Defense Mechanisms - DSA and CIS Flashcards
Defense Mechanisms
Unconscious protection from emotional pain
Keeps conflict out of the conscious mind
Serves to decrease anxiety
Maintains a sense of safety and self-esteem
People receiving medical care commonly use defense mechanisms to deal with fear and pain associated with their illnesses
Mechanisms often provide a short term gain at the expense of our overall functioning
Defense Mechanisms- imature vs mature (example)
Man deals with unacknowledged anger towards boss:
Immature: displacement–> verbally abuses office assistant
Mature: sublimation –> engages in racquetball (with boss?)
Narcissistic - Psychotic Mechanisms: Denial
Involuntary exclusion from awareness of intolerable facts about reality
Clinical Example: A baby dies in a fire after the unsuccessful attempt by the mother to save the child. The mother later insists that the child has been saved by a neighbor.
Normal in children
In adults may be indicator of severe pathology such as psychosis
Clinical syndromes/life circumstances in which denial is observed:
- Patients with fatal illness/severe injury who deny impending death or severity of injury
- Parents who refuse to acknowledge severity of illness in their child
Normal in children or adaptive in severe life circumstances
Narcissistic - Psychotic Defenses: Projection
Attributing one’s own personally unacceptable feelings to others
Clinical Syndromes: Paranoid delusions and hallucinations.
Normal in childhood: the imaginary playmate
Note: Projection is used on an immature level as well
- Rejection of intimacy through suspiciousness. Severe prejudice. Hypervigilance to external danger
Example: Notice how dishonest people often suspect you of the same.
Immature Defense Mechanisms: Acting Out
Avoiding painful feelings by behaving in an attention-getting socially inappropriate manner
Teen with a terminally ill sibling begins to do poorly at school and argues frequently with parents
A person may act out through substance use or sexual promiscuity
Immature Defenses: Somatization
Turning an unacceptable feeling or impulse into a physical symptom
Example: A man who is anxious about a new job develops a headache the morning of the first day of work.
Clinical example: Somatoform disorders
Immature Defenses: Splitting
Believing people or events are either all bad or all good because of intolerance of ambiguity
Example: A woman who believed that her physician was godlike – begins to think that he is a terrible physician when he is late for an appointment with her.
Clinical example: Borderline Personality Disorder
Immature Defenses: Undoing
Adopting acts which symbolically cancel or reverse a previous unwanted act or thought or event.
A woman who was an immaculate housekeeper develops a hand washing compulsion after her child develops pneumonia.
Normal: knocking on wood, saying Gesundheit, “I’m sorry.
Clinical: compulsive acts, obsessional thoughts
Neurotic Defenses: Displacement
Unconscious transfer of emotions from an unacceptable to acceptable person/object
Example: A man whose son was killed by a drunk driver attacks and seriously injures a drunken street person.
Everyday instances of “kicking the cat” due to anger engendered elsewhere which could not be expressed
Apparent in phobias
Neurotic Defenses: Dissociation
Separation of function of mental illnesses; mentally separating part of consciousness from reality; “forgetting “events have occurred
Example: A woman sexually abused as a child has two distinct personalities in adulthood.
Clinical manifestation: Dissociative Disorders
Normal Behavior: “The cinema of the prisoners,” noted in involuntary guests of the Gestapo in World War II
Neurotic Defenses: Intellectualization
Using the mind’s higher functions to avoid experiencing uncomfortable emotions
Clinical Example: A physician with a diagnosis of pancreatic cancer excessively discusses the statistics of the illness with his colleagues and family.
Neurotic Defenses: Isolation of Affect
Separating the feelings associated with a significant, uncomfortable event
Example: A person who expresses no emotion when discussing the loss of a loved one – isolating her emotion from the sad event
May occur in some obsessional states
Normal in development of language: vocalization preceding verbalization
Neurotic Defenses: Reaction Formation
Denying unacceptable feelings and adopting opposite attitudes
Examples: Unconsciously behaving in a friendly fashion towards someone one does not like
Clinical examples: obsessive compulsive disorders or personality
Normal behavior in the three year old child
Mature Defenses
Protect the person from fear and anxiety without social cost and possibly with benefit
In differentiating mature/immature defenses assess whether the mechanism benefits society and or the individual
Mature Mechanisms: Altruism
Unselfishly assisting others to avoid negative feelings
Example: A woman with a low self image volunteers in a soup kitchen on her day off
Generally serves to benefit society/self
Mature Mechanisms: Sublimation
Rerouting an unacceptable drive in a socially acceptable way
Clinical Example: A man whose son was killed by a drunk driver regularly speaks to high school students about the dangers of drunk driving
Mature Defenses: Humor
Expression of feeling without causing discomfort
Clinical Example: A man who has his leg amputated makes jokes of one legged people
Mature Mechanisms: Suppression
Consciously putting aside but not repressing unwanted feelings
Example: A breast cancer patient decides that she will worry about her illness for only ten minutes per day ( the Scarlet O’hara approach)
lawyer has a terrible day at work and yells at her husband for crappy dinner. What is that?
displacement
lawyer had bad day begins having an affair. month later starts suspecting husband of affair and starts scouring phone bill. What is this?
projection
fox smells its own den
cheater expresses her new belief that marriage isn’t so important with coolness. Has a lot of statistics to back it up. What’s up?
rationalization and intellectualization
soldier acts with heroicism saving comrades in iraq. Says he was outside his body the whole time not feeling it. What mechanism?
dissociation
often tied to trauma
heroic soldier is calm and not nervous when interviewed on 60 minutes. What mechanism?
isolation of affect
mega church leader talks of his great marriage and stuff but is meanwhile promiscuous with men and doing drugs
reaction formation– taking unacceptable desires and making them acceptable things (married to woman when desires men)
mega church leader goes on 4 day binge of cocaine and sex.
acting out
doctors can’t deal with dumb insulation and start making jokes.
humor
acknowledging the fears in the room and letting it out without people getting hurt too much
scared nerd gets ready for first date with lots of research.
anticipation
overworked spouse puts aside her crankiness to take care of the kids and saves up the discussion for when she has private time with the husband
supression
a healthy, mature defense
reaction formation vs sublimation
similar processes
unconscious- both have an end action or state that is socially acceptable
reaction formation- taking unacceptable desires and doing something acceptable instead. Not satisfying
sublimation- takes the internal drive and keeps it on the same course- wanting to hit people but going to play football instead.
repression vs suppression
supppression- allows the fear and feeling
repression- doesn’t allow them. (like denial)
BPD hallmarks
splitting
projection
acting out
OCD hallmarks
undoing
magical thinking
paranoid PD hallmarks
projection
most therapies work to
tear down immature defenses and replace with mature ones
what is splitting?
a mechanism in which self and others are seen as wholly good or wholly bad. There is a distinct failure to recognize and tolerate that people are composites of positive and negative traits
under stress, people
regress to defenses of lower levels
