MSN 6501 Non-nursing Theory
Joya Chatterjee

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Nursing is a practice discipline and it is considered to be applied science.
It has evolved through compilation of many different types of knowledge borrowed from numerous disciplines.
Psychological science or behavioral science, which first appeared in the 1800s , has major implications in nursing practice.
Sigmund Freud, founder of psychoanalytic school of psychology, presented his works on the relation between human thoughts and behaviors. This causes a major paradigm shift and developed many psychological theories.
His Psychodynamic theories attempt to explain multidimensional nature of behavior and how personality and behavior interact. It is a systemic way of understanding and identifying human behavior.

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Ego is the reality component of the personality and makes the impulse of the Id more socially acceptable. It controls behavior by making balance between Id, Superego and external impulses.
Superego inhibits the impulses of the Id. It encourages Ego to form realistic goals and strives for perfection.
According to Freud, the healthy personality develops with the balance of these traits of personality.

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Instinct is a building block of human behavior, according to Freud.
It is an inborn state of individual and human behavior and is motivated to release tension caused by unfulfilled instinctive drives or desires.
Each individual undergoes through predetermined developmental stages.
Successful completion of those stages leads to a healthy personality and failure to an unhealthy personality. This is known as Psychosexual development and it includes oral, anal, phallic, latency and genital stages.

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Freud’s theories, ideas and concepts have great impact on the understanding many processes of diseases and as well as the nature of treatments.
An individual nurse can relate to Psychodynamic theory to understand the complex nature of the individual personality development and to find the cause and remedy of a particular disease.
A nurse can also identify the needs of the patient and can respond to the pt behavior more appropriately with the help of the Psychodynamic theory.
He/she can relate the defense mechanism of the patient to individual maladaptive behaviors like substance abuse, anxiety and many neurotic phenomena.
Understanding of Psychodynamic concept s of Id, Ego, Superego ,instincts and defense mechanism are not only important in understanding abnormal behavior pattern but also in other areas of diseases. A nurse can recognizes the denial of the patient incase of major events like amputation, cancer, and loss of life by understanding the concepts of Psychodynamic Theory.
A nurse can relate individual non compliances with major health issues. This is a big issue in the health care system. Individual nurses have the opportunity to discuss with the patient about his or her denial of a particular disease and can help the patient to understand the importance of compliance with medicine, rest , diet and other related matters.
Nurses with the knowledge of psychodynamic are able to view the patient with broader aspects i.e. not only the body and disease but the inner causes behind the physique.

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Psychodynamic Social Science and Medical Education - research has been done to understand the growth and development of professionalization among medical students. This research helps to develop pedagogy of medical education.
Infant observation, experimental infant research and psychodynamic theory regarding lack of self/other differentiation –the author took infant observation, infant research and the psychodynamic theory to explore early development of internal objects.
Psychodynamic research perspective on development, psychopathology and treatment in later life -there is research on interplay of psychology, biology, sociology its effect on shaping adaptation of aging.
Research on patient’s own internal representation of psychotherapy with therapist.
Research to measure the outcome of the psychodynamic therapy.

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Anxiety sometimes are the main cause of many symptoms, in ventilator weaning areas many times the anxiety leads to failure to wean, identification of the cause of anxiety and its management help to wean the patient from the ventilator very smoothly, sometimes the presence of family member helps patient to relax there by reduces the anxiety. explanation of any kind of procedure create better understanding and healthy acceptable environment for the patient.
Understanding patient’s unconscious ,preconscious aspects of mind helps to relate patient’s behavior and the his response to the disease. Thus helps to plan nursing care for that individual patient.
It is not always easy to understand the underlying unconscious process of every behavior of the patient but the accepting this fact helps to develop a holistic care towards that individual.

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Knowledge of defense mechanism helps me understand the patient’s reactions in different situations like amputation, detection of cancer, HIV AIDS, and many other such cases. Patients typically adapt denial in most of these cases.
Regression is also not uncommon for patient to adapt in some of these areas.
Compliance to medication, Physician advice are essential areas of health care, but as a nurse with knowledge of psychodynamic I always try to find out the inner conflict for the non compliance of the medication or other such issues .It is one of the major areas to work with patients and to help them to overcome the conflicts and adhere to medical advices.
Obesity or childhood obesity is another area of my interest. May be fixation of oral stage, psychologically loneliness play important role. Understanding of that area is more important than treating the patient with exercise, diet and drugs.
Substance abuse, alcohol abuse these are increasing every day. Isolation, loneliness are the important issues regarding these, group therapy and other behavior therapy are helpful.
Last but not least knowledge of psychodynamic alerts me about counter transference while taking of patients especially mentally ill patients.

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