Erikson's Developmental Stages

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What are Erikson's Developmental Stages?

Birth to 18 months: Trust vs. mistrust 18 months to 3 years: Autonomy vs. shame 3 to 5 years: Initiative vs. guilt 6 to 12 years: Industry vs. inferiority; develop attitudes toward work 12 to 18 years: Identity vs. role confusion 18 to 35: Intimacy and solidarity vs. isolation 35 to 55: Generativity vs. self absorption or stagnation 55 to death: Integrity vs. despair

18 months to 3 years: Autonomy vs. shame

By this stage a growing child is more accomplished in some basic self-care activities, including walking, feeding, and toileting. This newfound independence is the result of maturation and imitation. The toddler develops his or her autonomy by making choices. Choices typical for the toddler age-group include activities related to relationships, desires, and playthings. There is also opportunity to learn that parents and society have expectations about these choices. Limiting choices and/or enacting harsh punishment leads to feelings of shame and doubt. The toddler who successfully masters this stage achieves self-control and willpower. The nurse models empathetic guidance that offers support for and understanding of the challenges of this stage.

3 to 5 years: Initiative vs. guilt

Children like to pretend and try out new roles. Fantasy and imagination allow them to further explore their environment. Also at this time they are developing their superego, or conscience. Conflicts often occur between the child's desire to explore and the limits placed on his or her behavior. These conflicts sometimes lead to feelings of frustration and guilt. Guilt also occurs if the caregiver's responses are too harsh. Preschoolers are learning to maintain a sense of initiative without imposing on the freedoms of others. Successful resolution of this stage results in direction and purpose. Teaching the child impulse control and cooperative behaviors helps the family avoid the risks of altered growth and development.

12 to 18 years: Identity vs. role confusion

Dramatic physiological changes associated with sexual maturation mark this stage. There is a marked preoccupation with appearance and body image. This stage, in which identity development begins with the goal of achieving some perspective or direction, answers the question, "Who am I?" Acquiring a sense of identity is essential for making adult decisions such as choice of a vocation or marriage partner. Each adolescent moves in his or her unique way into society as an interdependent member. There are also new social demands, opportunities, and conflicts that relate to the emergent identity and separation from family. Erikson held that successful mastery of this stage resulted in devotion and fidelity to others and to their own ideals. The nurse provides education and anticipatory guidance for the parent about the changes and challenges to the adolescent. Nurses also help hospitalized adolescents deal with their illness by giving them enough information to allow them to make decisions about their treatment plan.

Birth to 18 months: Trust vs. mistrust

Establishing a basic sense of trust is essential for the development of a healthy personality. The infant's successful resolution of this stage requires a consistent caregiver who is available to meet his needs. From this basic trust in parents, the infant is able to trust in himself, in others, and in the world. The formation of trust results in faith and optimism. A nurse's use of anticipatory guidance helps parents cope with the hospitalization of an infant and the infant's behaviors when discharged to home. Develop confidence in having needs met. To feel physically safe.

35 to 55: Generativity vs. self absorption or stagnation

Following the development of an intimate relationship, the adult focuses on supporting future generations. The ability to expand one's personal and social involvement is critical to this stage of development. Middle-age adults achieve success in this stage by contributing to future generations through parenthood, teaching, and community involvement. Achieving generativity results in caring for others as a basic strength. Inability to play a role in the development of the next generation results in stagnation. Nurses assist physically ill adults in choosing creative ways to foster social development. Middle-age persons often find a sense of fulfillment by volunteering in a local school, hospital, or church.

Erikson experiences old age

He lived until he was 91 and it seems during this time he and his co-researcher and wife, Joan Erikson, began to think that development continued past 65-70. After Erik's death Joan proposes a ninth developmental stage saying that it wasn't until their late 80s and early 90s that she and Erik really confronted aging.

Proposed Ninth stage

Joan Erikson proposed that in the ninth stage the previously resolved crisis points are revisited While in earlier life the positive elements of the stages were a source of strength, in the last stage strength comes from overcoming the negative elements Erikson considered that successful completion of the 9th stage will move an individual toward gerotranscendence

55 to death: Integrity vs. despair

Many older adults review their lives with a sense of satisfaction, even with their inevitable mistakes. Others see themselves as failures, with their lives marked by despair and regret. Older adults often engage in a retrospective appraisal of their lives. They interpret their lives as a meaningful whole or experience regret because of goals not achieved. Because the aging process creates physical and social losses, some adults also suffer loss of status and function (e.g., through retirement or illness). These external struggles are also met with internal struggles such as the search for meaning in life. Meeting these challenges creates the potential for growth and the basic strength of wisdom

Does a move toward gerotranscendence increase life satisfaction in old age?

More research needed

Explain self.

Move away from egocentricity - not preoccupied with themselves Ego-integrity - realisation that life's puzzle pieces form a whole Self-confrontation, discovery of hidden aspects of the self, both good and bad.

Explain gerotranscendence.

Positive stage. Tornstam proposed his theory on the basis of qualitative data from 50 interviews conducted with people aged 52 to 97 years. From these interviews he noticed a shift in perspective by satisfied elders away from materialistic and physical aspects of the world to a more internal focus. Three main dimensions: Cosmic Self Social

6 to 12 years: Industry vs. inferiority; develop attitudes toward work

School-age children are eager to apply themselves to learning socially productive skills and tools. They learn to work and play with their peers. They thrive on their accomplishments and praise. Without proper support for learning new skills or if skills are too difficult, they develop a sense of inadequacy and inferiority. Children at this age need to be able to experience real achievement to develop a sense of competency. Erikson believed that the adult's attitudes toward work are traced to successful achievement of this task. During hospitalization it is important for the school-age child to understand the routines and participate as actively as possible in his or her treatment. For example, some children enjoy keeping a record of their intake and output.

Explain social.

Social More selective, less interest in superficial relationships; more at peace and not afraid of being alone. Increasing need for solitude Move away from materialism - not really into physical possessions; why waste time if you don't need to keep up appearance for jobs? Move away from right / wrong duality

Explain cosmic.

Transcendence of borders between past and present Acceptance that not everything in life has an explanation New comprehension of death and of immortality through the genetic chain (teacher don't know what this means) Increased appreciation of small joys - don't have to go on big trip to be happy

How could we facilitate gerotranscendence?

We could: Acknowledge changes toward introspection as a normal part of aging Accept alternative definitions of time, or experiences of connection with dead relatives Not shy away from conversations about death Encourage activities such as discussion of the aging process, reminiscence therapy Allow time for solitude and meditation Facilitate access to quiet and peaceful times and places "It's all about the dash" Joan Erikson regarding the inscription on a headstone 1902-1994

18 to 35: Intimacy and solidarity vs. isolation

Young adults, having developed a sense of identity, deepen their capacity to love others and care for them. They search for meaningful friendships and an intimate relationship with another person. Erikson portrayed intimacy as finding the self and then losing the self in another. If the young adult is not able to establish companionship and intimacy, isolation results because he or she fears rejection and disappointment. Nurses must understand that hospitalization increases a young adults' need for intimacy; thus young adults benefit from the support of their partner or significant other during this time.


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