Theoretical Foundations in Nursing

STUDENT ACTIVITY SHEET BS NURSING / FIRST YEAR

Session # 22

LESSON TITLE: Materials:

▪ SIGMUND FREUD’S PSYCHOSEXUAL THEORY OF Pen and notebook
DEVELOPMENT
▪ ERIK ERIKSON'S STAGES OF PSYCHOSOCIAL
DEVELOPMENT

LEARNING TARGETS:
Upon completion of this lesson, you can:
▪ Acknowledge the background and credentials of these
local nursing theorists;
▪ Identify the major concepts and definitions of terms as
utilized in their respective models;
▪ Highlight their major areas of contributions in the Reference:
nursing field; and, Alligood, M. (2018). Nursing theories and their
▪ Describe each of these theories in view of their work (9th ed.). Singapore: Elsevier.
implications in the nursing field.

LESSON REVIEW/PREVIEW
Let us have a review of what you have learned from the previous lesson. Kindly answer the following questions on the
space provided. You may use the back page of this sheet, if necessary. Have fun!

What is the emphasis of Ludwig von Bertalanffy’s General Systems Theory?

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What are the three stages according to Kurt Lewin’s theory?
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MAIN LESSON
You will study and read their book, if available, about this lesson.

SIGMUND FREUD’S PSYCHOSEXUAL THEORY OF DEVELOPMENT

✔ This theory was developed by Sigmund Freud (1856-1939)
✔ This revolutionized the understanding of mental life and human behavior
✔ Freud's theories helped in understanding early development of sexuality and mental
functioning in the infant and adult psychological illnesses

Psychoanalytic Theory:
1. Structural Theory
2. Libido (Drive) Theory
3. Topographical Theory of mind
4. Theory of Narcissism

Freud’s Structural Theory Postulated the Existence of the Id, Ego, and Superego
ID EGO SUPEREGO
▪ First to develop ▪ Second structure to develop ▪ Third structure to develop
▪ Completely unconscious ▪ Operates on reality principle

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▪ Contains all drives ▪ Mediates conflict among id, ego, & superego
▪ Ruled by pleasure ▪ Provides reality testing
principle ▪ Monitors quality of interpersonal relations
▪ No awareness of reality ▪ Provides synthesis and coordination
▪ Carries out primary autonomous
functions
▪ Defends against anxiety
▪ Self-criticism based on moral
values
▪ Self-punishment
▪ Self-praise based on ego ideal
▪ Most functions are unconscious
▪ Conflict is the main concept of
structural theory

Libido Theory
✔ Libido theory assumes that biological needs (drives) fuel behavior
✔ The aim of behavior is to gratify the drive
✔ Drives are either sexual or aggressive in nature
✔ The libido theory explains that the sexual instinct plays an etiological role in the neuroses and that sexual
stimulation exerts a predominant force (which is called libido) on mental activity throughout life
✔ The discharge of libido is experienced as pleasure

Applications of the Theory of Nursing:

Freud’s theory has relevance to psychiatric mental health nursing practice at many junctures.
▪ First, the theory offers a comprehensive explanation of complex human processes and suggests that the
formation of a patient’s personality is strongly influenced by childhood experiences.
▪ Freud’s theory of the unconscious mind is particularly valuable as a baseline for considering the complexity of
human behavior.
▪ By considering conscious and unconscious influences, a nurse can identify and begin to think about the root
causes of patient suffering.
▪ Freud emphasized the importance of individual talk sessions characterized by attentive listening, with a focus on
underlying themes as an important tool of healing in psychiatric care.

ERIK ERIKSON'S STAGES OF PSYCHOSOCIAL DEVELOPMENT

✔ He was a psychoanalyst who developed the theory of psychosocial development.

✔ He was born on June 15, 1902 in Karlsruhe Germany.
✔ His classic work "Childhood and Society" set forth his theory of the life cycle.
✔ Young Man Luther, Identity: Youth & Crisis, & Gandhi's Truth are his other influential
works.
✔ He believed that the achievements and failures of earlier stages influence later
stages, whereas later stages modify and transform earlier ones.
✔ Erikson's conceptualization of psychosocial development based its model on the
epigenetic principle of organismic growth in utero.
✔ Erikson views psychosocial growth occurs in phases.

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8 Stages of the Life Cycle:
▪ Erikson explains developmental stages in which physical, cognitive, instinctual, and sexual changes combine to
trigger an internal crisis whose resolution results in either psychosocial regression or growth and the development
of specific virtues.
▪ Erikson defined virtue as "inherent strength".

▪ Trust versus Mistrust (birth to about 1 year)

→ The infant is taking the world in through the mouth, eyes, ears, and sense of touch.
→ A baby whose mother is able to anticipate and respond to its needs in a consistent and timely manner
despite its oral aggression will learn to tolerate the inevitable moments of frustration and deprivation
→ A person who, as a result of severe disturbances in the earliest dyadic relationships, fails to develop a
basic sense of trust or the virtue of hope may be predisposed as an adult to the profound withdrawal and
regression characteristic of schizophrenia (Newton DS, Newton PM, 1998).

▪ Autonomy versus Shame and Doubt (1 year to about 3 years)

→ "This stage, therefore, becomes decisive for the ratio between loving good will and hateful self-insistence,
between cooperation and willfulness, and between self-expression and compulsive self-restraint or meek
compliance." - Erikson
→ This oral-sensory stage of infancy, marked by the potential development of basic trust aiming toward the
achievement of a sense of hope.
→ Child will develop an appropriate sense of autonomy, otherwise doubt & shame will undermine free will.
→ An individual who becomes fixated at the transition between the development of hope and autonomous
will, with its residue of mistrust and doubt, may develop paranoiac fears of persecution.
→ Other disturbances of improper transition of this stage results in perfectionism, inflexibility, stinginess and
ruminative and ritualistic behavior of obsessive-compulsive personality disorder.

▪ Initiative versus Guilt (about 3 years to about 6 years)

→ Here, the child’s task is to develop a sense of initiative as opposed to further shame or guilt.
→ The lasting achievement of this stage is a sense of purpose.
→ The child's increasing mastery of locomotor and language skills expands its participation in the outside
world and stimulates omnipotent fantasies of wider exploration and conquest.

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 ▪ Industry versus Inferiority (about 6 years to about 12 years)
→ Here the child is in school-age, so called stage of latency.
→ He tries to master the crisis of industry versus inferiority aiming toward the development of a sense of
competence.

▪ Identity versus Role Confusion (about 12 years to about 21 years)

→ At puberty, the fifth stage, the task of adolescence is to navigate their “identity crisis” as each individual
struggles with a degree of “identity confusion.”
→ The lasting outcome of this stage can be a capacity for fidelity.

▪ Intimacy versus Isolation (about 20 years to about 25 years)

→ Young adulthood, at the stage of genitality or sixth stage, is marked by the crisis of intimacy versus
isolation, out of which may come the achievement of a capacity for love.

▪ Generativity versus Stagnation (about 26 years to about 64 years)

→ "Generativity is primarily the concern for establishing and guiding the next generation."
→ This failure of generativity can lead to profound personal stagnation, masked by a variety of escapisms,
such as alcohol and drug abuse, and sexual and other infidelities. Mid-life crisis may occur.

▪ Integrity versus Despair (about 65 years to death)

→ "The acceptance of one's one and only life cycle and of the people who have become significant to it as
something that had to be and that, by necessity, permitted of no substitutions."
→ The individual in possession of the virtue of wisdom and a sense of integrity has room to tolerate the
proximity of death and to achieve.
→ When the attempt to attain integrity has failed, the individual may become deeply disgusted with the
external world, and contemptuous of persons as well as institutions.

Application of the Theory in Nursing:

▪ Application of Erikson's stages of psychosocial development helps in analyzing a patient's symptomatic behavior
in the context of traumatic past experiences and struggles with current developmental tasks.
▪ When patients' resolutions of previous psychosocial stages have been so faulty as to seriously compromise their
adult development, they have the opportunity to rework early development through the relationship with the
therapist. (Newton DS, Newton PM, 1998)
▪ "The object of psychotherapy is not to head off future conflict but to assist the patient in emerging from each crisis
with an increased sense of inner unity, with an increase of good judgment, and an increase in the capacity `to do
well' according to his own standards and to the standards of those who are significant to him." (Erikson in Identity:
Youth and Crisis)

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to the
correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in your answer/ratio is not
allowed.

1. The source of all instincts, drives, reflexes, needs, genetic inheritance, and capacity to respond and motivation.
a. Id c. Superego
b. Ego d. Holistic
ANSWER: ________
RATIO:___________________________________________________________________________________________
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2. It differentiates subjective experiences, memory images, and objective reality and attempts to negotiate a solution.
a. Id c. Superego
b. Ego d. Holistic
ANSWER: ________

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RATIO:___________________________________________________________________________________________
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3. It is the second stage of Freud's theory. This is manifested by moving of the bowels and the fecal retention. Symptoms
of fixation include anal-expulsive personality/anal-retentive personality.
a. Oral stage
b. Latency stage
c. Genitalia stage
d. Anal Stage
ANSWER: ________
RATIO:___________________________________________________________________________________________
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4. This is the last to develop and represents the moral component of personality. Helps to choose right from wrong.
a. Id
b. Ego
c. Superego
d. Holistic
ANSWER: ________
RATIO:___________________________________________________________________________________________
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5. Freud's term for middle childhood, during which children's emotional drives are quieter, the psychosexual needs are
repressed, and their unconscious conflicts are submerged.
a. Oral stage
b. Latency stage
c. Genitalia stage
d. Anal Stage
ANSWER: ________
RATIO:___________________________________________________________________________________________
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6. Pepper is a 17-year-old child and is hospitalized because of asthma, according to the psychosocial theory, which of
the following is an appropriate intervention?
a. Tell the friends to visit the child
b. Encourage patient to help child learn lessons missed
c. Call the priest to intervene
d. Tell the child’s girlfriend to visit the child.
ANSWER: ________
RATIO:___________________________________________________________________________________________
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7. It involves learning basic skills and working with others.

a. industry vs. inferiority
b. initiative vs. guilt
c. autonomy vs. shame
d. intimacy vs. isolation
ANSWER: ________
RATIO:___________________________________________________________________________________________
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8. This is where the self "ego" appears and is striving for independence. Toddlers usually are fond of saying "No".
a. industry vs. inferiority
b. initiative vs. guilt
c. autonomy vs. shame
d. intimacy vs. isolation
ANSWER: ________
RATIO:___________________________________________________________________________________________
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9. Which of the following is TRUE about the Industry vs. Inferiority stage?
a. The end of life, the period of old age
b. Intimacy can be sexual or platonic.
c. The existence of a mutually caring and sharing relationship.
d. Peers foster inferiority, say exactly what they think.
ANSWER: ________
RATIO:___________________________________________________________________________________________
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10. What stage happens in adolescence?

a. industry vs. inferiority
b. identity vs role confusion
c. autonomy vs. shame
d. intimacy vs. isolation
ANSWER: ________
RATIO:___________________________________________________________________________________________
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RATIONALIZATION ACTIVITY
The instructor will now provide you the rationalization to these questions. You can now ask questions and debate among
yourselves. Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
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2. ANSWER: ________
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3. ANSWER: ________
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4. ANSWER: ________
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5. ANSWER: ________
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6. ANSWER: ________
RATIO:________________________________________________________________________________________
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7. ANSWER: ________
RATIO:________________________________________________________________________________________
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8. ANSWER: ________
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9. ANSWER: ________
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10. ANSWER: ________
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LESSON WRAP-UP

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Activity: CAT: MINUTE PAPER

This strategy provides feedback on whether or not you understand the lesson. Use the space provided in this activity
sheet to answer the following questions. Make sure to not miss a tiny detail!

What are the significant implications of Freud’s and Erikson’s theories to nursing today?
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