Self Awareness and Therapeutic Use of the Self in Nursing

Therapeutic Use of Self Awareness

Self-awareness and therapeutic use of the self in nursing is a part of psychiatric nursing and how to offer self for therapeutic purposes. 

 Self-awareness 

    Before he can begin to understand clients, the caregiver must first get to know himself. Self-awareness is the process of developing an understanding of one's own values, beliefs, thoughts, feelings, attitudes, motivations, biases, strengths, and limitations and how these qualities affect others. It allows the caregiver to observe, pay attention and understand the subtle reactions of the clients when they interact with them. and reactions

    Values ​​are abstract standards that give a person a sense of right and wrong and establish a code of conduct for television. Examples of values ​​are hard work, honesty, sincerity, cleanliness and order. The values ​​clarification process is useful for gaining insight into oneself and one's personal values.

    The value clarification process consists of three steps: selection, pricing, and action. Choosing is when the person considers a range of possibilities and freely chooses the value that seems correct. Bestowing is when the person looks at the value, appreciates it and attributes it publicly. Action is when the person puts value into action. For example, a clean and tidy student was assigned to live with another student who left clothes and food all over her room. The initially ordered student is not sure why she is reluctant to return to the room and feels tense in the presence of her roommate. Examining the situation, she realizes that they view the use of personal space differently (selection). Later, she discusses her conflict and decisions with her advisor and friends (award ceremony). Finally, she decides to negotiate an engagement with her roommate (acting).

    Beliefs are ideas that you believe to be true, such as "All old people are hard of hearing," "When the sun shines, it will be a good day," or "Pea plants should be planted on St. Patrick's Day." Some beliefs have objective evidence to support them. For example, people who believe in evolution have accepted the evidence supporting this explanation of the origin of life. Other beliefs are irrational and may persist even though those beliefs do not support evidence or are empirically contradictory. evidence exists For example, many people have irrational beliefs about cultures other than their own, which they have developed simply from the comments of others or fear of the unknown, not from any evidence to support such beliefs.

    Attitudes are general feelings or a frame of reference around which a person organizes his or her knowledge of the world. Attitudes such as hopeful, optimistic, pessimistic, positive and negative shape our view of the world and of people. A positive mental attitude occurs when a person chooses to put a positive spin on an experience, comment, or judgment. For example, in a crowded line, the person in front pays the change and slowly counts it out. The positive person in line would appreciate the extra minutes and use them for breathing and relaxation exercises. A negative attitude also affects the way you see the world and other people. For example, a person who has had an unpleasant experience with a rude waiter may develop a negative attitude toward all servers. Such a negative attitude can lead the person to behave rudely and unpleasantly with every waiter they meet.

    The caregiver must periodically reassess and adjust her beliefs and attitudes as she gains experience and wisdom. Constant self-knowledge allows the caregiver to accept the values, attitudes and beliefs of others, which may differ from their own. A person who fails to assess personal attitudes and beliefs may have a prejudice or bias against a group of people because of preconceived notions or stereotypical images of that group. It is not uncommon for a person to be ethnocentric (believing their own culture is superior to others') about their own culture, especially if the person has no experience of a culture other than their own. 

Therapeutic use of  self

    By developing self-awareness and beginning to understand their attitudes, the caregiver can begin to use aspects of their personality, experiences, values, feelings, intelligence, needs, coping skills, and perceptions to build relationships with clients. This is called the therapeutic use of self. Nurses use themselves as a therapeutic tool to build therapeutic relationships with clients and to help clients grow, change, and heal. Describing this therapeutic use of the self in the nurse-client relationship, Peplau (1952) believed that nurses must understand themselves clearly in order to foster their clients' growth and not limit clients' choices to those they support to appreciate.

    The personal actions of the caregiver arise from conscious and unconscious responses shaped by life experiences and educational, spiritual and cultural values. Caregivers (and all people) tend to use many automatic responses or behaviors simply because they are familiar with them. You need to examine these accepted responses or behaviors and assess how they support or hinder the therapeutic relationship. A useful tool for learning more about yourself is the Johari Window (Luft, 1970), which creates a "word portrait" of a person in four areas, showing how well that person knows themselves. The four areas assessed are as follows:

Quadrant 1: Overt/public qualities of self that one knows about oneself and that others also know.

Quadrant 2: Blind/unconscious qualities of self known only to others.

Quadrant 3: Hidden/private personal qualities known only to oneself.

Quadrant 4: Unknown: An empty quadrant symbolizing qualities not yet discovered by oneself or others.

    In creating a Johari Window, the first step for the caregiver is to assess their own qualities by making a list of them: Values, Attitudes, Feelings, Strengths, Behaviors, Achievements, Needs, Desires, and Thoughts. The second step is to find out the perceptions of others by interviewing them and asking them to identify the positive and negative qualities they see in the caregiver. To learn from this exercise, the opinions expressed must be honest; No sanctions should be imposed on those who list negative qualities. The third step is to compare lists and assign properties to the appropriate quadrant.

    If quadrant 1 is the longest list, this indicates that the caregiver is open to others; a smaller Quadrant 1 means that the caregiver shares little about herself with others. If quadrants 1 and 3 are small, the person shows little insight. Any change in one quadrant is reflected by changes in other quadrants. The goal is to work on moving qualities from quadrants 2, 3, and 4 to quadrant 1 (qualities known to self and others). 

knowledge pattern

    Nursing theorist Hildegard Peplau (1952) identified prejudice, or the way one person expects another to behave or speak, as a barrier to authentic relationship formation. Prejudice often prevents people from getting to know each other. Prejudices and different or conflicting personal beliefs and values ​​can prevent the nurse from establishing a therapeutic relationship with a client. Here is an example of prejudice disrupting a therapeutic relationship: Mr. Lopez, a client, has a preconceived stereotype that all caregivers are gay and refuses to let Samuel, a caregiver, care for him. Samuel has a preconceived stereotype that all Hispanic men use switchblades, so he is relieved that Mr. Lopez refused to work with him. Both men miss out on an opportunity to do important work together due to false preconceptions.

    Carper (1978) identified four patterns of knowledge in nursing: empirical knowledge (derived from nursing science), personal knowledge (derived from life experiences), ethical knowledge (derived from moral knowledge about nursing), and aesthetic knowledge (derived from the art of nursing). of nursing). . These patterns provide the caregiver with a clear method of observing and understanding each client's interaction. Understanding where knowledge comes from and how it influences behavior helps the nurse become more confident. Munhall (1993) added another pattern, which she called ignorance: when the nurse admits that she does not know the client or the client's subjective world, this opens the way for a truly authentic encounter. The nurse in a state of ignorance is open to seeing and listening to the client's points of view without imposing her values ​​or points of view on him. In psychiatric nursing, negative biases on the part of the nurse can negatively affect the therapeutic relationship; Therefore, it is particularly important that the nurse works to develop this openness and acceptance towards the client.