DEFENSE MECHANISM

1. DEFENSE MECHANISMS
Guided by-
Dr. Nimisha Mishra (M.D.) Presented by- Dr. Jag Mohan Prajapati
Dr. Sunil k. Ahuja (M.D.) JR1 PSYCHIATRY
Dr. Ambrish Mishra (M.D.) SSMC REWA
Dr. Dheerendra Mishra (M.D.,DNB)
Dr. Amrendra Singh (M.D.)

2. DEFINITION
 Defense mechanisms are defined as unconscious
psychological strategies brought into play by
various entities to cope with reality and to
maintain self image.
 purpose of the Ego Defense Mechanisms is to
protect the mind/self/ego from anxiety.

3. HISTORY
 Sigmund Freud
 Founder of psychoanalysis.
 Theory of Psychosexual Development .
 The Id, Ego, and Superego .
 Dream interpretation.
 Free association
 Anna Freud
 Child psychoanalysis
 Clear explanations of defense mechanism
 concept of signal anxiety

4. STRUCTURAL MODEL OF MIND

5. THE ID
 Reservoir Of Unorganized Instinctual Drives
 Based On The Pleasure Principle
 Unconscious Primary Process
 No Logic And No Time Line

6. SUPER EGO
 Internalized Societal And Parental Standards
 Predominantly Unconscious
 The Conscience
 The Ego Ideal
 Children Internalize Parental Values And
Standards At About The Age Of 5-6 yrs

7. EGO
 The moderator between the id and superego
 Sense of time and place
 Based on reality principle
 Predominantly conscious ,some part is
unconscious
 Defense mechanisms reside in the unconscious
domain of ego.

8. Basic concept –Types of Anxiety
 Reality Anxiety: most basic form of anxiety ,typically based on
fears of real and possible events, such as being bitten by a dog or
falling from a ladder.
• Neurotic Anxiety: comes from an unconscious fear that the basic
impulses of the ID will take control of the person, leading to
eventual punishment.
• Moral Anxiety: form of anxiety comes from a fear of violating
values and moral codes, and appears as feelings of guilt or shame.

9.  According to Freud, anxiety is an unpleasant inner state that people seek
to avoid.
 When anxiety occurs, the mind first responds by an increase in problem
solving thinking, seeking rational ways of escaping the situation.
 If this is not fruitful (and maybe anyway), ego has some tools it can use in
its job as the mediator, tools that help defend the ego, these are called Ego
Defense Mechanisms or Defenses.
 They helped shield the ego from the conflicts created by the id, superego,
and reality.
Intrapsychic
conflict(betwee
n id, ego ,
superego)
Anxiety
Reliance on
defense mechanism

10. Ego Defenses
 If the signal anxiety cannot be defused, it may
overwhelm the ego and allow the primitive
primary process thinking of the unconscious to
become manifested in the conscious life of the
person

11. Important properties
 Freud discovered most of the defense mechanisms and
identified five of their important properties:
1 Defenses are a major means of managing instinct and
affect.
2 They are unconscious.
3 They are discrete (from one another).
4 Although often the hallmarks of major psychiatric
syndromes, defenses are dynamic and reversible.
5 They can be adaptive as well as pathological.

12. Purpose of Defense Mechanisms
 Allow individuals a period of respite to master changes in self-image
that cannot be immediately integrated, as might result from puberty,
an amputation, or a promotion (i.e., changes in reality).
 Deflect or deny sudden increases in biological drives. Awareness of
instinctual wishes is usually diminished; alternatively, antithetical
wishes may be passionately adhered to.
 Enable individuals to mitigate unresolved conflicts with important
people, living or dead.
 Keep anxiety, shame, and guilt within bearable limits during sudden
conflicts with conscience and culture.

13. Classification of defense mechanisms:
 Defenses employed by ego can be listed
according to variety of classification:-
 Developmental by Anna Freud
 Valliant (1971)
 Bond et al. (1983)
 Perry and Copper (1985)
 American Psychiatric Association (1994)

14. Development by Anna Freud:
 Normally there is an orderly sequence as the child matures.
 Oral (0-18 months) - narcissistic defenses (Projection,
denial, distortion)
 Anal (18months-3 years) - Identification, undoing, reaction
formation, isolation, regression
 Phallic / oedipal (3- 6 years) - Intellectualization
 Latency (6 years to puberty) - Symbolization, sublimation

15. Narcissistic-Psychotic Defenses
 Projection
 Denial
 Distortion
These defenses are usually found as part of a psychotic process, but
may also occur in young children and adult dreams or fantasies. They
share the common note of avoiding, negating, or distorting reality.

16. Immature Defenses
 Acting out
 Blocking
 Hypochondriasis
 lntrojection
 Passive-aggressive behaviour
 Projection
 Regression
 Schizoid fantasy
 Somatization

17. Neurotic Defenses
 Controlling
 Externalization
 Displacement
 Dissociation
 Isolation
 Rationalization
 Reaction formation
 Repression
 Inhibition
 Intellectualization
 Sexualization

18. Mature Defenses
 Altruism
 Anticipation
 Asceticism
 Humor
 Sublimation
 Suppression

19. Narcissistic Immature Neurotic Mature
Projection Acting out Controlling Altruism
Denial Blocking Displacement Anticipation
Distortion Hypochondriasis Dissociation Asceticism
lntrojection Externalization Humor
Passive-aggressive behaviour Isolation Sublimation
Projection Inhibition Suppression
Regression Intellectualization
Schizoid fantasy Rationalization, Reaction formation , Repression
Somatization Sexualization

20. DENIAL
 Denial is simply refusing to acknowledge that an event has
occurred.
 Denial is one of Freud's original defense mechanisms. It is
considered one of the most primitive of the defense mechanisms
because it is characteristic of early childhood development.
 It is a form of repression, where stressful thoughts are banned
from memory.
 Many people use denial in their everyday lives to avoid dealing
with painful feelings or areas of their life they don’t wish to
admit.

21.  Involuntary exclusion of unpleasant or painful reality from
conscious awareness.
 Postulated by Sigmund Freud
 Simple denial - deny the reality of the unpleasant fact
altogether.
 Minimization- admit the fact but deny its seriousness
 Projection - admit both the fact and seriousness but deny
responsibility

22. TYPES OF DENIAL
 Denial of fact
 Denial of responsibility
 Denial of impact
 Denial of awareness
 Denial of cycle
 Denial of denial

23. Example:
1) Patient denies that his physician's diagnosis of cancer is
correct and seeks a second opinion.
2) Alcoholics vigorously deny that they have a problem.

24. DISTORTION
 Grossly reshaping external reality to suit inner
needs
Clinical illustration:
 Hallucinations
 Delusions especially grandiose

26. PROJECTION
 Perceiving and reacting to unacceptable inner impulses and their
derivatives as though they were outside the self
 Freudian Projection
 projective identification -connection of the self with that projected
impulse continues.
 Example-Blaming
 Clinical-Delusions and hallucinations
 Paranoid personality
 Projective Techniques-Rorschach ink-blot

27.  What you do:
Attribute your own undesirable impulses, feeling,
or desires to another person
Examples:
“I hate her” really means “I think she hates me”

29. ALTRUISM
 Rooted in the Latin word alter-meaning other.
 Altruism –means “living for others”.
 Key component-Selflessness- an unselfish regard for the
welfare of others
 Altruism was ignored as an area of study in social
psychology untill the mid-20th century even though Auguste
Comte coined the term 100 years prior.
 Using constructive and instinctually gratifying service to
others to undergo a vicarious experience.

30. EXPLANATION FOR ALTRUISM
 Psychologists have suggested a number of different
explanations for why altruism exists:
 Biological reasons:
Kin selection-We may be more altruistic towards those we are
related to because it increases the odds that our blood relations
will survives and transmit their genes to future generations.
Neurological reasons:
Altruism activates reward centres in the brain.

31.  Social norms:
Society’s rules,norms,expectations can also influence wh ether or
not people engage in altruistic behaviour.
The norm of reciprocity- A social expectation in which we feel
pressured to help others if they have already done something for
us.
For example: If your friend loaned you money few weeks ago,you
will probably feel compelled to reciprocate when he asks for loan
of rs 1000.He did something for you,now you feel obligated to do
something in.

33. ANTICIPATION
 Realistic thinking and planning about future unpleasurable
events.
 It is goal directed and implies careful planning or worrying
,premature but realistic affective anticipation of potentially
dreadful outcome.
• Ex: getting old –think ahead and plan your retirement wisely!
Ex: moderate amount of anxiety before surgery promotes post
surgical adaptation.

34. ASCETICISM
 Eliminating the pleasurable effects of experiences and
assigning moral values to specific pleasures. Gratification is
derived from renunciation.

35. SUBLIMATION
 Achieving impulse gratification and retention of goals
,but altering a socially objectionable aim or object to a
socially acceptable one
 It is nothing but channelizing rather than blocking or
diverting a unacceptable infantile or impulse into
personally satisfying and socially valuable behaviour
pattern
 Most productive

36.  Example:
1)A teenage boy with strong competitive and aggressive
feelings becomes a football player.
2)A young man who has lost his lover may turn to write
poetry about love.
3)A person who has aggressive feeling and can not express in
society can become a soldier or boxer.
4) A angry man does pushups to work off his temper.

39. HUMOUR

41. SUPPRESSION
 A conscious inhibition of impulses or ideas those
are incompatible with the individual’s evaluation
of himself according to his ego ideal.
Ex. Choosing not to think of the bad events to
avoid distress

43. DEFENSE MECHANISMS USED IN
VARIOUS PSYCHIATRIC DISORDERS:

44. Serial
number
Disorder Defense Mechanisms
1 Anxiety Repression
2 Phobia Displacement, Regression
3 OCD Isolation of affect, Undoing ,Reaction formation
4 Depression Regression, Turning of aggression against self
5 Mania Denial, Projection, Regression
6 Paranoid Projection, Regression,
Rationalization
7 Schizophrenia Regression, Projection,
Isolation of affect

45. Defense mechanisms in substance abuse
 Denial
 Isolation
 Rationalization
 Projection
 Minimizing

46. References
 CTP , 10th Edition
 Introduction to Psychology, Morgan and King
 Ego Defence Mechanism , George E Vaillant