Defense mechanisms are techniques used by individuals to reduce anxiety and resolve conflicts. They range from normal and successful mechanisms like repression and rationalization to less adaptive unsuccessful ones like denial and projection. Successful mechanisms help deal with reality while unsuccessful ones can create emotional problems if used excessively. Defense mechanisms originate from different developmental periods, and understanding them helps nurses support patients and their families cope with difficult diagnoses and end-of-life situations.

1. DEFENSE MECHANISM

2. Introduction
Defense mechanism are used to reduce
anxiety or resolve conflict by modifying
or changing one’s behaviors. Use of
defense mechanism is a normal process
of adjustment. However sometimes use
of these defense mechanism, can also
interfere with proper decision making
which may give rise to mental disorders..
Also known as mental mechanism.

3. Definition
Defense mechanism are the
techniques or mechanism used by an
individual to handle tension or reduce
anxiety or resolve conflict. These
provide initial protection for the
personality.

4. Types
 Successful mechanism
 Unsuccessful mechanism

5. 1- Successful mechanism
 Repression
 Rationalization
 Intellectualization
 Compensation
 Substitution
 Sublimation
 Identification

6. 2- Unsuccessful mechanism
 Suppression
 Reaction formation
 Displacement
 Denial
 Isolation
 Projection

7. Cont…
 Regression
 Conversion
 Fixation
 Fantasy
 Withdrawal
 Transference

8. 1- Successful mechanism
Commonly used normal defense
mechanism that help an individual to
deal with reality.

9. a) Repression
Unconscious involuntary forgetting of
painful thoughts. Impulses, feelings or
acts that are creating conflicts and
causing discomfort.
According to Freud ,
repression is basic
to all other forms of
defense mechanism

10. Cont..
E.g. A child may full angry with his
mother because she had punished
him. If he feel too guilty about his
anger he may be shown by the
accidental breaking of his favorite
things or in his bed wetting or refusal
of food.

11. b) Rationalization
Is the joy and delight of the average
human being. It is simply finding a
logical reason for the things one
wants to do.

12. Cont..
 e.g. The women who overspends to buy a
dress explains its purchase to her
husband and herself that the dress was on
scale and she may not get it so cheap
afterwards. A phrase “grapes are Sour” is
another example of rationalization.

13. c)Intellectualization
It is the distancing from on emotional
or threatening situation by talking or
thinking about it in intellectual terms

14. Cont..
e.g. A nurse, doctor or paramedical
worker cannot afford to become
emotionally attached to each patient.
So they use the technique of
detaching themselves from emotions
through calm abstract statements
about the situation

15. d)Compensation
Putting forth extra efforts to achieve
in an area to affect real, or imagined
deficiencies in another area. It means
something given to replace a loss to
make up defect.

16. Cont…
E.g. A student who fails in his studies
may compensate by becoming the
college champion in athletics.

17. e) Substitution
The individual preplaced one goal for
another or involve more acceptable
form of activity than displacing the
emotion on the another individual

18. Cont…
E.g A student who has not been able
to get admission to the MBBS course
may try to substitute it with a course
of physiotherapy.

19. f) Sublimation
Diverting unacceptable drives or
urges into a form that is acceptable to
society. The most important of these
are sexual desires others are
aggressive feeling. Agreed and even
lying.

20. Cont..
E.g A young man who has lost his
lover may turn to write poetry about
love.

21. g)Identification
Attaching to oneself certain qualities
associated with others, it operates
unconsciously and is significant
mechanism in super-ego
development.

22. Cont..
E.g Girls identify with their mother.
Later perhaps with their teacher, and
later still perhaps with a film star.
An illiterate father often takes his
son’s higher education as own
achievement.

23. 2) Unsuccessful mechanism
These are also called as
compensatory type defense in terms
of stress, when used in moderation
are adaptive, if used to excess they
frequently create emotional problems.
These patterns of behavior are
considered deviation and are usually
looked as symptoms of emotional
problem.

24. Suppression
Intentional or conscious, voluntary
forgetting of painful or unacceptable
thoughts, ideas, feelings and situation
that are creating conflict and causing
discomfort.

25. Cont..
E.g. A student consciously decides
not to think about her weekend so
that she can study effectively.

26. Reaction formation
It is something possible to conceal a
motive from ourselves by giving
strong expression to its opposite.

27. Cont..
E.g. the mother of an unwanted child
may feel guilt and so becomes over
indulged and overprotective of the
child to assure that she is a good
mother.

28. Displacement
Means substitute the real object of
owns feeling which are often
aggressive with another object.

29. Cont…
E.g. a person who is angry with his
boss, but cannot show it for
fear of loosing the job
may fight with his wife and
children on return from the
office or kick his dog.

30. Denial
Denial of reality is when we refuse to
accept or believe the existence of
something that is very unpleasant to us.
We use denial most often when faced with
death, serious illness or something painful
and threatening. Parents of fatally ill
children will also deny the serious nature
of illness for some times.

31. Cont….
Denial is quite harmless if practiced
in moderation, but can lead to serious
difficulties in health and life style if
practiced to excess.

32. Isolation
Separation of thoughts ideas or
impulses from its associated affect
ensuring that action does occur
E.g. If a teenage boy got an accident
with his bike he stops riding bike and
never talks about it.

33. Projection
Transferring the responsibility for
unacceptable ideas impulses wishes or
thoughts to another person. It is an
attempts to deal with our own shortcoming
by seeing them in other and denying them
in ourselves.
E.g. The student who believes that
everybody cheats in examination may also
cheat in the same way.

34. Regression
Returning to earlier develop mental level
involving less mature behavior and
responsibility when stress creates problem
at the present stage e.g. An adult
behaving like a child as practicing
regression or e.g. when the nurse makes
an error in giving medicines or nursing
care and then starts crying.

35. Conversion
 The unconscious expression of mental conflict
by means of physical symptoms that can be
expressed openly and without anxiety. E.g. the
boy who hates his father and is torn between
the desire to strike at him and fear of the
consequences if he does so develop a
paralyzed arm.

36. Fixation
It refers to the point in the individual
development at which certain aspects of the
emotional development do not advance. It is
inability of the individual to specific phase of
development at which progress ceased or
stopped.
E.g. thumbs sucking in adult age is an
example of fixation at oral phase.

37. Fantasy
In this we retire to make belief world where
everything is possible, where we are victors or
conquerors. This is more pronounced during
adolescence.
E.g. when one is having financial problem one
can escape from them temporarily by planning
how to spend an imaginary fortune.

38. Withdrawal
Whenever an individual suspects that he likely
to be criticized, disgraced on account of some
prior unfortunate experiences or failure, he
resorts to withdrawal. It is a protective devices
by which the individual prevents future hurt
and damage to his security by withdrawal from
people and avoiding all close interpersonal
relation.

39. Transference
The image of one person is unconsciously
identified with that of another
e.g. a patient who is found of his daughter
finds the nurse of the same age and height as
his daughter. So he transfer his positive
emotions to his nurse as his daughter. It may
be possible that he dislike his daughter and
shows his negative emotions to nurse by being
rude aggressive or abusive without any cause.

40. Defense mechanism and their
origin
 Origin in oral phase(0-2 years)
Compensation
Displacement
Denial
Fixation

41. Cont..
 Origin in habit training period (1-3
years)
 Conversion
Identification
Reaction formation
Transference
Sublimation

42. Cont…
 Origin in later period of childhood
(3-6 years)
Repression
Regression
Rationalization

43. Cont…
 Origin in latency period(6-12 years)
 Projection

44. Defense mechanism and the
nurse
 Understanding defense mechanism will
enable the nurse to support the patient
and his family. Denial e.g. in a common
reaction to a serious diagnosis or at the
time of death. The patient and his family
should be allowed to deny the situation
until they are prepared to face the reality.
The patient will often practice regression
thought tears, trembling or demanding
special treatment.

45. Cont…
Some patient may also practice
withdrawal and should be allowed to do
so.
Both well adjusted and
maladjusted individual make use of the
defense mechanism for their daily life. The
well adjusted individual use them
sparingly and in socially desirable ways,
whereas the maladjusted individual
including psychosis and neurotics use
them too frequently and inappropriately.

46. Bibliography
 Kapoor Bimla. Textbook of psychiatric
nursing;vol-I. Ed-2nd, Pub kumar publication,
P.p-19-24.
 Baswantappa BT. Fundamental of nursing
nursing; Ed-2nd ,pub- jaypee, P.p. 788-789.
 Jacob Anthika. Psychology for graduate
nurses; Ed-4th, pub-jaypee, P.p. 121-133.
 Sethi neeraj. Essential of psychiatry; Ed-2nd,
pub- lotus, p.p. 29-31