The document summarizes some key concepts from Freudian psychoanalytic theory, including: 1) Freud proposed three structures of the psyche - the id, ego, and superego. The id operates on the pleasure principle, the ego balances the id and reality, and the superego incorporates moral standards. 2) Defence mechanisms distort id impulses in socially acceptable ways to reduce anxiety. Immature defences like projection and passive aggression are common in children and may indicate intimacy issues in adults. 3) Valliant's classification organizes defences from narcissistic-psychotic like denial to more mature ones like humour and sublimation that indicate psychological health.

1. DEFENCE
MECHANISMS
-DR. BHAVIK CHHEDA

2. STRUCTURES OF THE PSYCHE
Freud proposed three structures of the psyche or personality:
Id
Ego
Superego

3. ID
• The id, the most primitive part, can be thought of as a sort of
house of biologically based urges. The urge to eat, drink,
eliminate and, especially, to be sexually stimulated.
• The sexual energy that underlies these urges is called the libido.
• The id operates according to what Freud called the pleasure
principle. That is, if left to itself, the id would satisfy its
fundamental urges immediately and reflexively as they
arose, without regard to rules, the realities of life, or morals of
any kind.
• The id, however, is usually bridled and managed by the ego.

4. EGO
• The ego consists of elaborate ways of behaving and thinking
which constitute the "executive function of the person. The
ego delays satisfying id motives and channels behavior into
more socially acceptable outlets, keeps a person working for a
living, getting along with people, and generally adjusting to the
realities of life. Indeed, Freud characterized the ego as working
in the service of the reality principle.”
• That is as ego tries to satisfy the id's urge for pleasure but only
in realistic ways that take account of what is possible in the real
world. The ongoing tension between the insistent urges of
the id and the constraints of reality help the ego develop
more and more sophisticated thinking skills.

5. SUPEREGO
• The superego corresponds closely to what we
commonly call the conscience. It consists mainly of
prohibitions learned from parents and other
authorities. The superego may condemn as "wrong
certain things which the ego would otherwise do to
satisfy the id. But the superego is not all fire and
brimstone. Its conscience-like proddings are also
guided by what Freud called the ego ideal, a set of
positive values and moral ideals that are pursued
because they are believed to be worthy.

6. • The ego's task of satisfying both id and superego
requires a somewhat risky balancing act. For example,
if the ego yields to the id's desire for something that is
morally forbidden, the superego may "punish" the ego
with feelings of guilt.

7. • Freud proposed three levels of consciousness, or
awareness: the conscious, the preconscious, and the
unconscious.
• At the conscious level, we are aware of certain things
around us and of certain thoughts.
• At the preconscious level are memories or thoughts that
are easily available with a moment's reflection-for
example, what we had for breakfast, or our parents' first
names.
• In contrast, the unconscious contains memories,
thoughts, and motives which we cannot easily call up.

8. • All of the id is unconscious; the ego and superego include material
at all three levels of consciousness.

9. • When anxiety becomes overwhelming, it is the ego's place to
protect the person by employing defence mechanisms.
• The signaling function of anxiety is seen as crucial, and
biologically adapted to warn the organism of danger or a threat
to its equilibrium.
• Defence mechanisms work by distorting the id impulses into
acceptable forms, or by unconscious or conscious blockage of
these impulses.
• All defence mechanisms are responses to anxiety and how the
consciousness and unconscious handle the stress of a social
situation.

10. GEORGE VALLIANT’S
CLASSIFICATION
• Narcissistic-psychotic Defences:
• Projection, Denial, Distortion.
• Immature Defences:
• Acting out, blocking, hypochondriasis, introjection, passive aggressive behaviour,
projection, regression, schizoid fantasy, somatisation.
• Neurotic Defences:
• controlling, displacement, dissociation, externalization, inhibition,
intellectualization, isolation, rationalisation, reaction formation, repression,
sexualization.
• Mature Defences:
• Altruism, anticipation, asceticism, humour, sublimation, suppression.

11. NARCISSISTIC-PSYCHOTIC
DEFENCES:
• These defences are commonly found as a part of a
psychotic process, but may also occur in young
children and adult dreams or fantasies.
• They share a common note of avoiding, negating or
distorting reality.

12. PROJECTION
• Individuals attribute characteristics they find
unacceptable in themselves to another person.
• Eg.: A husband who has a hostile nature might
attribute this hostility to his wife and say she has
an anger management problem.
• In some cases projection can result in false
accusations.

13. DENIAL
• Denial involves the rejection of a fact that is too
painful for a person to accept.
Freud argued that there are three types of denial:
• Simple denial: occurs when someone denies that something
unpleasant is happening. For example, a person with
terminal cancer might deny that he/she is going to die.
Minimization: occurs when a person admits an unpleasant
fact while denying its seriousness. A person about to get
divorced might, for example, brush the divorce off as no big
deal.
Projection: For example, the cancer patient might insist that his
or her doctor is providing inadequate care and that a different
doctor could provide a different outcome.

14. DISTORTION
• Grossly reshaping the experience of external reality to suit inner
needs, including unrealistic megalomaniac beliefs,
hallucinations, wish-fulfilling delusions, and employing sustained
feelings of delusional grandiosity, superiority, or entitlement.
• Minor: devaluation, idealization, omnipotence.
• Major: autistic fantasy, projective identification, splitting of self
image
• Dysregulation: delusional projection, psychotic denial,
psychotic distortion.

15. • Devaluation:
• Attributing exaggerated negative qualities to self or others.
• Idealization:
• Attributing exaggerated positive qualities to self or others.
• Omnipotence:
• Acting as if self is possessed with special powers and abilities
and is superior to others.

16. • Autistic fantasy:
• Excessive daydreaming as a substitute for human relationship,
effective action or problem solving.
• Projective identification:
• Falsely attributing to another the feelings thoughts or impulses of
self, differing from simple projection by the fact that the individual
doesn't fully disavow what is projected; rather miss attributes them
as justifiable reactions to the other person.
• Frequently the individual induces those very feelings in others that
were believed to be there, making it difficult to untangle the
situation.
• Splitting of self image:
• Compartmentalizing opposite effect states and failing to integrate
the positive and negative qualities of self orders into cohesive
images self an object images tend to alternate between polar
opposites

17. • Delusional projection:
• Attributing non reality based thoughts emotions and impulses
to others delusions about external reality usually of a
persecutory nature example blaming others society history
economy for self failure
• Psychotic denial:
• Gross impairment of reality testing.
• Psychotic distortion:
• Gross impairment in pursuing reality differently than others.

18. IMMATURE DEFENCES:
• Fairly common in preadolescents years and in adult
character disorders.
• Often mobilized by anxieties related to intimacy or its
loss.
• Although regarded as socially awkward and
undesirable, they often moderate with improvement in
interpersonal relationships or with increased personal
maturity.

19. ACTING OUT
• The direct expression of an unconscious wish for impulse
in action to avoid being conscious of the accompanying
affect. The unconscious fantasy, involving objects, is lived
out and impulsively enacted in behavior, thus gratifying
the impulse more than the prohibition against it. On a
chronic level, acting out, Involves giving in to impulses to
void the tension that would result from postponement of
their expression.
• Acting out may include fighting, throwing fits, or
stealing. In severe cases, acting out is associated with
antisocial behavior.

20. BLOCKING
• Patient blocks out bad thoughts or memories, having
no memory of them.
• Eg.:
• During exams or viva.
• Introducing girlfriend to family.

21. HYPOCHONDRIASIS
• Exaggerating or overemphasizing an illness for the
purpose of evasion and regression.
• Responsibility can be avoided , guilt can be
circumvented and instinctual impulses are warded off.

22. PROJECTION
• Mechanism by which the ego attributes its own
intolerable sexual and aggressive impulses to the
outside person or agency.
• Coping with one’s unwanted motives by shifting them
on to someone else.
• Anxiety arising from internal conflicts can then be
reduced and problem dealt with as though it were in
the external world.

23. INTROJECTION
• Introjection is the opposite of projection. Introjection, which is common
among children and parents, occurs when a person internalizes the
beliefs of other people.
• While everyone learns from the external world and takes on elements of
other people’s beliefs and ideas, introjection occurs with minimal
thought. A woman who adopts her friends’ views, after they have been
carefully explained and considered, is not introjecting, but a child who
reflexively adopts a parent’s views without thought can be said to
be introjecting.
• Introjections involve attitudes, behaviors, emotions, and perceptions
that are usually obtained from influential or authoritative people in one’s
life. They are neither digested nor analyzed; they are simply adopted as a
part of one’s personality as concepts that one considers should be
believed or behaviors that one thinks ought to be followed. Introjections
do not involve an individual’s personal integrity or morality.

24. PASSIVE AGGRESSIVE BEHAVIOUR
• These patients turn their anger against themselves.
This phenomenon is called masochism, includes
procrastination, silly or provocative behavior, self
demeaning ,clowning and frankly self destructive acts.
• Instead of expressing hostility against another person,
represses the hostility but ventilates it against own self
in the form of self criticism and self accusation.

25. REGRESSION,
• Attempting to return to an earlier libidinal phase of functioning to
avoid the tension and conflict evoked at the present level of
development.
• The ego abandons the matured path of gratification and takes resort
to pregenital or less objectionable attitude towards its object of
gratification.
• Regression is normal phenomenon as well. Some amount of
regression is needed for relaxation, sleep and orgasm in sexual
intercourse.
• In the face of threat, one may retract to an earlier pattern of
adaptation, possibly a childish or primitive one.
• For eg, an adolescent who is overwhelmed with fear, anger and
growing sexual impulses might become clingy and start exhibiting
earlier childhood behaviors he has long since overcome, such as
bedwetting, nail biting etc.

26. SCHIZOID FANTASY
• Indulge in Autistic fantasy (daydreaming, eccentric speech) to
resolve conflict and to obtain gratification.
• Inter personal intimacy is avoided and eccentricity serves to
repel others.
• The person does not fully believe in fantasies and does not insist
on acting them out.
• Example: A 15-year-old boy dreams of being the world chess
champion. He spends nearly all of his time alone studying the
game and won't discuss other topics.
• Clinically seen in Schizoid & Schizotypal Personality ,Narcissistic
Personality Disorders.

27. SOMATISATION
• Converting psychic derivatives into bodily symptoms
and tending to react with somatic manifestations
rather than with psychic manifestations.

28. NEUROTIC DEFENCES:
• Common in apparently normal, healthy individuals as
well as in neurotic disorders.
• Function usually in the alleviation of distressing affects
and may be expressed in neurotic forms of behaviour.
• Depending on circumstances, they can also have an
adaptive or socially acceptable aspect.

29. CONTROLLING
• Attempting to manage or regulate events or objects in
the environment to minimize anxiety and to resolve
inner conflicts.

30. DISPLACEMENT
• The motive remains unaltered but the person substitutes
a different goal object for the original one.
• Often the motive is aggression that for some reason, the
person cannot vent on the source of anger.
• Shifting an emotion or drive from one idea or object to
another that resembles the original in some aspect or
quality.
• Ex.: A man gets angry at his boss, but can’t express his
anger to his boss for fear of being fired. He instead
comes home and kicks the dog or starts an argument
with his wife.

31. DISSOCIATION
• Polly anna(subconscious bias towards the positive) like
replacement of unpleasant affects with pleasant ones.
• Temporarily but drastically modifying a persons
character or one’s own sense of personal identity to
avoid emotional distress.
• Includes fugue states and hysterical conversion
reactions.
• Personality Disorder, PTSD, Somnambulism.

32. EXTERNALIZATION
• Tending to perceive in the external world and in
external objects, elements of one’s own personality,
including instinctual impulses, conflicts, moods,
attitudes and styles of thinking.
• For example, a patient who is overly argumentative
might instead perceive others as argumentative and
himself as blameless.

33. INHIBITION
• Involuntary decrease or loss of motivation to engage
in some goal directed activity to prevent anxiety
arising out of conflicts with unacceptable impulses.
• Eg in Normal: Social Shyness.
• Clinically in OCDs & Phobias.

34. INTELLECTUALIZATION
• Excessively using intellectual process to avoid affective
expression or experience.
• To avoid intimacy with people, attention is paid to
external reality to avoid the expression of inner
feelings and stress is placed on irrelevant details to
avoid perceiving the whole.
• Professionals who deal with troubled people may
intellectualize in order to remain helpful without being
overwhelmed by sympathetic involvement.

35. ISOLATION
• Characteristic of the orderly, controlled persons who
are labelled as Obsessive compulsive personalities.
• Splitting or separation of an idea from the affect that
accompanies it, but is repressed.
• In splitting, persons towards whom patients feelings
are, or have been, ambivalent are divided into good
and bad.
• Ex. In a ward, a patient may idealize some staff
members and uniformly disparage others.

36. RATIONALISATION
• Offering rational explanations in an attempt to justify
attitudes, beliefs or behaviour that may otherwise be
unacceptable.
• It is a method to support an attitude with false
reasons.
• Substituting an acceptable conscious motive for an
unacceptable unconscious one.
• Ex.: Grapes are sour.

37. • Rationalization is very common among medical
professionals in covering up medical errors.
• “Why disclose the error?, the patient was going to die
anyway”
• “Telling the family about the error will make them feel
worse”
• “It was patient’s fault, if he wasn’t so obese, sick etc. this
error wouldn't have caused so much harm”
• “Well we did our best, these things happen.”

38. REACTION FORMATION
• Transforming an unacceptable impulse into its opposite
• Characteristic of obsessional neurosis
• If this mechanism is frequently used at any early stage of
ego development it can become a permanent character
trait, as in obsessional character.
• Thus love may cover up unconscious hate, shyness serves
as defence against exhibitionism.
• Ex : when a 2nd child is born in a family the first child may
show extraordinary concern for the welfare of the
Newborn. This way his unconscious hate and aggression
for his little brother is covered up.

39. REPRESSION
• Repression is the unconscious blocking of
unacceptable thoughts, feelings and impulses.
• Ego excludes from the consciousness all the
psychological contents which it cannot fit in
harmoniously.
• Primary Repression: Curbing of ideas and feelings
before they have attained consciousness.
• Secondary repression : Excluding from awareness what
was once experienced at the conscious level.

40. • Repressed feelings do not cease to exist by mere
expulsion from the consciousness. Ego takes further
steps to deal with these pent up impulses :
• a) Further reinforcement of repression
• b) Finding out substitute channels for outlet of
impulse.

41. SEXUALIZATION
• Endowing an object or function with a sexual
significance that it did not previously have or
possessed to a smaller degree, to ward off anxieties
associated with prohibited impulses or their
derivatives.

42. MATURE DEFENCES:
• Healthy and adaptive throughout the life cycle.
• Socially adaptive and useful in integration of personal
needs and motives, social demands, and interpersonal
relations.
• They can underlie seemingly admirable and virtuous
patterns of behaviour.

43. ALTRUISM
• Involves an individual getting pleasure from giving to
others what the individual would have liked to receive.
• Ex. Using Altruism a former alcoholic serves as an
Alcohol Anonymous sponsor to a new member,
achieving transformation process that may be life
saving.

44. ANTICIPATION
• Realistically planning or anticipating future inner
discomfort.
• Involves careful planning or worrying and premature,
but realistic anticipation of dire and potentially
dreadful outcomes.
• Ex. Moderate amount of anxiety before surgery
promotes post surgical adaptation.

45. ASCETICISM
• Eliminates pleasurable effects of experiences. Uses
morals to assign values to specific pleasures.
• Derives gratification from renunciation of all
consciously-perceived base pleasures.

46. HUMOUR
• Using comedy to overtly express feelings and thoughts
without personal discomfort and without producing an
unpleasant effect on the others.
• Mature humor allows individuals to look directly at
what is painful.

47. SUBLIMATION
• For Freud, sublimation was the highest level of ego
defence
• Consists of redirection of sexual impulses to socially
valued activities and goals.
• He believed that much of our cultural heritage is the
product of sublimation.
• Ex. A writer may divert his libido to creation of poem/
novel. Thus indirectly satisfying drives.
• Rejection by lover may induce one to divert his energy to
human welfare or artistic and literary activities.

48. SUPPRESSION
• Consciously or semi consciously postponing attention
to a conscious impulse or conflict.
• Issues may be deliberately cut off but they are not
avoided.

49. • Underlying defenses—the unconscious mental processes
that the ego uses to resolve conflicts among the four
lodestars of the inner life: instinct (wish or need), reality,
important persons, and conscience.
• When defenses are most effective, especially in those
with personality disorders, they can abolish anxiety and
depression.
• Thus, abandoning a defense increases conscious anxiety
and depression—a major reason that those with
personality disorders are reluctant to alter their behavior.

50. WHERE DO DEFENCE
MECHANISMS OPERATE ?
• Delusional disorder:
• Reaction Formation: against Aggression, Dependence Needs
and feelings of Affection and transform the need for
dependence into staunch independence.
• Denial: To avoid awareness of painful reality.
• Projection: To protect themselves from recognizing
unacceptable impulses in themselves.

51. • Personality disorders.
• Fantasy: many people with schizoid personality, seek solace
and satisfaction within themselves by creating imaginary lives,
especially imaginary friends.
• Dissociation/Denial: behave like anxious adolescent adults
who, to erase anxiety, carelessly expose themselves to exciting
dangers,
• Isolation: characteristic of controlled, orderly persons who are
often labelled obsessive-compulsive personalities. Remember
the truth in fine detail, but without affect.
• Projection:

52. • Splitting: Persons towards whom patients’ feelings are
ambivalent are divided into good and bad.
• Passive Aggression: Turn their anger against themselves.

53. • Substance use disorder.
• Denial: often the 1st Line of Defence. He will reason that
because he hasn’t lost a job or been rushed the ER, there
not be a problem.
• Compartmentalization: when a addict separates a part of
themselves (the part that doesn’t conform to their personal
beliefs and values) from all other parts.
• Repression: Occurs when Denial no longer gets the job done.
Allows the addict to simply forget the effects of the behaviour.
• Rationalization: particularly insidious because it masquerades
as reason.

54. THANK YOU