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Transcript of CHA_0013
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Chapter 13
Understanding Anxiety and Anxiety Defenses
Chapter 13
Understanding Anxiety and Anxiety Defenses
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Anxiety vs. FearAnxiety vs. Fear
ANXIETY
• Reaction to an unspecified danger
FEAR
• Reaction to a specific danger
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SlideSlide
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Anxiety operationally definedAnxiety operationally defined
13-313-3 (Fig. 13-1)(Fig. 13-1)
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Perceptual field heightened
Grasps what is happening
Identifies disturbing things
Can work toward a goal
Can examine alternatives
Experiences slight discomfort
Restlessness, irritability
Mild tension relieving behaviors
Perceptual field heightened
Grasps what is happening
Identifies disturbing things
Can work toward a goal
Can examine alternatives
Experiences slight discomfort
Restlessness, irritability
Mild tension relieving behaviors
Mild AnxietyMild Anxiety
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Perceptual field narrows
Selective inattention
Needs to have things pointed out
Problem solving ability moderately impaired
Benefits from guidance
Shaky voice, concentration difficult
Sympathetic nervous system symptoms
Somatic complaints
Perceptual field narrows
Selective inattention
Needs to have things pointed out
Problem solving ability moderately impaired
Benefits from guidance
Shaky voice, concentration difficult
Sympathetic nervous system symptoms
Somatic complaints
Moderate AnxietyModerate Anxiety
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Perceptual field greatly reduced
Attention scattered
Self-absorbed
Can’t attend to events or see connections
Perceptions distorted
Feelings of dread/doom
Sympathetic nervous system symptoms
Confusion, purposeless activity
Perceptual field greatly reduced
Attention scattered
Self-absorbed
Can’t attend to events or see connections
Perceptions distorted
Feelings of dread/doom
Sympathetic nervous system symptoms
Confusion, purposeless activity
Severe AnxietySevere Anxiety
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Unable to focus on environment
Terror, emotional paralysis
Hallucinations/delusions
Muteness, severe withdrawal
Immobility or extreme agitation, severe shakiness
Disorganized, irrational thinking
Unintelligible speech
Sleeplessness
Unable to focus on environment
Terror, emotional paralysis
Hallucinations/delusions
Muteness, severe withdrawal
Immobility or extreme agitation, severe shakiness
Disorganized, irrational thinking
Unintelligible speech
Sleeplessness
Panic Level AnxietyPanic Level Anxiety
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Manage conflict and affect
Are relatively unconscious
Are discrete from one another
Are often hallmarks of psychiatric syndromes
Are reversible
Are adaptive as well as pathological
Manage conflict and affect
Are relatively unconscious
Are discrete from one another
Are often hallmarks of psychiatric syndromes
Are reversible
Are adaptive as well as pathological
Defenses against AnxietyDefenses against Anxiety
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SublimationSublimation
13-913-9
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HumorHumor
13-1013-10
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SuppressionSuppression
13-1113-11
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CompensationCompensation
13-1213-12
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IntrojectionIntrojection
13-1313-13
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IdentificationIdentification
13-1413-14
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RepressionRepression
13-1513-15
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DisplacementDisplacement
13-1613-16
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Reaction FormationReaction Formation
13-1713-17
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SomatizationSomatization
13-1813-18
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UndoingUndoing
13-1913-19
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RationalizationRationalization
13-2013-20
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RegressionRegression
13-2113-21
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ProjectionProjection
13-2213-22
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DenialDenial
13-2313-23
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Help identify anxiety and antecedents to anxiety
Anticipate anxiety-provoking situations
Demonstrate interest
Encourage talk about feelings and concerns
Keep communication open
Use clarification to understand
Encourage problem solving
Use role playing, modeling
Explore behaviors used in past
Provide outlets for excess energy
Help identify anxiety and antecedents to anxiety
Anticipate anxiety-provoking situations
Demonstrate interest
Encourage talk about feelings and concerns
Keep communication open
Use clarification to understand
Encourage problem solving
Use role playing, modeling
Explore behaviors used in past
Provide outlets for excess energy
Interventions: Mild to Moderate AnxietyInterventions: Mild to Moderate Anxiety
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Maintain calm manner
Remain with client
Minimize environmental stimuli
Use clear, simple statements and repetition
Low pitched voice; speak slowly
Reinforce reality if distortions occur
Listen for themes
Meet physical and safety needs
Set verbal limits/physical limits
Assess need for medication or seclusion
Maintain calm manner
Remain with client
Minimize environmental stimuli
Use clear, simple statements and repetition
Low pitched voice; speak slowly
Reinforce reality if distortions occur
Listen for themes
Meet physical and safety needs
Set verbal limits/physical limits
Assess need for medication or seclusion
Interventions: Severe to Panic AnxietyInterventions: Severe to Panic Anxiety
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