BMS2-K13

Schools of Psychiatry,
Intellegence,
Leadership
Elmeida Effendy
Psychiatric Department
Medical Faculty USU
1

ANTECEDENT
A group of student came late at the
morning lecturer & the lecturer
prohibited them to follow the lecture
The students reaction are vary :
grumbling, angry, go home, etc
Tendency explain about personality
theory by learning new cases & new
studies report
3

 Freudian Sigmund Freud

Psychoanalysis
Individual Psychology Alfred Adler
Analitical Psychology Carl Gustav
Jung
British psychoanalytic schools : The
Klenian School : Melanie Klein,
Wilfred Bion, Donald W Winnicott

object
relation
Psychoanalytic
theory : Fairbairn, Michael Balint
The trait approach : genetics of
personality
:
Gordon
Allport,
Raymond Cattell
Interpersonal Harry Stack
Sullivan,
Karen
Horney,
Erich
Fromm, et al

 Ego Psychoanalysis Anna Freud,

Heinz Hartmann, David Rappaport,
Erik Erikson et al
Psychobiologic Adolf Meyer
Learning Theory Watson, Wolpe,
Pavlov, et al Behavior Therapy

 Life span approach : Erik Erikson

Humanistic approach : Abraham
Maslow,Carl Rogers
Attachment Theory : John Bowlby,
Mary Ainsworth
Hollistic Eclectical Kusumanto
Setyonegoro
7

Classic
Psychoanalysis
Sigmund Freud : founder of classic
psychoanalysis
In his view, symptoms,thoughts,feelings
&behavior could all be viewed as the
final common pathways of meaningful
psychological process, many of which
were unconscious
8

Psychoanalysis

1.
2.
3.

Topographical Model of the Mind

Unconscious
Pre conscious
Conscious

10

Unconscious
All of the drive that tries to
discharge & all the things that not
remembered by the individu
Those element cant reach the
conscious level again
Primary process thinking fulfill the
need of instinctual drive without
delaying it & without thinking about
the reality

11

 Unconscious memory no connection

with the reality (except if there are
words or events that interdependent
with the memory which fall into
oblivion)
Limited for the pleasurable needs

12

Pre conscious
Door to the conscious & unconscious
Secondary thinking process avoiding
the unsatisfy, delaying the instinctual
drive, considering the external reality,
rational & according to condition
Pre conscious = unconscious that easy
to recall to become conscious

13

Conscious
Perceptual apparatus that receive
stimuli from outside
Part of mental life that been aware
by the individu
Attention cathexis Tracking pre
conscious & instructing attention for
pre conscious
Preconscious process to become
conscious hypercathexis
14


1.
2.
3.

Structural Theory of the Mind

Id
Ego
Super Ego

15

Id

Basic instinctual drive since birth

Pleasurable principal
Unconscious
Id ego & superego (energy &
development)

16

Ego
Personality executive part
Relationship between id & ego
Reality principle
Conscious, pre conscious & unconscious
Secondary process
Ego defense unconscious

17

Superego
. Superego

ego conscience
ego ideal
Ego that experienced particular
specialization
Conscious & unconscious
Moral
Oedipal conflict
Ego conscience right or wrong
Ego ideal things that been dream
by the individu inner feeling
18

The Neopsychoanalytic
Approach
Alfred Adler
Carl Gustav Jung
Karen Horney

19

Adlerian School
Alfred Adler (1870-1930):Individual
psychology
Masculine protest :the tendency to move
from a passive, feminine role to a
masculine active role
Inferiority complex: sense of inadequacy&
weakness that is universal & inborn
Birth order results in lifelong influence on
character % lifestyle

20

Jungian School
Carl Gustav Jung (1875-1961) :analytical
psychology
Unconscious

Personal:acquisitions of personal life, everything

forgotten,repressed,subliminally perceived,
thought,felt
Collective :inherited possibility of psychic
functioning in general, i.e : structure of the brain

21

 2 types of personality organizations

Introverts:focus on their inner worldof
thoughts,intuitions,emotions & sensations
Extroverts :more oriented toward the outer
world, other persons & material goods

Each person has a mixture of both

components
Persona,the mask covering personality : the
face a person presents to the outside world
Anima :mans undeveloped feminity
Animus : womans undeveloped masculinity
22

Karen Horney (1885-1952)

persons current personality
attributes result from the
interaction between the person & the
environment& are not solely based on
infantile libidinal strivings carried
over from childhood
Holistic psychology
23

Psychobiologic
Adolf Meyer :
1. Learning living human observed
the whole thing about the man
2. The whole thing from the man
integration from the arranged
function hierarchyly
o Individu & its behavior interaction
from various factor :
.. dynamic,
somatic, psychologic & social process
24

When facing a case : dynamic,

genetic, psychobiologic, objective
& common sense principality
Objective : human behavior can be
observe objectively

25

 Common sense :
a. Human must be critical
b. according to order which have been
agreed on.
c. Theory which have been agreed on
have to be applied according to
requirement of public society.

26

The Interpersonal &

Cultural Approach
Erich Fromm
Harry Stack Sullivan
Henry Murray

27

Erich Fromm (1900-1980)

5 character types that are common to &
determined by, Western culture:

1.receptive personality :passive

2.exploitative personality : manipulative
3.marketing personality: opportunistic &
changeable
4.hoarding personality: saves & stores
5.productive personality :mature& enjoy love &
work

28

Harry Stack Sullivan

(1892-1949)
Prototaxic mode: undifferentiated thought that
cannot separate the whole into parts or use
symbols. Occurs in infancy & schizophrenic
patients
Parataxic mode: events are causally related
because of temporal or serial connection
Syntaxic mode: logical, rational & most mature
type of cognitive functioning of which person is
capable

29

Henry Murray (1893-1988)

Personology : study of human
behavior
Focused on motivation, a need that is
aroused by internal or external
stimulation
Thematic Apperception Test (TAT)

30

Behavioral Theory
Something
that
resulted
from
learning process learn ought to earn
to be improve by learning process too.
Behavioral theory :
1. Classical conditioning therapy
2. Operant conditioning therapy

31

Classical conditioning therapy

(dealing with reflectory behavior)
a. Reciprocal inhibition : patient conduct
behavior which as reciprocal from the
arising out physical symptom
reducing or overcoming the anxiety
b. Desensitization : patient alternately
think of or write down what the
scariest thing until the less fearful

32

 c. Aversive conditioning : giving

unpleasant stimuli for the patient
when they do something
inappropriate

33

Operant conditioning theory

Changing /eliminating behavior that
had been done voluntarily = behavior
modification

34

Learning Theory
Classical conditioning
Ivan Petrovich Pavlov

35

 Operant conditioning
BF Skinner

36

 Social learning

Albert Bandura
Julian Rotter

37

The Trait Approach: The

Genetics of Personality
Gordon Allport
Raymond Cattell

38

Gordon Allport (1896-1967)

The founder of humanistic school of psychology
Propriem: strivings related to maintenance of self
identity & self esteem
Traits :chief units of personality structure
Personal dispositions : individual traits that
represent the essence of an individuals unique
personality
Maturity :capacity to relate to others with
warmth &intimacy & an expended sense of self

39

Raymond Cattell
(1905-1998)
Introduced the use of multivariate
analysis & factor analysis-statistical
procedures that simultaneously
examine the relations among multiple
variables & factors to the study of
personality

40

Life span approach :Erik Erikson

8 stages of the life cycle

1. Trust vs Mistrust (0-18 months)

2. Autonomy vs Shame & doubt(18 months-3
years)
3. Initiative vs Guilt ( 3-5 years)
4. Industry vs Inferiority ( 5-13years)
5. Identity vs Role Confusion (13-21years)
6. Intimacy vs Isolation (21-40 years)
7. Generativity vs Stagnation (40-60 years)
8. Integrity vs Despair (60 years death)

41

Hollistic Eclectic
Kusumanto Setyonegoro

o Eclectic = accepting all real correct

fact and reality and there is
relation with the patient suffer
o Hollistic = to exert to look into all
manpower energy as a unique
individual in its struggle for the
perfect recovering of physical and
mental health.
42

43

 Ability to assimilate factual

knowledge, to recall either
recent or remote events, to
reason logically, to manipulate
concepts (either number or
words), to translate the abstract
to the literal and the literal to
the abstract, to analize &
synthesize forms, & to deal
meaningfully & accurately with
problems & priorities deemed
important in a particular setting
44

Intelligence Testing
1905 : Alfred Binet introduced the
concept of the mental age (MA),
which is the average intellectual
level of a particular age

45

 The intelligence quotient is the ratio

of MA to CA (chronological age),
multiplied by 100 to eliminate the
decimal point : it is represented by
the following equation
IQ = MA X 100

CA

46

Classification of Intelligence by IQ Range

Profound mental retardation : below 20 or 25

Severe mental retardation
: 20-25 to 35-40
Moderate mental retardation : 35-40 to 50-55
Mild mental retardation
: 50-55 to about 70
Borderline
: 70-79
Dull normal
: 80 to 90
Normal
: 90-110
Bright normal
: 110 to 120
Superior
: 120 to 130
Very superior
: 130 and above

47

48

Things to know :
Definition of leadership
Leaderships trait
Leaderships styles

49

 Doctors / psychiatrists entering

public mental health systems are
frequently dismayed to find that
they are not automatically
considered the leaders of their
teams

 Leadership is a difficult attribute to

define and teach
It involves not only the knowledge of
what needs to be done to accomplish the
organizations goals but also the ability
to communicate that knowledge to a wide
array of staff members and others

 It includes the ability to see that

what happens in one part of the
organization will affect all other
parts eventually

 The vast majority of directorships of

public mental health programs are
held by members of the major mental
health professions
For any discipline, special skills are
required to achieve high-level
management and leadership positions

 Some of those skills are best

gained by additional training,
some can be acquired only by
experience under the tutelage
of a good mentor, and others
require a combination of
experience and education
Once can gain the necessary
education without pursuing
further degrees in public
administration or management

 Such degrees can be helpful after

on- the job training, but it is often
more efficient to undertake an
appropriate reading program and
avail oneself of the many short
courses on specific topics available in
most communities

Management Skills
To be a successful public mental
health administrator, one must have a
basic understanding of how
communities are organized, how they
choose their leadership, and how the
formal and informal power structures
work

 Administrators must know how to frame

their programs in a manner that will be
acceptable to the powers that be
Without that acceptance, the program
conceptualizations will go for naught
To be successful un what arena, one must
be aware of prevailing public attitudes,
where support can be found, the opinions
of key community leaders, and when one is
wasting time

 Abilities in the areas of public

speaking and salesman ship are
helpful, and neither are learned in
most psychiatric training programs

Technical Skills
Political skills and agility may be hard to
learn in a formal manner, but the skills
that concern public administration and
management are not.
They deal with budget, personnel
management, organization, control and
leadership

 To manage a public mental health

program, one must learn how to read
and manage the budget process and
how to read and manage the final
product.
The budget is where all the plans for
the program come to fruition or fail

 Planning and budgeting are inseparable

functions
Every governmental jurisdiction has
its own budgeting process, but they
are similar and are easily to
understood if one takes the time to
familiarize oneself with the major
players and to participate in the
process

Leaderships styles
Autocratic
Democratic
Laissez faire

62