Ch. 7 Self reflection & self awareness

Erik erikson

-a maturational process that was likely mediated by the naturally occurring physiological changes -individual must successfully and sequentially meet physiological and psychosocial challenges roughly corresponding to a chronological age in order to be prepared to meet challenges of the next stage -2 additional tasks between intimacy and generativity: career consolidation - men must achieve sense of reasonable meaning and purpose in career, generativity - keeper of the meaning; act beyond the small confines of family to ensure culture and life persists

Emotional intelligence

-a measurement of interpersonal phenomena -accurate conscious perceptions and monitoring of one own's emotions -modification of one's emotions so their expression is appropriate -accurate recognition of and response to emotions in others -skill in negotiating close rships w/ others -capacity for channeling emotional energy to goal achievement

Johari Window Model

-a model to understand the different methods of increasing awareness, including feedback as well as self disclosure -the larger the area know to self and others, the more elements of the self that are available through which to filter, interpret, and cope w/ feedback provided by environment - nonverbal and verbal feedback & feedback received from one's own body in response to stress -blind area reduced through seeking and receiving feedback from others and environment -self disclosure is a strategy to decrease hidden area of self - taking risks in new experiences -nurse's humility demonstrated by acknowledging his or her current understanding is inadequate or faulty

emotions

-affective response (our feelings) that arise as a reaction to the meaning ascribed to perceptions and thoughts

sympathy

-an affirmation of separateness from another's painful experience; does not involve experiencing what the other person is thinking or feeling , does not engage the core functions of the nurse

Strategies related to use of self

-authenticity -mindfulness -presence

social roles

-chosen or acquired without voluntary decision making -gender roles, student roles, leader, follower, boss, employee -certain social roles are predictable based on the individual's position in the family

presence

-condition in which all of one's attention and energy are focused in the moment on the purpose of that moment -alive and energized -nurse's ability to convey mindful presence, willing to go where the patient leads, and ability to convey courage my provide the patient with a message that his or her experience of suffering can be safely shared

Roger's model of authenticity

-consistency between one's actual physiological state, emotions, and cognitions and the awareness of that experience and the behavioral and emotional expression of that state as reflective of authentic living

Negative impact on self esteem

-death of a parent -dysfunctional parenting -inadequate opportunities for education -low level of parental education

William James

-defines self that includes both I & Me -I self: acts in order to learn, self as knower; takes initiative to seek experiences and understanding -me self: self as known; person has access to and is composed of consciously known elements -all the people, things, and characteristics in which individual has an emotional investment -def. of self explains sense of loss of self that is experienced when moving, losing a job -self concept: part of self that lies within the conscious awareness; encompasses perceptions, thoughts, and feelings as well as values and ideals

cognition

-described as the more complex processes of creating order and meaning from experiences -schemes: behaviors organized and planned through a cognitive process -2 process: assimilation & accommodation

Mindfulness

-form of self awareness that may be described as a state of being in the present moment and accepting things for what they are without judgment -individual is aware in the current moment but not reacting automatically. responsive and aware of the conscious decision to respond

Abraham Maslow

-hierarchy of human needs -individual would not seek need fulfillment at highest level if basic human needs not met -self actualization includes comfort with one's own self and one's life meaning; associated with knowing who one is, understanding purpose in life, sense of how to accomplish that purpose -individual will not be reasonably motivated to seek and successfully achieve the developmental milestones if basic needs unmet

James & Swain

-importance of self generated action in establishing the sensory motor systems in the developing brain -infant begins learning relevant visual and auditory and tactile patterns at birth, building neural pathways to being able to recognize people, toys, and letters

Use of self in nursing practice

-nurse has an opportunity to positively influence the provision of care directly, as well as indirectly through modeling and teaching caregivers and family members -nurse defined as caretaker of suffering; suffering individual changes between enduring and emotional release -patients efforts to conceal suffering motivated by the shame and stigma w/ mental illness - typical human emotional responses interpreted as pathology if experienced by an individual receiving treatment for mental health -suffering & shame assoc. w/ mental illness restricted pt's willingness to be open w/ care - nurse can influence the resolution of facade by engaging in a caring conversation with the patient and help pt reconnect on an interpersonal level; nurse creates time and space for patient to share their story an assist in interpreting as needed to help the pt answer the question "why"

Ida Jean Orlando

-nurse use any part of their reaction to the patient as the starting point to begin to validate the patient's experience of distress and plan interventions to reduce that stress; perceptions, or cues picked up by any of the five senses; thoughts that are stimulated by perceptions and feelings

Authenticity

-nurse's awareness of genuine personality, character, and values as well as the nurse's demonstrated behavior that is consistent w/ that awareness, despite pressures to behave otherwise -pts acknowledged importance of clinician's open, genuine, nonjudgmental attitude - seek out HCP who said it like it is, real, straight up, honest -nurse being knowingly present in their life and interacting with full unknowingness about other's life -individual is aware of the present moment, chooses how to live life in the moment, and takes responsibility for that choice - decision based on critically assessing available options and making choices that reflect true self -nurse who seeks authenticity are dissatisfied with some aspects of their lives and decide to face problem despite anxiety induced; nurse's authenticity is reflected in how nurse directs energy toward getting to know patient as the patient is, in the patient's world

self reflection

-opportunity for nurse to examine their own actions and motivations and feelings

Characteristics of self

-perceptions, thoughts, and feelings. our senses, cognitive abilities, and feelings

High self-esteem characteristics

-perform task equally well with or without observations -possess positive perceptions of themselves and abilities -have strong social support systems -respond assertively to criticism

Orlando contends nurse should depend on patient to verify what

-presence of the patient's distress -possible source of that distress -plan for mgmt of the distress -evaluation of the effectiveness of that plan nurse must be aware of what parts of the reaction to the patient are a reaction to a part of the nurse's own self - by validation of perceptions, thoughts, feelings, nurse confirms what the patient needs and meet those needs

Self concept

-reflects body image, emotional status, role performance, life goals, sense of identity, spirituality, and the relationship between one's real self and one's ideal self -refers to how one characterizes oneself - including thoughts, attitudes, feelings, and beliefs one has about the nature of one's personality and how it is organized

Self system purposes

-self definition, by supporting the individual's development of a consistent sense of self -protection, by providing a barrier to anxiety -connection, by establishing the characteristics that ensure security in interpersonal relationship

henry stack sullivan

-self system made up of self images reflected from interactions with one's environment; good me, bad me, not me -good me: one who is safe and cared about to his or her good sense of self, the smiling -bad me: defining self negatively stimulated by the punishing, disapproving, or invalidating experiences of self -not me: defined as that intensely anxiety-inducing situation experienced as overwhelming and destructive of self

Theoretical Foundations

-socrates considered self as the "essential" element of man; speculated on the rship between self and mind - center of will, self motivation, and knowing as well as source of development of personal insights into one's desires and feelings -descartes: i think, therefore i am; body controlled by mind, which receives information from the body's interaction with the environment -Johnson and colleagues: identify anatomical location of the process of conscious reflection on self - examining brain activity as measured by increased blood flow during response to questions that encompass a sense of self - questions about own attitude, belief, and traits

Positive impact on self esteem

-stability of a living environment -supportive parental figures -mentors as well as structured sport activities and opportunity to be praised for one's success

process of reflection

-subjective, involving a conscious focus attention to exploration an understanding of the thoughts and feelings that are in one's conscious awareness -developing and comparing an objective understanding of self that may have been experienced subjectively without understanding -nurse measures effect of reflection in increased self understanding and in changes in hos or her own thoughts and behaviors -requires preparation - nurse must want to reflect -reflection grounded in attitude of openness and eagerness to turn one's focus in rather than out and become aware of and think about the feelings and ideas that are being uncovered -nurse chooses what and how much to reflect; process of deciding whether to change as well as act of change itself

Hildegard Peplau

-therapeutic significance of what happens between the nurse and patient and recognizes that the nurse is involved in a continual process of developing self within relationship -ability to trust others and become comfortable with dependency, to delay satisfaction, and develop what she refers to as participation skills

Empathy

-understanding and experiencing the feelings, thoughts, and experience of another from the other's perspective - connecting with and feeling what the other person is feeling -emotional system that supports our ability to empathize emotionally and cognitive system that involves understanding of other's perspective

Carl rogers

-used a systems theory perspective to describe the self as consisting of a pattern of conscious perceptions and values of I or Me -self develops through a process of interaction with the environment, noting that this interaction may result in unconscious incorporation of others' ideas and values into one's own self -self seeks internal consistency and drives the individual to engage in actions that are consistent w/ internal self -experiences that are not consistent w/ the self are perceived as threats and are avoided

Chabris and Simons

-used the term attentional blindness to refer to the process of seeing what is important and paying relatively little attention to the rest of the visual stimulation

low self-esteem characteristics

-view themselves and their abilities negatively -do not perform well under observations -lack a strong support system -respond poorly or defensively to criticism

Questions nurse can ask to determine authenticity

-what behaviors do I use that convey trustworthiness; what behaviors come across as less than trustworthy -what behaviors do i engage in that communicate sensitivity -how good am i at communicating with others clearly -am i able to see the world from the point of view of my patient and understand patient's values & beliefs

Process recording

-written record of an interaction between two or more individuals. process of validation

Self esteem

a personal judgment of self worth, based on the amount of overlap that exists between ideal self - the self one should or would like to be and what one believes to be true about the actual self

Scaffolding

abstract and less understood concepts are mapped onto understood skills and concepts, while retaining character of original. noted easily when interacting with whom one has had a close relationship with

self awareness

capacity to actively identify, process, and collect information about one's internal mental state and public behaviors -awareness develops through examining one's own behavior and also through receiving feedback about that behavior

body image

how one views ones own body in relation to one's own perceptions of what is valuable or beautiful as well as in relation to how one views other's perceptions; degree of importance vary according to developmental stage and culture

Perceptions

primary element in the nurse's initial reactive response to the behavior of the patient; includes the capacities of the five sense and is the primary cognitive process by which an individual collects sensory data & clusters it into a pattern

Assimilation

process of using or transforming the environment so it can be placed in preexisting cognitive structures ex. use of touching and grasping activity to explore new things

Neuroplasticity

the ability within the brain to constantly change both the structure and function of many cells in response to experience or trauma; may form the basis for the individual's ability to recover from trauma, an impoverished early environment, or experience of suffering

Body space

the amount of distance that provides a sense of comfort in social situations -4 body spaces: intimate, personal, social, public -how one uses body space: proxemics

accommodation

the process of changing cognitive structures to accept something from the environment ex. child modifying the touching behavior to one that would be successful for patting a dog

Self

the union of elements (body, emotion, thoughts, sensations) that make up an individual being, as well as the consciousness of one's own being

reflection

thinking and feeling behaviors used to create and clarify the meaning of an event

Balcetis and Dunning

used sophisticated ocular tracking processes to confirm that individual's motivation will affect what their senses actually respond to; "13"