Psychoanalytical Viewpoint Psychosocial Theory Notes

Psychoanalytical Viewpoint Psychosocial Theory Introduction

The psychosocial theory was advocated by Erik Erikson in 1963. Erikson was born in Denmark, brought up in Germany, and travelled across Europe during adolescence. He also interacted with many social groups in the United States. Due to his wide sociocultural interaction, he could quote similarities between varied social groups.

The sociocultural interaction may be with microsystems such as a family or macrosystems such as society. This helped him to emphasise on social and cultural aspects of personality development and advocate the psychosocial theory.

Read And Learn More: Paediatric Dentistry Notes

The theory proposes that child (human) behavior evolves on the basis of the child’s (individual) interaction with the sociocultural environment. The roots of the sociocultural influence of the child can be reasoned out to manage the behaviour of the child in the dental operatory.

As Erikson’s theory accepts several ideas of Freudian theory including the concept of Id–Ego–Superego, it is described as a neo-Freudian theory, and Erikson himself is called an Ego psychologist.

But Erikson had different ideas in some aspects. Freud believed that children are passive slaves to their biological urges whereas Erikson described them as active and adaptive explorers who seek to gain control of their environment on the basis of the sociocultural influence.

Core Of Psychosocial Theory

Biological maturation is a process where the child inadvertently becomes older with time. The personality of a child eventually evolves in different stages. Each stage represents a social crisis. The child has to win social acceptance or social recognition corresponding to the age.

This needs an increase in efforts with each passing stage of biological maturation. The social crisis arises when the child is expected to win the social recognition corresponding to the age on one side while the strategic effort required to do so is presented on the other side.

Since the want for social recognition is the root of the crisis, it is described as a social crisis. The child has to successfully resolve each crisis and win over it to meet the social crises at the next stage.

When the crisis is resolved, it is termed a positive outcome. When the child (individual) succumbs to the crisis, it is termed a negative outcome. The social entity that helps the child to resolve the crisis is termed the key social agent. The child’s behavior and personality evolve as one crisis is resolved after the other.

Stages In Psychosocial Theory

Erikson enumerated eight different social crises, which occur during the lifetime of an individual, on the basis of his observation of multiple, varied sociocultural environments he encountered. These social crises are called psychosocial stages and have the following features:

• Are universal, i.e. present in the same order and pattern and specific age group in all individuals
• Have a key social agent, which influences the outcome
• Have a positive outcome
• Have a negative outcome

1. Stage 1 Trust Versus Mistrust
   • Age group: 0–1 year
   • Stage 1 corresponds to the oral stage of Freud.
   • Crisis: Initially, the child requires a caregiver to respond and attend to the basic needs.
   • Outcome: If the child gets an ideal caregiver who can attend to the basic needs, the child develops trust in the environment and people. An ideal caregiver feeds when the child is hungry, changes diapers when wet, attends to crying instantaneously, appears when beckoned, smiles when smiled at and displays warmth and affection. Conversely, if the caregiver is rejective and inconsistent, the child views the world as a dangerous place filled with unreliable people and develops mistrust.
   • Key social agent: Mother or primary caretaker
2. Stage 2 Autonomy Versus Shame/Doubt
   • Age group: 1–3 years
   • Stage 2 corresponds to the anal stage of Freud.
   • Crisis: The child attempts to take care of his/her own needs.
   • Outcome: Th child who has developed ‘trust’ in others (positive outcome with Stage 1) feels sufficiently confident to communicate his wishes to his parents. Hem tries to feed and dress up himself, looks after his personal hygiene and so on. Thus, the child gains autonomy. The child with mistrust in the environment (negative outcome with Stage 1) lacks the self-confidence to express his desires to his parents. He fails to become autonomous and experiences shame and doubt.
   • Key social agent: Parents
3. Stage 3: Initiative Versus Guilt
   • Age group: 3–6 years
   • Stage 3 corresponds with the phallic stage of Freud.
   • Crisis: Children tend to accept responsibilities beyond their capacity.
   • Outcome: Autonomous (positive outcome with Stage 2) children undertake more goals and activities. However, these can conflict with the interests of the family members. If the family members guide the child to retain and exercise the initiative without disturbing the interests of other family members, it will lead to a positive outcome. If they contradict all the initiatives sternly, the child develops guilt (negative outcome).
   • Key social agent: Family
4. Stage 4: Industry Versus Inferiority
   • Age group: 6–12 years
   • Stage 4 corresponds to the latency stage of Freud.
   • Crisis: At this age, children have to master social and academic skills. They tend to compare themselves with their peers.
   • Outcome: Th children become industrious and self-assured if teachers and peers guide and influence them to acquire social and academic skills (positive outcome). If they do not acquire these skills, they feel inferior with no self-assurance (negative outcome).
   • Key social agents: Teachers and peers
5. Stage 5: Identity Versus Role Confusion
   • Age group: 12–18 years
   • Stage 5 is comparable to the genital stage of Freud.
   • Crisis: At this stage, adolescents are at a crossroads between childhood and adulthood. They strive to establish their basic social and occupational identities.
   • Outcome: If society guides them, they acquire an identity. Otherwise, they remain confused about their role as an adult in society (role confusion).
   • Key social agents: Peers, teachers, guides, and media
6. Stage 6: Intimacy Versus Isolation
   • Age group: 18–25 years
   • Stage 6 corresponds to the genital stage of Freud.
   • Crisis: Th adolescent at this stage strives to form strong personal relationships.
   • Outcome: If the adult is able to establish a relationship with a lover, spouse, or friends (both sexes) he gains intimacy or a sense of love and companionship. He feels important with self-esteem (positive outcome). If he is unable to form any intimate relationships, he acquires a feeling of loneliness or isolation (negative outcome).
   • Key social agents: Lover, spouse, and close friends
7. Stage 7: Generativity Versus Stagnation
   • Age group: 25–40 years
   • Stage 7 corresponds to the genital stage of Freud
   • Crisis: Th adult faces the task of becoming productive at work, raising his/her family, building a fortune, and looking after the next generation.
   • Outcome: Th cultural norms strictly followed by the adult and his/her intricate interaction with spouse and children can help in productivity at work and raising an integrated family. Such an adult is entitled as a generative adult. If the adult is unable to assume responsibility and exhibit productivity, he becomes stagnant and self-centered.
   • Key social agents: Spouse, children, and cultural norms
8. Stage 8: Ego Integrity Versus Despair
   • Age group: 40–65 years
   • Crisis: In this stage, the adult will look back at life.
   • Outcome: If the individual views his life as meaningful, productive, and happy and he is satisfied with his achievements, he is said to have attained ego integrity. He must have lived a life completely fulfilling his ambitions and expectations. On the other hand, if the adult sees life as one filled with disappointment, unfulfilled promises, and unrealized goals, he/she is in despair.
   • Key social agents: Past life experiences Erikson’s stages 5-8 correspond to the Freudian genital stage as Freudian theory classifies all individuals above the age of 12 years to be in the genital stage.Children with a negative outcome ataparticularstage are more susceptible to the negative outcome of the next stage too. For instance, a child experiencing ‘shame and doubt’ (Stage 2) is more prone to develop a guilt of not being competent. He is not confident to take up initiative to complete tasks (negative outcome of Stage 3).However, it does not imply that a turnaround in his character will not occur. It occurs in the presence of a strong, influential, supportive, and highly encouraging key social agent at a particular stage. The higher the stage where a turnaround in the character is attempted, the stronger the social agent should be.

The conclusion Table gives an overview of the stages of psychosocial theory. Erikson proposed that the successful resolution of each crisis prepares the individual for the next psychosocial conflict. In contrast, a person who fails to resolve one or more of life’s social conflicts has more chance of encountering failures in the future. Child behavior in the dental office can be described on the basis of psychosocial theory.

• Application of Erikson’s Theory in a Dental Operatory.

A 3-year-old child requires comprehensive dental care. The mother of the child admits that she could not spend much time with the child for the first two years due to her career development plans.

The child, most probably, has not been attended to well by the primary caretaker. No other individual is a perfect substitute for the mother. So it is the prospect that the child would have developed mistrust with society (Erikson’s Stage 1).

It is expected that the child does not gain the trust with the dentist. Development of trust is the first step to establishing communication or orientation with the child. It is only on establishing communication that psychological behavior management can be carried out.

The child will lack the cooperative ability to be handled psychologically in the dental operatory. Pharmacological modes of behavior management are required for providing necessary dental care to the child.

Theory Of Hierarchy Of Needs

Abraham Maslow (1954) established that the fulfillment or non-fulfillment of the needs of an individual influences his behavior and determines his personality. This theory is called the hierarchy of needs. It is also a psychodynamic theory as it emphasizes on one’s social requirements. Hence, it has been discussed along
with Erikson’s psychosocial theory. The features of this theory are as follows:

These needs are in a hierarchical architecture. This implies that the social need at every stage has to be necessarily attained or satisfied for the next level of social needs to be sought. There can be no ‘bypass’ of levels.

There are five levels of needs that can be represented by a pyramid.

The basic levels of needs are more primitive, and broader and form the base of the pyramid. They concentrate more on the sustenance of life.

The higher levels of needs are more mature, and specific and form the apex. They indicate the quality of life.

Only when the lower levels of needs are satisfied will the individual pursue satisfying the next higher level of needs. The pyramid of needs is depicted

1. Level 1 – Physiological needs: Th basic needs such as food, air, water, sleep, and so on are the physiological needs. They are required for the sustenance of life and have to be satisfied always.
2. Level 2 – Security: On attainment of basic needs, the individual seeks to gain physical, psychological, and socioeconomic security. He would look for shelter, avoidance of pain, employment, self-protection, and similar aspects.
3. Level 3 – Social needs: When the individual feels secure, his priority is to love and be loved. It is his social need to give and receive affection and gain acceptance from family, peers, and neighbors.
4. Level 4 – Esteem: On expressing love and being loved, the individual would strive to gain competence at work, become successful in their career and become self-reliant. The individual wants to create an identity and reputation in society. This is done by propagating self-esteem and a conscious effort to hold it high.
5. Level 5 – Self-actualisation: On gaining positive self-esteem, the individual frames a long-term vision or an objective or purpose of life. He focuses his time/energy on his mission and executes all possible strategies to achieve the same.

Conclusion Ths, an individual whose requirements are fulfilled at each level would reach the stage of self-actualization to achieve the ambition and become a positive, productive personality.

However, an individual whose needs are not met at one level stagnates in life and progresses no further. For instance, if the physiological needs and security are met (Stages 1 and 2), the person goes to the next level. If the social needs (Stage 3) are not satisfied by his spouse and family, the person will not progress to attain positive self-esteem and self-actualization (Stages 4 and 5) of his goals.

Summary

The psychosocial theory and the theory on the hierarchy of needs are psychodynamic theories that lay emphasis on sociocultural influences.