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Program Studi Ilmu Keperawatan Universitas

Diponegoro

RESPON
PSIKOLOGIS
TERHADAP STRESS
Diyan Yuli Wijayanti
Psychologic Responses

 Anxiety
 Fear
 Anger
 Depression
 Defense mechanisms: compensation, denial,
displacement, identification, intellectualization,
introjection, minimization, projection,
rationalization, reaction formation, regression,
repression, sublimation, substitution, undoing.
Anxiety

 Gelisah
 Apprehension
 Dread
 Firasat
 Tidak berdaya

Can be experienced at the conscious,

subconscious, or unconscious level
Anxiety

Berbeda dengan fear :

Anxiety Fear

Sumber tidak teridentifikasi Sumber teridentifikasi

Berhubungan dengan “future” Sekarang

Tidak jelas Jelas

Result of psychological or emotional Result of a discrete physical or

conflict psychologic entity
 Level cemas
Videbeck (2008)
1. Cemas ringan
a. Respons fisik
 Ketegangan otot ringan
 Sadar akan lingkungan
 Rileks atau sedikit gelisah
 Penuh perhatian
 Rajin
 Level cemas
Videbeck (2008)
b. Respon kognitif
 Lapang persepsi luas
 Terlihat tenang, percaya diri
 Perasaan gagal sedikit
 Waspada dan memperhatikan banyak hal
 Mempertimbangkan informasi
 Tingkat pembelajaran optimal
 Level cemas
Videbeck (2008)

c. Respons emosional
 Perilaku otomatis
 Sedikit tidak sadar
 Aktivitas menyendiri
 Terstimulasi 
 Tenang
 Level cemas
Videbeck (2008)

2. Cemas sedang
a. Respon fisik :
 Ketegangan otot sedang
 Tanda-tanda vital meningkat
 Pupil dilatasi, mulai berkeringat
 Sering mondar-mandir, memukul tangan
 Suara berubah : bergetar, nada suara tinggi
 Kewaspadaan dan ketegangan menigkat-
 Sering berkemih, sakit kepala, pola tidur
berubah, nyeri punggung
 Level cemas
Videbeck (2008)

b. Respons kognitif
 Lapang persepsi menurun
 Tidak perhatian secara selektif
 Fokus terhadap stimulus meningkat
 Rentang perhatian menurun
 Penyelesaian masalah menurun
 Pembelajaran terjadi dengan
memfokuskan
 Level cemas
Videbeck (2008)

c. Respons emosional
 Tidak nyaman
 Mudah tersinggung
 Kepercayaan diri goyah
 Tidak sabar
 Gembira
 Level cemas
Videbeck (2008)
3. Cemas berat
a. Respons fisik
 Ketegangan otot berat
 Hiperventilasi
 Kontak mata buruk
 Pengeluaran keringat meningkat
 Bicara cepat, nada suara tinggi
 Tindakan tanpa tujuan dan serampangan
 Rahang menegang, mengertakan gigi
 Mondar-mandir, berteriak
 Meremas tangan, gemetar
 Level cemas
Videbeck (2008)

b. Respons kognitif
 Lapang persepsi terbatas
 Proses berpikir terpecah-pecah
 Sulit berpikir
 Penyelesaian masalah buruk
 Tidak mampu mempertimbangkan informasi
 Hanya memerhatikan ancaman
 Preokupasi dengan pikiran sendiri
 Egosentris
 Level cemas
Videbeck (2008)

c. Respons emosional
 Sangat cemas
 Agitasi
 Takut
 Bingung
 Merasa tidak adekuat
 Menarik diri
 Penyangkalan
 Ingin bebas
 Level cemas
Videbeck (2008)
4. Panik
a. Respons fisik
 Flight, fight, atau freeze
 Ketegangan otot sangat berat
 Agitasi motorik kasar
 Pupil dilatasi
 Tanda-tanda vital meningkat kemudian menurun
 Tidak dapat tidur
 Hormon stress dan neurotransmiter berkurang
 Wajah menyeringai, mulut ternganga
 Level cemas
Videbeck (2008)

b. Respons kognitif
 Persepsi sangat sempit
 Pikiran tidak logis, terganggu
 Kepribadian kacau
 Tidak dapat menyelesaikan masalah
 Fokus pada pikiran sendiri
 Tidak rasional
 Sulit memahami stimulus eksternal
 Halusinasi, waham, ilusi mungkin terjadi
 Level cemas
Videbeck (2008)

c. Respon emosional
 Merasa terbebani
 Merasa tidak mampu, tidak berdaya
 Lepas kendali
 Mengamuk, putus asa
 Marah, sangat takut
 Mengharapkan hasil yang buruk
 Kaget, takut
 Lelah
Fear

 Respon terhadap sesuatu yang sudah ada atau

jelas.
Contoh :
 The beginning nursing student may be fearful in
anticipation of the first experience in a client
setting. The student may fear that the client will
not want to be cared for by the student or that the
student might harm the client
Anger

 Subjective feeling of animosity

 Can be expressed in a non alienating verbal
manner – positive emotion and sign of
emotional maturity
 Do the verbal communication than –
constructive
Depression
 Negative
 Extreme feeling of sadness, despair, dejection, lack of
worth, emptiness
 Tanda dan gejala berbeda antara individu satu dengan yang
lain
 Emotional symptom: tiredness, sadness, emptiness,
numbness
 Behavior sign: irritability, inability to concentrate, difficulty
making decision, loss of sexual desire, crying, sleep
disturbance, social withdrawal
 Physical sign: loss of appetite, weight loss, constipation,
headache, dizziness
Defense mechanisms

 Unconscious
 Psychologic adaptive mechanisms/ mental
mechanisms to defend, establish compromises
among conflicting impulses, allay inner
tension
 Protect person from anxiety – precursors to
conscious cognitive coping mechanisms –
solve problem
Defense mechanisms

Defense mechanism Examples Use/purpose

Compensation:
Covering up weaknesses by A high school student too Allow a person to
emphasizing a more small to play football overcome weakness and
desirable trait or by becomes the star long- achieve sucess
overachievement in amore distance runner for the
comfortable area track team

Denial:
An attempt to screen or A woman, though told her Temporarily isolated a
ignore unacceptable father has metastatic person from the full impact
realities by refusing to cancer, continues to plan a of a traumatic situation
acknowledge them family reunion 18 months
in advance
Defense mechanisms
Defense mechanism
Displacement:
The transferring or
discharging of emotional
reaction from one object or
person to another object or
person
Examples Use/purpose
A husband and wife are Allows for feelings to be
fighting, and the husband expresses through or to less
becomes so angry he hits a dangerous objects or
door instead of his wife people

Identification:
An attempt to manage A new graduate suddenly Helps a person avoid self-
anxiety by imitating the left in charge emulates her devaluation
behavior of someone feared faculty role model
or respected
Defense mechanisms

Defense mechanism Examples Use/purpose

Intellectualization:
A mechanism by which an emotional The pain over a Protect a person
response that normally would parent’s sudden death from pain and
accompany an uncomfortable or is reduced by saying, traumatic events
painful incident is evaded by the use of “he wouldn’t have
rational explanation that remove from wanted to live with a
the incident any personal significance disability”
and feeling
Defense mechanisms
Defense mechanism Examples Use/purpose
Minimization:
Not acknowledging the A person says, “Don’t Allows a person to
significance of one’s believe everything my wife decrease responsibility for
behavior tells you. I wasn’t so drunk own behavior.
I couldn’t drive”.
Projection:
A process in which blame A mother is told her child Allows a person o deny the
attached to others or the must repeat a grade in existence of shortcomings
environment for school, and she blames this and mistakes; protect self
unacceptable desires, on the teacher’s poor image
thoughts, shortcomings, instruction. A husband
and mistakes forgets to pay a bill and
blames his wife for not
giving it to him earlier
Defense mechanisms
Defense mechanism
Rationalization:
Justification of certain
behavior by faulty logic and
ascribing motives that are
socially acceptable but did not
in fact inspire the behavior
Introjection:
A form of identification that
allows for the acceptance of
others’ norms and value into
oneself, even when contrary to
one’s previous assumptions
Examples
A mother spanks her
toddler too hard and says it
was all right because he
couldn’t feel it through the
diapers anyway
A 7-year-old tells his little
sister, “Don’t talk to
strangers”. He has
introjected this value from
the instructions of parents
and teacher
Use/purpose
Helps a person cope
with the inability to
meet goals or certain
standards.
Help a person avoid
social retaliation and
punishment; particulary
important for the child’s
development of
superego
Defense mechanisms
Defense mechanism Examples Use/purpose
Reaction formation:
A mechanism that causes An executive resent his bosses for Aids in reinforcing
people to act exactly calling in a consulting firm to repression by allowing
opposite to the way they make recommendation for change feelings to be acted out
feel in his department but verbalizes in a more acceptable
complete support of the idea and way.
is exceedingly polite and
cooperative
Regression:
Resorting to an earlier, An adult throws a temper tantrum Allows a person to
more comfortable level of when he does not get his own return to appoint in
functioning that is way. A critically ill client allows development when
characteristically less the nurse to bathe and feed him nurturing and
demanding and dependency were
responsible needed and accepted
with comfort
Defense mechanisms
Defense mechanism
Sublimation:
Displacement of energy
associated with more primitive
sexual or aggressive drives into
socially acceptable activities
Substitution:
The replacement of a highly
valued, unacceptable, or
unavailable object by a less
valuable, acceptable, or
available object.
Examples Use/purpose
A person with excessive Protect a person from
sexual drives invests behaving in irrational,
psychic energy into a well- impulsive ways
defined religious value
system
A woman wants to marry a Helps a person achieve
man exactly like her dead goals and minimize
father and settles for frustration and
someone who looks a little disappointment
bit like him
Defense mechanisms
Defense mechanism
Undoing:
An action or words designed to
cancel some disapproved
thoughts, impulses, or act in
which the person relieves guilt by
making reparation
Repression:
An unconscious mechanism by
which threatening thoughts,
feelings, and desires are kept from
becoming conscious; the present
material is denied entry into
consiousness
Examples
A father spanks his child
and the next evening
brings home a present for
him.
A teenager, seeing his
best friend killed in a car
accident, becomes
amnesic about the
circumstances
surrounding the accident
Use/purpose
Allow a person to
appease guilty feelings
and atone for mistakes
Protect a person from
a traumatic experience
until he or she has the
resources to cope.
Common coping mechanisms grouped by
developmental appropriateness

Age Coping mechanisms

0-5
Delusional projection
Denial
Distortion
3-15
Projection
Fantasy
Somatization
Acting out
Passive-aggressive behavior
Common coping mechanisms grouped by
developmental appropriateness

Age Coping mechanisms

3-adulthhood Intellectualization
Repression
Displacement
Reaction formation
Dissociation

12-adulthhood Altruism
Humor
Suppression
Anticipation
Sublimation