________1. Intense emotional ________2.

8th month anxiety

Normality and Mental Health Dr.Artuz (November 5, 2012)

________3. Drive reaching ________4. Development of sexual strivings that brings child into an erotic relationship with parent of the opp. Sex

NOTES: Normal Psychological Development Stage of dependency o Bonding: Mom Baby Important for psychological development o Attachment: Baby Caregiver Is the pregnancy Wanted? Planned? with Rejection: No Bonding Period of Mastery of Body Self Esteem Normality Mental Health Promotion Newborn must be provided with care by the mother : Primary concern is SURVIVAL

Background Noise (in utero) Refers to the mothers rhythms (heartbeat, breathing) Calms down baby

Homeostasis Sense of balance felt from within when needs are met Refers to the confidence of the newborn: development of Trust vs. Mistrust When Disturbed: o Displeasure

Mental Health I. II. III.

1st 3rd week of life: Social Smiles/ Endogenous Smiling In response to two stimuli: o Auditory : mothers voice o Visual: human face

6th week of life: smiles in response to familiar objects

Primary sleep waking cycles Alert inactive Alert active Crying

Internal Process Hunger Responsiveness of External Environment (response of caregiver) Biological to psychological relationship

Mental Apparatus of the Newborn Alerting (eg. Kicking, crying) o preparation for use of the feeding apparatus, activities which communicate the need for food Nurturing Figure --- OBJECT o Refers to the mother/ caregiver Basic Drive (Instincts)

Pleasure Principle ID: Primitive, wants, pleasure principle in newborn EGO: moderator; intellectual development,, problem solving skills; in school age SUPEREGO: conscience; in phallic stage (oedipal complex)

Stage of Dependency :Early relations, Anxiety o Best Time to leave Baby : 1st half / 1st 6 mos. Of life With sense of separateness Leaving child by the 2nd half of life will make child more likely to develop stranger anxiety in the future 6 months: Development of Stranger Anxiety

Mental Apparatus Biological Necessity of the mother Smile in response to specific individuals Psychic object representations (8th month anxiety)

Period of Mastery of the Body Objects separate from self Curiosity about his body (finger sucking, genital play) Mastery of the neuromuscular system Speech and language begins Sphincter control

Bladder and Bowel Training Retain Urine / Feces To prolong pleasurable sensations To defy mother (stubbornness) To please the mother Urinates or moves bowels As defiant act For his own pleasure (narcissistic) Get rid of what is bad (projection)

o o

1- 3 years old: Period of Mastery Age to set limits and inculcate values If Unresolved: Disorders of bowel function Morbid stubbornness Over cleanliness / meticulousness (miserliness, hoarding)

Stage of Primary and Sexual Differentiation Reality Principle o Learn limitations o Recognize requirements of those in the external environment o Anticipate o He begins to know what parents like/ dislike o Internalized objects/ idols o Development of superego consciousness and conscience o Consistency and Predictability is important for psychological development o Unsatisfactory early relationships may lead to: Low self confidence Increased dependence on external objects Excessive frustration/ rage

The Oedipus Complex Parental values and conscience development Appearance of sexual strivings that bring the child into an erotic relations with the parent of the opposite sex and a rivalrous relation with the parent of the same sex Important for gender and sexuality development Boys: begins to assoc. with and identify himself with the males of the family o He sees the father as his rival o He becomes protective/ possessive of the mother o Castration anxiety o Resolves by 5 -6 years Girls:must shift from mother to father to achieve adult heterosexual status o Tomboy phase o Resolves in puberty or later By 3 years old knows gender but is flexible until 5 years of age. Superego/ conscience: Heir to Resolution Failure of Development or Resolution: o Lack of sustained relationship with 2 parents Infantile, dependent modes of relating in adult life (helpless, dependent) Shallow relationships Low frustration tolerance o Removal of the opposite sex parent before beginning of the phallic phase Over attachment/ over involvement with the same sex parent homosexual object choice Gender of the parent id not a decisive factor In court (child custody); behaviour of parent is more important Extremely Harsh / Punitive Attitude of the Father o In Boys: Impotence and homosexuality Exaggerated character traits of positivity, compliance and timidity

In Girls: Strong aggressive masculine traits Found to marry brutal, sadistic men

Development and Resolution of the oedipal complex formation of the superego social conscience

The Latency Period (School age : 6- 10 y.o) Growing importance of the ego: intellectual development, problem solving skills Development of social relationship outside the family Early sexual conflicts are under the control of the ego o o o o Solitary masturbation Sexual curiosity peeping Daydreaming What is possible only in fantasy and what is permissible in reality Gang Formation Homosexual in composition Contempt and hostility for the opposite sex The leader does things first Provides the illusion of strength and vulnerability The sense of belongingness gives strength and affords status Cruelty and Sadism Regressive phenomenon

Character formation Intellectual development o From sexual to nonsexual objects o Greater development of ego functions concerned with learning, reasoning, judgment

Affluenza Increased incidence of psychological problems Anxiety and depression among teenagers

Self esteem Generally stable but can fluctuate Realistic, appreciative opinion of ones self o Realistic: accurate and honest o Appreciative: positive feelings and liking Self- esteem I Self- defeating shame Self defeating Pride (self-love)

More likely to work hard Engage in healthy behaviors Friendlier More espressive More reactive Less likely to devevlop psychiatric disorder In substance abuse, more likely to respond to treatment and is less likely to relapse

Normality and Mental Health Behaviour/ personality that are typical or acceptable

Determinants of Mental Health Social disadvantage o Poverty o Limited education o Gender discrimination o Unhealthy lifestyle Human Rights o Civil, political, economic, social and cultural rights o Good mental health does not coexist with abuse of basic human rights o Women and children o Treatment and rehabilitation of those with mental illness Social Capital o Social interaction, trust and association o A feature of social organization that encourages coordination and cooperation for mutual benefit Higher Social Capital Protects people from social isolation Lower crime levels Improves schooling and education Enhance community Durkheim, 1897 Weak social and disruption of local community organization increase suicide rates Shaw and McKay, 1942

OECD, 2001 Studies link between levels of social confusion, anticosocial and Physical Health o Closely associated with mental health o Depression is an acknowledged risk for cardiovascular disease o Poor social support, adverse working conditions

Pathways: 1. Physiological Systems 2. Helathbehaviors

Evidence for Mental Health Promotion Early childhood interventions Gender equality Mentzl health determination in schools Mental health interventions at work (stress in the workplace) Violence prevention

References: Kaplan: synopsis of Psychiatry George Engel: Psychological Development in Health and Disease Glenn Schiraldi: The self esteem workbook