Jarvis Chapter 2

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Psychosocial Development

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Erik Erikson (1902 to 1994) focused on cultural and societal influences as determinants of behavior. Erikson was concerned with the growth of the ego, the conscious, organized, rational part of the personality. He described eight stages of ego development that encompass the life span

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trust versus mistrust

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has a broad psychosocial dimension. The crucial element in this stage is the quality of the parent-child relationship. The infant is completely helpless and depends on the parent for food, warmth, comfort, and companionship. When the parent is responsive and consistent in nurturing, the psychological conflict is resolved on the positive side and the infant learns trust. The security from this trust extends to trust in others and in the self. The infant learns that the world is a safe and reliable place and that he or she is welcome in it. If the parent is unresponsive, unnurturing, haphazard, or abusing, the infant learns mistrust. Since the infant never feels secure, he or she experiences anxiety and alienation and may protect him- or herself by withdrawing. Without a trusting foundation, this individual will flounder in attempts to resolve future crises.

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Autonomy Versus Shame and Doubt (1 to 3 Years).

The quest for autonomy characterizes the psychologic conflict of Erikson's second stage. The toddler wants to be autonomous and to govern his or her own body and experiences. The child wants to apply newly attained skills to explore the world. However, the child has not yet attained any sense of discrimination or judgment. The parent lives in the balance of letting the child explore but also firmly protecting the child from experiences that are dangerous or frustrating for the child's current ability level. This conflict is resolved favorably when the parent uses patience and appropriate guidance and has reasonable expectations of the toddler's capabilities and attention span. A parent who is overcontrolling or undercontrolling may foster a negative outcome. Then the child may feel shame and experience doubts about his or her own ability.

Erikson believed that toilet training symbolizes this stage. The toddler's muscle maturation has progressed to the “holding on” and “letting go” of things; this naturally extends to the sphincter muscles.

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Cognitive Development

During the 2nd year, the toddler is still considered to be in Piaget's sensorimotor period. The readiness for independence is demonstrated between 12 and 18 months as the child now tries out new activities and new experiments to reach a goal. To reach a desired toy in her toybox, a girl at this age may try the various routes of taking out each object one by one, overturning the box and dumping the contents out, or climbing into the box herself. Learning comes by trial and error.

Between 18 and 24 months, the child develops mental representation for external events. This is a major achievement because the toddler can think through plans to reach a goal rather than merely perform them and observe the results by trial and error.

The concept of object permanence now is fully developed. The toddler comprehends both visible and invisible displacements. That means the child can search for an object in several places, even though it was not seen as it was hidden.

Around age 2, Piaget's preoperational stage begins. This use of symbols to represent objects and experiences is discussed in the next section on preschoolers.

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nitiative Versus Guilt (4 to 5 Years).

For this stage of ego development, Erikson believed that the child's chief task is to develop a sense of initiative. With increasing locomotor and mental power, the child now has an energy surplus, resulting in determination and enterprise. The child plans and attacks a new task with gusto and wants to stay with it. Any failures are easily forgotten in the quest to test the world. When the parent encourages, reassures, and cheers the child on (while protecting him or her from harm), the child learns self-assertion, spontaneity, self-sufficiency, direction, and purpose. But if the parent ridicules, punishes, or prevents the child from following through on tasks that could be done, the child feels guilty. The guilt exists not only when the child acts inappropriately but also when he or she is thinking of goals that the child would like to accomplish.

By nurturing successes and promoting a healthy self-image, the parents help the preschooler develop self-esteem. Self-esteem is the judgment the child makes about his or her own worth as well as any feelings about the judgment (Berk, 2006). Self-esteem is most important because it becomes the way we value our own competence. Our self-esteem affects our emotional experiences, future behavior, and long-term psychological adjustment (Berk, 2006).

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Cognitive Development

Piaget's preoperational stage covers age 2 to 7 years, a longer span than the preschool years. It is characterized by symbolic function, because the child now uses symbols to represent people, objects, and events. This process is liberating. Now the child can conjure up thoughts of the father, for example, without actually seeing him or hearing his voice. The symbolic function is revealed in child's play, as in delayed imitation. That means a child can witness an event, form a mental representation of it, and imitate it later in the absence of the model. For example, a little boy watches his father dress and leave for work, then later in the day the boy wraps a tie around his neck, packs his “briefcase,” and heads for the door.

Although representational thought is a great milestone, the preschooler's thinking continues to be limited. Thinking is concrete and literal. The preschooler focuses on only one aspect of a situation at a time and ignores others, a characteristic known as centration. For example, given a pile of blocks, a preschooler will sort by color (red, blue, yellow), or by shape (square, triangle, circle), but not by both. According to Piaget, a child in the preoperational stage is egocentric. This child cannot see another's point of view and feels no need to elaborate his or her own point of view, because the child assumes everyone else sees things as he or she does (Piaget, 1968). However, recent research suggests that 4-year-olds can have an awareness of another's view (Berk, 2006).

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Psychosocial Development

Erikson highlighted the directing of energy into learning skills when he characterized middle childhood as a period focused on industry versus inferiority. In this stage, age 6 to 11 years, the child focuses much of the time at school. Now, the approval and esteem of people outside the immediate family become important. The child wins this recognition by working and producing. Play and fantasy give way to mastering the skills that the child will need later to compete in the adult world. This child values independence in tackling a new task and takes pleasure in carrying it through to completion. The young worker is eager, diligent, and absorbed. Also, the value of social relationships emerges as the child sees the benefits of working in an organized group. Children learn to divide labor and to cooperate to achieve a common goal.

Real achievement at this stage builds a feeling of confidence, competence, and industry. The child is rewarded by his or her own inner sense of satisfaction in achieving a skill and, more importantly at this age, by external rewards such as approval from teachers, parents, and peers in the form of grades, allowance, or special gifts. Problems arise when the child feels inferior. If the child believes that he or she cannot measure up to society's expectations, the child loses confidence and does not take pleasure in the work. A gnawing feeling of inferiority and incompetence grows and will continue to haunt this child.

The reality is that no one can master everything. There is bound to be something at which each child will feel inferior. Caring parents and teachers will try to balance these weaker skills with areas in which the child can excel. The problem is that, in some cultures, success in certain areas has a higher social value, particularly among peers. For example, in some Western cultures, team sports are admired more than playing chess, or success in reading may be rewarded more than in drawing. The challenge to adults is to provide the successful experiences and positive reinforcement so that each child can achieve.

At this age, peer approval is beginning to be significant. During middle childhood, it is important to belong to a peer group. The peer group is a key socializing agent. Group solidarity is enhanced by secret codes or strict rules. The child conforms to group rules because acceptance is paramount. The child begins to prefer peer group activities to activities with the parents.

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Cognitive Development

Piaget labels the stage of middle childhood, age 7 to 11 years, as the period in which the child focuses on concrete operations. At this age, the child can use symbols (mental representations) of objects and events in more logical ways. This means a child can experience mentally what she or he would have had to do physically before. For example, to describe the classic hopscotch maneuvers to you, a girl now can articulate them (“first you hop on one foot …”) rather than merely performing them.

Armed with the ability to use thinking to experience things or events, the school child can:

• Use numbers. While counting with numbers begins in preschool years, the school-age child has the combinational skill to add and subtract, multiply and divide.

• Read. By using printed symbols (words) for objects and events, the child can process a significant amount of information. Also, reading fosters independence in learning.

• Serialize. While this begins in preschool years, the school-age child can order objects by an increasing or decreasing scale, such as according to number size (smallest to largest) or weight (lightest to heaviest).

• Classify. This is the ability to sort objects by something they have in common. While young children can do this, the school-age child is able to organize a hierarchy of classes and subclasses. It shows in the school-age child's penchant for collections: rocks, shells, novelty cards, cars, and dolls. A child spends many hours sorting the collections, and the logic of the classification system gets more complex as the child grows.

• Understand conservation principles. Understanding conservation of matter is the ability to tell the difference between how things seem and how they really are. It is the ability to see that mass or quantity stays constant even though shape or position is transformed. For example, the child who can conserve sees that two equal amounts of water remain the same even if one is poured into a beaker with a different shape.

At this age, thinking is more stable and logical. The school-age child can decenter and consider all sides of a situation to form a conclusion. The school-age child is able to reason, but this reasoning capacity still is limited because he or she cannot yet deal with abstract ideas.

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Psychosocial Development

Erikson believed the main psychologic conflict of adolescence (the fifth stage in his theory) to be ego identity versus identity confusion. The adolescent is preoccupied with how he or she looks to others, and how that image fits with his or her own view of the self. If this process is successful, a sense of ego identity emerges, culminating in what Erikson terms a career choice. If unsuccessful—if the teen is unsure of his or her skills, self-worth, or sexual identity—identity confusion results. The adolescent feels cut adrift and experiences anxiety about being a social outcast.

Finding one's own identity is stressful. In the search for identity, teens often form cliques; wear fad clothing; and follow rock singers, movie stars, or charismatic heroes in an attempt to siphon identity from them. Falling in love also feeds the quest for personal identity; the teen projects his or her own ego qualities onto another person and tries to understand them as they are reflected by the loved one.

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Cognitive Development

Adolescence corresponds to Piaget's fourth stage, in which the person focuses on formal operations and the ability to develop abstract thinking, deal with hypothetical situations, and make logical conclusions from reviewing evidence. Now, thinking is no longer confined to the concrete or the real but encompasses all that is possible. Abstract thinking is liberating. The adolescent is no longer limited to the present but can ponder the lessons of the past and the possibilities of the future. The adolescent now can analyze and use scientific reasoning. One can imagine hypotheses and then set up experiments to test them. One learns to use logic and solves problems by methodically eliminating each possibility, one by one. This opens the doors to new academic achievements such as mastering advanced mathematical concepts, chemistry, physics, or logic (Fig. 2-8).

This analytic thinking extends to values. Developing personal values is a part of the search for identity. The adolescent does not accept packaged values of parents or institutions but can reason through his or her inconsistencies and recognize injustices. The adolescent is sensitive to hypocrisy and notes when an adult professes a value (such as honesty) and then acts counter to it (such as cheating on income tax).

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Psychosocial Development

Erikson's sixth stage covers the first years of early adulthood, from 20 to 24 years. He believed the major psychologic conflict to be resolved is that of intimacy versus isolation. Once self-identity is established after adolescence, it can be merged with another's in an intimate relationship. During the early 20s, the adult seeks the love, commitment, and intimacy of an intense lasting relationship. This mature relationship includes mutual trust, cooperation, sharing of feelings and goals, and complete acceptance of the other person. Although Erikson had a heterosexual union in mind, this intimacy could be satisfied through a homosexual relationship or through a bond with a cause or an institution.

Erikson believed that without a secure personal identity, a person cannot form a love relationship. The result is the negative outcome of a person who is isolated, withdrawn, and lonely. This person may fill the void with numerous transient liaisons or promiscuity, but Erikson believed that these experiences will be found to be shallow and the person will feel remote and alone.

Daniel Levinson's (1986, 1996) time frame of early adulthood is much broader than Erikson's. It encompasses 22 to 40 years. Levinson believes that an adult's life alternates between periods of structure building, in which a lifestyle is fashioned, and periods of transition, in which this lifestyle is evaluated, appraised, and modified.

The era of Early Adulthood has two structure-building periods. In the 20s (about 22 to 28 years), the novice adult establishes the “entry structure,” a first provisional lifestyle linking him or her to adult society. He or she is building a home base. During this time, the first set of important choices are made concerning a mate, friends, an occupation, values, and lifestyle. In making these choices, the person must juggle the conflicting drives of (1) exploring many possibilities and keeping options open on the one hand, and (2) securing some stability on the other hand (Levinson et al, 1986).

The Age Thirty Transition, age 28 to 33 years, is a time of self-reflection. Questions asked include “Where am I going?” and “Why am I doing these things?” This is the first major reassessment in life. A person ponders aspects that he or she wants to add, exclude, or modify in life. The person feels, “If there is anything I want to change I better start now, or it will be too late” (Levinson et al, 1986).

According to Levinson, the rest of the 30s (33 to 40 years) is characterized by settling down. A person takes the reforms or the reaffirmations established during the transitional period of the 30s and fashions a culminating life structure, one that realizes his or her youthful aspirations. During these years, the adult strives to establish a niche in society and to build a better life in all the choice points. This person is building a nest, using deliberation and seeking order and stability.

Sometimes, the reforms include having children. The addition of children brings a major readjustment to the couple's relationship. Roles are reshaped in the new family unit. For some couples, the father is more involved in child care than most fathers were in past generations. The mother's role may include a choice between full-time parenting or a return to employment outside the home. Women are fully in the work force now. Although the opportunities are wider, the risk for stress exists because choices often must be made. The tension shifts from having no choice in a former traditional role to whether or not the right decision is being made now.

However, for many women, the luxury of having options does not exist. Single parents struggle to support themselves and their children. Often they have neither the time nor the financial resources to provide the basic needs for their children or for themselves.

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Cognitive Development

During adolescence, cognitive functioning reached the new level of formal operations, or the capacity for abstract thinking. This level continues, but the young adult's thinking is different from the adolescent's. The young adult is less egocentric and operates in a more realistic and objective manner. Now the young adult is close to maximum ability to acquire and use knowledge. The potential for sophisticated problem solving and creative thinking is at a new height.

Education continues for many young adults, from formal courses in college to on-the-job training, military service, and continuing education classes. Usually, this education prepares the young adult to do some type of work. Work is an important factor in the young adult's life because it is tied closely with ego identity. A person with job satisfaction feels challenged, rewarded, and fulfilled. One who is frustrated with work feels bored and apathetic.

However, other young adults cannot find work. Those from dysfunctional families, those from low-income households, and those who have recently immigrated to the United States lack the resources to obtain the education they need. Because the United States has become an increasingly technologic society, fewer jobs are available for people with little schooling. Unemployment has profound social implications, and one of them is a lack of money for health care. A frustrating clinical paradox arises for the health care provider. That is, nurses and physicians can assess a person, diagnose health problems, and treat or make appropriate referrals, but the individual may fail to comply when he or she does not have the money.

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Psychosocial Development

Physical, personal, and social forces all interact during the era of middle adulthood. How a person reacts to the physical cues of aging affects his or her personality and self-perception. A success or disappointment in the career affects a person's self-image, stress level, and interpersonal relationships.
Erikson believed that the most important task for personality development is resolution of the conflict of generativity versus stagnation. Erikson believed that during the middle years adults have an urge to contribute to the next generation. This need can be fulfilled either by producing the next generation or by producing something to pass on to the next generation. Thus, middle-aged adults want to rear their own children or to engage in other creative, socially useful work. The motivation is to create and/or nurture those who will follow.

The middle-aged adult needs to be needed, to leave something behind, to leave his or her mark on the world. Generativity is sharing, giving, contributing to the growth of others. If this need is not fulfilled, the negative outcome is stagnation. Stagnation means experiencing boredom and a sense of emptiness in life, which leads to being inactive, self-absorbed, self-indulgent, and a chronic complainer.

Levinson (1986) describes the era of middle adulthood as beginning with a mid-life transition. Roughly between 40 and 45 years, the person starts a major reassessment: “What have I done with my life?”

The rest of the 40s, according to Levinson, involves making choices and building a new life structure. The person confronts reality; some goals simply cannot be met. This must be accepted and goals adjusted. The person takes stock and emerges with a new perception of the self and the environment. For those who have come through the mid-life transition and have found inner meaning, life will be “less tyrannized by the ambitions, passions, and illusions of youth” (Levinson et al, 1986).

For women, the mid-life transition includes the issue that the biologic boundary of childbearing is now in sight. Women feel a time pinch that forces a survey of their life. Aging and biology force women to review options that were set aside and that will be closed off in the now-foreseeable future. Even those satisfied with the number of children that they have or those without children will face this review.

Whatever the central issue, all those in mid-life transition explore the meaning of their career, their family, and their personal identity. In terms of career, a person who spent the 30s searching for power and responsibility now may crave inner meaning (Levinson, 1986). Also, the middle-aged adult is aware of the time left until retirement. This may result in a reordering of career goals or in a new career path.

Career reassessment is intertwined with personal and family reassessment. New roles emerge as the middle-aged adult deals with growing children and aging parents. This popularly is termed the “sandwich generation.” The adult often is caught in a “squeeze” between the simultaneously changing needs of adolescent children and aging parents.

Role realignment occurs in the individual's relationship with aging parents. Even if the parents are healthy and active, a role reversal occurs. The middle-aged adult gradually starts to take the parent's place as the one in charge. When one of the parents dies, the middle-aged adult is confronted with loss of the protective myth that “Death cannot happen to me or my loved ones” (Gould, 1979). The parent was a shield between the self and death. Once the parent dies, the middle-aged adult is more vulnerable and realizes the limited quantity of time left.

Another family task facing the middle-aged adult is to help the adolescent child in his or her search for identity. The parent must adjust to the adolescent's desire to be independent and less involved in the family activities and the need for increased responsibility. Some parents nurture the independence and delight in the budding individual. Others tend to be overprotective and controlling. They may feel that their adolescent is too immature. Or they do not want the adolescent to make the same mistakes that they did. The adolescent resents this attempt to relive the parent's life through his or her own. Also, some parents dread the empty nest.

Once the youngest child does leave home, the parent faces the empty nest. If the parent (often the mother) has focused only on the children, she may feel left with little to live for. Will she find something as important as the children to replace them? This dilemma is more poignant now than it was in the past when adult children stayed fairly close to home. With society's current mobility, the grown child often starts a new nuclear family at a faraway location.

The empty nest leaves parents alone as a couple again. They may face a relationship that is devoid of meaning apart from their children. They may find themselves dissatisfied, that they do not know each other, that they have drifted apart. Divorce may result and loom as a major crisis. Other couples find this a positive and liberating phase. Their marriage is happier, with shared activities, increased freedom, and more time to travel. They look back on the shared memories of parenting with a satisfied smile.

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Cognitive Development

Intelligence levels remain generally constant during middle adulthood. Intelligence is further enhanced by the knowledge that comes with life experience, self-confidence, a sense of humor, and flexibility. The middle-aged adult is interested in how new knowledge is applied, not just in learning for learning's sake. Continuing education courses meet the need to keep knowledge current in occupational and personal interest areas. Many middle-aged adults are seeking college degrees for the first time or are pursuing advanced degrees.

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he Life Review.

One important task of late adulthood is performing a life review. Older adults have finished all or most of their life's work. Their contribution to society and to their own immortality are mostly completed (Levinson et al, 1986). The life review is a cataloging of life events, a considering of one's successes and failures with the perspective of age. The objective of the task is to gain a sense of integrity in reviewing one's life as a whole (Fig. 2-13).

This period relates to Erikson's last ego stage, with its key psychological conflict of ego integrity versus despair. A successful resolution to this final conflict occurs when the adult accepts “one's one and only life cycle as something that had to be and that, by necessity, permitted of no substitutions” (Erikson, 1963). The adult feels content with his or her one life on earth, satisfied that if it were possible to do it over again, he or she would live it the same way. The older adult reviews events, experiences, and relationships and realizes that these have been mostly good. There are cherished memories. The person has had a meaningful part in human history and can meet death with equanimity.

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Psychosocial Development

Levinson (1986) suggests a relationship between physical changes of the body and personality. By 60 years, most people are aware of some body decline. Although variations exist, most aging persons have at least one serious illness or limiting condition and are aware of the increasing frequency of death in peers. These issues, coupled with society's negative connotation of aging, lead to a fear that the person has lost all vestiges of youth, even those to which he or she had a tenuous hold during middle adulthood. The person fears that the youth within is dying. The task, then, is to look for a new form of youthfulness, a new force of inner growth to sustain the last era.

The era of late adulthood directs this inner youthfulness toward new creative endeavors. The older adult has stepped off center stage both in formal employment and in the family clan. This can be traumatic because it means a loss of recognition and authority. But now the person can direct energy inward. When financially and socially secure, the older adult can pursue whatever activity is important. One has paid one's dues to society and now can pursue whatever is pleasing. The person creates a new balance with society; he or she is less interested in society's extrinsic rewards and more interested in using inner resources (Fig. 2-12).