Coping Mechanisms and Ego Defense

8/2/2019 Coping Mechanisms and Ego Defense

1/25

Coping mechanisms and egodefense

Jeffrey Clothier, M.D.


2/25

Objectives

Student will be able to describe thedefense mechanisms

Student will be able to identify defensemechanisms from short vignettes


3/25

Study of ego defensemechanisms - psychodynamics

1) Describes the dynamic interactions ofunconscious and conscious forces in the

mental life of a person2) The dynamic interactions are often

interpreted as conflicts in unconscious

drives and forces which in turn becomeexpressed in the relationships of theindividual


4/25

Ego defenses

When the conflicts in the unconscious riseto a heightened level the the conflicts

threaten to become manifested in theconscious life of the person

This is a way to discharge the anxiety

created between the unconscious conflicts


5/25

The tripartite model of the mind

Freud Ego

ID

Superego

The id is need gratifying and impulsive,instinctual

Hedonic drives for instance Superego is roughly eq. to conscience

Determines that some needs are not consistent withan underlying view of ones self (Ego ideal)


6/25

Ego

Ego is the mediator between the unconsciousworld of the Id and Superego and the consciousworld of reality

The egos job is to mediate the struggle betweenthe superego and id

When superego and id are in conflict the person

experiences signal anxiety Ego must convert the signal anxiety to defuse it

and make it less threatening.


7/25

Ego Defenses

If the signal anxiety cannot be defused itmay overwhelm the ego and allow the

primitive primary process thinking of theunconscious to become manifested in theconscious life of the person


8/25

Developmental aspects

The Id is the earliest component of thepsychodynamic apparatus

The infant is basically in a pleasure seeking mode ofoperating (sometimes this is confused with sexuality)

The infant also conceives of the world in a narcissisticfashion. Things exist only as they relate to him or her

At times the pleasure seeking runs into barriers in theoutside world

This result in infants being confronted with reality

New skills and coping mechanisms develop


9/25

Orderly sequence of development

Normally there is an orderly sequence as thechild matures

If significant trauma occurs the child may havedifficulty learning the mechanisms that arenormally learned at these times Fixated uneven development of ego function which

results in a part of the ego retaining more primitive or

immature function Repetition compulsion replay of events related to

significant traumas


10/25

Stages

Oral

Anal

Phallic

Latency

Genital


11/25

There are characteristic defensemechanisms used in specifc stages

It is possible to describe defensemechanisms along a hierarchy of

maturation- actually done first by FreudsDaughter (Anna)

The defenses used provide some

evidence for stages where there arefixations


12/25

Defense mechanism classification

Narcissistic Immature Neurotic MatureDenial Acting out Displacement Altruism

Projection Regression Dissociation Humor

Distortion Passive-aggressivebehavior

Reactionformation

Sublimation

Splitting Schizoid fantasy Repression Anticipation

Somatization Isolation Suppression

Introjection Rationalization Asceticism

Hypochondriasis Sexualization

Blocking Intellectualization


13/25

Other immature defensemechanisms

Splitting-the tendency to see things aseither black or white

The rigidity prevents the normal flexibilitywhich is necessary in dealing with ambiguity

Borderline and narcissitic PD use this

Magical thinking- Undoing


14/25

Some characteristic defensesused in specific stages

Oral- narcissistic defenses Projection, denial, distortion

Anal- Identification, undoing, reaction formation, isolation,

regression

Phallic / oedipal

Intellectualization Latency

Symbolization, sublimation


15/25

Examples

After a difficult day on Internal medicine aMedical student returns home to his wife.

He recounts every thing he encountered inmeticulous detail without apparentemotional display.

Name that defense mechanism


16/25

#2

When his wife mentions that he seemed tonot have much emotion about all that

happened the student becomes irate andbelittles his wife.

Name that defense mechanism


17/25

#3

At work the next day the student reportshis outbursts to his colleagues and states

she deserved it after-all she should knowbetter than to bother him after a long day


18/25

#4

Maria is a song writer. She reports herbest work is done when she feels near

despair. It is as though her grief isexpressed through her music.


19/25

#5

After Christmas you notice you over spent.You decide to forget to pay one of your

credit card bills. Throughout the nextmonth you periodic remember it needs tobe paid but do not.


20/25

#6

You have just received the pathologyreport on one of your patients. It is cancer.

When you inform the patient she becomeswithdrawn and noncommunicative


21/25

#7

With time, 2 days, she begins to respondbut becomes more dependent on her

family for things she previously did even 2days before.


22/25

#8

The lady doth protest too much,

methinks


23/25

#9

Molly is in love with Bob. She describeshim as her soul mate. On Saturday night

he is sick and cancels their date. OnSunday she gets up and is extremelyangry with Bob and breaks up.


24/25

#10

Molly misses Bob after 7 days and thengoes out on Saturday night to a singles

bar. She then ends up with a one nightfling which she regrets.


25/25

Documents

Coping Mechanisms and Ego Defense