Regulation Of Anxiety In Personality Functioning Affects:
•Operation of cognitive controls.
•Achievement of Potential levels of intellectual functioning.
How Anxiety Is Manifested In The Individual’s Functioning?
•Does the anxiety disturb the patient?
•Does the anxiety generate failure in performance?
•Does the anxiety reduce capacity to deal with frustration?
If Anxiety Impedes Performance, Then The Patient May Show Self-Defeating Behavior, Such As:
•Withdrawing from tasks.
•Becoming non-communicative or uncooperative.
•Becoming discouraged or depressed.
•Engaging in impulsive behavior.
If anxiety is not regulated or managed adaptively, then problems may emerge, including
•Depression, withdrawal, or inhibition of effort.
•School failure or job loss.
•Irritability & aggression.
•Passivity or dependency.
Is the anxiety consciously experienced?
•The extent to which the pt is experiencing anxiety
•Pt’s anxiety and latent personality conflicts
- conflicts between control and impulse
- impacts on the intactness of the pt’s ego
•How might the anxiety be managed?
- Is it experienced passively? Does it stimulate fantasy? Does it lead to some sort of activity?
- Is the pt terrified about his/her needs and therefore become inhibited, social inconspicuous, isolated, or withdrawn?
Diagnostic implications with anxiety that is experienced
•When the behavior is ego-syntonic (ie. when the pt’s problematic behavior doesn’t cause personal distress)
Character neurosis (personality disorders in DSM-IV)
•When the behavior is ego-alien
•Acting-out usually is defined as the behavioral substitute for a conflict
•Instead of thinking about the problem, the pt engages in doing or behaving in order to
escape from anxiety
•The presence, characteristics, and qualities of acting-out
•An acting-out type of person?
•Does acting-out only serve to reduce anxiety? With additional ways?
•Is the anxiety reduced completely?
•Ex. Obsession & compulsion
•The hallmark of acting-out
- phobic symptoms
- depression, etc.
•Interfering with the ability to learn and master intellectual and cognitive skills
•Ego-dystonic anxiety disorders (excepting PTSD)
•The largely ego-syntonic acceptance of destructive or socially inappropriate behavior
•Acting-out accompanies characteristics
- underdevelopment of superego
- passive-aggressive patterns
Is the anxiety somatized?
- parts of body
- internal organs
- physiological functioning
•Somatization vs. hypochondriasis
•Somatizers cannot easily tolerate frustrations and the direct experience of the distress
of anxiety. They bind the anxiety in bodily expression to avoid experiencing it directly.
•Acting-in frequently relates to anger, hostility, or sexuality.
•Characteristic or specific
•Psychological factors affecting medical condition (psychosomatic disorders)