Psychological theories of development
The formation of personality is based on concepts describing the phased development of the psyche. The most famous is the theory of Erik Erikson, who proved that a person overcomes specific psychological crises throughout life. Unlike psychoanalysis, he did not reduce all phases exclusively to sexual needs.
- Oral phase: basic trust and a sense of security are established.
- Anal phase: willpower is formed (at the age of 1.5–3 years).
- Phallic and latency phases: development of initiative and the pursuit of mastery.
- Youth and early adulthood: search for social roles and building close relationships. Fixation at this stage leads to a feeling of wasted time or loneliness.
- Adulthood and old age: the desire to pass on experience to students is replaced by the comprehension of life. Successful resolution of the crisis of old age brings satisfaction, while unsuccessful resolution brings the fear of death.
The second important concept was proposed by Carl Gustav Jung, who focused on the direction of mental energy. In childhood and youth, extraversion dominates (the search for recognition and friends), while old age brings a period of introversion — a time of comprehension and silent wisdom.
Features of communication with children and adolescents
The physician's interaction with young patients changes cardinally depending on their age:
- Infants and toddlers (under 3 years): Explore the world through oral and tactile sensations, experience a strict attachment to the mother. The child is a passive participant in treatment; all manipulations are performed only in the presence of parents. Punishments are absolutely meaningless; the best way to correct behavior is distraction.
- Preschoolers (4–5 years): Actively copy adults, strive to demonstrate skills. At this age, children are sensitive to praise, an «agreement» can be established with them, and ignoring them is perceived as the harshest punishment.
- Early school age children: Look for new role models among significant adults, actively accumulate information. Require a partner-like discussion of their health.
- Adolescents: The most difficult cohort. Active separation from parents and a shift of authority towards peers occur. Adolescents painfully experience bodily changes (fear of losing attractiveness) and often resent medical examinations. The main communication tactic is active listening without judgmental statements and avoiding direct arguments.
Crises of adult and elderly patients
As patients grow older, their priorities and vulnerabilities change, requiring specific tactics from the physician:
- Mature youth: Patients take responsibility upon themselves, recognize their professionalism, and do not tolerate advice from elders, regarding it as an intrusion into their personal lives.
- Midlife crisis (around 40 years): An acute sense of approaching old age arises. Patients try to prove their physical strength and are prone to rash steps. In communication, they respond well to compliments about their physical shape. According to Jung, this period involves the breakdown of stereotypes: men discover sentimentality in themselves, while women seek independence and realization in work.
- Involuntary age (in women): Chronologically coincides with menopause. Periods of depression and unjustified anxiety about health frequently occur.
- Old age: The main dominating attitude is a persistent desire not to be a burden to others. Elderly people resign themselves to illnesses and concentrate on the successes of their grandchildren. It is important for the physician to assign them unburdensome tasks to maintain their sense of being needed.
Stress, defenses, and communication
Personality development inevitably encounters obstacles causing frustration — an extremely unpleasant state due to the inability to satisfy a need. To cope with stress, the psyche uses individual strategies (coping). The best adaptation is achieved by people who use active forms of coping, and during frustration (according to S. Rosenzweig), by those who treat the situation impunitively (believing that everything will resolve itself). The internal locus of control is also important — the patient's confidence in their ability to manage the situation.
Unconscious reactions are provided by mechanisms of psychological defense:
- Conversion: causes transient somatic disorders against the background of stress.
- Projection: attributing one's own unacceptable feelings to other people.
- Pedantry: refers to neurotic defense mechanisms.
Many approaches interpret the driving forces of personality differently. In humanistic psychology (A. Maslow, C.R. Rogers), self-actualization is considered the most important need, while in the behavioral direction (B.F. Skinner), it is the conditioned reflex. E. Berne's theory emphasizes that to understand the patient's hidden motives, it is necessary to read the meta-meaning through non-verbal communication.
Briefly: answers to topical questions
What is the difference between the concepts of «character» and «personality» in psychiatry?
Personality is a stable combination of socially significant qualities, individual traits, typical forms of emotional reactions, and human behavior. Character is the behavioral (middle) level of personality organization.
| Characteristic | Personality | Character |
|---|---|---|
| Definition | A stable combination of socially significant qualities and individual traits | The behavioral (middle) level of personality organization |
| Manifestations | Typical forms of emotional reactions and behavior in society | A system of attitudes toward oneself, others, work, and things |
What types of character accentuation exist according to K. Leonhard and A.E. Lichko?
The sources do not provide a complete classification of accentuation types separately by K. Leonhard and A.E. Lichko, however, the following variants are described:
- Demonstrative type — egocentric, infantile, manipulating others, striving to be the center of attention.
- Hyperthymic type — active, sociable, optimistic, hardworking, striving for leadership.
- Dysthymic type — pessimistic, passive, modest, kind, altruistic.
- Stuck type — exhibits distrust and stubbornness in behavior.
What 8 stages of psychosocial development does Erik Erikson distinguish?
Erik Erikson distinguishes eight stages of psychosocial development, at each of which psychological crises are overcome:
- Oral phase — formation of a sense of security and trust.
- Anal phase — formation of willpower.
- Phallic phase — formation of initiative.
- Latency phase — formation of professional skills, pursuit of mastery.
- Adolescence (genital phase) — choosing a place in life by testing oneself in various roles.
- Young adulthood — establishment of close relationships based on mutual understanding.
- Adulthood — self-improvement, the desire to pass on skills to children.
- Old age — comprehension of the path traveled, reconciliation with a weakening body.
What mature mechanisms of psychological defense exist?
Mature mechanisms of psychological defense provide the best level of adaptation, based on socially approved behavior.
- Sublimation — symbolic satisfaction of hidden, unacceptable impulses through activities approved by society.
- Compensation — shifting attention from one's weaknesses to one's strengths.
- Altruism — helpfulness and genuine care for others masking one's own dissatisfaction.
- Humor — explicit discussion of an unpleasant situation in a way that is pleasant for everyone.
- Suppression — a conscious or partially conscious decision to postpone thinking about an unpleasant situation.
- Affiliation — seeking emotional support from others.
What is frustration and what types of reactions to it are distinguished by S. Rosenzweig?
Frustration is an extremely unpleasant mental state caused by the prolonged inability to satisfy an urgent or dominant need. S. Rosenzweig distinguishes three types of reactions to frustration:
- Extrapunitive — blaming other people and demanding compensation from them.
- Intrapunitive — blaming oneself and striving to correct the mistake made.
- Impunitive — the belief that no one is to blame and the situation will resolve itself.
To remember Jung's age vectors, imagine an hourglass: in youth, psychic energy is directed outward (extraversion, the upper wide part); during the mid-life crisis at 40, the sand passes through the narrow neck (breaking of stereotypes); and in old age, the focus narrows and directs inward (introversion, the lower part).
Class and exam questions
What is the essence of the mid-life crisis according to C.G. Jung's concept?
There is a breakdown of life stereotypes and reconciliation with opposite roles. Men discover sensuality within themselves, while women take the initiative and strive for career independence.
How to properly communicate with a teenage patient?
It is necessary to use the principle of active listening, categorically avoiding direct arguments and value judgments. It is important to remember that for them, the opinion of peers is much more significant than the authority of adults.
Which psychological defense causes somatic symptoms?
This mechanism is called conversion. It causes the appearance of transient somatic and neurological disorders in response to stress.
What else to study on this topic
- Eric Berne's Concept: Psychological Games and Intimacy
- Impunitive Type of Reaction to Frustration According to Rosenzweig
- Internal Locus of Control and Its Impact on Patient Compliance
- Behaviorism and B.F. Skinner's Conditioned Reflex Concept
- Inferiority Complex in A. Adler's Theory
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