3. Introduction
• Defense Mechanisms are psychological strategies brought into play by the
unconscious mind to manipulate, deny or distort reality so as to maintain a
socially acceptable self-image.
• It is originated by Sigmund Freud and finalised by his daughter Anna Freud.
• It occur when our ego cannot meet the demands of reality.
• Healthy people normally use these mechanisms throughout life.
• It becomes pathological only when its persistent use leads to maladaptive
behavior such that the physical and/or mental health of the individual is
adversely affected.
• The purpose of ego defense mechanisms is to protect the mind/self/ego from
anxiety and/or social sanctions and/or to provide a refuge from a situation
with which one cannot currently cope.
4. • primary reason that those with personality disorders are
reluctant to alter their behavior is abandoning a defense
increases conscious awareness of anxiety and
depression.
• To help those with personality disorders, psychiatrists
must appreciate patients’ underlying defenses.
5. Genesis of Defense Mechanisms
• personality consists of 3 components; the id, ego and superego.
• Id- basic biological urges such as hunger, thirst, and sexual impulsees. It
motivates individual to seek them immediately and by all means necessary.
• Ego- satisfies the id’s urges using means that are rational, socially
acceptable and safe.
• Superego- ensuring that the solution proposed by ego are in compliance
with your own morals, ethics and your internalised set of rules.
• When the demands of the id start overpowering the ego it deploys defense
mechanism to prevent the id’s impulses to enter the conscious mind and to
there by avoid anxiety.
6. Classification of Defense Mechanisms
• The defence mechanisms can be classified hierarchically
according to the level of maturity associated with them.
1. Narcissistic Defences (most primitive - children, persons
psychotically disturbed, pathological)
2. Immature Defences (seen in adolescents and some non-
psychotic patients)
3. Neurotic Defences (encountered in obsessive-compulsive and
hysterical patients, and adults under stress)
4. Mature Defences ( healthy and adaptive throughout the life
cycle)
7. 1. Narcissistic-Psychotic Defenses
– almost always severely pathological
– users of these mechanisms frequently appear irrational or insane to others.
– common in overt psychosis.
– found throughout childhood and adult dreams
• Projection
– Perceiving and reacting to unacceptable inner impusles and their derivatives as though
they were outside the self. (delusions about external reality - usually persecutory in
nature)
– EXAMPLE:- A surgeon who did mistake in operation may insist that it happened because
theatre nurse and ward boy did their task badly.
A business person who values punctuality is late for a meeting and states , “sorry I’m
late. My assistant forgot to remind me of the time.”
8. • Denial
– Psychotic denial of external reality.
– Seeing, but refusing to acknowledge what one sees, or hearing,
and negating what is actually heard.
– Denial avoids becoming aware of some painful aspect of reality.
– At the psychotic level, the denied reality may be replaced by a
fantasy or delusion.
– EXAMPLE:- When some very near and dear one die in the
family. Some people say no, he is still alive.
9. • Distortion
– Grossly reshaping the experience of external reality to suit
inner needs, including unrealistic megalomanic beliefs,
hallucinations, delusions.
– Example, a student may believe that he failed a test because of
difficult questions, not because they did not prepare fully.
10. 2. Immature Defenses
– often present in preadolecent and adults
– Excessive use of such defences is seen as socially
undesirable.
• Acting out
– The direct expression of an unconscious wish or impulse in
action without conscious awareness of the emotion that drives
the action to avoid being conscious of the accompanying affect.
– Example; Instead of saying, “I’m angry with you,” a person who
acts out may instead throw a book at the person, or punch a hole
through a wall.
11. • Introjection
– The introjection of a loved object involves the internalization of
characteristics of the object with the goal of ensuring closeness
to and constant presence of the object.
– If the object is lost, introjection nullifies or negates the loss by
taking on characteristics of the object.
– Introjection of a feared object serves to avoid anxiety through
internalizing the aggressive characteristic of the object, and
thereby putting the aggression under one’s own
control(“identification with the aggressor”).
12. • Passive- aggressive behavior
– Aggression toward an object expressed indirectly and
ineffectively through passivity, masochism, and turning against
the self.
– e.g. procrastination
– say you've asked your partner or a roommate to take care of
the dishes multiple times, and they don't outright say no—but
they don't intend to do the dishes.
13. • Regression
– A return to a previous stage of development or functioning to avoid the
anxieties or hostilities involved in later stages.
– A return to earlier points of fixation embodying modes of behavior
previously given up.
– This is often the result of a disruption of equilibrium at a later phase of
development.
– EXAMPLE:- Nurse makes an error in giving medication and starts crying.
A person who is depressed may withdraw to his or her room, curl up in a
fetal position on the bed.
14.
15. • Fantasy
– retreating into your own imagination to avoid stressful situations
or to reach your unattainable goals.
– It is a defense commonly used by children, but it is also used
by adults when they are feeling challenged by their
circumstances.
– Example, someone who has been working long hours month
and feeling burned out might use fantasy to think about the
vacation they will take when they have the opportunity.
16. • Somatization
– The defensive conversion of psychic derivatives into bodily
symptoms; tendency to react with somatic rather than psychic
manifestations.
– Infantile somatic responses are replaced by thought and affect
during development (desomatization); regression to earlier
somatic forms or response (resomatization) may result from
unresolved conflicts and may play an important role in
psychophysiological and psychosomatic reactions.
17. 3. Neurotic Defenses
– common in apparently normal and healthy individuals as well as in neurotic disorders.
– they can have an adaptive or socially acceptable aspect.
• Displacement
– Shifting an emotion or drive cathexis from one idea or object to another that
resembles the original in some aspect or quality, but evokes less distress.
– e.g. mother yelling at child because she is angry at her husband.
• A person who is angry with his boss but cannot show it for fear of losing the job may fight with
his wife on return from the office.
18. • Dissociation
– A temporary but drastic modification of character or sense of personal
identity to avoid emotional distress; it includes fugue states and
hysterical conversion reactions.
– e.g, day dreaming, highway hypnosis
• Externalization
– A tendency to perceive in the external world and in external objects
components of one’s own personality, including instinctual impulses,
conflicts, moods, attitudes, and styles of thinking.
– Example, a patient who is overly argumentative might instead perceive
others as argumentative and himself as blameless.
19. • Inhibition
– The unconsciously determined limitation or renunciation of
specific ego functions, singly or in combination, to avoid anxiety
arising out of conflict with instinctual impulses, superego, or
environmental forces or figures.
– Accepting a modified form of their original goal.
– Example; becoming a high school basketball coach rather than
a professional athlete.
20. • Intellectualization
– It is the avoidance of feelings in an emotional situation and, instead,
focusing on thoughts and using logic.
– example, if person A is rude to person B, person B may think about the
possible reasons for person A’s behavior. They may rationalize that person
A was having a stressful day.
• Isolation
– The intrapsychic splitting or separation of affect from content resulting in
repression of either idea or affect or the displacement of affect to a
different or substitute content.
– example, describing a murder with graphic details with no emotional
response.
21. • Rationalization
– A justification of attitudes, beliefs, or behavior that might
otherwise be unacceptable by an incorrect application of
justifying reasons or the invention of a convincing fallacy.
– Example; a girl fails to get admission for nursing course may
point out a number of difficulties of nursing profession.
– A person with out vehicle says that he does not want to risk his
life by driving.
22. • Reaction formation
– It is acting in a way that is opposite to what you are feeling or
thinking.
– EXAMPLE:- Women who actually dislike her mother in law hide
her feelings by being always nice to her.
23. • Repression
– Consists of the expelling and withholding from conscious
awareness of an idea or feeling.
– It may operate either by excluding from awareness what was
once experienced on a conscious level (secondary repression),
or it may curb ideas and feelings before they have reached
consciousness (primary repression).
– Example; A man is jealous of his good friend’s success but is
unaware of his feeling of jealousy.
24. 4. Mature Defenses
– found among emotionally healthy adults
– admirable and virtuous patterns of behavior.
• Altruism
– The vicarious but constructive and instinctually gratifying service to
others, even to the detriment of the self.
– This must be distinguished from altruistic surrender, which involves a
masochistic surrender of direct gratification or of instinctual needs in
favor of fulfilling the needs of others to the detriment of the self, with
vicarious satisfaction only being gained through introjection.
• Anticipation
– The realistic anticipation of or planning for future inner discomfort:
Implies overly concerned planning, worrying, and anticipation of dire
and dreadful possible outcomes.
25. • Asceticism
– The elimination of directly pleasurable affects attributable to an
experience.
– Asceticism is directed against all “base” pleasures perceived
consciously, and gratification is derived from the renunciation.
• Humor
– The overt expression of feelings without personal discomfort or
immobilization and without unpleasant effect on others.
– humor decreases the anxiety associated with a situation by
pointing out something funny or ironic about it.
26. • Sublimation
– The gratification of an impulse whose goal is retained, but whose aim or object is
changed from a socially objectionable one to a socially valued one.
– Sublimation of aggressive impulses takes place through pleasurable games and
sports.
– Thus, in sublimation, feelings are acknowledged, modified, and directed toward
a relatively significant person or goal so that modest instinctual satisfaction
results.
– Example; aperson who has aggressive feeling and cannot express it in society
can become asoldiur or boxer.
– A teenage boy with strong competitive and aggressive feeling becomes a foot
ball player.
27. • Suppression
–The conscious or semiconscious decision to delay
paying attention to an emotion or need in order to cope
with the present reality.
–Issues may be deliberately cut off, but they are not
avoided.
–EXAMPLE:- Student consciously decides not to think
about her insult in examinations hall so that she can
study effectively.
28. Unhealthy Defense Mechanisms
• Defense mechanisms stop people from facing reality,
leaving the original stress to worsen over time.
• The more primitive defense mechanisms often cause
more issues, particularly if they’re used too often or for too
long.
• In contrast, the more advanced defense mechanisms are
healthier and less likely to cause problems; however,
even they might be overused.
29. Signs of an Unhealthy Use of Defense Mechanisms
• You’re often accusing others of doing things that you’d
like to be doing but can’t admit to, leading to relationship
conflicts (projection)
• You have difficulty paying attention in stressful situations
due to maladaptive daydreaming (dissociation)
• You’re avoiding people, places, or things that upset you
(avoidance)
• You tend to feel distrustful in relationships with no basis to
be concerned (repression)
30. • Your friends point out that you act childishly at
inappropriate times (regression)
• You often get angry or irritable with family after a difficult
work day (displacement)
• You’re arriving late to work routinely after using alcohol or
other substances on the prior day, but you’re telling
yourself that you still get the work done and do not have a
problem (denial)
31. Treatment for Unhealthy Defense Mechanisms
• Often consistent with treatment for anxiety disorders
– anger management,
– grief counseling,
– medication,
– lifestyle changes.
32. References
1. KAPLAN & SADOCK’S SYNOPSIS OF PSYCHIATRY TWELFTH EDITION
2. KAPLAN & SADOCK’S COMPREHENSIVE TEXTBOOK OF PSYCHIATRY T E N T H E D I T I O N
3. https://www.choosingtherapy.com/defense-mechanisms/
