Mental Health and Mental Illness

Chapter 2 Lecturer: Jomar D. Devano, R.N.

Self-awareness
} The

process by which the nurse gains recognition of his or her own feelings, beliefs, and attitudes.

Mental Health
y

A state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, a positive self-concept and emotional stability. A positive state in which one is responsible, displays selfawareness, is self-directive, is reasonably worry free and can cope with usual daily tensions. Ability of people couples, families, and communities to respond adaptively to internal and external stressors.

Mental Health
} Balance

in persons internal life and adaptation to reality. state of well being in which a person is able to cope with the normal stresses of daily life and his ability to realize his potentials (WHO).

}A

Factors Influencing Mental Health

  

inherited characteristics nurturing during childhood life circumstances

Criteria for Positive Mental Health

(Joint Commission on Mental Illness and Health (1958) & Dr. Marie Jahoda)

     

attitude toward the individual self growth, development and self-actualization integrative capacity autonomous behavior perception of reality mastery of ones environment

5 Freedoms Demonstrated by Mentally Healthy People

    

The freedom to see and hear what is here instead of what should be, was or will be. The freedom to say what one feels and thinks, instead of what one ought. The freedom to feel what one feels, instead of what one ought. The freedom to ask for what one wants, instead of always waiting for permission. The freedom to take risks in ones behalf, instead of choosing to be only secure and not rocking the boat!

Ways to Maintain Mental Health

Factors that influence the ability to maintain and achieve mental health:
   

engaging in interpersonal communication significant others or support people personal strategies resorting to human hiding places or ego defense mechanisms

Ego Defense Mechanism

Ego Defense Mechanism

}

mental processes first described by Sigmund Freud (1946). methods of attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings, or events. usually unconscious, specific intrapsychic adaptive efforts which are employed by the person to resolve emotional conflict and to cope with anxiety.

Characteristics


it is automatic it is not the defense mechanism that is pathological but it is the frequency of its use used by both mentally healthy and mentally ill individuals

Purposes
}Self security protection }Anxiety (or fear) reduction }Mental conflict resolution }Esteem (self) protection

Ego Defense Mechanism

           

Repression Suppression Conversion Symbolization Dissociation Identification Introjection Sublimation Compensation Rationalization Projection Displacement

           

Undoing Generalization Reaction formation Regression Fixation Intellectualization Acting-out Denial Fantasy Isolation Insulation Substitution

Ego Defense Mechanism

Woman has no memory of the } An involuntary, mugging she suffered automatic submerging yesterday.

REPRESSION

SUPPRESSION Students decides not to about a parents illness to study for a Intentional exclusion of forbidden ideas and test.
anxiety producing situations froma friend she Woman tells the unconscious level cannot think about her sons death forgetting A voluntary right now. or postponing I rather not talk about it, right The only DM operating now! at the conscious level.

of painful, unpleasant thoughts and feelings Woman has no memory before age 7,into the unconscious. when she was removed
from abusive parents.
}

Unconcious forgetting

Ego Defense Mechanism

CONVERSION Teenager forbidden to see X-rated movies is tempted to do so by } Transferring of mental friends and develops blindness, conflict or emotional and the teenager is unconcerned anxiety into sight. about the loss ofphysical
symptom to release tension. A soldier experiences sudden
blindness after witnessing his best friend dying from a grenade blast } Emotional problems

SYMBOLIZATION
}

An object, idea, or act represents another through of Engagement ring symbol some common aspect and love. carries the emotional feeling associated with the other. A man who was spurned by a

librarian develops a dislike of External becomes books and reading. representations of internal.
Allows emotional selfexpression.

are converted to Diarrhea before exam.

physical symptoms.

Ego Defense Mechanism

DISSOCIATION
The act of separating and detaching a strong, Amnesia that charged recall of yesterdays auto accident. emotionally prevents conflict from ones consciousness. Adult remembers nothing of childhood sexual abuse. } Dealing with emotional conflict by a temporary alteration in consciousness or identity. A woman raped found wandering a busy highway traumatic amnesia. } This detached information is blocked from conscious awareness, which allows the person to defer or postpone experiencing an emotional impact or painful feelings.
}

Ego Defense Mechanism

IDENTIFICATION
the imitator Nursing student becoming a
}
y

INTROJECTION
Accepting another persons Persons who and values attitude, beliefs, dislikes guns as ones own. avid hunter, just becomes an Incorporate feelings & emotions, values & beliefs, Acting personality. traits and& dressing like Jesus

critical care nurse because this is the specialty of an instructor } Attempting to she admires.

like a best friend.

pattern or resemble the personality of an admired, idealized person.

Christ.

Symbolic assimilation or taking into oneself a love/hated object.

Ego Defense Mechanism

SUBLIMATION Person who has quit smoking sucks on hard candy when the } Re-channeling of urge to smoke arises. COMPENSATION
}Napoleon complex: diminutive The act of making up for a

consciously intolerable or socially Person goes for a 15-minute walkunacceptable eat when tempted to junk food. behaviors or impulses into personally or An aggressive person joins socially acceptable. debate team.

real or imagined deficiency man becoming emperor. with a specific behavior ( by concentrating or developing otherself-esteem Nurse with low attributes.

Overachievement in one area to offset real or perceived deficiencies in another area.

works double shifts so her supervisor will like her.

Ego Defense Mechanism

RATIONALIZATION
Student blame behavior to failure on } Excusing own avoid guilt, responsibility, teacher being mean.
}

PROJECTION
Man who has thought about Unconscious blaming sexual same-gender of unacceptable inclinations or relationship, but never had thoughts on an external object. one, beats a man who is gay.
scapegoat Attributing ones own unacceptable feelings and thoughts to others.

Man says he beats his wife } Attempting to justify or modify because she doesnt listen to unacceptable needs and him. feelings to the ego, in an effort It wasnt worth it, anyway, it is all for the best.
to maintain self respect and prevent guilt.

conflict, anxiety, or loss of selfconcept.

Ego Defense Mechanism

DISPLACEMENT
Feelings are transferred, redirected mad at the boss Person who is or discharged from the appropriate person or yells at his spouse. objects to less threatening person or object.
}

UNDOING
} }

Person who RESTITUTION cheats on a

Child who is harassed by a } Ventilation of intense feelings bully at school mistreats a towards persons less threatening sibling. who younger than one
aroused those feelings.

Exhibiting acceptable behavior to make up Man who is ruthless in business for or negate donates large unacceptableamount of money behavior. to charity.

spouse brings the spouse a bouquet of roses.

Ego Defense Mechanism

STEREOTYPING
} } }

REACTION FORMATION
}

GENERALIZATION SPLITTING Viewing people as all good, and others as all bad.

Person exaggerates or have childrencertain actions overdevelops becomes a supermom. by displaying exactly the opposite behavior, attitude, or feeling from what he Person who despises or she normally would show the boss tells in a everyone what a great boss she is. given situation.

Woman who never wanted to

} Student hating her CI OVERCOMPENSATION

may act very courteously towards her.

Ego Defense Mechanism

anxiety, allow one to feel more comfortable, and permit Man pouts like a 4-year-old if he is dependency. developmental stage to feel safe or acts needs met. A 27 year old havelike a 17 y.o. on

REGRESSION Five-year-old asks for a bottle when Temporarilybrother is being } new baby retreating to past levels of behavior that reduce fed.

FIXATION
y

not at the center of his girlfriends attention. } Moving back to a previous her first date with a fellow employee

Permanent or persistence delay Never learning to into later life of interests and gratification. behavior patterns appropriate to an early age, without stressors. the personality resulting from unsuccessful completion of tasks in a developmental stage.

Lack of clear sense of identity as a adult. Immobilization of a portion of

Ego Defense Mechanism

Person shows no emotional y The act of transferring emotional expression when intellectual sphere. concerns into the discussing serious car accident.
y

INTELLECTUALIZATION

ACTING - OUT
}

Separation of the emotions of a painful event or situation from the facts involved; acknowledging the Dear Johnnot the emotions. facts but Letter the groom

is trying to figure out with his y Exaggeration of room mate why intellect. his fiance changed her mind to avoid confronting her.

Dealing with emotional conflicts or stressors Physical or verbal aggression. through actions rather than through reflection or feelings to feel temporarily less helpless or powerless.

Ego Defense Mechanism

Diabetic eating chocolate } Failure to acknowledge an candy. unbearable condition
} Failure to admit reality of a Spending money freely when situation or how one enables broke. the problem to continue. } Blocking the seek help Waiting 3 days toawareness offor reality. severe abdominal pain.

DENIAL

FANTASY

Imagined events or mental images to express unconscious conflicts, gratify unconcious wishes or prepare for anticipated future events. Wishful thinking.

Daydreaming.

Temporary flight from reality to anxiety.

Ego Defense Mechanism

ISOLATION
A rape victim talks about the } Process of separating rape experience without an unacceptable feeling, idea, or showing any emotion.
}

INSULATION
Withdrawal with passivity, becoming inaccessible in order to avoid further threatening circumstances.

impulse from ones thoughts.

EMOTIONAL ISOLATION

Ego Defense Mechanism

SUBSTITUTION
}

The unconscious act of replacing a goal when it is blocked.

} The replacement of to have her own children opens a day Woman who would likea highly valued unacceptable object that is more acceptable to ego. care center. }

Replacing the desired unattainable goal with one that is attainable.

Mental Illness

Mental Illness
y

A state of imbalance characterized by a disturbance in persons thoughts, feelings and behavior. A mental disorder or condition manifested by disorganization and impairment of function that arises from various causes such as psychological, neurobiological and genetic factors. Illness or syndrome with psychologic or behavioral manifestations and / or impairment in functioning due to a social, psychologic, genetic, physical / chemical or biologic disturbance.

Population at risk for mental illness

      

with familial or genetic predisposition to mental illness. with poor access to health care
disadvantages (homeless and poor) misusing substance

undergoing lifestyle victims of violence elderly poor

Misconceptions about Mental Illness

     

Abnormal behavior is different or odd, easily recognized. Abnormal behavior can be predicted and evaluated. Internal forces are responsible for abnormal behavior. People who exhibit abnormal behavior are dangerous. Maladaptive behavior is always inherited. Mental Illness is incurable.

Characteristics of Mental Health and Mental Illness

Characteristics of Mental Health and Mental Illness Mental health

5

Mental illness
4 4

Accepts self and others Is able to cope with or tolerate stress Can return to normal functioning if temporarily disturbed

Feels inadequate Has poor selfconcept Is unable to cope

Exhibits maladaptive behavior

Characteristics of Mental Health and Mental Illness Mental health

5

Mental illness
4

Is able to form close and lasting relationships Uses sound judgment to make decisions Accepts responsibility for actions

Is unable to establish a meaningful relationship Displays poor judgment

Is irresponsible or unable to accept responsibility for actions

Characteristics of Mental Health and Mental Illness Mental health

5 5

Mental illness
4 4

Is optimistic Recognizes limitations(abilities and deficiencies) Can function effectively and independently

Is pessimistic Does not recognize limitations (abilities and deficiencies Exhibits dependency needs because of feelings of inadequacy

Characteristics of Mental Health and Mental Illness Mental health

5

Mental illness
4

Is able to distinguish imagined circumstances from reality Is able to develop potential and talents to fullest extent

Is unable to perceive reality

Does not recognize potential and talents because of poor selfconcept

Characteristics of Mental Health and Mental Illness Mental health

5

Mental illness
4

Is able to solve problems

Avoids problems rather than coping with them or attempting to solve them Desires or demands immediate gratification

Can delay gratification

Characteristics of Mental Health and Mental Illness Mental health

5

Mental illness
4

Reflects a persons approach to life by communicating emotions, giving and receiving, working alone as well as with others, accepting authority, displaying a sense of humor, and coping successfully with emotional conflict.

Reflects a persons inability to cope with stress, resulting in disruption, disorganization, inappropriate reactions, unacceptable behaviors, and the inability to respond according to the persons expectations and the demands of society.

Mental Health and Mental Illness

Chapter 2 Lecturer: Jomar D. Devano, R.N.