Interpersonal theory 3rd lecture

Interpersonal theory
3rd Lecture
? This concept focuses on interaction between an individual and his environment
? Personality is shaped through “interaction” with significant others
? We internalize approval or disapproval form our parents


Harry Stack Sullivan (1892–1949
Personality has three SELF-SYSTEM
1. “Good Me” develops in response to behaviors receiving approval by parents/SO
2. “Bad Me” develops in response to behaviors receiving disapproval by parents/SO
3. “Not Me” develops in response to behaviors generating extreme anxiety in parents/SO and this is denied as part of oneself

Mental Health is Viewed as:
1. Related to conflict or problematic interpersonal relationships
2. Past relationships, inappropriate communication and current relationship crisis are etiologic factors of mental illness
Treatment of Mental illness:
? Focuses on anxiety and its causes
? Therapeutic relationship with client that is active and participative
? Feelings and emotions are verbalized by the clients to modify problematic relationships


Usefulness in Nursing
? Nurse and client can participate in and contribute to the relationship that is therapeutic
? This relationship can be used as a corrective interpersonal experience
? Anxiety management

Humanistic theory
? Human nature is positive and growth centered and existence involves search for meaning and truth
? Maslow’s theory of Needs are organized in a hierarchy





Mental illness in this framework
1. The failure to develop one’s FULL potential leads to poor coping
2. Lack of self awareness and unmet needs interfere with feelings of security
3. Fundamental human anxiety is fear of death which leads to existential anxiety
Application of the theory to Nursing
1. NCR is based on positive regard, respect and empathy
2. Nurses assess the spiritual aspects of the client including religion, love and relationships
3. Through reflective listening and emphatic responses, the nurse helps the client gain self-understanding






































Behavioral Theory

? This concept describes a person’s function in terms of identified BEHAVIORS
? People learn to be who they are
? Behavior can be observed, described and recorded
? Behavior is subject to reward or punishment
? Behavior can be modified by changing environment


? The Classical Conditioning by Pavlov
? Learning can occur when a stimulus is paired with an unconditioned response
? Conditioned responses happens when stimulus is present
? Acquisition – gain of learned response
? Extinction – loss of learned response

B. F. Skinner (1904–1990)
? Positive reinforcement increases the frequency of behavior
? Removal of negative
reinforcers increases the frequency of behavior

? The Operant Conditioning by Skinner
? Rewards and punishments are utilized
? Positive reinforcement- rewards
? Negative reinforcement-
? Positive punishment
? Negative punishment- withdrawing reward

Mental Illness is viewed as:
? Mal-adaptive BEHAVIORS are learned through classical and operant conditioning
? Mal-adaptive behaviors can be changed by altering environment



Application to Nursing
1. The nurse assess both adaptive and ,al-adaptive behaviors
2. The nurse and client collaborate in identifying behaviors that need to change
3. Behavioral modification techniques are utilized by the nurse in the treatment of mental illness





Hildegard Peplau: The Power of
Empathy


? Hildegarde Peplau’s (1909–1999) theoretic perspectives continue to be an important base for the practice of psychiatric–mental health nursing. Influenced by Harry Stack Sullivan, Peplau introduced the first systematic theoretic framework for psychiatric nursing and focused on the nurse–patient relationship in her book

Interpersonal Relations in Nursing in 1952 (Peplau, 1952).


She believed in the importance of the “interpersonal environment,”
? which included interactions between person and family, parent and child, or patient and nurse.
? She believed in the importance of the “interpersonal environment,”
? which included interactions between person and family, parent and child, or patient and nurse.

? Peplau also emphasized the importance of empathic linkage, the ability to feel in oneself the feelings experienced by another person or people. The interpersonal transmission of anxiety or panic is the most common empathic linkage. According to Peplau, other feelings, such as anger, disgust, and envy, can also be communicated nonverbally by way of empathic transmission



There are various levels of anxiety
? MILD: Awareness heightens
? MODERATE: Awareness narrows
? SEVERE: Focused narrow awareness
? PANIC: Unable to function