Critical Incident-Psychology essay
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This essay investigates the literature available on clinical experience in nursing practice. It gives details of a typical clinical case that practicing nurses encounter in the course of their practice. In view of this example, it is clear that medical practitioners should be gentle to their patients because this could just be the therapeutic magic. In addition, the essay attempts to connect the clinical experience to the psychological theories. According to the available literature, the psychological theories include behavioral theory, humanist theory, social psychology theory and personality theory. These theories are applied in the clinical setting to prevent patient misunderstanding, and thus promote the overall wee-being with regards to the patient’s personal development (Lilienfeld, 2002).
Recently, I came across a patient with quite unfamiliar traits. Although being old enough to answer my clinical questions necessary to get his medical history, he would simply avoid me. The 50-year old man, who had been brought to the clinic by his teenage daughter ironically, let the young lady answer my questions. According to her, he was perfectly able to talk, and he had talked quite a lot as they walked to the clinic. However, he would fall silent in the presence of a new face or people he is not used to. Undoubtedly, the old man’s “shyness” got worse as more patients got to the waiting line outside my office. Indeed, it was initially hard trying to discern what had come of the gentleman. However, from the little conversation that I had with his daughter, it became clear that he was suffering from a psychological problem. At that moment it occurred to me that symptoms of depression, and especially loss of self-esteem, might be to blame. That was certainly the old man’s illness and the reason why he would avoid direct eye contact with anyone (Halloway, 2004).
This realization called for a change of tact, as I knew that no amount of persuasion would convince the old man to frankly speak to me about his condition. And so, I took him to an isolated room and made him feel utterly comfortable before I could re-start the question session. After a bit of psychological manipulations, the 50-year old man accepted to willingly talk to me. According to him, he could not tell what had become of him. He had been well at the workplace when colleagues started streaming to his office one after the other asking why he looked so socially withdrawn and lonely. He could certainly not explain why he behaved the way he did, as nothing extraordinary had happened to his life. If anything, he had long divorced his wife, but that could not possibly be the right time to be stressed about it. With regards to the symptoms he had observed so far, constant headaches were his main worry, as they prevented him from falling asleep. In addition, he had suddenly become emotional, always quarreling with people around him, including at the office. According to him, his life was taking a dangerous turn by trying to alienate him from the people and turn a once jovial and perfectly sociable character into a lonely and depressed individual. That was what made him sad, especially considering that he had started being a burden to his little daughter, who should have been at school learning (Blatner, 1997).
However, it was the sense of guilt that completely ruined the old man. A look at his face would certainly reveal the extreme guilt that he had inside him. Besides the fact that his wife or older members of his family did not accompany him to the clinic, he had an obvious sense of worthlessness written on his face. In fact, that was the reason why he had not asked anyone else to accompany him, as he felt that it would draw unnecessary interest to his medical condition. This greatly showed how much he had lost interest in the life’s pleasures and social activities. These findings formed the most part of my diagnosis. Thus, I decided to engage him in a casual discussion to know the severity of his condition. For instance, I easily noticed how many times he talked about death and how bad he felt about his condition. In most instances, he would behave as though he had no future at all, and that it was only a matter of time before he could pass away. That was why he constantly thought about taking his life, a feeling that is quite common amongst people with depression. According to him, it was high time he started bidding bye to the people he loved, as there was no future ahead of him. In fact, he would pull out his mobile phone and call his relatives in my presence, except that he would not tell them what exactly was wrong with him. Indeed, it was a desperate medical condition that I had encountered in several years (Benjamin, 2005).
The theories of clinical psychology can be used quite effectively to interpret the psychological issues related to the narrated clinical experience. The central role of clinical psychology has been the desire to ensure professionalism and due hospitality in clinical assessments, as well as the actual practice of psychotherapy. The medical practitioners in this medical field are the major contributors to the proper diagnosis and treatment of mental illnesses. Basically, they train humanistic theories, behavioral therapy, as well as family therapy. Although not as popular as physiotherapy or chemotherapy, clinical psychology has considerably gained an international fame since World War I, when the first intelligence tests were developed. This was in response to the degree of trauma that resulted from the events of the war. For instance, most women and children had witnessed their husbands or fathers maimed in cold blood, as the opposing side sought to subdue their opponents. It was at this juncture that medical practitioners, aware of the complex medical condition of their patients, invented the idea of clinical psychology. It still remains a critical diagnostic tool, as well as a reliable therapeutic intervention to mental illnesses (Lilienfeld, 2002).
There is a perfect connection between humanist psychological theory and the clinical diagnosis in the narration. According to the available literature, this theory emphasizes a holistic understanding of human existence through progressive investigation of self-actualization and personal spiritualism. It holds the belief that people are well-intentioned, and that this only changes when people begin to view their lives differently. According to this theory, the fundamental idea, is that people have the inherent capacity to gauge their levels of personal awareness, and that they have a duty to control how they behave in any social context. Besides, it opines that individuals generally posses the power of personal freedom of choice, as well as the ability to define their destiny. However, this capacity is lost in patients with mental illnesses, as they do almost everything unconsciously. For instance, the 50-year old father in the narration above could not control his social fears and the obvious sense of guilt. In fact, he loathed the fact that he could not stand up to a crowd or maintain an eye contact with his doctor. In clinical practice, these are some of the inherent traits that physicians or clinical pharmacists should look for in their diagnosis or therapeutic intervention (Pilgram & Treacher, 1992).
The fundamental idea behind behavioral psychology is that people acquire behavior through environmental conditioning of their minds. In clinical practice, this technique is widely popular, as it helps physicians to teach their patients on how to adopt new behaviors. This was perfectly applicable, considering that the old man had a family and people that he ought to socially relate to. Thus, a feeling of social withdrawal would certainly signify deviation from his set of behaviors. For instance, having been a family man, he must have had the courage to face anyone in any situation without fear of retribution. However, this considerably changed, as he began to find it quite difficult to reveal his medical condition to his relatives. In fact, this explained why he wanted his teenage daughter to accompany him to the clinic instead of other elderly persons. Although this was not directly applicable to my patient’s situation, it has the potential of designing a possible therapeutic intervention for his case. For instance, patients with mental incapacity could be taught how to get back their social confidence by giving them the opportunity to associate with people who will accept their conditions (Routh, 1994).
In addition, the social psychology theory is also perfectly applicable to the clinical situation in question. This theory basically focuses on specific social phenomena that greatly define people’s personal behavior. For instance, a group behavior can cause a radical shift in the way people think and reason. Moreover, there could be some social influence, such as family love, that can considerably alter people’s mental capacity, and thus their personal behavior. Considering the old man’s clinical case, it was obvious that the change of behavior had nothing to do with group or family influence. This is due to the obvious fact that the social groups to which he belonged promoted a more sociable life. Thus, when he adopts the opposite, it becomes clear that something more that social influence has affected him. Besides, the fact that he feels guilty to willingly share his personal condition with his family or relatives points to a man struggling with a deviant behavior. This would support a physician’s assertion that the old man had developed a mental problem that required an immediate intervention (Silva, 2003).
The connection between the 50-year old man’s condition provides a perfect link to the personality theory of psychology. This theory attempts to explain why people behave in a particular manner. It also assesses people’s patterns of thoughts and social orientations, and attempts to relate them to their mental capacity. According to this theory, the constant mentioning of death and suicide by the patient pointed to a possibility that he could be planning to commit suicide. Thus, it gives the medical investigator an idea of what exactly is going on in the patient’s mind. Conventionally, the feeling of guilt and the obvious desire to commit suicide is very common among people with mental incapacity related to depression. This could either be major depressive illnesses or just minor ones. In fact, the most renown psychologists concede that this theory is not only perfectly applicable to a clinical setting, but it also forms the basis for psychological diagnosis and therapy. Essentially, the evaluation of the patient’s choice of words was significant in assessing his condition and providing the best therapy (Pilgram & Treacher, 1992).
In conclusion, the study and the use of psychology in clinical practice is a complex matter that requires a proper understanding of people’s normal behavior and the factors that may precipitate a change of behavior. This is only possible through the use of the humanist theory, social psychology theory, personality theory and behavioral theory among others. This should form the foundation of their application in clinical practice.