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Child is not a mini size measure adult

 What s the difference between child and

adult ?

Elementary differences
Child : have the character of egocentricly, everything evaluated by the child pursuant to importance of himself sexual apparatus hadnt been formed finely; event that had the sexual character will be interpreted as something that have the pregenital character
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 < 7 years old : not yet thinking pursuant to

causality; baby cant differentiate himself & things coming from the outside
dont have the concept concerning time, childs

behaviour especially influenced by instinctual motivation; if id is more dominant, child determined by fulfilled immediately of his satisfaction (fulfilled by demand of instinctual motivation)

Differences between Child & Adolescent Psychiatry and Adult Psychiatry

1.Child not yet ready : to express his suffered trouble or problem to give good & directional information for referring to his past 2. Child express his emotional difficulty

through his behaviour difficulty in giving food, sleep, urination/defecation ; behaviour problem, emotional or somatic symptoms
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 3.Childs personality s

influenced by environmental factor; existence of the change in environment or family will result in child experienced a larger changes again himself 4. Child express his feeling & fantasy through games or by playing 5. If the obtained symptom come from environment or family, the involved family member better engaged family therapy or environmental manipulation
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 In facing child with psychiatric disorder we

must pay attention to :

1.Parent-child relationship; role of parents &

emotional atmosphere influence in forming personality, especially below 5-6 years old 2.Child step by step performs the forming of personality to adult personality by elements since he was born & environmental situation
plays a part in growth & maturation of later

personality
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 3. Child is not a white piece of paper/ tabula

rasa (Johns Locke concept), which quiescently accept the character formulation processed by his parents. Child give active contribution in forming his character 4.Inharmonious relationship between his parents the child experience

mental disorders * Child & adolescent psychiatry psychiatry

family
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Child Development
Born with intrinsic factor :ability & potency

boundary

the nature experienced changes by

interaction with environmental factor ( representing extrinsic factor)

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 Intrinsic factor : hetero constitutional &

represent the matrix for the childs development in the future

Extrinsic factor : influence the adjustment

& development of child

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Extrinsic factors that plays a role

Attitude & attention of the parents
Emotional atmosphere in the family Norm & ethics in the family Religious life in the family Social economy level

Parents educational level

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Theories of Personality & Psychopathology

Sigmund Freud Topographical Model of the Mind Structural Theory of the Mind Psychosexual Development Erik Erikson Psychosocial Development Jean Piaget Psychocognitive Developmnet
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 Jerschildt Psycho affective Development

Stella Chess Psychomotor Development

Kohlberg Moral Development

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Topographical Model of the Mind

Freud divided the mind into 3 regions: 1. The Conscious System 2. The Preconscious System 3. The Unconscious System

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 1. The Conscious System Perceptions coming from the outside world or

from within the body or mind are brought into awareness Consciousness : a subjective phenomenon whose content can be communicated only by means language or behaviour

attention cathexis

Conscious

Preconscious
hypercathexis
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 2.The Preconscious System Comprises: mental events, processes & contents that can be brought into conscious awareness by the act of focusing attention Interfaces with unconscious & conscious regions of the mind To reach conscious awareness: contents of the unconscious must become linked with words & become preconscious Serves
to maintain the repressive barrier to censor unacceptable wishes & desires
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 3. The Unconscious System Dynamic Mental contents & processes are kept from

conscious awareness through the force of censorship or repression Closely related to instinctual drives Limited to wishes seeking fulfillment Characterized by primary process thinking, which is principally aimed at facilitating wish fulfillment & instinctual discharge (pleasure principal) Consists of id, ego, superego

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Preconscious
Conscious

Unconscious

censors are over powered

elements

can enter consciousness

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Structural Theory of the Mind

CONSCIOUS
EGO UNCONSCIOUS Id

SUPEREGO CONSCIOUS

UNCONSCIOUS

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Structural Theory of the Mind

ID

SUPEREGO EGO

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 1.Id reservoir of unorganized instinctual

drives

primary process thinking

pleasure principal
(menginginkan

sesuatu dan ingin terlaksana dengan segera tanpa memperdulikan realita)

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 2. Ego spans all 3 topographical dimensions of conscious, preconscious & unconscious Executive organ of the psyche & controls motility, perception, contact with reality Reality principle

secondary process thinking

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 3. Superego Moral conscience: ideals & values internalized from parents Children internalized parental values & standards at 5-6 years old

Ego ideal : what a person

should do & shouldnt do

Through out the latency period , children

continue to build on early identifications through air contact with admired figures, formation of moral standards, aspirations & ideals
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Stages of Psychosexual Development

Oral stage : birth- 18 months
Anal stage : 18-36 months Urethral stage Phallic stage : 3-5 years Latency stage : 5-6 years-11-13 years

Genital stage : 11-13 years-reaches young

adulthood
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 Oral stage :

birth:-18 months

Centers on the mouth, lips, tongue Oral sensations : thirst, hunger, pleasurable

tactile stimulations evoked by the nipple or its substitute Oral triad : eat, sleep, relaxation Oral drives : Libidinal (oral erotism) >> early part s of oral phase Aggressive (oral sadism):

biting, chewing, spitting, crying, destroying

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 Objectives
to establish a trusting dependence on nursing &

sustaining objects comfortable expression & gratification of oral libidinal needs without excessive conflict or ambivalence from oral sadistic wishes

Pathological traits : excessive

optimism, narcissism, pessimism, dependent, envy & jealousy

Character traits: capacities to
give & receive from others without dependence,

envy rely on others with a sense of self-reliance & self trust

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Anal Stage: 18-36 months

Maturation of neuromuscular control over sphincter More voluntary control over retention or expulsion of

feces

Toilet training
Anal erotism : sexual pleasure in anal functioning:

retaining the precious feces & presenting them as a precious gift to the parent Ambivalence Anal sadism : feces : powerful & destructive weapons

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 Objective : striving for independence & separation

from the dependence on & control by the parent

Pathological traits : orderliness

,obstinacy, willfulness, stubbornness, frugality, messiness, defiance, rage, sadomasochistic tendency

Character traits: personal autonomy, capacity for

independence & personal initiative without guilt, self-determining without shame or self doubt, lack ambivalence ,willing cooperation without excessive willfulness or self diminution or defeat
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Urethral Stage
Transitional stage between anal & phallic

stage Urethral erotism : pleasure in urination & retention Pathological trait s : competitiveness, ambition, development of penis envy Character traits : budding gender identity & subsequent identifications

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Phallic stage : 3-5 years

Primary focus of sexual interests, stimulation &

excitement in genital area Penis : female evidence of castration Genital masturbation

Oedipal wishes
Objectives: to focus erotic interest in genital area

& genital functioning, identification

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 Character traits: foundations for an emerging sense of sexual identity, sense of curiosity without embarrassment, initiative without guilt Regulation of drive impulses & direction to constructive end Internal source of regulation is superego; based on identifications derived primarily from parental figures

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Latency Stage : 5-6 years-11-13 years

Relative quiescence or inactivity of sexual

drive Primarily homosexual affiliations for boys & girls Sublimation of libidinal & agressive energies into learning, play activities, exploring environment
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 Objectives: further integration of oedipal identification consolidation of sex-role identity & sex roles mastery skills Character traits Essential basis for a mature adult life of satisfaction in work & love

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Genital stage : 11-13years-reaches young adulthood

Physiological maturation of systems of

genital functioning & attendant hormonal systems intensification of drives, particularly libidinal drive
Regression in personality organization;

reopens conflicts of previous stages of psychosexual development

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