Identity
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Health Promotion Disease Prevention |
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N4225 |
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Jill Gallin, CPNP, MS, BSN |
Defining Identity
Webster’s Dictionary
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Identity:1 The condition of or fact of
being the same or exactly alike; sameness; oneness. [groups united by
identity of interest] 2 The condition or fact of being a specific person or
thing; individuality |
Identity
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Abstract concept |
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Not something we are born with (only
genetic identity) |
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Develops over time |
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Constantly evolving |
Dimensions of Self
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Genetic |
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Physiologic |
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Physical (gender, age) |
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Emotional |
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Social |
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Cultural |
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Moral |
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Spiritual |
Define yourself
Identity and Health are
Dependent on one Another
WHO
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Health is a state that is not
determined by the absence of disease but by optimal levels of physical,
mental and social wellbeing.” |
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Physical mobility, independence and
control are impossible for those with disabilities to achieve |
Faull et al. Identity
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Health and identity are dependent on
one another |
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Disability strengthens one’s sense of
“I” |
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“Rather than health being achieved despite
disability, participants believed they had achieved health because of
disability.” |
‘Normal’ Identity
Development
Actions to Sustain
Self Development
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Maintenance of relationships that
provide nurture, support |
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Participation in purposeful activity,
working, productivity, provide income and support and satisfaction |
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Adequate nutrition, exercise and rest |
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Participation in education and
recreational activities |
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Enjoyment of aesthetic and cultural
activities |
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Enhancement of spirituality |
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Experience necessary losses and grief |
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Introspection and self examination |
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Family
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“Among the various systems with which
the individual affiliates and in which the individual is nurtured, the family
is surely the most significant” |
The Family serves to:
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Educate |
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Role play |
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Set rules/norms |
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Define responsibilities |
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Provide decision making skills |
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Supports personal boundaries and
eventually separation . . . leading to self care |
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Adolescence
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The central task of adolescence is
formation of a stable identity |
“Serendipity”
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One adolescents thoughts reflecting
identity development |
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A window into an adolescents mind |
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Themes |
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Fear |
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Risks |
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Transformation of self |
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Torn between childhood and adulthood |
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Self image |
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Difficulty in asking for help and
guidance |
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Desire for autonomy |
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Relationship development |
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Dreams |
"“Serendipity”"
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“Serendipity” |
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Thoughts rushing through my mind |
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Answers I need to find |
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A reason without fault |
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To unlock this forbidden vault |
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Full of fears and pain galore |
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So helpless wanting nothing more |
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Hiding within the depths of unhappiness |
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Fully knowing the risks of this |
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But unable to break away |
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So scared that I must stay |
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Petrified to transform |
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But sick of being so forlorn |
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Torn between both worlds I live |
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But unwilling to give in |
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I walk the ropes of sanity |
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Lacking any potential vanity |
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Engulfed in terror here I stand |
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Longing for a helping hand |
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But incapable of such a request |
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Losing myself in this vast mess |
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Hanging on by one last thread |
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Dreams exploding in my head |
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Thoughts combining into one |
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This night is nearly done |
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But one last thing I do inquire |
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As the night feasts upon my desire |
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I ask that no one show me any pity |
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And that my life be left to serendipity
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-Anonymous |
Erickson’s components of
healthy identity
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Development of personal identity (sense
of uniqueness, and self esteem) |
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Sense of autonomy, independence from
parents |
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Ability to relate to same sex and
opposite sex peers |
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Commitment to a vocational choice |
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Race
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Total identity is made up of |
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Personal identity |
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Racial identity |
Abnormalities/ Pathology of
Identity Development
Defining Identity Crisis
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Identity Crisis: The condition of
being uncertain of one’s feelings about oneself, esp. with regard to
character, goals, and origins, occurring esp. in adolescence as a result of
growing up under disruptive,
fast-changing conditions. |
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Identity Crisis
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Refusal to self examine |
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Inability to form positive
relationships |
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Lack of decision making skills |
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Dependence |
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Avoiding responsibility |
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Unwillingness to make moral judgments
or the absence of morality |
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‘Onion Skin’
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“I see myself as an onion, composed of
different layers. The external layers
are for people that I don’t know that well.
The agreeable, the social [layers], and as you go inward, there are
more sides [that I show] to people I know.
I am not sure about the innermost [layer], whether there is a core.” |
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-Anonymous college student |
Challenges to Identity
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Teen parenting |
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Foster Care |
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Poor mental health |
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Gender identity disorders |
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Trauma |
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Chronic illness |
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Physical Disability |
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Acute |
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Chronic |
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Grief |
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Many other challenges |
Teen Parenting
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Lists generated by teen parents
expresses different wants, needs and expectations of ‘typical teens’ and
‘typical parents’ |
Typical Teen
Characteristics
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Independent |
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Experimentation |
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Exploration |
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Self-centered/self absorbed |
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Spontaneous |
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Unpredictable |
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Unreliable |
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Irresponsible |
Typical Parent
Characteristics
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Dependable |
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Satisfied |
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Stable |
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Selfless |
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Planned |
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Predictable |
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Reliable |
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Responsible |
Teens
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Independent |
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Experimentation |
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Exploration |
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Self-centered/self absorbed |
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Spontaneous |
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Unpredictable |
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Unreliable |
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Irresponsible |
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Foster Care
“Nobody’s Children”
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“Without the filter of good parenting,
the immediate environment and broader social milieu exert their destructive
influences unchallenged.” |
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Foster youths personal identity
achievement is adversely affected. |
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Positive racial identity is impaired,
stable and healthy total identity is extremely unlikely.” |
Yancey (1992)
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“The task of positive self-image
formation in children of color includes perception of racial differences,
identification as a member of a socially devalued group, and coexisting
acceptance of the self as a unique and worthy individual, while distancing oneself
from the inferior societal stereotype of the majority.” |
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“Parents aid children in distinguishing
between their own self image and the role imposed by society” |
PRIDE
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Personal and Racial/Ethnic Identity
Development and Enhancement |
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“To support the development of a stable
identity, ethnically marginalized youngsters in foster care must be exposed
to positive role models of the same ethnicity and of both genders.” |
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Hybrid of one on one mentoring and
career days |
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“Who am I?” Where do I fit into the
world?” |
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Teens reported feeling less isolated
and relief that adults in their situation had “made it” |
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Poor Mental Health
Eating Disorders “Who am
I?”
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Compulsive overeater “She’s not Fat,
She’s my mom” |
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Anorexia |
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Bulemia |
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Addictions
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Alcohol & Drug abuse |
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He Wo Un Poh: Recovery in Native
America |
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Alzheimer’s Disease
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Dementia is viewed as a threat to self |
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Self Maintaining Stance
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Protects self from threat |
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Normalizes situation |
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“normal wear and tear” |
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“It’s got a lot to do with age.” |
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Minimize difficulties |
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“just a jumble” |
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Maintains prior sense of self |
Self Adjusting Stance
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Engage potential threat and attempt to
integrate experience into the self |
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Confront difficulties |
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Adjust one’s sense of self accordingly |
"Is lack of awareness
a..."
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Is lack of awareness a symptom of
dementia or a response made by a threatened self? |
Other Mental Health
Conditions
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Susan White, “Mistaken Identity” |
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Oliver Sacks |
Gender Identity Disorder
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Persistent cross gender identification
(in childhood) |
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Evidence of discomfort about one’s
assigned sex |
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Significant distress or impairment in
social, occupational or other areas of functioning |
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Overwhelming desire of the patient to
acquire the anatomical sexual characteristics of the chosen gender |
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‘Red flag’ associated
disorders
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Social isolation commonly seen in
males, particularly during adolescence |
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Frequency of anxiety-depression
syndrome |
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Frequency of personality disorder |
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Engagement in personality disorder |
Ethics of gender identity
disorder?
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Physically, endocrinologically and
genetically normal individual |
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Only treatment is surgical sex
reassignment |
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Disorder is based solely on subjective
diagnosis of provider |
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http://www.jennifer-o.com/
Chronic Illness
Alice Alcott’s Identity
Crisis
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The loss of confidence in one’s health
and normal bodily processes |
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A betrayal of fundamental trust,
mourning for the bodily foundation |
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“Empowerment”
Grief & Loss
Loss as part of natural
development
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Loss of innocence |
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Loss of youth |
Unexpected Loss
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Sudden death |
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Loss of employment |
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Having to move ** |
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Expected loss
Relationship Loss
Grieving at Times of Change
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Graduation |
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New Year |
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Birthday |
"“Unacknowledged grief
can put..."
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“Unacknowledged grief can put a whole
in one’s identity ie. A person’s family may be un-whole without it’s member.” |
In Conclusion
We are born only with a
genetic identity
"As nurses and
providers of..."
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As nurses and providers of health
promotion and disease prevention we can assist people in their quest for a
positive identity, in turn enabling them to achieve a state of good health. |