Mental Health TheoriesAmy L. Goldsberry
This paper is being submitted for Carly Behnkes Mental Health course on January 6, 2019.
Mental Health TheoriesFor many years, the topic of mental health carried a lot of negative implications. People who were seen as crazy were sent away and locked up in mental health institutions. Movies often depicted these hospitals full of people in straight jackets yelling and screaming. There have been countless individuals and groups who have spent their lives replacing the negative image and stigma that was once associated with mental health and have helped create a movement of awareness, acceptance, and hope.
Sigmund Freud is one of the most well-known names of those who pioneered the field of mental health. According to Halter and Varcarolis, he is remembered as the father of psychiatry. Freud developed the psychoanalytic theory, which claims psychological conditions stem from traumatic events in early childhood or infancy and are often not consciously remembered. Freud identifies three divisions of mental activity: the conscious, the preconscious and the unconscious mind (Halter & Varcarolis, 2017). The conscious mind is simply what a person is aware of; their known thoughts and feelings. The preconscious mind is relatable to a gut feeling or the good angel on one shoulder and the devil on the other. Freud claims that the biggest part of a persons mind lies within the unconscious, which holds primitive feelings of memories and traumatic events (Halter & Varcarolis, 2017). Freud believed that using a technique, called, free association, helps the unconscious mind bring deeply rooted memories to the conscious mind to help work through traumatic events that may have contributed to mental health conditions. Freud’s model of personality development is correlated with phases of life-based upon individual needs and different levels of sexual development. Birth through one and a half years of age is known as the oral stage where a sense of trust is developed. Ages one and a half to three years is the anal phase and focuses on gratification. The phallic stage for ages three to seven is when an individual will develop a sexual identity. Latency from seven to 12 is when sexuality is repressed and close relationships with same-sex peers are developed. The last stage of human development according to Freud is the genital phase, which is marked by relationships with a member of the opposite sex (Halter & Varcarolis, 2017).
Free association could be used in nursing practices to help patients identify unknown fears. For example, someone could be very afraid to take a certain type of medication but is unsure why. A nurse could help the patient remember that they once heard of someone who took that medication and had a serious reaction to that medication and had life-threating complications.
I do not feel that Freud’s theory of human development is pertinent to today’s culture and is too sexual in nature. Admittingly, I am not an expert on his theory, I see a lot of room for criticism. For example, what about individuals who are gay. I feel his theory is about finding a “reason” for someone to “become” gay, or imply it is a choice based upon a traumatic event. I do not feel that I would be able to use this within my own nursing practice, mainly due to my own unfamiliarity with it. I do not have a lot of interest of diving in deeper to this theory to help my patients. I do feel like there are other theories that are more consistent with my personality.
Interpersonal theory is another important component of mental health history, proposed by American psychiatrist, Harry Stack Sullivan (Halter & Varcarolis, 2017). He believed that human development, as well as personality or mental health disorders, are caused by interpersonal situations and the primal human desire of being connected with others (Halter & Varcarolis, 2017). He also recognized anxiety as a key to behavior and self-esteem. Sullivan identified that people avoid anxiety by focusing on the good parts of themselves and lessened or ignored the bad sides. Halter and Varcarolis used the example of identifying when someone is good at something, like being a good skier and telling others. Sullivan theorized that people tend to not talk about or ignore the bad parts of themselves. Their example was of a young girl raised in a religious family had feelings for another girl and simply ignored those feelings since it was seen as wrong or bad (Halter & Varcarolis, 2017).
For me, acknowledging and identifying causes of anxiety could be a very critical part of the nursing care I provide. If a client appears anxious about a specific procedure, task, medication, etc., I can try and help identify that and help the client not simply ignore the anxious feelings which could escalate into a more critical situation.
Sullivan and Freud were similar in their theories by identifying different phases of development within an individuals life. Both saw the importance of the caregiver in an infant and childs life. A major difference is that Freud saw the cause of issues solely on trauma or negative events that were pushed out of the conscious mind. Sullivan recognized that interpersonal relationships influenced mental health and emotional well-being.
I am an empathetic person and I do not feel that Freuds therapeutic relationship model would work well for me. I think that the transference from the patient onto me would quickly take a toll on me and affect my own mental well-being. Additionally, I do not identify many areas of my own childhood or my own personality as relating to sexual or personality development. When I think of Freud I think of comments like Daddy issues or Mommy issues and it makes me uncomfortable. I do believe a lot of it has to do with me not being fully educated on his theory. I am able to identify more to Sullivans theory with my own life as I did not have a positive relationship with my mother growing up, and the tense, stressful relationship has carried into my adulthood.
I have never found myself fitting into one specific description for anything. I often identify and can empathize with both sides of a situation. Similarly, with theories of mental health, I find myself identifying with little pieces of each. As I further my research within this class and throughout my nursing career, I hope that I am able to eventually see my own beliefs and theory unfold and help create a lasting legacy.
Halter, M. J. & Varcarolis E.M. (2017). Mental health and mental illness. In
Varcarolis (Ed.), Essentials of mental health nursing: A communication approach to
evidence-based care (pp.19-33) St. Louis, MO: Elsevier.