Republic of the Philippines

Bicol University
Graduate School, Gubat Campus
Masters of Arts in Nursing
Gubat, Sorsogon

Name:

Dhonnalyn Amene-Caballero, RN

Topic:

Dynamic Behavior

Subject:

Mental Health and Hygiene

Professor:

Pierre Dellosa

Dynamic Behavior
Represents an individual typical way of responding to a threatening,
anxiety-producing stimulus.

Appearance

Behaviors

Communication

Behavior pattern is a syndrome or complex of symptoms observed in

the actions, feelings, and thoughts of clients are acting out.

The individual symptom symbolizes the conflictive and defensive

elements of an emotional conflict.

They provide clues of what the person have been and is

thinking, feeling and experiencing and responding to in his
struggle to resolve the conflict as well to meet his deprivations
and needs.

During period of conflict, frustration, and anxiety, some clients act out
a pattern of behavior having a dominant characteristics, such as
withdrawal or aggression.
The ways of reacting have been learned in attempts to adapt to life
situations, but they may become grossly pathological in both their
appearance and effects.
When attempts to resolve mental conflicts are not successful,
frustration and anxiety increase.
Symptoms that may be part of a pattern:
Waxy Flexibility
An overt response to a stimulus of a suggestive nature is observed.
A body posture is imposed by another is readily accepted and
maintained rigidly for a prolonged period of time by a patient who may
be perceiving an overwhelming emotion of threatening stimulus such
as fear or hallucinations.
The joins of the individuals extremities may be flexed or extended
during catatonic episodes just as ones bends a soft candle into
position.
Pathologic Limb Rigidity
the introjections of a high level of anxiety and other emotions
perceived in response to a threatening situation.
It may symbolize withdrawal from emotionally painful reality with an
associated need communications.
Compulsions
Ritualistic displacement of anxiety through repetitive actions carried
out against the patients conscious wishes, such as repetitive hand
washing, counting, checking, touching which have a symbolic
relationship to underlying conflict.
This includes reenacting the event or putting oneself in situations that
have a high probability of the event occurring again. This "re-living"

can also take the form of dreams, repeating the story of what
happened, and even hallucination.
Echopraxia
Compulsive replacement of anxiety through automatic duplication of
the immediately observed movements and gestures made by another
individual in the patients presence.
imitation of an action: the compulsive imitation of the actions of
others, often a sign of a psychiatric disorder.
May be a security achieving operation which is stronger than ones
conscious control.
Echolalia
Representing the speech of another, like a resounding echo, as if
experiencing a compulsion to respond.
May be a security achieving operation or the pathologic suppression of
data which is emotionally painful to verbalize.
Impulsiveness
Sudden, unpredictable outburst of activity, such as striking physically
at someone without thinking about the rationale and effects of the
behavior.
A fearful hallucinating client might project hostility upon a person who
approaches and interrupts his hallucinatory behavior and to whom the
client may attribute the voices being heard.
Tics and Spasm
Involuntary jerking and twitching of some part of the body, usually
localized in the neck, face and head.
This behavior appears to be of organic etiology but may be of psychic
origin.
Anxiety is displaced through such actions as intermittent eye blinking
and spasmodic movements of the mouth or neck which are motivated
by unconscious emotional conflicts.
Punning

 The injection of witty or clever remarks into a conversion, or the

humorous use of a word in such a way as to suggest a different
meaning.
or the use of words having the same sound, but different meanings,
which attract the listeners attention and gain for the patient the control
of the immediately environment.
Rhyming
Rhyming of phases or whole sentences in a lyrical poetic manner
during conversation or writing which may symbolize the conflictual
elements and needs associated with a mental conflict.

I am knitting a halter for Walter to lead me to the altar.

Clang Association
a linkage of similar word sounds, such as seven, heaven, eleven to
compensate for defects in memory and communication which may be
of psychic or organic origin.
Neologisms
the coining of new words that have symbolic meaning, or the
conferring of new meanings upon words that are used commonly;
Eisenhead (Eisenhower), newspulp (newspaper).
Blocking
sudden stopping of speech which occurs when the trend of thought has
been lost owing to anxiety producing thought association.
Irrelevance
verbal responses which are not pertinent to or related to the
immediate communication content, giving the impression of
distractibility or a defect in comprehension and thought processes.
Circumstantiality
The inclusion in conversation by a highly anxious individual of many
unnecessary details, scattered thoughts and explanations.
The pressure of invading thoughts and feedings tend to disorganize the
communications and delays the reaching of the goal points of the
conversation.

When asked about a certain recipe, could give minute details

about going to the grocery store, the shopping experience,
people there, and so on.

Flight of Ideas
A continuous stream of conversation with rapid shifts in topics owning
to pressure of thoughts, sometimes characterized as topic jumping.

Word Salad
a disconnected flow of communication made up of a mixture of words,
phrases, and sentences which sound meaningless and as if the product
of dissociations and the pressure of invading thoughts.

this is the atomic age and I will see the light. You could be
Helen of Troy. Or are you? Blue, yellow, green red is a rainbow in
the sky. I am dedicated toa acause. My father was cremated in a
barrel. Last night there was a thunder and I was poisoned. The
golden rule is broken. One, two, three, four. That fellow they said
is mental. Who did it? (patient laughs without cause.)

Its a sure thing. Youre telling me?

Mutism
The state of being silent or voiceless.
In the absence of organic etiology mutism is of psychic origin. It may
be the result of early life frustrations experienced when attempts were
made to use verbal language or it may symbolize a need to
communicate.
Euphoria
an abnormal exaggerated (extreme) feeling of wellbeing which is out of
proportion to environmental and interpersonal stimuli.
It may represent a pathological reaction-formation (overcompensation)
to an opposite feeling state.
It may precede an emotionally exciting phase of illness and is revealed
in statements such as:

I feel great! Terrific! Absolutely Jim Dandy!

Elation
An effective reaction extending beyond a state of euphoria, It is
characterized by increased anxiety and psychomotor activity in which
the persons thinking, communications, and body movements escalate.
Apathy
a dulling or reduction of emotional response to stimuli so that one
reacts with less interest, attention, and feelings than normal.

Blunting
a flattening of affect or loss of the capacity to experience and express
emotion at normal intensity.
It may progress from a loss of feeling of sympathy toward a relative
and to a loss of such primitive emotions as fear, rage, and the sexual
drive.
Blunting is not considered a favorable prognostic sign.
Even an unfavorable emotional response is considered more desirable
because it indicates the presence of an affective capacity which can be
stimulated with the hope of effecting a behavior response and charge.
Ambivalence
the coexistence of two opposing drives, desires, feelings or emotions.
wanting and also fearing an anticipated hearing. One of the
components of ambivalence is usually repressed but gives rise to
feelings of guilt and anxiety which may be projected.

Lability
sometimes characterized as emotional instability. Owing to the sharp
influence of rapidly changing thoughts and feeling tones, the patient
manifest quick shifts in emotional responses, as if gliding from on into
another affect.

Pleasantness may be followed in quick succession by show of

irritability.

Irritability
Feeling emotionally out of harmony with a situation.

I dont want to talk. Dont bother me.

Suspicion
A lack of trust in others, often accompanied by an anxiety producing
anticipation of a response from others or a helping that is feared.
Insight
being able to recognize and accept the fact that one is ill even though
the dynamics of the illness are not understood.
Disorientation
Being unaware of the correct date, time, place, etc.

This isnt a hospital. Its a concentration camp!

A dissociative process related to memory impairment which may be

organically caused of the result of acute mental conflict with highly
affective related factors involved.
Comprehension
Having an ability to understand communications as well as what is
taking place in ones environment.
Distractibility
The interference of anxiety and environment stimuli with ones ability
to focus attention upon communications and occurrences.

The a door opens, and patient turns his attention from the
immediate act or conversation.

Impairment of Judgment
Inability to adequately size up a situation or recognize the logic of
explanations owing to intellectual impairments caused by organic
changes or psychic conflict.
Attention

 Being able to focus ones senses and intellectual responses upon

communication and environment situation for a period of time.
Suggestibility
being readily responsive to stimuli of a suggestive nature.
Accepting an imposed body posture (waxy flexibility) and carry out a
posthypnotic suggestion.
Preoccupation
persistent introspection and inward reflection, thus internalizing
instead of externalizing intellectual activity and affect. It is a
manifestation of the defense mechanism introjections.

Hallucinations
Impairment of the special senses ( olfactory, visual, tactile, auditory)
by which the patient perceives in response to his own inner
stimulation, that is his beliefs, delusions, feelings, unfulfilled wishes
and needs.
Illusions
A misinterpretation of an external stimulus by any of the special
senses.
Hearing thunder and identifying it as a bomb
Seeing a shadow on the wall and identifying it as a mammal.
Delusions
A false belief motivated by the affective aspect of the personality to
which the patient clings.
For that reason delusion cannot be changed through intellectual appeal
approaches, such as, attempts to reason with the individual.
There are many type of delusions:

Delusion of persecution theyre out to get me

Guilt Ive done terrible things to hurt so many people

Poison This food is poisoned

Grandeur I live like a country squire

Unworthiness I dont deserve to eat

Infidelity My wife has another man

Ideas of reference
A belief held by the patient that something in the environment has a
meaning especially intended for him.
A patient hears two night nurses whispering while making rounds and
says, theyre plotting against me. I heard them.
He may read a newspaper item and interpret it as a message intended
for him.
Alien control
A belief held that one is under the stronger influence of another person
or force.
A patient explains his destructive action by projecting the blame. God
told me to do it.
Im being dictated to from another world

Cosmic Identification
expressing the delusion that one has abilities which may be likened to
the powers of a supreme being.
This is a pathological identification defense that may be used when
one has experienced personal failure and feelings of helplessness.
Depersonalization
verbalizing the belief that one no longer exist or experiences the
former normal feeling reactions but is instead perceiving as if one were
something inanimate or unreal and had lost the capacity to perceive as
a living being.
It symbolizes a losing of ones personal identity and escape from the
reality of an emotional intolerable situation by an insecure and self
observing personality.

 It may be a reaction formation defense (over-compensation) against

anxiety, rage or deprivation when other defenses have failed, such as
hypomania.
I dont feel like I used to anymore
Im like a ghost, an empty shell
Im not my real self
Transfer of Personality
The client believes that he is someone else, and he acts like that other
person.
The mechanisms of denial and identification are manifested in this
behavior.
There is dissatisfaction with the true self and the need to be
dissociated from the discomforts and anxiety of the realities of living.
Repression is also part of this defensive behavior.
a client who assumes the mannerisms of a prominent movie star,
adopted her well-know style of behavior, hair fashion and name .

Memory impairments
Memory defects vary in degree and type and may be of organic,
emotional, or mixed origin and sharply circumscribed in limits of time.
Experience and recollection are split off and become consciously
inaccessible.
A loss of memory for recent events is known as anterograde
amnesia.

this may be associated with a senile psychosis, as a temporary

effect of electrotherapy, or an aftermath of a catastrophe, such
as an earthwake, fire, or flood.

Forgetting events in ones life is known as retrograde amnesia.

May be observed following a long interpersonal struggle which

terminates ina crisis situation.

It demonstrates the use pathological repression and dissociation

of the present with ones past life.

Stupor
a reduction in mental alertness and awareness which may vary in
degree and depth from drowsiness to comatose states and the
appearance of pathological body reflexes.
in the absence of organic causes the origin may be psychic, as is
observed in catatonic stupor which is a dissociative reaction to an
overwhelming emotion.
Confabulation
falsification of facts or distortion of memory which is not deliberate but
the result of mental deterioration which produces gaps in memory that
motivate defensive compensatory actions.
Pseudologica Fantastica
false logic of a fantastic nature that is motivated by a low self esteem
and weak superego.

Impersonation of celebrities, pathological lying, and the writing of false

signatures are abnormal uses of the mechanism of identification.

Basic Psychiatric Concepts and Principles in Nursing:

Principles in the care of the Psychiatric clients.

There is an interrelationship between mind and body.

Every individual has intrinsic worth and dignity

Every living organism possesses a Dynamic life-giving force.

Human beings have common physical and emotional needs.

Communication is the basis of social exchange.

Perceptions of reality are individualistic.

Self-concepts are influence by social interchanges.

Self-awareness influence one understands of other persons.

Ideation; feelings, moods, and actions constitute behavior.

All behaviors is never static.

All behavior is meaningful and purposeful.

Emotional equilibrium (homeostasis) may alter with internal and

external changes and demands.

Stress and strain maybe produced by both internal and external

changes and demand.

Coping with stress and strain is an individualistic ability.

Illness can be a learning experience.

Interests and aptitudes represent growth potentialities.

Human growth and personality development represent the result of a

complex process.

Knowledge of personality development structure provides a framework

for studying behavior.

Individual concepts of specific illness may be of cultural social or

familiar origin.

Changes which alter or threaten the capacity functioning of the human

body evoke physical and emotional reaction.

Basic Psychiatric Concepts and Principles in Nursing :

General Principles of Psychiatric Nursing:

Patients need to be accepted exactly as they are.

Nurses can use self-understanding as a therapeutic tool.

Consistency can be used effectively to contribute to patients security.

Patients need to be allowed to expression of negative emotions.

Reassurance must be given subtly and in a manner acceptable to the

patient.

An intellectual, rational approach to patients problem with him is

useless.

Anything that produces or increases patients anxiety is not good for

the patient.

Patients behavior should not be interpreted to them.

Discussion of personal relationship and personal values should be

initiated only by the patient.

An explanation of routine procedures should always be given on the

patients level of understanding.

Verbal and physical force should be avoided if humanly possible.

The observation of mentally ill patients should be directed towards

analysis of why the patients behaves as he does.

Reasonable objectively towards the patients behavior should

contribute to the effective use of interpersonal relationships as a
therapeutic atmosphere.

Intimate relationship with the patient is not conductive to a therapeutic

atmosphere.

Nursing should center on the patient as a person not on the control of

symptoms.

Many procedures may require modification in method to meet the

needs of patient with behavior problems, but basic principles are not
altered.

The social structure of the institution and the ward unit should be
organized to promote social participation on the part of the patient.