PSYCHODYNAMICS

Predisposing Factors
Certain genetic patterns
may interact with other
neurological, biochemical,
and environmental
factors, contributing to
increased vulnerability to
certain mental illness.

Genetics/Family history
On the father side
there were history of
mental illness his

(Isaacs, 2005. Mental

Health and Psychiatric
Nursing. 4th ed)

(grandfather)

Personality is shaped
through interaction with
significant others, the
child internalizes approval
or disapproval from the
parents and therefore the
self is shaped by the
parental view of the child.

Lack of trust
(He was raised not to trust
other people; his parents
are always scolding him.)

(Isaacs, 2005. Mental

Health and Psychiatric
Nursing. 4th ed)

Precipitating factors

Stress produces distress

and creates physical and
psychological demands on
an individual, requiring
coping and adapting.

Stressful events (death

threat for their family)

(Isaacs, 2005. Mental

Health and Psychiatric
Nursing. 4th ed)

SYMPTOMATOLOGY
Insomnia

Inability to sleep or
disrupted sleep pattern is
the common symptoms of
psychiatric disorder.

Auditory Hallucination
Delusions
MOTHER

FATHER
Mr Delfin

SCHEMATIC DIAGRAM

Mrs Dulfa

49 years old

47 years old

Businessman

Businesswoman

Characteristics:

Characteristics:

Protective father, good provider

A caring mother.

Courtship
Mrs. Dulfa is from Iloilo and they met in Kulaman and fell in love with each
other and eventually got engaged.

Marriage
They exchanged vow in Sto. Nino Parish Church, Kulaman. Until
now, they lived a happy life.

Children

1st
Dulfo

2nd
Dolly

3rd
Dally

4th
Delly

5th
Dellin

6th
Della
(Decease
d)

Prenatal
Mr. Dulfo is the first child of Mr. and Mrs. Delfin. When she was
pregnant Mrs. Dulfa took care of herself. Nothing unusual
happened during her pregnancy.

Natal
Mr. Dulfo was born on February 14, 1989 in a hospital in their
hometown. He was delivered via normal spontaneous vaginal
delivery.

Infancy (0-18 months)

Erik Eriksons psychosocial theory: Trust vs. Mistrust

7th
Dello

It is the stage where an infant is learning on how to trust his environment. During
the first year of life of individual, for his physiologic and psychological needs, he
depends on his parents or caregiver. Fulfilment of these needs is required to develop
the basic sense of trust of a child. If a child failed to achieve trust , years later, he will
have difficulty in trusting other people.
Sigmund Freuds psychosexual theory: Oral stage
According to Freud, An infants source of pleasure is through his mouth If this
gratification wont be satisfied, it can result to a condition called oral fixation, which is
evidenced by preoccupation with oral activities in later life such as smoking, drinking
alcohol, over eating, or biting his/her nails. On the other hand, if it is overly gratified,
they have the tendency become followers, overly dependent upon others or credulous
type of a person.
Significant persons:
The most significant person is the mother or the caregiver.
Significant task

Viewing the world safe and reliable

Viewing relationships a nurturing, stable and dependable.

On Mr. Dulfo
When he was an infant, Dulfos mother had breastfed him and took care of him for a
while. She got busy, and entrusted Dulfos needs to a helper. He has no proper bonding
with his parents because they are always away from home.

Analysis:
In this stage of development, Dulfo was unable to achieved trust because his parents
has no time to provide his needs. When he grew up, he manifested characteristics such
as being suspicious and hes having a hard time building trust to others. Dulfo
developed MISTRUST.

Toddlerhood (18mos-3 years old)

Erik Eriksons psychosocial theory: Autonomy vs. Shame and doubt
In this stage, a toddler is learning to cultivate sense of self-concept through his
immediate social environment. Parents play a significant role in this stage. The toddler
learns self-control and beginning of independence. The childs most favourite word is
no, this is to show his autonomy. This may be annoying on the part of a caregiver, but
it is essential in development of the childs own free will. With the healthy sense of selfesteem and security, the child will be able to deal with periodic failures later.

Sigmund Freuds psychosexual theory: Anal stage

In this stage, anus and surrounding area are major source of toddlers interest.
Anus and surrounding area are major source of interest. During this time of life, if the

child is overly toilet trained, there is a chance that the child will become obsessive
convulsive. If it is otherwise, the child will become messy and disorganized.
Significant Persons:
The most significant person is the parents.
Significant Task:

Achieving a sense of control & freewill.

Fine muscle coordination & gross motor skills improving.

On Mr Dulfo
When he was a toddler, his parents are starting to become overly protective of
him. Whenever he wants to play, his father got mad of him. So, usually he was alone.
He grew as a shy type person. There is no information about his toilet training but
according to his sister Dulfo is the organized type and is very demanding.
Analysis:
The information is not enough on this stage. Mr. Dulfo failed in this stage because he
grew up being shy of others. He was unable to practice his autonomy since his father is
the one who decides for himself when he was a child. On this stage he settled for
SHAME AND DOUBT
Preschool (3-6 years old)
Erik Eriksons psychosocial theory: Initiative vs. Guilt

On this stage, the child learns assertiveness and the ability to affect interpersonal
environment. This is the time when the children begin to initiate task. It is evident by
asking why constantly. They begin to wonder the purpose of things around them. If
the caregiver, did not let the child do the initiative he will develop guilt.

Sigmund Freud psychosexual theory: Phallic Stage

The most significant person is the parent on the opposite sex. The focus of the
child is the genitals. Penis is organ of interest for both sexes in this stage. Also, in this
stage oedipal complex (wish to marry opposite-sex parent and be rid of same sex
parent) is very common. Failure to complete this task will result to overly closed
relationship on the parent of the opposite complex.
Significant task:

Beginning development of a conscience and learning to manage conflicts and

anxiety.
Develops locomotion.

On Mr Dulfo
During his preschool years, Mr Dulfo, was unable to build enough bonds to his
mother because she was so busy. At this period of time, Dulfo was unable to develop
his initiative. All his actions were being watched by his father. His father will not let him
play outside. Whenever he committed wrong action, he got scolded by his father. He
never had a free will to do something he wants as a child.

Analysis:
During this time, Dulfo is always being reprimanded. If his father doesnt like his actions,
he got beaten. He did not develop initiative to do things because he was afraid of his
father. as he grew, Dulfo is still afraid to do on his own because his father will always
get in the way. At this stage, he develop GUILT.
School age (6-12 years old)
Erik Eriksons psychosocial theory: Industry vs. Inferiority
In this stage, competitive plays are very common for children to build their confidence.
Children intended to do better when they are recognized. This is the time when the child
learns self-confidence through cooperation and competition. Failure to achieve this
stage will result to a condition called inferiority complex.

Sigmund Freuds psychosexual theory: latency stage

This is the time when the child establishes same-sex relationships. They play or interact
with the same-sex children. At this age, sexual drive channelled into appropriate
activities such as school work and sports. This is the final stage of psychosexual
development.
Significant Persons:

Peers neighbour and classmates or schoolmates play a vital role in forming oneself
towards competence and confidence.
Significant task:

Arising competence towards self and others.

Confidence forming
Widening of skills and knowledge

On Mr Dulfo
School age (6-12 years old)
During his time, Mr. Dulfo, though a shy type, he begins to compete in school. He was
an honour student until he graduated elementary and he was also active in any school
activities before. He has some friends but he never trusted them. He is always reserved.
He usually plays basketball alone.
Analysis
Since, he was achiever during his elementary years; we can say that he developed
INDUSTRY. On the other hand, he did not actually build a friendship with same sex
children, because he always doubts them. In later years, he finds it very difficult to
communicate with other people.

Adolescence (12-18 years old)

Erik Eriksons psychosocial theory: Identity vs. Role Confusion
This is the time when the children develop their sense of self. They identify their self as
a man or a woman. ). In this stage, children become more mature than when they were
in school age. They engage in activities involving choosing a career or vocation and
start to develop interpersonal relationships towards opposite sex. If this stage is not
resolve there is a big chance that he will have confusion on his gender.

Sigmund Freuds psychosexual theory: Genital Stage

This is the beginning of puberty and biologic capacity of orgasm; it involves the capacity
for true intimacy. The adolescent establishes relationship with opposite sex and finds
gratifying work.
Significant persons:
Peers and opposite sexes

Significant task:

Develop a sense of self and belongingness

Building maturity with in self

On Mr Dulfo,
During his adolescence, Dulfo still finds it hard to trust other people. He never had a
problem in identifying himself as a man. During his first and second year in high school,
he still an achiever but it deviated when he became addict to computers. He was also
being bullied by the students in their school. Eventually, he stopped attending school.
After a year he entered school again. He became more suspicious of other people. He
had a girlfriend but they did not last. He has also no friends in opposite sex. He was
third year in high school when he began to lose his friends. He avoided them because
he thought that they have ulterior motives in befriending him. During this period also, he
became rebellious, whenever he was being reprimanded he always ran away from
home. He hates to be scolded. His relationship with his father got worse. He has so
many dreams when he was an adolescent but none of them came true. He was still
afraid to voice out what he wants in life. He did not do what he wants. His never
achieved his goals and he did not enter college.
Analysis:
This was the time when Dulfo begins to lose his own self. He did not build his own
identity because he is always alone. He was unable to express his true feelings that
lead to confusion and he was incapable of building relationship on the opposite sex
since he has no trust. He developed ROLE CONFUSION.
Young adulthood (19-40 years old)
Erik Eriksons psychosocial theory: Intimacy vs. Isolation

This is the period, when an adult is being formed. Young adult builds loving relationship
and meaningful attachments to others. He become more capable of choosing a marital
partner and performs work and social roles. He is getting more responsible about his
life.

Significant Persons:
Peers and partner.
Significant Task:

Develop a sense of self and belongingness

Achieve new and more matured relationship towards opposite partner

On Mr Dulfo
During this age, Mr. Dulfo is always alone. He neither has friends or girlfriend. He was
so dedicated on his work in their business. He doesnt want to communicate with people
outside their family. He isolates himself from other people. This was also the time when

his family got in to trouble and given a death threat. He began to show symptoms such
as auditory hallucinations, delusions and insomnia. He was admitted to a hospital and
his condition his now getting better. We had observed that he still suspicious when we
first met him. He doesnt really talk and still isolate himself from others. When we had an
art therapy, all his characters are always alone. He also said that the characters in his
drawing are lost and are looking for someone else to be with.
Analysis:
He did not develop intimacy because he has no trust to other people. He doubted their
sincerity. We can say that he also looking for sense of belongingness but it contradicts
in his actions because he is always alone.He developed ISOLATION.