Psychiatry Nursing

Seminar
Erik Erikson
 Erik Erikson’s
Psychosocial theory of personality
Erik Erikson & the background of the theory
 Introduction of the theory
Erikson’s theory is based on the concept of epigenesis
ie, Development occurs in sequential clearly defined stages
Each stage must be satisfactorily resolved for development to occur
smoothly.
Any failure will result in physical, cognitive, social or emotional
maladjustment.
 Stages of psychosocial development
Infancy- Trust versus mistrust
Toddler- Autonomy versus shame and doubt
Pre-schooler- Initiative versus guilt
School age – Industry versus inferiority
Adolescence- Identity versus role confusion
Young adulthood- Intimacy versus isolation
Adulthood- Generativity versus stagnation
Old age- Ego integrity versus despair
Birth- 18 months
Associated virtue-
Hope
Trust

Others are
dependable and
reliable

Self confidence, Optimism, Faith in the

gratification of needs, Hope
Mistrust

World is an
unpredictable,
untrustworthy, and
possibly dangerous
place.

Emotional dissatisfaction,
Suspiciousness, Difficulty in
IPR
 Psychopathology
¨Paranoia
¨Schizoid personality disorder
¨Schizophrenia
¨Psychosis
¨Depression
¨Addiction
18 months- 3
years
Associated
virtue- Will
 Don’t try anything
new.
I cant do anything
properly
Its better to adhere
to whatever others
say.
 Autonomy Vs shame & Doubt

o Lack of self confidence

Sense of self control o Lack of self control
Ability to delay o Rage against self
gratification o Self doubt
Self confidence o Shame
Autonomy o Perfectionism
 Psychopathology
• Obsessions
• Compulsions
• OC personality disorder
• Paranoid personality (Others are controlling them)
• Impulsivity
• Delinquency
3-5 yr
 Initiative vs guilt

Associated
virtue…
Purpose
 Initiative

Self control
Assertiveness
Conscience
Creativity
Initiative
Personal achievement
Guilty

 Sense of defeat
 Excess guilt
 Anxiety
 Psychopathology
Conversion disorder
Inhibition
Phobia
Psychosomatic disorder/ symptoms
5-13 yr
industry
 industry

Self confidence
Learn Satisfaction
Compete, co-operate Pleasure in involving
Engage in different tasks with others
and activities Productive
Want achievement Creativity
Receive recognition
Encouragement
 Industry vs inferiority

Associated
virtue-
Competence
Inferiority
 Inferiority

Unrealistic
expectations of  Inadequacy
parents  Inferiority
Harsh discipline  Difficulty in interpersonal
Unsupportive relationships
teachers  Inability to complete tasks
Unsupportive successfully
environment  Passive/ aggressive
 Decreased self esteem
 Psychopathology
Conformist immersion
Creative inhibition
Inertia
13-21 y
Identity vs role confusion
What What is the
Who am career suits purpose of
I ?? me?? my life??

What religious,
isis moral & political
ti t y cr
n values suit me??
Ide
 Identity

Self confidence
Emotional
stability
Sexual identity
Occupational
identity
 overcoming identity issues
• Forming Cliques
• Not tolerating individual differences
• Fall in love
 Role confusion

Negative identity
Self consciousness
Doubt
Confusion
Decreased self confidence
Rebellious
Identity diffusion
Problems in gender identity and
sexual role
 Psychopathology
Conduct disorder
Delinquent behaviour
Gender related identity disorder
Borderline psychotic disorders
Schizophreniform disorder
Psychotic disorder
21-40 y
 Intimacy vs isolation

Associated virtue is
 Intimacy

Forming intense
lasting relationships
Mutual love, respect
Total commitment to
the partner
Stable marital
relationship
Who are more prone for isolation?
Who are more prone for isolation?
• Dysfunctional family
• Deprived of love
• Mistrust
• Who cant tolerate ego loss due to experiences like sexual orgasm,
moments of intensity in relationships etc
 isolation

 Withdrawl
 Social isolation
 Difficulty in IPR
 Marital
disharmony
 Superficial Sexual
contacts
 Psychopathology
Schizoid personality disorder
Distantiation
Sexual disorders
40-60 y
Generativity vs Stagnation
I want to Iam happy.
contribute to I got my
my family and grand kids
society

Could I Am I needed
achieve my in my family
life goals? and society?
 Generativity vs Stagnation

Virtue:
Care
 GENERATIVITY
Gratification
Service to society
Satisfaction
Sense of achievement
 Stagnation

Lack of concern of welfare of others

Pre-occupation with self
Pseudo engagement in job
Not taking higher responsibility
Decreased self esteem
Withdrawn
Isolated
Self indulgent
 PSychopathology
• Midlife crisis
• Premature invalidism
 Integrity
Acceptance
Of oneself o When successfully completed other
Of significant others stages of life
o Little desire only to make major
Self worth
changes in how their lives have
Dignity progressed.
No fear of death
Integrity
Integrity vs despair

Virtue
:Wisdom
 Despair

e s
l u r
fa i
s t
p a
o n
u s
c
Fo
 Despair
Worthlessness
Helplessness
Second chance of life
Suicidality
Fear of death
Lonliness
Anger
Lack of self identity
 Psychopathology
Extreme alienation
Despair
 Erikson’s approaches in therapy
Child psychologist
Primary- Identify the problem
Basic requirement- Establishing trust
Therapist active with empathetic listening & Verbal reassurance
Co-operation from family
Erikson’s approaches in therapy..
Involved play in therapy
Mutuality
Dream and free association
Didn’t favor hypnosis
 Implication in nursing
Basic trust
Developmental problems
Incorporates sociocultural theory in the development of personality.
To analyze patient’s symptomatic behaviour in the context of
traumatic past experiences and current developmental tasks
To rework early stages of development with unresolved crisis
Develop comprehensive & holistic care plan
 Critique

• Focused so heavily on the stages

• Believed that completion of one stage is a prerequisite for next stage
• Vague
• More attention given to childhood than adulthood
RESEARCH EVIDENCE
Any Queries???
Conclusion
 Reference
Benjamin James Sadock, Virginia Alcott Sadock, Synopsis of
psychiatry, 10th edition; Jaypee Publications
Townsend C. Mary, Psychiatric mental health nursing, 8th edition:
Jaypee publications
Hockenberry J. Marilyn, Wong’s essentials of paediatric nursing, 2nd
edition, Elsevier