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105 Cards in this Set
- Front
- Back
Psychology
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the science of mind, emotions and behavior.
the mental, emotional or behavioral characteristics typical of a group or an individual or a particular form of behavior |
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Why is Psychology important for the TCM practitioner?
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patient interaction or communication is the essence of clinical practice.
TCM recognizes the unity of mind and body, the individuality of each patient, and the fact that emotional roots are very often the cause of disease. So, we need to be able to include psychological factors in our assessment of the patient. We must know how to listen to the patient, educate the patient and address issues such as noncompliance, stress and substance abuse with the patient. |
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What organ is most affected by stress?
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Liver
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Neurosis
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self defeating behavior
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Psychosis
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insanity
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REBT
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Rational Emotive Behavior Therapy
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How many emotional states are there?
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3
positive negative excessive |
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How many types of beliefs are there?
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2
Rational (reality based) irrational (non-reality based) |
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What are the cognitive steps to anxiety?
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1) something bad might happen
2) It must not happen 3) It would be awful if it did happen |
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The most radical differences among people
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the ones most likely to be traceable to the environment
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Belief system
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values, attitudes, beliefs, thoughts and cognitions, conditioning, habits
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Human behavior
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a process of adaptation for survival based on external environmentally perceived factors.
Perceptions... processed through one's Belief system>> behavior |
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mood
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more consistent feeling
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affect
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current emotion
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The 7 Affects
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joy
thought anxiety sorrow fear fright anger |
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Two types of behavior
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Self-Enhancing
Self -defeating (Freud called Neurosis) |
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ABC's of emotional disturbance
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Activating event
Irrational Belief about the experience Upsetting Emotional Consequences |
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Black and White thinking
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Dichotomous
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Overgeneralization
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one event = characteristic of life in general
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Selective abstraction
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one event is focus, other ignored
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Disqualifying the positive
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doesn't count - only saying that to...
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Mind reading
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I know she thinks...
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fortune telling
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negative expectations are facts
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Catasrophizing
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exaggerates negative events
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Minimization
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positive events are real, but insignificant
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Emotional reasoning
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if I feel that way it must be true
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Labeling
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failure means I AM a failure
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Personalization
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assuming I am the cause of something
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Magical thinking
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lucky charms
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How to successfully manage a patient
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if is important to know the patient's beliefs, what he or she thinks about his/her problem (and TCM) and how the patient hopes you will help him/her.
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Personality disorder
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spirit disorder
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Psychosomatic Illness
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Hysteria
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Depression
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Neurasthenia
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Dependent personality
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I am helpless, I need help
Attachment |
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Passive-Aggressive
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Suspicious - I could be taken advantage of
Resistance |
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Avoider
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Its dangerous
avoidance |
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Histrionic
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I need to impress (exalt you then turn on you)
Overly dramatic |
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Narcissistic
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I am special
uses others |
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Paranoid
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people are possible enemies
wariness |
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obsessive/compulsive
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must not make mistakes
perfectionist |
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Anti-social (sociopath)
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people are to be taken advantage of
manipulates |
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Schizoid
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I need plenty of space
Isolation |
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Border-line
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your space is my space ( doesn't respect boundaries)
merges personalities |
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PTSD
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traumatic event that caused serious pain and suffering or involved actual or threatened death or serious injury
Person's response included intense fear, helplessness or horror Event is experience w/recollections, dreams, feeling as though is recurring, distress at "triggers", avoidance of connected stimuli, etc Symptoms of increased arousal - sleep difficulties, outbursts of anger, hypervigilance Treatment: Refer to mental health professional - dispute irrational beliefs - teach that worrying is counter-productive. |
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Anger Model
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1) A should or should not is violated
2) the violation is evaluated in light of Low Frustration Tolerance (I can't stand it) 3) The violation is "awfulized" 4) The person who did or failed to do this thing is judged as "terrible" 5) the person should be punished and I will do the punishing |
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Steps to Neurotic Behavior
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Irrational response to events, based on our belief >> negative or excessive emotions >> Self-defeating or neurotic behavior
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Obsessive Compulsive Disorder (OCD)
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an anxiety disorder w/ recurrent, unwanted, intrusive ideas, images or impulses that seem silly, weird, nasty or horrible and urges to do something that will lessen the discomfort due to those obsessions
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Attention Deficit Disorder (ADD) and with Hyperactivity (ADHD)
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Unable to sit still, pay attention - onset before age 7 and causes significant impairment
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3 cognitive causes of depression
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self-blame
self-pity other-pity |
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Schizophrenia
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severe thought disorder w/ distorted perceptions of reality, impaired reasoning, disorganized speech and behavior. Delusional beliefs, possible auditory and visual hallucinations.
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Morality
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refers to the ability or quality or character by the individual to translate moral principals into actions or deeds
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Morals
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refers to the individual's ability to make a distinction between right and wrong conduct
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Ethics
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refers to the application of moral standards of conduct and judgements of a specific group or profession
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Codes of Ethics
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most professions are expected to have an ethical code by which its members are bound. These codes are most frequently articulated by major organizations within the profession. These codes provide a basis for evaluation for professional behavior.
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Moral Derivatives of the Four Basic Principles
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veracity
confidentiality privacy fidelity prudence temperance fortitude |
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veracity
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don't lie or be deceptive
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confidentiality
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patient information
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privacy
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physical body
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fidelity
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doing what you say you will do
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prudence
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acting w/ deliberation and discretion, performing the correct procedure for the correct reason
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temperance
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self-restraint or self-control in professional conduct (not over-charging, treating excessively or responding to sexually aggressive persons)
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Fortitude
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attending to the patient even in the face of possible harm or damage to the practitioner
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Four Models of Physician-Patient Relationship
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paternalistic
informative interpretive deliberative |
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paternalistic
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physician decides what is best for the patient
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informative
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physician provides the available facts about the condition and treatment options. Assumes the patient has clear values and can choose from the options (provider and consumer)
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Interpretive
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physician provides information and also helps the patient find his/her values and what treatment option would match them (counselor)
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Deliberative
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physician provides information and also dialogues with patient concerning which treatment would be best, discussing options and values (teacher or friend). May recommend
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Informed Consent
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1) taking a history
2) doing a proper exam 3) arriving at a reasonable diagnosis 4) formatting a reasonable treatment plan 5) informing the patient above, including risks, cost and expectations (prognosis) |
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Patient has the right to
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1) receive info form Dr and discuss - copies of medical records - get 2nd opinion
2) make health care decisions - accept or refuse any treatment 3) courtesy, dignity, responsiveness 4) confidentiality 5) continuity of health care 6) adequate health care |
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Patient's Role
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1) accept and submit to treatment
2) give truthful history 3) follow directions of provider 4) keep appointments 5) pay for appointments |
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Doctor's Role
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1) provide knowledge and skill
2) be ethical 3) establish and maintain rapport with patient 4) develop risk control strategies for practice 5) comply with legal scope of practice |
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Skin tends to bleed more and there are often sores with red color that do not heal, tend to be slow-growing
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Refer
could be malignant melanomas -cancerous mole skin cancer or Aids |
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Irregular, black, changing moles
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advise patient of unusual moles they many not see on their backs or ears
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persistent cough with some blood, dyspnea, night sweats
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could be TB
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coughing up blood or vomiting bright red blood
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refer to ER
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chronic dry cough with wheezing or whistling sound breathing
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could be asthma
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Itchy, watery eyes, sneezing, running, stuffy nose, temporary loss of smell, headache, dark circles under the eyes
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could be allergies
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Blood pressure of 140/90 on several visits that doesn't respond to the treatments
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refer out
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Blood pressure of 160/100 or higher
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refer immediately for consultation
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BP 140/90 or higher during pregnancy, even if first visit
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refer for consultation
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headache, weakness, numbness, paralysis, esp one side of body
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could be stroke
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sweating, SOB, pain radiating to the arm, neck or jaw
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could be angina
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Deep chest pain with fatigue, nausea, abdominal diseases
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could be myocardial infarction
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unexplained weigh loss
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could be cancer, diabetes, etc
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excessive hunger, thirst, urination, with weight loss that persists after one or two treatments
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could be diabetes
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suicidal thoughts or wishes with depression
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refer immediately
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dark blood in stool not from obvious hemorrhoids, black stool with abdominal pain, diarrhea and weight loss, unresponsive after no more than three treatments
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could be colon cancer
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Blood in urine, burning urination, fever, back pain, unexplained edema
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could be kidney infection
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Yellow sclera, yellow urination and jaundice
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could be HAV
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chronic pelvic pain, vaginal bleeding after menopause established
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could be uterine cancer
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Vagina hemorrhage greater than or equal to one pad or tampon every 30 minutes
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refer to ER
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large lump on one side of breast with discharge from nipples
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could be breast cancer
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Vagina or penile discharge or sore, pain and itchy
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could be STD
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frequency, urgency, dysuria or bleeding urination
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could be prostate cancer
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Headache, dizziness, visual disturbances
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possible brain tumor
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tripping, slowness of movement, tremor
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possible Parkinson's disease
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acute back pain, sciatica with sudden weakness of one foot (when patient dorsiflexes big toe against practitioner's finger)
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could be spinal nerve impingement
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acute low back pain with loss of bowel or bladder function
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refer immediately to ER
could be spinal cord tumor or disc herniation |
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Chest Pain/ Angina/ Heart Attack
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call 911 or other emergency services immediately if chest pain is crushing or squeezing, increases in intensity, or occurs with any of the symptoms of a heart attack:
sweating SOB pain radiating to the arm, neck or jaw nausea and vomiting dizziness rapid and/or irregular pulse |
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Normal BP
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below 130/85
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High-normal BP
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130-139/85-89
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High BP
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over 140/90
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Type I Diabetes
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occurs when the pancreas fails to make insulin. It usually occurs in childhood or adolescence but can develop at any age. People with type I diabetes must inject insulin every day.
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Type II Diabetes
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occurs when body cells become resistant to insulin. This reduces the amount of glucose that can be used by the cells at any one time. Type 2 diabetes is more common among adults, especially those who are overweight and over age 40.
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TCM Diagnosis for Diabetes
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1) Lung heat and Yin damage
2) Stomach heat 3) Kidney Yin Xu |