NCM-117 - PRELIMINARIES
INTRODUCTION OF PYSCHIATRIC MENTAL SIDE NOTES: sa kanya nagmula
mesmerism or known as hypnotism
HEALTH CARE
1. EARLY HISTORY
a. Associated with sin and demonic possession.
b. Perceived as incurable.
c. Treatment was inhumane and brutal.
2. THE MIDDLE AGES
a. Not care by families
b. Often imprisoned or line on the street
c. Hospital of St. Mary of Bethlehem
d. Refuge for the destitute and afflicted.
3. THE 15TH THROUGH 17TH CENTURY
a. Skepticism about the curability was rampant.
b. Thought have no feelings.
c. Believed to lack understanding.
d. Treated
BENCHMARKS IN PSYCHIATRIC HISTORY
• Rosenblat’s ABC of Community Response
A – Assistance: gives food and money
B – Banishment: wandering band
4. THE 18TH CENTURY
a. French and American Revolutions
b. Campaigns for the abolition of slavery
through championing of equal rights for
women
c. Care for the impoverished
a. BENJAMIN RUSH (1745-1813) – FATHER OF AMERICAN
PSYCHOLOGY
a. Emphasized need for pleasant surroundings.
b. Diversional and moral treatment
c. Inducement of fright cause mentally ill to
regain their sanity.
d. Credited with inventing with tranquilizer chair
and the Gyrator (nirorotate, para
magprovide ng cerebral circulation).
b. PHILLIPPE PINEL (1745-1826)
a. Advocate kindness, understanding and moral
treatment.
b. Placed in charge of a large hospital in Bicerte
c. Releasing the insane from chains
d. Reformation of societal attitudes toward
those suffering from mental illness
c. WILLIAM TUKE (1732-1822) - ADVOCATE
a. Advocate humane treatment of the mentally
ill.
b. Raises money to establish homes.
SIDE NOTES: Was a merchant, kumuha ng
money to establish homes
- English Merchant
d. FRANZ ANTON MESNER (1734-1815)
a. Renewed the ART OF SUGGESTIVE HEALING -
mesmerism.
b. A form of hypnotism
ang
5. PERIOD OF ENLIGHTENMENT
• PHILLIPPE PINEL (FRANCE) AND WILLIAM TUKE
(ENGLAND)
o PINEL – unchained the mentally ill;
superintendent of the French Institution,
Bicetre (men) and Salpetriere (women)
o TUKE – established the York Retreat
o The insane were no longer treated as less
human.
o Human dignity was upheld.
o The ASYLUM MOVEMENT was developed
– protection, social support, or sanctuary
from the stresses of life.
6. THE 19TH CENTURY: THE EVOLUTION OF THE PSYCHIATRIC
NURSE
a. First psychiatric hospital in America at
Williamsburg, Virginia, in 1773
b. McLean Asylum, the first U.S. institution to
provide humane treatment.
c. The psychiatric nursing role had not yet been
established.
d. Mental conditions became deplorable.
e. Need for reform was urgent.
7. THE 20TH CENTURY: THE ERA OF PSYCHIATRY
(LINDA RICHARDS – FIRST PSYCHIATRIC NURSE)
a. Improved social attitudes promoted sensitivity
toward the mentally ill.
b. ADOLPH MEYER (1866-1950) – PSYCHIATRIST
FROM SWEDEN
i. Focused on physical and emotional
maturational changes.
ii. Emphasized the need to study the
person’s whole environment.
iii. Introduced the concept of common
sense psychiatry.
SIDE NOTES: TREATMENT RATHER THAN
DISEASE
1. Biochemical
(neurotransmitter)
2. Genetic (namamana)
3. Psychosocial
4. Presence of emotional
stressors
c. DOROTHEA LYNDE DIX (1802-1887) – RETIRED
SCHOOL TEACHER
i. Led the crusade about the inhumane
treatment and conditions of mentally
ill patients that led to proliferation of
the state hospitals.
SIDE NOTES: Nagpatayo ng mga
hospitals
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d. CLIFFORD BEERS (1876-1943) – PATIENT THAT sa kasunod. If hindi, dun papasok
WAS TREATED WITH MENTAL ILLNESS ang conflicts.
i. Contributed to preventive care FREUD talks about FIXATION
through his class work, A MIND THAT ii. Popularized the term catharsis
FOUND ITSELF, published in 1908. (Example: sobrang galit,
ii. A descriptive account of his pinagsusuntok yung pillow, walang
tormenting experiences nasasaktan na tao) repressed
iii. Established the mental hygiene feelings from traumatic experience,
movement, in promoting the early VERBAL DISPLACEMENT, dream
detection of mental illness. interpretations, and explanations for
e. EMIL KRAEPELIN (1856-1926) hysteria.
i. Devised a classification of mental iii. Established the basis of the
disorders. psychoanalytical technique.
ii. Emphasis on the observation and h. CARL GUSTAV JUNG (1875-1961)
research in conditions known as i. Founded analytic psychology.
praecox dementia and mania ii. Proposed and originated the
SIDE NOTES: (old term for concepts of extroverted and
schizophrenia) introverted personality.
(praecox – occurred in the early life) iii. Focused on the creative impulse and
(mania – mood disorder, bipolar spirituality of the individual.
disorder now a days) i. KAREN HORNEY (1885-1952)
f. EUGENE BLEULER (1857-1939) i. Neuroses stem from cultural factors
i. Coined the term SCHIZOPHRENIA and impaired interpersonal
(organic illness and can be inherited) relationships
SIDE NOTE: (splitting of the mind -- SIDE NOTES: Basic anxiety from
psychosis) impaired personal relationships
ii. Included the 4A’s Anxiety from cultural factors
Apathy - No emotions j. HARRY STACK SULLIVAN (1892-1949)
- flat affect i. Postulated the hypothesis of
Autism - No world interpersonal theory.
- Has no contact SIDE NOTES: (The society creates our
w/ reality personality, our personality is based /
Ambivalence - presence of due to our interpersonal relationship,
between 2 the people around it)
opposing feelings ii. Stimulated the development of
Looseness of - through talking multidisciplinary approaches to
association - no speech psychiatric and milieu therapy.
connection
HILDEGARD PEPLAU: Nurse-patient
(apathy (Aphex blunty) (no relationship
emotions), autism (has own world, no - Father of interpersonal psychiatry
contact with reality), ambivalence
(presence of between 2 opposing 8. PERIODS OF SCIENTIFIC STUDY
feelings), looseness of association a. SIGMUND FREUD – emphasized the
(alogia) (no speech connection)) importance of early life experiences in
shaping mental health.
g. SIGMUND FREUD (1856-1939) – NEUROLOGIST b. EMIL KRAEPELIN – developed classification of
FROM VIENNA, AUSTRIA mental illness.
i. Credited with the development of c. EUGENE BLEULER – was optimistic about
psychoanalysis, psychosexual treatment.
theories, and neurosis. d. Humans could be studied, and that study held
PSYCHOSEXUAL THEORY promise for treating and curing mental health
1. Oral problems.
2. Anal e. The study of the mind and treatment
3, Phallic approaches flourished.
4. Latency f. “Decade of the Brain” (Kraeplin) (described
5. Genital the symptoms and outcomes of mental illness)
Kailangan maovercome ang
certain level para maging okay

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9. THE 21ST CENTURY 2. Responsible for making
a. NEUROSCIENCE AND GENETICS diagnoses and prescribing
OPPORTUNITIES treatment.
b. UNDERSTANDING OF THE LINK BETWEEN ii. CLINICAL PSYCHOLOGIST
BEHAVIOR AND EMOTIONS, BRAIN, AND 1. Involved in administering and
GENES. interpreting psychological
i. Information Systems: The Internet and testing.
Cyberspace 2. Provide psychotherapy and
1. Ex. Internet, Telemedicine or behavioral modification.
Telemental Health Center Nagbibigay ng therapy
Very essential especially Interprets drawings
during pandemic Observes plays
ii. Complementary Therapies iii. PSYCHIATRIC SOCIAL WORKER
1. Ex. Aside from Psychotropic 1. Primarily involved in
drugs, ito ang ginagamit identifying and dealing with
Aromatherapy, social issues that affect
Acupuncture, Massage clients and their families.
therapy, biofeedback 2. Gather psychological data
(attached to a computer, on admission.
like ecg, with relaxation 3. Provide crisis intervention
techniques), herbs, and abuse, trauma and
nutritional approaches. psychotherapy.
c. TRENDS IN PSYCHIATRIC-MENTAL HEALTH iv. PSYCHIATRIC CLINICAL NURSE
NURSING SPECIALIST
i. Influenced by the social and 1. Present educational
economic climate of the times. programs for nursing staff
ii. 1960s and 1970s changes within 2. Provides consultation
health facilities paralleled the services to nurses who
deinstitutionalization of mental health require assistance in the
care. planning and
Pwede na sila ilabas, di na lang implementation of care for
nakakulong individual clients.
iii. 1980s there was an enormous growth v. PSYCHIATRIC NURSE
in freestanding psychiatric facilities 1. Provides ongoing assessment
that resulted in client abuse and of the client condition.
misuse of health care to fill empty 2. Administers medications.
beds. - Check for cheeking
Nagkaron ng proliferation of private 3. Assists clients with
institutions therapeutic activities as
iv. Decrease in the number of required.
psychiatric admissions and eventual Bibliotherapy: watch movies
closure of psychiatric units and 4. Focus is on one-to-one
hospitals. relationship development.
v. Increases loss of job. vi. OCCUPATIONAL THERAPIST
vi. Evidence-based health care is the 1. Primarily involved in
driving force behind treatment providing an array of
approaches. activities that enable client
vii. Future trends, demands of advanced to gain skills to perform ADL.
technology. 2. Creative activities and
viii. Research therapeutic relationship skills
ix. New lifestyle pattern. are used.
d. MENTAL HEALTH TEAM (INTERDISCIPLINARY vii. MENTAL HEALTH WORKER OR
TEAM) PSYCHIATRIC AIDE
Sonta: Girl room 1. Functions under the
Shangrila: Boys room supervision of the psychiatric
i. PSYCHIATRIST nurse
1. Serves as the leader of the 2. Provide direct care to clients.
team.

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viii. INTERNIST OR PRIMARY CARE
PROVIDER PSYCHOLOGICAL FACTORS
1. Co-occurrence of medical • Plays a pivotal role in a person’s ability to mobilize
problems and conditions adaptive coping processes.
necessitates collaboration. 1. EGO FUNCTION AND HEALTH
If may diabetes, a. EGO
hypertension, seizure i. The major personality
ix. DIETICIAN mechanism that mediates
1. Plans nutritious meals for all between the person and the
clients. environment
x. CHAPLAIN ii. Described as the guardian of
1. Assess, identifies, and attends vital balance.
to the spiritual needs of iii. Ego function
clients and their family 1. Refers to the
members. inherent ability to
adapt to internal
MENTAL HEALTH AND MENTAL-ILLNESS and external
demands or stress of
COTINUUM the environment.
MENTAL HEALTH reality principle
• Refers to the ability of people – couples, families, iv. Defense Mechanisms
and communities – to respond adaptively to 1. Refers to a
internal and external stressors. predominantly
• Being at peace with one self, with others, with unconscious self-
nature, and with GOD. protective process
• Mens sana in corpore sano in societe (A sound that seeks to shield
mind in a sound body in a sound society) the ego from intense
feelings or affect or
VARIABLES AFFECTING MENTAL HEALTH impulses.
1. BIOLOGICAL FACTORS – prenatal and perinatal SIDE NOTES:
influences, physical health, neuroanatomy, and Involuntary
physiology. (Suppression – only
2. SOCIOCULTURAL FACTORS – family stability, child- conscious defense
rearing patterns, economic level, housing mechanism)
membership in a minority, religious influences, and
values. A. DIFFERENT LEVELS OF DEFENSE MECHANISM
3. PSYCHOLOGICAL FACTORS – parent, sibling, and 1. PSYCHOTIC MECHANISM
infant/child relationship, IQ, self-concept, skills, talents, a. Commonly in healthy individuals before age 5
and emotional developmental level. i. DELUSIONS PROJECTIONS – involves attributing
unacceptable thoughts, emotions, and
A. NEUROBIOLOGICAL FACTORS impulses to another source that is not based in
• Hans Selye (Generally Adaptation Syndrome) made reality. (delusions – fixed false beliefs)
his explanation of stress in terms of adaptation. 3 ii. DENIAL – unconscious refusal to admit an
stages: unacceptable idea or behavior.
1. ALARM REACTION – initial reaction iii. DISTORTION – believing something to be true
to stress (fight or flight) when it is not.
2. STAGE OF RESISTANCE – reaction to SINABING MAHIRAP ANG EXAM PERO TOTOO,
continued stress. (homeostasis/ DI KA LANG TALAGA NAGREVIEW
balance/ equilibrium) iv. SPLITTING – black or white.
3. STAGE OF EXHAUSTION – results Pag may magandang ginawa sayo, gusto
from prolonged exposure to stress. ka. Pag di sinunod ang gusto, ayaw sayo.
- Weakened immunologic BOARDERLINE PERSONALITY
SIDE NOTES: Projections- Palabas
B. CULTURAL FACTORS Interjections- Paloob
• Concerns about health disparities and changing 2. IMMATURE MECHANISMS
demographics must be priority to ensure cultural a. Common in ages 3 and 15
competence. i. PROJECTION – unconsciously (or consciously)
blaming someone else for one’s difficulties.

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ii. SCHIZOID FANTASY – tendency to retreat into
fantasy to avoid the present situation.
Fantasizing to be superman, DAYDREAMING
iii. HYPOCHONDRIASIS – exaggerated
psychosomatic symptoms.
Namamanifest sa symptoms kung ano iniisip.
E.G. naghahanap ng iba’t ibang doctor para
masabi yung diagnosis na gusto ko
iv. PASSIVE-AGGRESSIVE BEHAVIOR – expression
of negative feeling, resentment, and
aggression in an unassertive passive way.
(rebellion)
v. ACTING OUT – impulsivity (tantrums)
vi. IDENTIFICATION – conscious or unconscious
after a respected person
(ginagaya ang isang tao/ idols)
vii. RATIONALIZATION – conscious or unconscious
attempts to prove that one’s feelings or
behaviors are justifiable.
(Sour-graping)
viii. REGRESSION – unconscious return to an earlier
and more comfortable developmental stage.
Thumbsucking; paurong/dating ang reactions
if nararanasan anxiety
ix. DEPENDENCY – constantly seeking approval.
(Dependent Personality Disorder)
3. NEUROTIC DEFENSES
a. Common in ages 3 and 90
i. INTELLECTUALIZATION – consciously or
unconsciously using only logical explanations
without feelings.
More on knowledge ang shineshare instead of
showing emotions
ii. REPRESSION – unconscious and involuntary
forgetting of painful ideas, events, and
conflicts.
(Unconscious forgetting – rape patients, abuse
patients, vehicular accident, trauma).
iii. DISPLACEMENT – unconsciously discharging
pent-up feelings to a less threatening object.
Binubuntong ang galit sa ibang tao/bagay na
inferior sa kanya
iv. REACTION-FORMATION – conscious behavior
that is the exact opposite of an unconscious
feeling.
Tulak ng bibig, kabig ng dibdib
Hindi congruent ang sinasabi sa ginagawa
v. DISSOCIATION – unconscious separation of
painful feelings and emotions from an
unacceptable idea, situation, or object.
Balewala na, parang wala nang nangyari
vi. EMOTIONAL ISOLATION – inability to share
one’s feelings with others.
4. MATURE MECHANISMS
i. ALTRUISM – a sense of unconditional concern
for the welfare of others
Uunahin ang iba bago ang sarili
ii. HUMOR – overt expression of ideas and
feelings (Especially those that are unpleasant
to focus on or too terrible to talk about) that
gives pleasure to others.
iii. SUBLIMATION – consciously or unconsciously
channeling instinctual drives to acceptable
activities.
(anger to arts, sports)
Nagdrawing/sports na lang kesa ibunton galit
sa ibang tao/bagay
iv. SUPPRESSION – conscious exclusion from
awareness anxiety-producing feelings, ideas,
and situations.
“Wag na muna nating pag-usapan”
Hindi pa ready ishare
v. UNDOING – consciously doing something to
counteract or make-up for a wrongdoing.
Guilt: pinaghanda yung anak ng pagkain
pagkatapos pagalitan
vi. OTHERS
1. Introjection – unconsciously
incorporating values and attitudes of
others as if they were your own.
Eventually, magagaya attributes/ugali
ng ibang tao. E.g. if nananakit yung
tatay, pagtanda eh nananakit din sya ng
anak
2. Compensation – consciously covering up
for a weakness by making up a desirable
trait.
Mag-aaral/ dapat maging honor student
since hindi sporty para macompensate
yung kulang ko.
3. Conversion – unconscious expression of
intrapsychic conflict symbolically
through physical symptoms.
(Conversion-reaction)
(under stress, nakakaramdam ng pains)
DIFFERENT LEVELS OF PRACTICE
1. GUIDING PRINCIPLES:
a. The nurse views the client as a holistic being.
b. The nurse focuses on the client’s strength and
assets, not on his weaknesses and liabilities.
c. The nurse accepts the client as a unique
human being who has value and worth
exactly as he is.
d. The nurse has a potential for establishing a
relationship with most if not all clients.
e. The nurse explores the client’s behavior for the
need it is designated to or the message it is
communicating.
f. The nurse views the client’s behavior
nonjudgmentally while assisting him to learn
more effective adaptations.
g. The quality of the interaction in which the
nurse engages with the client will be directed
to a more satisfying interpersonal relationship.
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5 ASPECTS OF PHYSICAL ATTENDING (ACTIVE LISTENING) i. Sum total of the individual
S Facing Squarely ii. Refers to all that the individual is, feels
O Open posture and does consciously and
L Slightly Leaning Forward unconsciously; manifested as
E Eye Contact interaction in his environment.
R Relaxed (fixation – persistent focus)
d. DIVISIONS OF THE MIND
STANDARDS OF CARE - Universal i. CONSCIOUSNESS/CONSCIOUSS
• STANDARD I. Assessment – collects patient data. 1. All memories that remain
• STANDARD II. Diagnosis – analyze the assessment. within an individual’s
• STANDARD III. Outcome Identification – ultimate goal. awareness
• STANDARD IV. Planning – with the family. ii. UNCONSCIOUSNESS
• STANDARD V. Implementation – of intervention. 1. All memories, conflicts,
• STANDARD Va. – Counseling – assist’s in improving or experiences, and material
regaining previous coping abilities. that have been repressed
• STANDARD Vb. Milieu (modification of the and cannot be recalled at
environment) Therapy – maintain therapeutic will.
environment. iii. PRE/SUBCONSCIOUSNESS
• STANDARD Vc. Promotion Self-care Activities – foster 1. All memories that may have
mental and physical well-being. been partially forgotten. Can
• STANDARD Vd. Psychobiologic Interventions – restore be recalled to consciousness
and prevent further disability. with some effort.
• STANDARD Ve. Health-Teaching – assist in productive e. STRUCTURES OF PERSONALITY
and healthy patterns of living. i. ID – pleasure principles
• STANDRD Vf. Case Management – coordination with 1. Meeting demands through
health care services and continuity of case. the use of fantasies and
• STANDARD Vg. Health Promotion and Maintenance. images.
• STANDARD Vh. Evaluation – expected outcome. ii. EGO – reality principle
1. Comprises of rational, logical
ADVANCED PRACTICE INTERVENTION: thinking and intelligence.
• STANDARD Vi. Psychotherapy. 2. Age 3
• STANDARD Vj. Prescriptive Authority and Treatment – iii. SUPEREGO – “the conscience”
uses procedure and treatment in accordance to state 1. Inner control, concerned
and federal law. with right or wrong.
• STANDARD Vk. Consultation – provides services and 2. Age 5 or 6
enhance abilities of other clinicians.
SUPEREGO IS COMPOSED OF:
THE ROLE OF PSYCHIATRIC NURSE AS A TEAM MEMBER • EGO IDEAL – rewards the person with feelings of well-
1. WARD MANAGER – monitors operations being and pride when person conforms to the
2. SOCIALIZING AGENT – helps to recognize and cope demands of the superego
stress. • CONSCIENCE – punishes the person with guilt feelings
3. COUNSELOR – emphatic listener when person deviates from the demands of the
4. PARENT SURROGATE superego
5. PATIENT ADVOCATE o It is important to note that the rewarding and
6. TEACHER – focused on acquiring SKA. punishing of the superego is based on the
7. TECHNICAL ROLE internalized standards of right and wrong and
8. THERAPIST – uses the principles developed through the not on reality.
practice of psychotherapy.
9. REALITY BASE – help client make decision. 2. BEHAVIORAL THEORY
10. HEALTH ROLE MODEL a. Emphasis is on the behaviors of the person
b. B.F. Skinner, is a prominent behavioral theorist
c. Dorothea Orem – needs a composite self-
THEORIES OF HUMAN BEHAVIOR care action to survive
1. PYSCHONANALYTICAL THEORY d. A person is best understood by observing
a. SIGMUND FREUD: The Father of Psychoanalysis what he or she does in a particular situation
b. Believed that personality is formed during 3. COGNITIVE THEORY
early childhood, particularly the first 6 years of a. Emphasize the mental processes involved in
life knowing
c. PERSONALITY

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b. Piaget, developed a theory of reasoning base
on the responses of children and young
people

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