The document discusses Freud's concept of defense mechanisms, which are unconscious strategies used by the ego to reduce anxiety and maintain self-esteem. Defense mechanisms filter out disturbing thoughts and keep inner conflicts from entering consciousness. They become maladaptive when used rigidly or to excess. Common defense mechanisms include repression, suppression, rationalization, and projection.

2. According to Freud, everyone uses defense
mechanisms on an ongoing basis to screen out
potentially disturbing experiences.
 A problem arises when they are used in a rigid
or extreme manner.

3. The ego protects itself by employing a number of
defense mechanisms. According to Hough (2002),
defense mechanisms are strategies designed to protect
the individual against painful anxiety and ensure that the
ego is not overwhelmed.

4. Defense mechanisms are unconscious mental techniques
used by the ego to keep conflicts out of the conscious mind,
thus decreasing anxiety and maintaining a person's sense of
safety, equilibrium, and self esteem.
Ego- the part of the mind that mediates between the
conscious and the unconscious and is responsible for reality
testing and a sense of personal identity .Compare with id
and superego.

5. Psychological strategies brought into play by the
unconscious mind to manipulate, deny, or distort
reality and to maintain a socially acceptable self
image.

6. To protect against anxiety, people use various tactics
to keep unacceptable thoughts, instincts and feelings
out of conscious awareness.

7. Adaptive defenses
- Healthy responses to stressful situations
 Maladaptive defenses

8. SUPPRESSION deliberately pushing personally
unacceptable emotions out of conscious awareness
(the only defense mechanism that includes some aspect
of consciousness).
Making a conscious decision not to think about financial
problems while studying for an exam.


9. Expressing personally uncomfortable feelings
without causing emotional discomfort (a
relatively "mature" defense mechanism.
e.g. John jovially talks about the humiliating
experience in which he slipped on the mud
while a group of people watched.

10. Expressing a personally unacceptable feeling in
a socially useful way.
– e.g. A man who got into fights as a teenager
becomes a professional boxer.

12. – Shifting unacceptable feelings or impulses from
the target of those feelings to someone less
threatening or to an object.
– e.g. after John was criticised by his boss, he
remained quiet but later shouted at his subordinate
for no good reason.

13. Using the mind's higher functions to avoid experiencing
emotion.
A sailor whose boat is about to sink calmly explains the
technical aspects of the
hull damage in great detail to the other crew members.
Rather than focus on the upsetting aspects having the mother
admitted to the old people’s home, john spoke at length about
the difficult economic times.

14. Adopting opposite attitudes to avoid personally
unacceptable emotions.


15. Unconscious expelling disturbing wishes, thoughts or
experiences from awareness.
e.g. John was unable to remember any of the details
associated with his traumatic road traffic accident.

16. The most basic and fundamental defence mechanism is
called repression and implies the purposeful forgetting of
anxiety-laden thoughts, memories or desires.
 Extreme reactions as well as high levels of anxiety can be
indicative of repressed thoughts and feelings. A 5-year-old
child who was previously toilet-trained begins to wet the
bed when his mother has a new baby .
Reverting to behavior patterns like those seen in someone
of a younger age.

18. Expressing a personally unacceptable feeling (e.g.,
rage) in a socially acceptable way (a relatively
"mature" defense mechanism)
A man who got into fights as a teenager, becomes a
professional prize fighter.

19. Attributing one's own personally unacceptable feelings to
others. Associated with paranoid symptoms and prejudice.
E.g.- A man with unconscious homosexual impulses begins to
believe that his boss is homosexual

20. Distorting one's perception of an event so that its negative
outcome seems reasonable.
A man who loses an arm in an accident says the loss of
his arm was good because
it kept him from getting in trouble with the law .

21. Not accepting aspects of reality that a person finds
unbearable.
– e.g. An alcoholic insisting that he is a social drinker.

22. Dealing with emotional conflict or stress by actions rather
than thoughts and feelings.
– e.g. A depressed 14 year old girl has sexual encounters
with multiple partners after her parent’s divorce.

23.  -Transference and countertransference are unconscious
mental attitudes based on important past personal
relationships. These phenomena increase emotionality
and may thus alter judgment and behavior in patients'
relationships with their nurse (transference) and nurse'
relationships with their patients (countertransference).

24. In positive transference, the patient has confidence in the
doctor. If intense, the patient may over-idealize the nurse or
develop sexual feelings toward the nurse.
In negative transference, the patient may become resentful or
angry toward the nurse if the patient's desires and expectations are
not realized. This may lead to noncompliance with medical advice.

25. In countertransference, feelings about a patient who
reminds the nurse of a close friend or relative can
interfere with the nurse's medical judgment.