Mental Health and Mental Illness

Self-awareness

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

Mental Health

A state of emotional, psychological, and social wellness evidenced by satisfying interpersonal

relationships, effective behaviour and coping, a positive self-concept and emotional stability.

A positive state in which one is responsible, displays self-awareness, 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.

Balance in persons internal life and adaptation to reality.

A 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).

Factors Influencing Mental Health

inherited characteristics

nurturing during childhood

life circumstances

Criteria for Positive Mental Health

attitude toward the individual self

growth, development and self-actualization

integrative capacity

autonomous behavior

perception of reality

mastery of ones environment

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

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

1. REPRESSION
o An involuntary, automatic submerging of painful, unpleasant thoughts and feelings into
the unconscious.
o Unconcious forgetting
o Ex. Woman has no memory of the mugging she suffered yesterday.
o Ex. Woman has no memory before age 7, when she was removed from abusive parents.

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

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

4. SYMBOLIZATION
o An object, idea, or act represents another through some common aspect and carries the
emotional feeling associated with the other.
o External becomes representations of internal.
o Allows emotional self-expression.
o Engagement ring symbol of love.
o A man who was spurned by a librarian develops a dislike of books and reading.

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

6. IDENTIFICATION
o the imitator
o Attempting to pattern or resemble the personality of an admired, idealized person.
o Nursing student becoming a critical care nurse because this is the specialty of an
instructor she admires.
7. INTROJECTION
o Accepting another persons attitude, beliefs, and values as ones own.
o Incorporate feelings & emotions, values & beliefs, traits and personality.
o Symbolic assimilation or taking into oneself a love/hated object.
o Persons who dislikes guns becomes an avid hunter, just like a best friend.
o Acting & dressing like Jesus Christ.

8. SUBLIMATION
o Re-channeling of consciously intolerable or socially unacceptable behaviors or impulses
into personally or socially acceptable.
o Person who has quit smoking sucks on hard candy when the urge to smoke arises.
o Person goes for a 15-minute walk when tempted to eat junk food.
o An aggressive person joins debate team.

9. COMPENSATION
o The act of making up for a real or imagined deficiency with a specific behavior ( by
concentrating or developing other attributes.
o Overachievement in one area to offset real or perceived deficiencies in another area.
o Napoleon complex: diminutive man becoming emperor.
o Nurse with low self-esteem works double shifts so her supervisor will like her.

10. RATIONALIZATION
o Excusing own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self-
concept.
o Attempting to justify or modify unacceptable needs and feelings to the ego, in an effort
to maintain self respect and prevent guilt.
o Student blame failure on teacher being mean.
o Man says he beats his wife because she doesnt listen to him.
o It wasnt worth it, anyway, it is all for the best.

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

12. DISPLACEMENT
 o Feelings are transferred, re-directed or discharged from the appropriate person or
objects to less threatening person or object.
o Ventilation of intense feelings towards persons less threatening than one who aroused
those feelings.
o Person who is mad at the boss yells at his spouse.
o Child who is harassed by a bully at school mistreats a younger sibling.

13. UNDOING
o RESTITUTION
o Exhibiting acceptable behavior to make up for or negate unacceptable behavior.
o Person who cheats on a spouse brings the spouse a bouquet of roses.
o Man who is ruthless in business donates large amount of money to charity.

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

15. REACTION FORMATION

o Person exaggerates or overdevelops certain actions by displaying exactly the opposite
behavior, attitude, or feeling from what he or she normally would show in a given
situation.
o OVERCOMPENSATION
o Woman who never wanted to have children becomes a super-mom.
o Person who despises the boss tells everyone what a great boss she is.
o Student hating her CI may act very courteously towards her.

16. REGRESSION
o Temporarily retreating to past levels of behavior that reduce anxiety, allow one to feel
more comfortable, and permit dependency.
o Moving back to a previous developmental stage to feel safe or have needs met.
o Five-year-old asks for a bottle when new baby brother is being fed.
o Man pouts like a 4-year-old if he is not at the center of his girlfriends attention.
o A 27 year old acts like a 17 y.o. on her first date with a fellow employee

17. FIXATION
 o Permanent or persistence into later life of interests and behavior patterns appropriate
to an early age, without stressors.
o Immobilization of a portion of the personality resulting from unsuccessful completion of
tasks in a developmental stage.
o Never learning to delay gratification.
o Lack of clear sense of identity as a adult.

18. INTELLECTUALIZATION
o The act of transferring emotional concerns into the intellectual sphere.
o Separation of the emotions of a painful event or situation from the facts involved;
acknowledging the facts but not the emotions.
o Exaggeration of intellect.
o Person shows no emotional expression when discussing serious car accident.
o Dear John Letter the groom is trying to figure out with his room mate why his fiance
changed her mind to avoid confronting her.

19. ACTING OUT

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

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

21. FANTASY
o Imagined events or mental images to express unconscious conflicts, gratify unconcious
wishes or prepare for anticipated future events.
o Wishful thinking.
o Temporary flight from reality to anxiety.
o Daydreaming.
 22. SUBSTITUTION
o The unconscious act of replacing a goal when it is blocked.
o The replacement of a highly valued unacceptable object that is more acceptable to ego.
o Replacing the desired unattainable goal with one that is attainable.
o Woman who would like to have her own children opens a day care center.

Mental Illness

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.