Ego Defenses

Question 1

Expressing unacceptable feelings and thoughts through actions.

A young boy throws a temper tantrum when he does not get the toy he wants.

Answer 1

Acting Out - Immature Defense

Question 2

Avoiding the awareness of some painful reality.

Pt is not acknowledging a piece of bad news, as thought it was never said.

Answer 2

Denial - Immature Defense

Question 3

Redirection of emotions or impulses to a neutral person or object.

Man yells at his family when he has a bad day at work.

Teacher gets yelled at by principal, so she goes home and yells at her husbands dinner selection.

Answer 3

Displacement - Immature Defense

Question 4

Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress. Patient has incomplete or no memory of traumatic event. May lead to multiple personalities.

A victim of sexual abuse suddenly appears numb and detached when she is exposed to her abuser.

Answer 4

Dissociation - Immature Defense

Question 5

Partially remaining at a more childish level of development.
Adult throwing a temper tantrum for an uncontrollable situation.

A surgeon throws a temper tantrum in the OR because the last case ran late.

Answer 5

Fixation - Immature Defense

Question 6

Expressing extremely positive thoughts of self and others while ignoring negative thoughts.

A patient boasts about his physician and his accomplishments while ignoring any flaws.

Answer 6

Idealization - Immature Defense

Question 7

Largely unconscious assumption of the characteristics, qualities, or traits of another person or group.

—> A child abuser was himself abused as a child.

A resident starts putting his stethoscope in his pocket like his favorite attending, instead of wearing it on his neck like before.

Answer 7

Identification - Immature Defense

Question 8

Using facts and logic to emotionally distance oneself from a stressful situation.

In a therapy session, patient diagnosed with cancer focuses only on rates of survival.

Answer 8

Intellectualization - Immature Defense

Question 9

Separating feelings from ideas and events.

—> A veteran can describe horrific war details without any emotion.

Answer 9

Isolation - Immature Defense

Question 10

Demonstrating hostile feelings in a non confrontational manner; showing indirect opposition.

A disgruntled employee is repeatedly late to work but won’t admit it as a way to get back at his manager

Answer 10

Passive Aggression - Immature Defense

Question 11

Attributing an unacceptable internal impulse to an external source
—>A man who wants to cheat on his wife accuses his wife of being unfaithful.

Answer 11

Projection - Immature Defense

Question 12

Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame.

After getting fired, claiming that the job wasn’t important anyway

Answer 12

Rationalization - Immature Defense

Question 13

Replacing a warded-off idea or feeling with an (unconsciously derived) emphasis on its opposite.

Threatening someone you strongly dislike in an excessively friendly manner in order to hide your true feelings.

A patient with lustful thoughts enters a monastery

Answer 13

Reaction Formation - Immature Defense

Reduces anxiety by taking up the opposite feeling, impulse, or behavior

Question 14

Involuntarily withholding an idea or feeling from conscious awareness —> Underlies all other defense mechanisms.

A 20 y/o does not remember going to counseling during his parents’ divorce 10 years earlier.

Answer 14

Repression - Immature Defense

Question 15

Believing that people are either all good or all bad at different times due to intolerance of ambiguity. Commonly seen in borderline personality disorder.

A patient says that all the nurses are cold and insensitive but the doctors are warm and friendly

Answer 15

Splitting - Immature Defense

Question 16

Replacing an unacceptable wish with a course of action that is similar to the wish but socially acceptable.

Teenager’s aggressive urges toward his parents high expectations are channeled into excelling in sports.

Answer 16

Sublimation - Mature Defense

Question 17

Alleviating negative feelings via unsolicited generosity, which provides gratification.

Mafia nos makes large donation to a church

Answer 17

Altruism - Mature Defense

Question 18

Intentionally withholding an idea or feeling from conscious awareness; temporary.
Pt voluntarily chooses not to think about a piece of bad news.

Choosing not to worry about the big game until it’s time to play

Answer 18

Suppression - Mature Defense

Question 19

Appreciating the amusing nature of an anxiety-provoking or adverse situation.

Nervous medical student jones about the boards.

Answer 19

Humor - Mature Defense

Question 20

Involuntarily turning back the maturational clock and going back to earlier modes of dealing with the world (vs fixation)

An adult that is whining, bed wetting, and crying describes what defense?

Or, an 8 y/o girl who is being bullied in school starts carrying
around her security blanket again.

Seen in children under stress such as illness, punishment, or birth of a new sibling (like bed wetting in a previously toilet trained child)

Answer 20

Regression - immature

She is regressing from an earlier stage of life

Question 21

Patient projects feelings about formative or other important persons onto physician (eg psychiatrist is seen as parent)

Answer 21

Transference

Question 22

Doctor projects feelings about formative or other important persons onto patient (eg patient reminds physician of younger sibling)

Answer 22

Countertransference