B.

Schematic Diagram of Psychodynamics

PRECONCEPTION

Mother Father

Both parents planned

the pregnancy

Wanted Child

Had a regular prenatal

check-up

Took the prescribed

vitamins

Ate nutritious foods such

as vegetables and fruits

Reached the full term

pregnancy

Delivered via normal

spontaneous vaginal delivery at
their home and was attended
by a “trained hilot” on October
26
11, 1997
 During the pre-conception stage, Win-win’s parents planned to have a second baby. They
wanted a boy but was happy nevertheless of what God gave them. His father had a stable job as a
security guard and her mother was a housewife. Her mother had a regular prenatal check-up and
took all the prescribed vitamins, she was also able to eat nutritious foods because his husband
provided him with foods necessary to have a healthy pregnancy. Her mother delivered via
normal spontaneous vaginal delivery on at their house without complications and was attended
by “trained hilot”.

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 INFANCY (0 – 18 MONTHS)
TRUST VS MISTRUST

Mother is a housewife with a Father is a security guard in

center task of taking care of China Bank and is a
her children responsible and loving father

Parents met the basic

needs of Win-win

Win-win was exclusively

breastfed by her mother
for 2 days but was
introduced to mixed
feeding for 6 months

Parents provided
comfort and affection

When Win-win would cry

her mother would feed her
and sing her a lullaby

Win-win was assisted by her parents

throughout her developmental milestones
such as sitting and crawling

Parents spent time for

interaction between their 28
children
 When the father would get home
from his work he makes sure to
spend time interacting with win-win

TRUST

The trust versus mistrust stage is the first stage of psychologist Erik Erikson’s theory of
psychosocial development, which occurs between birth and approximately 18 months of age.
According to Erikson, the trust versus mistrust stage is the most important period in a person’s
life because it shapes our view of the world, as well as our personalities. It is in this initial stage
of development that children learn whether or not they can trust the world. As you might deduce,
it is the care they receive from their parents and other adults that is critical to forming this trust.
Because an infant is entirely dependent upon his or her caregivers, the quality of care that the
child receives plays an important role in the shaping of the child’s personality. During this stage,
children learn whether or not they can trust the people around them. When a baby cries, does his
caregiver attend to his needs? When he is frightened, will someone comfort him? When she is
hungry, does she receive nourishment from her caregivers?

During this stage, Win-win was provided with basic needs such as foods, love, attention,
care and affection from their parents. When patient is hungry, she is being fed. When she wets,
her mother would change her diaper and when the patient would cry, her mother would cuddle
and sing a lullaby. As she grows, patient was assisted by her mother and father with sitting,
crawling, standing and walking. It was also that time that both parents and the child bonded.
Thus developing trust.

TODDLER (1 – 3 YEARS OLD)

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 AUTONOMY VS SHAME & DOUBT

Mother was lenient Father supervised

about the toilet training
Win-win

Toilet training started

at 1 and 6 months old

Able to sit dependently

at 8 months old with
supervision of mother

Able to sit independently

at 10 months old

Able to stand when she

was one and was assisted
by her mother and walker

Able to walk at 1 and 8

months old

AUTONOMY
Autonomy versus shame and doubt is the second stage of Erik Erikson’s stages of
psychosocial development. This stage occurs between the ages of 18 months to around age 2 or 3
years. According to Erikson, children at this stage are focused on developing a greater sense of

30
self-control. Gaining a sense of personal control over the world is important at this stage of
development. Toilet training plays a major role; learning to control one’s body functions leads to
a feeling of control and a sense of independence. Successfully potty-training can help children at
this stage of development gain a greater sense of autonomy.
This was the time wherein the caring and supervision from the parents was prominent.
Her parents weren’t very particular with toilet training and she wasn’t reprimanded whenever she
wets her underwear. The patient learned to go to the bathroom at two years and 6 months old.
She was able to achieve the developmental milestone with the guidance of her parents. Her
mother guided her until she was able to do things on her own. When his father is at home he
would spend time assisting Win-win with her activities. For this reason, the patient was able to
develop autonomy.

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 PRESCHOOL (3 – 5 YEARS OLD)

INITIATIVE VS GUILT

Mother provided Father sent Win-

care for win-win Win to preschool

Parents guided and

supported her

She was provided with

appropriate toys

She was allowed to play

with children outside

Able to go home
during meal time

Developed courage
and independence

INITIATIVE

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 Initiative versus guilt is the third stage of Erik Erikson’s theory of psychosocial
development. This stage occurs during the preschool years, between the ages of 3 and 5. During
the initiative versus guilt stage, children begin to assert their power and control over the world
through directing play and other social interaction. Children need to begin asserting control and
power over the environment by taking initiative by planning activities, accomplishing tasks and
facing challenges. During this stage, it is important for caregivers to encourage exploration and
to help children make appropriate choices. Caregivers who are discouraging or dismissive may
cause children to feel ashamed of themselves and to become overly dependent upon the help of
others.

During this stage, Win-win entered preschool. Her mother prepares her food and her
father takes her to school and fetch her after. It was this times that the patient started to play
outside and developed independence and have initiative in playing games for her to win the
game. Her mother didn’t need to look for her because she would come home when its meal time.
The patient developed initiative.

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 SCHOOL AGE (6 – 12 YEARS OLD)

INDUSTRY VS INFERIORITY

Mother prepared patient’s Father worked and monitored

meals and things for school win-win with her studies

Win-win was able to

go to school

She participated in
school

Active child; joined

quiz bees and singing
contest

Excellent student

She does her

homework before
playing

One of the top

performing students in
their school

Trusted by her
teachers 34
 INDUSTRY

Industry versus inferiority is the fourth stage of Erik Erikson's theory of psychosocial
development. The stage occurs during childhood between the ages of five and twelve. Children
are at the stage where they will be learning to read and write, to do sums, to do things on their
own. Teachers begin to take an important role in the child’s life as they teach the child specific
skills. It is at this stage that the child’s peer group will gain greater significance and will become
a major source of the child’s self-esteem. The child now feels the need to win approval by
demonstrating specific competencies that are valued by society and begin to develop a sense of
pride in their accomplishments. If children are encouraged and reinforced for their initiative, they
begin to feel industrious and feel confident in their ability to achieve goals. If this initiative is not
encouraged, if it is restricted by parents or teacher, then the child begins to feel inferior, doubting
his own abilities and therefore may not reach his or her potential.

During this stage, Win-win was fully supported by her father in her studies. Her mother
mostly stays at home but she prepares win-win’s necessities for school. Win-win’s excellence
was discovered at this time. She performed well at school and participates in school activities
and extracurricular activities. Her teacher trusted her because she is a responsible child. The
patient developed industry.

ADOLESCENTS (13 – 20 YEARS OLD)

35
IDENTITY VS ROLE CONFUSION

Mother wasn’t very involved in

Father is very supportive and is
win-win’s educational and
involved in her daughter’s life
social life

Win-win stays at home

most of the time
(introvert)

Has few friends

Patient is very studious

Did not verbalize

about being in a
relationship

Didn’t have vices such

as drinking and
smoking

Win-win’s father got

fired from his job

Experience financial
problems
36
Win-win’s parents started to
fight frequently

Started to manifest
changes in behavior

Brought to SPMC-
IPBM for treatment

Win-win was treated

and was able to attend
college

Win-win wasn’t
compliant with her
medications

Started to manifest
behavioral changes
again

Patient wasn’t allowed

by her mother to go
outside their house
37
 Patient was brought to
SPMC-IPBM again for
treatment

ROLE CONFUSION

The fifth stage is identity vs. role confusion, and it occurs during adolescence, from about 12-18
years. During this stage, adolescents search for a sense of self and personal identity, through an
intense exploration of personal values, beliefs, and goals. During adolescence, the transition from
childhood to adulthood is most important. Children are becoming more independent, and begin
to look at the future in terms of career, relationships, families, housing, etc. The individual wants
to belong to a society and fit in. This is a major stage of development where the child has to learn
the roles he will occupy as an adult. It is during this stage that the adolescent will re-examine his
identity and try to find out exactly who he or she is. Erikson suggests that two identities are
involved: the sexual and the occupational.

As Win-win grows, her parents especially her father gave her love, care and support. She
is an introverted kind of person. She stays at home most of the time and didn’t go out with her
friends. The patient didn’t have vices and was not involved in a romantic relationship with
someone of the opposite sex. At the age of 16 the patient manifested behavioral changes which
opted his father to take her to SPMC-IPBM to get her checked and be treated. Patient wasn’t able
to manifest the symptoms for a while but since she wasn’t able teat her meals and take her
medications on time, her symptoms started to appear again. For this reason the patient was able
to develop Role Confusion.

38