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STRESS AND STRESS AND

MECHANISMMECHANISM OF ADAPTATION OF ADAPTATION

Sylvia D. Elvira, M.DSylvia D. Elvira, M.DDepartment of PsychiatryDepartment of Psychiatry

Faculty of Medicine - University of Faculty of Medicine - University of IndonesiaIndonesia

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Shinta, female, 23 years old, 3 months ago on her way Shinta, female, 23 years old, 3 months ago on her way back from work, was shocked by the news that her back from work, was shocked by the news that her viance married another woman because the woman viance married another woman because the woman has already pregnant.has already pregnant.

Later, she vomits, staggered out, and felt as if she Later, she vomits, staggered out, and felt as if she was going to pass out. During the week after, she had was going to pass out. During the week after, she had difficulties in sleeping, experienced multiple difficulties in sleeping, experienced multiple awakening at night, and when she eats she often felt awakening at night, and when she eats she often felt nauseous. Her condition recovers gradually, but her nauseous. Her condition recovers gradually, but her sight was getting worst and now she cannot see at all. sight was getting worst and now she cannot see at all. The ophthalmologist stated that there is not any single The ophthalmologist stated that there is not any single problem in her eyes.problem in her eyes.

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Adi, male, 48 years old, a businessman once quite Adi, male, 48 years old, a businessman once quite successful, but for about ten years ago, since the successful, but for about ten years ago, since the monetary crisis in this country, suffers a huge loss monetary crisis in this country, suffers a huge loss and his company went bankrupt, and then his wife and his company went bankrupt, and then his wife started complaining, insulting, frequently asked started complaining, insulting, frequently asked for divorce, and finally left him about three years for divorce, and finally left him about three years ago. According to him, he always try to be ago. According to him, he always try to be optimistic, but he complains of pain in the chest, optimistic, but he complains of pain in the chest, as if it was press by a heavy burden and he often as if it was press by a heavy burden and he often felt short of breath. He went to see a doctor to felt short of breath. He went to see a doctor to check on his condition, and was told that his heart check on his condition, and was told that his heart was rather weak. That was really struck him and was rather weak. That was really struck him and he doesn’t feel optimistic anymore. For the last he doesn’t feel optimistic anymore. For the last months he prefers to be alone and sometimes he months he prefers to be alone and sometimes he had suicidalhad suicidal ideas.ideas.

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HOW CAN WE EXPLAIN THOSE HOW CAN WE EXPLAIN THOSE CASES?CASES?

Usually, an organ is mentioned as having Usually, an organ is mentioned as having pathologypathology if there is a if there is a deviationdeviation or or destruction. But how about destruction. But how about the mindthe mind??

Symptoms: Symptoms: anatomy = normal, but the anatomy = normal, but the function is disturbedfunction is disturbed

Abnormality – Abnormality – related to the related to the situation & situation & cultureculture

Changing in function (express in behavior, Changing in function (express in behavior, feelings and thoughts), triggered by: feelings and thoughts), triggered by: A. ORGANIC Factor A. ORGANIC Factor

B. PSYCHOLOGICAL FactorB. PSYCHOLOGICAL Factor C. A + BC. A + B

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SEVERAL ESSENTIAL FACTORSSEVERAL ESSENTIAL FACTORS (RELATIONSHIP OF THE BODILY (RELATIONSHIP OF THE BODILY

FUNCTION & DISTURBANCES IN MIND)FUNCTION & DISTURBANCES IN MIND)

Events which shocking the emotion, can triggers Events which shocking the emotion, can triggers abnormality in the function of the bodyabnormality in the function of the body or make or make an individual suffers from an illness.an individual suffers from an illness.

Emotional response usually follows by Emotional response usually follows by physiological changesphysiological changes (disgust, nauseous, (disgust, nauseous, etc.etc.))

Physical response can be prolonged Physical response can be prolonged body and mind disorder body and mind disorder

Attitude, behavior, words of a Attitude, behavior, words of a physicianphysician = = important role in alleviating & aggravating important role in alleviating & aggravating of patient’s condition.of patient’s condition.

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STRESS

STRESS ImbalanceImbalanceImbalanceImbalance Adaptation Adaptation

mechanismmechanismAdaptation Adaptation mechanismmechanism

SucceedSucceedSucceedSucceedFailedFailed

HomeostaHomeostasissis

HomeostaHomeostasissis

DisorderDisorderDisorderDisorder

Neurotransmitter Autonom

System Endocrin SystemImmune System

Neurotransmitter Autonom

System Endocrin SystemImmune System

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HOW IF AN INDIVIDUAL FACINGHOW IF AN INDIVIDUAL FACINGA PROBLEM?A PROBLEM?

Disturbances in the equilibrium Disturbances in the equilibrium stressstressuses all of ways, methods & techniques: uses all of ways, methods & techniques: * rational & irrational * rational & irrational

* Cs & UCs * Cs & UCs * realistic & fantastic * realistic & fantastic

changes (physical & psychological) changes (physical & psychological) A new adjustment A new adjustment : works & doesn’t work: works & doesn’t work

new adaptationnew adaptation new stress new stress

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What does an individual do What does an individual do when he or she faces a problem ? when he or she faces a problem ?

((a) a) Make changesMake changes or or adjustmentadjustment to the situation to the situation that he or she dealing with:that he or she dealing with:

- Has experience - Has experience knows how to handle knows how to handle

- A new situation - A new situation experiment before experiment before

finding the right wayfinding the right way

(b) (b) AvoidAvoid or make a distance to the situation or make a distance to the situation

a + b : a + b : - it might work - it might work safe & satisfied safe & satisfied

- if it doesn’t work - if it doesn’t work still b e a still b e a

sense of insecurity & dissatisfactionsense of insecurity & dissatisfaction

(c) (c) Try and learn to liveTry and learn to live withwith

insecurity & insecurity & dissatisfactiondissatisfaction

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To face & overcome the problems To face & overcome the problems of life: of life:

there are certain methods & there are certain methods & techniques that will be used:techniques that will be used:

DEFENSE MECHANISMDEFENSE MECHANISM

Broad definition: Broad definition: every every method that are used: method that are used: * * rational & irrational * rational & irrational * Cs & Ucs * Cs & Ucs * realistic & fantasticrealistic & fantastic

Narrow definition: mechanism of ego to * eliminate anxiety * shift to fantasy:

several ways, Cs & UCs

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DEFENSE MECHANISMDEFENSE MECHANISM

Individual:Individual: tries to fulfill the needs tries to fulfill the needs X problems X problems

Capability ~ limitationCapability ~ limitation The environmant (+) or (-)The environmant (+) or (-)

To achieve the goal:To achieve the goal:Avoid or minimize failureAvoid or minimize failure

Human has a great capacity,Human has a great capacity, if in reality cannot achieve satisfaction if in reality cannot achieve satisfaction

shift shift fantasyfantasy

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SEVERAL DEFENSE MECHANISMSEVERAL DEFENSE MECHANISM(WHICH ARE (WHICH ARE POTENTIALLY POTENTIALLY

PATHOGENICPATHOGENIC))

From immature or From immature or pathological to the most pathological to the most mature or healthymature or healthy

DenialDenial ProjectionProjection Reaction formationReaction formation Undoing Undoing IsolationIsolation RepressionRepression

SplittingSplitting Projective Projective

identificationidentification DenialDenial IntrojectionIntrojection BlockingBlocking

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DEFENSE MECHANISMDEFENSE MECHANISM THAT ARE THAT ARE POTENTIALLY PATHOGENICPOTENTIALLY PATHOGENIC

DENIAL:DENIAL: negating pain sensations or negating pain sensations or anticipation of an unpleasant accidentanticipation of an unpleasant accident

REPRESSIONREPRESSION: : feelings & impulse of pain that can feelings & impulse of pain that can not be accepted are pushed out of the not be accepted are pushed out of the Cs-mind.Cs-mind.

PROJECTIONPROJECTION: : failure is blamed at others or situations.failure is blamed at others or situations.

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DEFENSE MECHANISMDEFENSE MECHANISMTHAT ARE POTENTIALLY THAT ARE POTENTIALLY

PATHOGENIC PATHOGENIC (2)(2)

INTROJECTION:INTROJECTION: internalization of the object (other person) to internalization of the object (other person) to establish closeness & constant presence of it.establish closeness & constant presence of it.

REACTION FORMATION:REACTION FORMATION: forms a reactive attitude against it (believe forms a reactive attitude against it (believe that those impulses do not exist)that those impulses do not exist)

UNDOING:UNDOING: ritualistic action that has symbolic ritualistic action that has symbolic meanings to undo or negate or forget an idea or meanings to undo or negate or forget an idea or thought or impulses (the individual doesn’t thought or impulses (the individual doesn’t aware of it)aware of it)

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DEFENSE MECHANISMDEFENSE MECHANISMTHAT ARE POTENTIALLY PATHOGENIC THAT ARE POTENTIALLY PATHOGENIC (3)(3)

ISOLATION:ISOLATION: separates memory (of a traumatic exp.) separates memory (of a traumatic exp.) from the emotional experience.from the emotional experience.

BLOCKING:BLOCKING: one of the function of emotion is stopped one of the function of emotion is stopped or blockedor blocked

DISPLACEMENT:DISPLACEMENT: purposeful, UCs shifting from one object purposeful, UCs shifting from one object to another to solve a conflict.to another to solve a conflict.

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DEFENSE MECHANISMDEFENSE MECHANISM (WHICH ARE (WHICH ARE POTENTIALLY POTENTIALLY

PATHOGENICPATHOGENIC) ) (4)(4)

RATIONALIZATION:RATIONALIZATION: a justification of attitudes, beliefs, or behavior a justification of attitudes, beliefs, or behavior that may acceptable by incorrect application that may acceptable by incorrect application of of justifying reasonsjustifying reasons..

REGRESSION:REGRESSION: retreat to the former of adaptation (in effort retreat to the former of adaptation (in effort to handle or adjust to an extremely difficult to handle or adjust to an extremely difficult situation)situation)

SOMATIZATION:SOMATIZATION: conversion of psychic derivatives into conversion of psychic derivatives into bodily bodily symptoms.symptoms.

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DEFENSE MECHANISMDEFENSE MECHANISM (WHICH ARE (WHICH ARE POTENTIALLY POTENTIALLY

PATHOGENICPATHOGENIC)) (5)(5)

SPLITTING: SPLITTING: isis an UCs process that an UCs process that actively separates actively separates contradictory feelings, self-representations, or contradictory feelings, self-representations, or object representations from one anotherobject representations from one another (good (good from bad, love from hate, etc, to preserve from bad, love from hate, etc, to preserve positively colored experiences, affects, self & positively colored experiences, affects, self & object representations, in safely isolated mental object representations, in safely isolated mental compartments, free from contamination by compartments, free from contamination by negative counterpart.negative counterpart.

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DEFENSE MECHANISMDEFENSE MECHANISM(WHICH ARE (WHICH ARE POTENTIALLY POTENTIALLY

PATHOGENICPATHOGENIC) ) (6)(6)

PROJECTIVE IDENTIFICATION:PROJECTIVE IDENTIFICATION: is an UCs three-steps process by is an UCs three-steps process by which aspects of oneself are disavowed which aspects of oneself are disavowed and attributed to someone else.and attributed to someone else.

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MATURE DEFENSE MECHANISMMATURE DEFENSE MECHANISM

SUPRESSION SUPRESSION ALTRUISM ALTRUISM SUBLIMATION SUBLIMATION HUMORHUMOR

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MATURE DEFENSE MATURE DEFENSE MECHANISMMECHANISM

SUPRESSION:SUPRESSION: the Cs banishing of unacceptable the Cs banishing of unacceptable thoughts or feelings from your mindthoughts or feelings from your mind

ALTRUISM:ALTRUISM: the subordination of your own needs and the subordination of your own needs and interests to those of othersinterests to those of others

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MATURE DEFENSE MATURE DEFENSE MECHANISMMECHANISM (2)(2)

SUBLIMATION:SUBLIMATION: an UCs process by which an UCs process by which consciously unacceptable drives or consciously unacceptable drives or wishes are channeled into socially wishes are channeled into socially acceptable alternativesacceptable alternatives

HUMOR:HUMOR: the ability to playfully poke fun the ability to playfully poke fun at yourself and the situation you are at yourself and the situation you are in – an invaluable part of mental in – an invaluable part of mental health.health.

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Thank Thank youyou