DR AJU JOSEPG STUDENT 16-07-2014

DEFENCE MECHANISMS

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Psychoanalytic Theory

Sigmund Freud constructed a model of personality with 3 interlocking parts:the ‘id’,the ‘ego’ & the ‘super ego’.

Id,the most primitive one-biologically based urges

To eat,drink,eliminate & especially to be sexually stimulated. id operates through pleasure principle without any rules,realities,morals.Id is bridled & managed by ego.Ego delays

satisfying id’s motives & channels behaviour in socially acceptable way.

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Involuntary coping Mechanisms

Id’s unconscious demands are instinctual, infantile and amoral . They must be blocked by ego and superego.

Super ego,the conscience,prohibitions learned from parents & authorities.

Because of this conflict and persistence of unsatisfied demands, anxiety and guilt are aroused.

Defence mechanisms resides in the unconscious domain of ego.

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George Valliant’s Classification

Narcissistic Defences : Most primitive. In children and adults who are psychotically disturbed.

Immature Defences: adolescents and some non neurotic patients.

Neurotic Defences: in OCD and hysterical patients and in adults under stress.

Mature defences

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NARCISSISTIC DEFENCES

DENIAL

DISTORTION

PROJECTION

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DENIAL

Avoiding the awareness of some painful aspect of reality by negating sensory data.

It abolishes external reality.A person who is a functioning

alcoholic will often simply deny they have a drinking problem, pointing to how well they function in their job and relationships.

Simple Denial,minimisation,Projection

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DISTORTION

Grossly reshaping external reality to suit inner needs

Including hallucinations, wish fulfilling delusions, unrealistic megalomania.

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PROJECTION

Mechanism by which the ego attributes its own intolerable sexual and aggressive impulses to the outside person or agency.

Coping with one’s unwanted motives by shifting them on to someone else.

Anxiety arising from internal conflicts can then be reduced and problem dealt with as though it were in the external world.

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IMMATURE DEFENCES

ACTING OUT BLOCKING HYPOCHONDRIASIS INTROJECTION PASSIVE AGGRESSIVE BEHAVIOUR REGRESSION SOMATIIZATION SCHIZOID FANTASY

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ACTING OUT

Expressing an unconscious wish or impulse through action to avoid being conscious of an accompanying affect.

Involves chronically giving in to an impulse to avoid the tension arising from postponement of expression.

Instead of saying, “I’m angry with you,” a person who acts out may throw a book at the person, or punch a hole through a wall.

When a person acts out, it can act as a pressure release, and often helps the individual feel calmer and peaceful once again.

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Ex. Tantrums,For instance, a child’s

temper tantrum is a form of acting out when he or she doesn’t get his or her way with a parent.

apparently motiveless assaults, child abuse

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BLOCKING

Temporarily or transiently inhibiting thinking

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HYPOCHONDRIASIS

Exaggerating or overemphasizing an illness for the purpose of evasion and regression.

Responsibility can be avoided , guilt can be circumvented and instinctual impulses are warded off.

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INTROJECTION

Reverse of projection Internalizing the qualities of an object.

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PASSIVE AGGRESSIVE BEHAVIOUR

These patients turn their anger against themselves. This phenomenon is called masochism, includes procrastination, silly or provocative behaviour, self demeaning ,clowning and frankly self destructive acts.

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TURNING AGAINST SELF : Instead of expressing hostility against another rperson, represses the hostility but ventilates it against own self in the form of self criticism and self accusation

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REGRESSION

Attempting to return to an earlier libidinal phase of functioning to avoid the tension and conflict evoked at the present level of development.

The ego abandons the matured path of gratification and takes resort to pregenital or less objectionable attitude towards its object of gratification.

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Regression is normal phenomenon as well. Some amount of regression is needed for relaxation, sleep and orgasm in sexual intercourse.

In the face of threat, one may retract to an earlier pattern of adaptation, possibly a childish or primitive one.

For eg,an adolescent who is overwhelmed with fear, anger and growing sexual impulses might become clingy and start exhibiting earlier childhood behaviors he has long since overcome, such as bedwetting,nail bitting etc.

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SOMATIZATION

Converting psychic derivatives into bodily symptoms and tending to react with somatic manifestations rather than with psychic manifestations.

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SCHIZOID FANTASY

Indulge in Autistic retreat to resolve conflict and to obtain gratification.

Inter personal intimacy is avoided and eccentricity serves to repel others.

The person doesnot fully believe in fantasies and doesnot insist on acting them out.

Eg in normals striptease shows,day dreaming on pornographic materials

Clinically seen in Schizoid & Schizotypal Personality ,Narcissistic Personality Disorders.

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NEUROTIC DEFENCES

CONTROLLING DISPLACEMENT EXTERNALIZATION INTELLECTUALIZATION ISOLATION RATIONALIZATION DISSOCIATION REACTION FORMATION REPRESSIONSEXUALISATION

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CONTROLLING

Attempting to manage or regulate events or objects in the environment to minimize anxiety and to resolve inner conflicts.

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DISPLACEMENT

The motive remains unaltered but the person substitutes a different goal object for the original one.

Often the motive is aggression that for some reason, the person cannot vent on the source of anger.

Shifting an emotion or drive from one idea or object to another that resembles the original in some aspect or quality.

Example is the man who gets angry at his boss, but can’t express his anger to his boss for fear of being fired. He instead comes home and kicks the dog or starts an argument with his wife.

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EXTERNALIZATION

Tending to perceive in the external world and in external objects, elements of one’s own personality, including instinctual impulses, conflicts, moods, attitudes and styles of thinking.

For example, a patient who is overly argumentative might instead perceive others as argumentative and himself as blameless

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Intellectualization

Excessively using intellectual process to avoid affective expression or experience.

To avoid intimacy with people, attention is paid to external reality to avoid the expression of inner feelings and stress is placed on irrelevant details to avoid percieving the whole.

Professionals who deal with troubled people may intellectualize in order to remain helpful without being overwhelmed by sympathetic involvement.

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Isolation

Characteristic of the orderly, controlled persons who are labelled as Obsessive compulsive personalities.

Splitting or separation of an idea from the affect that accompanies it but is repressed.

In splitting, persons towards whom patients feelings are, or have been, ambivalent are divided into good and bad.

Ex. In a ward, a patient may idealize some staff members and uniformly disparage others.

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Rationalization

Offering rational explanations in an attempt to justify attitudes, beliefs or behaviour that may otherwise be unacceptable.

It is a method to support an attitude with false reasons

Substituting an acceptable conscious motive for an unacceptable unconscious one.

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Rationalization is very common among medical professionals in covering up medical errors

“Why disclose the error?,the patient wass going to die anyway”

“Telling the family about the error will make them feel worse”

“It was patient’s fault,if he wasn’t so obese,sick etc. this error woudn’t have caused so much harm”

“Well we did our best,these things happen.”

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Dissociation

Polly anna(subconscious bias towards the positive) like replacement of unpleasant affects with pleasant ones.

Persons who often dissociate are seen as dramatizing and emotionally shallow.

Temporarily but drastically modifying a persons character or one’s own sense of personal identity to avoid emotional distress.

Multiple Personality Disorder,PTSD,Somnambulism.

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Reaction formation

Transforming an unacceptable impulse into its opposite

Characteristic of obsessional neurosisIf this mechanism is frequently used at any early stage

of ego development it can become a permanent character trait, as in obsessional character.

Thus love may cover up unconscious hate, shyness serves as defence against exhibitionism.

Ex : when a 2nd child is born in a family the first child may show extraordinary concern for the welfare of the Newborn. This way his unconscious hate and aggression for his little brother is covered up.

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Repression

Repression is the unconscious blocking of unacceptable thoughts, feelings and impulses.

Ego excludes from the consciousness all the psychological contents which it cannot fit in harmoniously.

Primary Repression: Curbing of ideas and feelings before they have attained consciousness.

Secondary repression : Excluding from awareness what was once experienced at the conscious level.

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Repressed feelings do not cease to exist by mere expulsion from the consciousness.

Ego takes further steps to deal with these pent up impulses : a) Further reinforcement of repression b) Finding out substitute channels for outlet of impulse

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Ex. When a child finds out about the birth of a 2nd baby, he may feel his love is divided. He feels jealousy and rivalry towards his little brother. He represses his aggression for fear of punishment or further loss of love. But may channelize his aggression through some other activity, ex. By breaking his brothers toys.

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Sexualisation

Endowing an object or function with a sexual significance that it did not previously have or possessed to a smaller degree, to ward off anxieties associated with prohibited impulses or their derivatives.

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INHIBITION

Involuntary decrease or loss of motivation to engage in some goal directed activity to prevent anxiety arising out of conflicts with unacceptable impulses.

Eg in Normals: Social Shyness.

Clinically in OCDs & Phobias.

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Mature defences

AltruismAnticipationHumourSuppressionSublimation

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ALTRUISM

Involves an individual getting pleasure from giving to others what the individual would have liked to receive.

Ex. Using Altruism a former alcoholic serves as an Alcohol Anonymous sponsor to a new member, achieving transformation process that may be life saving.

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Anticipation

Realistically planning or anticipating future inner discomfort.

Involves careful planning or worrying and premature, but realistic anticipation of dire and potentially dreadful outcomes.

Ex. Moderate amount of anxiety before surgery promotes post surgical adaptation

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Humour

Using comedy to overtly express feelings and thoughts without personal discomfort and without producing an unpleasant effect on the others.

Freud suggested that “Humour can be regarded as the highest of these defensive processes”

Mature humour allows individuals to look directly at what is painful.

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Suppression

Consciously or semi consciously postponing attention to a conscious impulse or conflict.

Issues may be deliberately cut off but they are not avoided.

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Sublimation

For Freud, sublimation was the highest level of ego defence

Consists of redirection of sexual impulses to socially valued activities and goals.

He believed that much of our cultural heritage is the product of sublimation.

Ex. A writer may divert his libido to creation of poem/ novel. Thus indirectly satisfying drives.

Rejection by lover may induce one to divert hi energy to human welfare or artistic and literary activities.

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Reference

Kaplan and Sadock, Synopsis of Psychiatry, 9th edition

Kaplan and Sadock, Comprehensive textbook of Psychiatry, 10th edition

Morgan and King, 2004, Introduction to Psychology, 7th edition

Internet

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