Nursing Diagnoses in Psychiatric Nursing Care Plans and Psychotropic Medications

(^280) The theory of object relations suggests that the individual^ ●• • • • •^ ing and the ability to explore the environment indepen-psychic fusion of mother and child. The child views the Phase 3 (5 to 10 months), Differentiation Phase.is established, and the child is able to internalize a sus-The child is beginning to recognize that there is separ-ateness between the self and the parenting fian effective, constant manner. A sense of separateness individuation process and learns to relate to objects in self as an extension of the parenting fisight. Separation anxiety is resolved.Constancy Phase.phase is characterized by increased locomotor function-Phase 6 (24 to 36 months), On the Way to Object dently. A sense of separateness of the self is increased.there is a developing awareness of external sources of need fulfiPhase 5 (16 to 24 months), Rapprochement Phase. Awareness of separateness of the self becomes acute. This is frightening to the child, who wants to regain some lost closeness but not return to symbiosis. The child wants the mother there as needed for “emotional refueling” and to maintain feelings of security.tained image of the loved object or person when out of Phase 2 (1 to 5 months), Symbiotic Phase. Phase 4 (10 to 16 months), Practicing Phase.ALTERATIONS IN PSYCHOSOCIAL ADAPTATION llment. In this phase, the child completes the gure, although gure. A type of This

2506_Ch16_275-309.indd 0280 2506 Ch 16 275 - 309 .indconstancy is never achieved, the child continues to view objects instead reward clinging, dependent behaviors. In this way, the feel threatened by the increasing autonomy of her child and so withdraws her emotional support during those times of development. This fiwith borderline personality is fitheir behavior reflchild comes to believe that(people) as parts—either good or bad. This is called splitting, a primary defense mechanism of borderline personality.Symptomatology (Subjective and Objective Data)Individuals with borderline personality always seem to be in a state of crisis. Their affect is one of extreme intensity and ment that persists into adulthood. In addition, because object d 0 “To grow up and be independent = a ‘bad’ child.”“Mom withholds nurturing from ‘bad’ child.”Consequently, the child develops a deep fear of abandon-“To stay immature and dependent = a ‘good’ child.” 280 ects frequent changeability. These changes xation occurs when the mother begins to xed in the rapprochement phase or she may 1 10/1/10 9:36:57 AM 0 / 1 / 10 9 : 36 : 57 AM