If a boy is too close with the mom, or father is too distant with the son: he will have difficulty identifying with the father, instead he identifies with the mother. If father is also close to child and is able to identify with the male figure, the son may be identifying himself as a female, and might have homosexual attraction, going for the male sex. Father should show respect to his wife, the child is able to repress urges of wanting to be with the parent of the same sex. They would convert their suggestive feelings into love and respect. Superego LATENCY (5/6 to 11/13 years old) • Identification with other figures o Time when kids tend to shy away to the opposite sex. They tend to hate each other, and don’t want to be contaminated with other sex. Pathology would be lack of inner control, child becomes problematic, conduct problems in school, not able to sublimate his sexual and aggressive drive, child may abuse younger kids sexually, bullies in school. If not able to resolve and sublimate drive.

Sublimation of drives Lack inner control Capacity for mastery, defined roles o Child may gain mastery of himself, he’s able to figure out what his role is in the world. GENITAL STAGE • Last stage. • Engaging in sexual intercourse. Pleasure gained in a context in a relationship that is satisfying and that is • Not just mere pleasure from manipulating the genitals, engaging sexual intercourse with the opposite sex in a relationship that is satisfying and that’s going to last. Ability to integrate both sex and love. At the same time ability to balance work and love. PSYCHOSOCIAL STAGES OF LIFE Erik Erikson (1) Trust vs. Mistrust (0-18 months) • Child develops trust by having all his needs satisfied. If all their needs are satisfied, they can attain trust, trust among others that they can satisfy their needs as well as trust in one’s self. If they have a relatively caring environment, they will be able to develop optimism, that they would expect what’s the best to be. To develop with the desire with expectation. • Hope is the desire with the expectation. You expect something in the future and at the same time, you develop something that you want to happen. • Unresolved issues may lead to: (1) Psychosis= people who do not know what’s real and what’s not real. (2) Paranoid= those who are suspicious (if environment is not caring enough, trust is not developed.) (3) Depression (2) Autonomy vs. Shame and Doubt (1.5-3 years) Anal stage of Freud; 18 months to 3 years old Attaining a sense of confidence and their drive over themselves. • Child at this point is gaining more skills. Parent has to allow their child to practice their skills to give them a sense of confidence that they can do it on their own. If the parents do not impose any limitations to the child, it may impose danger. Child may put

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finger on socket, etc. Age within hyperactivity is normal. • They develop the will to regulate their impulses, whether they will obey their mother or not. The more a child is put to shame, the more he feels disturbed and feel a bad child, and may be delinquent later on. Having the feeling of doing everything wrong. • Parents must not be too strict with the child. Establishing authority among the children may be obtained by adjusting discipline according to the personality of the child. • If too controlling, the more the children become defiant. • If the parents are too punitive, the child would be quiet, meek, compliant. It may good, but child may not develop normally. • Impulse disorder or anxiety disorder. The child may have obsessive-compulsive disorder later on. (3) Initiative vs. Guilt (3.5 to 5 years old) • Initiative is doing things according to own volition. • Child is able to do more things for themselves. If parents appreciate this, child may develop confidence. If the parents react as if child did something wrong, then child may become guilt-ridden. Allowing them to solve their problem, they are able to attain the virtue of purpose and ambition. • Children having dealing with harsh criticism or censure may be guilt ridden, overanxious, no motivation, phobia, conversion, and develop psychosomatic disorders. (4) Industry vs. inferiority (5 to 13 years old) • Industry refers to the ability to work and acquire adult skills, a sense of mastery and accomplishment. They also gain confidence in being able to do things. Child learns the work principle of having to find pleasure in completing their work such as assignments and getting high grades. • If parents don’t appreciate and are never satisfied with the achievements made by the child, child may end up feeling inferior. If parental expectations are too high or difficult to please, child may me discouraged, suffer inferiority complex, develop low self esteem, and therefore may give up. Parents

must be careful not to compare siblings. Providing opportunity to discover talents and praise develops discipline, competence, and selfconfidence of the child.

(5) Identity vs. Role diffusion (13 to 21 years old) • Teenagers try to define who they are, what they stand for, what they believe in, what their role is in their life and in the society. • Role diffusion- teenagers break down and suffer psychosis. • Parents at this point have difficulty shifting gears. Teenagers tend to move away from their parents. • Allow them the freedom to choose and decide: dress, music, friends, career. There must be open communication, respect their privacy, provide guidance, and proper discipline. Democratic discipline. • Fidelity= Commitment to beliefs and goals • Psychosis, schizophrenia, gender identity disorder (6) Intimacy vs. Isolation (21 to 40 years old) • The stage when individuals get married. Intimacy is the ability to honor commitment in marriage even when that requires sacrifice and compromise. Woman should be willing to sacrifice medical school when pregnant. Isolation refers to the context of individuals who are selfish, self-indulgent, and selfabsorbed. • Love is being generous enough to share one’s self to others. There must be a balance of love and work. (7) Generativity vs. Stagnation (40 to 60 years old) • Stage of mid-life crisis. Raising children who will become responsible and concerned citizens of the world so they can improve and establish a better society. To individuals with no children, this can also be a way of passing knowledge, skills, values to the young, which gives them sense of satisfaction and fulfilment. Allows people to become productive and creative. • Stagnant individuals are those who remain selfish, one can have a lot of children and yet be stagnant by not raising them well. They tend to spoil their children, leading them to be selfish brats.

Introspect- This is the stage where adults look back and see what goals they have set earlier. May be the stage where they change their careers and even their partners. There must be concern for others and the desire to help others.

(8) Integrity vs. Despair (>60 years old) • As we grow older, we get weaker, sick, and end up approaching death. They tend to give up authority from the younger ones. They tend to enjoy their grandchildren and gratify from their hobbies. They try to retrospect from the past and reflect from the things they have done along their career. People at this stage become closer to God to prepare for the next life. • Virtue that develop is wisdom, for the acceptance of the past that all that happened was good. COGNITIVE DEVELOPMENT Jean Piaget 1. Scheme • Action or mental representations that organize knowledge. Behavioural schemes, physical activities that develop a child, mental strategy that solves a problem (could be physical or mental scheme). 2. Assimilation • Occurs when children incorporate new information into their existing scheme. 3. Accommodation • Ability of the child to adjust to their scheme, how they can adjust their knowledge to fit new information and experiences. Example: If we saw parents put on their shoes, we would attempt to wear our shoes, but we have to know that left shoe must be worn on the left foot. There will be a trial-or-error before mastering the skill. 4. Organization • Grouping isolated behavior into higher orders. Example: Pencil used to draw the picture, crayons used to color the picture, paintbrush and paint to paint the picture. One can organize activities about drawing and painting. 5. Equilibration • When child thinks a certain way, but realizes that he’s thinking is not applicable anymore. The child has to update his knowledge.

There are 4 stages: 1. Sensorimotor (0-2 years old) • Child basically coordinates with five senses and body movements. Learning is through trial & error. • Substages: o Simple reflexes (0-2 months)  Rooti ng, sucking, grasp, startling. o Primary circular reaction (2-5 months)  They repeat a behaviour they experienced.  They tend to coordinates their own body and their 5 senses. o Secondary circular reaction (5-9 months)  They repeat an activity towards an object.  They anticipate consequences of their own behaviour.  Acts purposely to change environment. o Coordinati on of secondary circular reaction (9-12 months)  Ther e is a need to coordinate both the sense of sight and sense of touch— movement and senses.  Open /close– they try to mimic the other person’s movement  Inten tional behaviour  Look for hidden toy in 10 months o Tertiary circular reaction (1-1 ½ years)  Infan t begins to be curious of the many properties of the objects, they experiment many things to that specific object. They explore new possibilities with that object, marks the start of curiosity.

 Seek s out new experiences;  Prod uces novel behaviours —push buttons, insert objects in bottle, shake table to get toy. o Symbolic thought (1 ½ years- 2 years)  Visu al image or mental symbol of words to signify for real objects or events in the environment The child can just imagine and remember what he experienced earlier.  They start to use their reasoning.

• Phenomenalistic causality- if 2 things happened one after another, they would think that the prior event caused the succeeding event. 3. years) Concrete operational (7-11 • The child is able to serialize things. They can classify objects, kids in this stage tend to collect things based on their classification. • Inductive reasoning. They tend to generalize objects and events to other context. • Reversibility of processes and relationships. Formal operational (11/12 years old) • Teenager is more logical and scientific. They try to look for best solution and utilize deductive reasoning • They are able to understand abstract concepts such as religion, philosophy, theology, etc. • Hypothetical thinking◊ The teenagers are more future oriented. • Adolescent egocentrism is when the teenager becomes very self-conscious. • Personal fable is part of the adolescent egocentrism wherein they think of themselves as very unique and special, that no one could understand them. They also think that they’re invincible, that nothing can harm them.



Pre-operational (2-7 years): Divided into 2: • Symbolic function (2-4 years) • Child continuous to be able to represent an object mentally. Their scribbles may represent different objects even though they all look the same, they can symbolize different meanings. • They can also engage in different pretend play. • Child exhibits egocentrism wherein the child does not understand anyone’s perspective other than their own. • Intuitive thought (4-7 years) • The opposite of logical, where the child listens his feelings • Centration refers to the fact that the child nearly focuses on one characteristic of the object. Example: when the child compares 1 ball of clay and one elongated clay. They only focus on the length alone or in just one characteristic of the object. • They can’t grasp sameness. • They define words for function. Example: Chair is for sitting down, pen is for writing.

MORAL DEVELOPMENT: • Changes in thoughts, feelings, behaviours regarding standards of right and wrong. • Intrapersonal dimension which refers to how one regulates one’s activities when alone. • Interpersonal dimension which refers to how one regulates social interaction and arbitrates conflict • Has 2 dimensions: • Intrapersonal • Interpersonal Moral development according to Jean Piaget • 3 stages of World development by Jean Piaget: • Heteronomous morality (47 years old)

• Rules are unchangeable and handed down by all mighty Authority • Judges rightness/ wrongness of act by the consequences of the act. • Immanent justice- a definite punishment whenever a child does something bad. • Transition morality (7-10 years old) • Autonomous morality (≥ 10 years old) • Flexible rules for convenience of all. • Judges right or wrong by intention. Moral development according to Lawrence Kolberg • Pre-conventional stage • Good and bad interpreted in terms of external rewards/ punishments. • Stages: • Immediate gratification (0-6 months) • “I want it now!” • Cry, tantrums • End justifies the means (612 months) • They follow that dictum: “I want it and I don’t care what it takes to get it” • Biting, grabbing, criminals • Punishment and obedience orientation (1-3 years) • “Might is right” • Avoid physical punishment, unquestioning deference to power • Goodness of action determined by consequence received • Child obeys out of fear of physical punishment • Instrumental relativism/ hedonism (3-7 years) • Golden rule: “Don’t do unto others what you would not want other to do to you” • “You scratch my back, I’ll scratch your back” • Tallion Principle “An eye for an eye” (Immanent justice) • GoodWhat is beneficial to me • • • Conventional stage Abide by certain internal standards dictated by family, society, and law. Conventional stages

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Know good vs. bad, right vs. wrong Stages: • Stage of interpersonal concordance or conformity (7-9 years old) • Follow rules for the sake of maintaining law and order. • “Good boy/ Nice girl”conform to rules so as to please authority • “Soldier in War”- Blind obedience, respect for authority • GoodWhat is approved and dictated by those he loves and respects. • Stage of Law and order orientation (9-12 years old) • “I don’t want to break any rules” • Obeys rules to maintain peace and social order • Complies with his duty and responsibility • Morality dictated by avoidance of dishonour • Good is what is legal Post-conventional stage Recognizes the alternative moral values, explore options, decide on personal moral code. Stages: • Stage of social contractlegalistic orientation (1218 years) • “Let’s decide what is best for us” • Situation ethics, what’s right and what’s wrong depend on the situation. • Realized relativism of values and impermanence of rules • Voluntary compliance, exception to rules • Right depends on current circumstances • Stage of universal ethical principles (> 18 years old) • “Let’s decide what is best for everyone” • Good maintains respect and dignity for all fellowmen, equality • Right is self determined, autonomous from law.

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