Personality Disorders Flashcards
What is the id?
Instinctive biological drives and desires; “I want”; can lead to overindulgence and disregard for rights of others
What is the ego?
Logical and language based problem solving; “I think”; balances the needs of the id with the external reality (social context)
What is the superego?
Moral conscience based on ideal and values of society; “I should”; can be the self critical aspect of personality
What are defense mechanisms?
How the ego solves problems, balancing the id and superego; resolves conflicts between the desires of the id and restrictions of the superego; keeps the person connected to reality (exhibited in daily behaviors)
What are the characteristics of defenses?
They are unconscious, change with circumstances, can be useful (coping) or harmful (pathological), and vary by intensity or extent
Why do we have defense mechanisms?
Major psychological drive for most poeple is to reduce tension; a major cause of tension is anxiety; resolve it by increasing problem solving thoughts (seek rational solution or seek how to escape situation) and if cannot resolve the tension then defense mechanisms take over
What are primitive defenses?
Occur natrually throughout childhood, in dreams, and in psychotic adults; if frequently used in non-psychotic adults can be severely pathological; these three defenses in conjunction permit one to effectively rearrange external experiences to eliminate the need to cope with reality
What are the 3 primitive defense mechanisms?
Projection, denial and splitting
What is projection?
Grossly frank delusions about external reality, usually of a persecutory nature; the self projects paranoid ideas out onto the world and onto other people; ex, a person who cheated on his wife believes his wife is having an affair even though there is no evidence of it
What is denial?
Refusal to accept external reality because it is too threatening; arguing against an anxiety provoking stimulus by stating it doesnt exist; a common initial response to shock or grief
What is splitting?*
Seeing some people as all good and others as all bad; often seen in borderline personality disorder; sometimes can occur within one other person; ex. Pt idolizes you but demonizes previous provider or office staff
What are the types of basic (neurotic) defenses?
Dissociation, passive aggressive, rationalization, undoing, reaction formation, acting out, blocking, intellectualization, isolation of affect, introjection/identification, somatization/hypochondriasis, regression and displacement
What is displacement?
Shifts sexual or aggressive impulses to a more acceptable or less threatening target; redirecting emotion to a safer outlet; separation of emotion from its real object and redirection of the intesne emotion toward someone or something that is less offensive or threatening in order to avoid dealing directly with what is frightening or threatening; ex. Parent yells at child when actually angry with spouse
What is regression?
Temporary reversion of behavior to an earlier, less mature, more child like behavior, rather than handling unacceptable impulses in a more adult way; ex. An adult begins talking in baby talk when stressed
What is somatization/hypochondriasis?
Transforming negative feelings towards others into negative feelings toward self, pain, illness, anxiety; e.g. student feels embarrassed by resident on rotation, then next day has upset stomach arriving at the rotation
What is introjection/identification?
Opposite of projection because it involves taking others’ behaviors or emotions and internalizing them; when person is aware of this it is an imitation; when person is not aware (unconscious) it is a defense; e.g. abused child becomes an abusive parent
What is isolation of affect?
Separating feelings from ideas and events; La belle indifference seen in conversion disorder and Alzheimer’s (very calm when talking about something that seems sad/shocking/stressful); cognitive information is recalled but emotions are avoided; e.g. person is describing a murder with graphic detail but no emotional response evident
What is intellectualization?
Focusing on and exaggerating the intellectual aspect of a situation so as to distance oneself from anxiety; emotion replaced by thoughts, separating emotions from ideas; e.g. physician focuses on test results rather than pt’s emotions
