Defense Mechanism Sergio Hernandez, MD - PowerPoint Presentation

Slide1

Defense Mechanism

Sergio Hernandez, MD

SUNY at Buffalo, School of Medicine

Department of PsychiatrySlide2

Objectives

Know the distinguishing features between adaptive and maladaptive defense mechanisms.

Define each defense mechanism presented.

Give an example of each defense mechanism presented.Slide3

Defense Mechanism Definition

Universal phenomena that are part of adaptive function.

Defenses may be adaptive or maladaptive depending on:

The degree to which reality is distorted.

The flexibility or rigidity of the defense.

Whether it serves the intended goal of adaptive equilibrium.Slide4

Defense Mechanisms

It is important to remember that defense mechanisms are largely

unconscious

.

They function in us to resolve intrapsychic conflict (conflicting feelings, wishes, impulses, etc.) and the anxiety it produces.Slide5

Becoming a Self

3 important stages:

Mimicry

: the imitation of another’s behavior.

Introjection

: a loved or hated person, or part of a person is incorporated into one’s self, but

retains the identity of the original person

.

Identification

: the taking over of attitudes and behaviors of significant others and

experiencing those attributes as part of one’s own identity

.Slide6

Definitions of Common Defenses

Immature Defenses:

Repression

Denial

Displacement

Reaction Formation

Projection

Rationalization

Intellectualization

Isolation

Splitting

Projective Identification

Mature Defenses:

Suppression

Sublimation

Humor

AltruismSlide7

Repression

Removing threatening or unacceptable memories, impulses, and thoughts from awareness.

The repressed material is

not subject to voluntary recall

.

A patient cannot recall any interactions with his angry volatile father from ages 10-14 despite excellent recall of other events during this time period.Slide8

Denial

Protecting one’s self from unpleasant reality by refusing to perceive it.

“Missing the obvious.”

A patient with chronic bipolar disorder stops taking medications stating, “I’ve never been mentally ill.”Slide9

Displacement

Emotions, ideas, or wishes are transferred from their original object and directed to a more acceptable substitute.

A surgical resident who is angry with her attending chastises and humiliates her medical students for being “difficult and helpless.”Slide10

Reaction Formation

Directing overt behavior and attitute in precisely the opposite direction of one’s underlying, unacceptable impulses.

A secretary who hates her boss and cannot quit her job has violent impulses towards him but instead bakes him cookies.

A teenager with homosexual impulses that would be unacceptable to family instead bullies and mocks an openly homosexual classmate.Slide11

Projection

Attributing to others one’s own unacceptable impulses, thoughts, and desires.

A husband in couple’s therapy accuses his wife of not trusting him and wanting a divorce, despite his own frequent jealous accusations and attempts to sabotage their therapy.

A patient screams at his therapist, “I’m not angry! You’re angry!” as the therapist sits quietly.Slide12

Rationalization

Thinking up logical, socially approved reasons for our past, present or proposed behavior.

An office worker who is embezzling money from his firm explains his behavior by thinking, “they won’t even miss the money and I need it more than they do!”Slide13

Intellectualization

The use of scientific or abstract thinking as a means of avoiding affectively painful realities or thoughts

A medical school professor announces to his class that he has just been diagnosed with terminal cancer, and goes on to discuss the cellular make-up of the malignancy as well as the statistical survival rates.Slide14

Isolation

Separating emotional components from a thought, resulting in repression of either the emotion or the idea

A patient in therapy describes the details of her son’s sudden death without emotion. When asked the patient says she was “emotionally devastated.”

A resident entering his old medical school to give a lecture experiences a feeling of panic and anxiety “out of nowhere” without recognizing the cognitive component of the memory.Slide15

Splitting

Perceiving one’s self and others as “all good” or “all bad” rather than experiencing self or others ambivalently (good and bad).

Splitting is often used with other defenses such as idealization or devaluation.Slide16

Personality Integration

Good

mom

Bad mom



Integration

Mom:

Good and BadSlide17

Splitting

Good Mom

Bad Mom



Good Mom

Bad Mom

Trauma, abuse

Prevent Integration

No capacity to see an object as both good AND bad. There is only either/or.Slide18

Splitting

A patient tells a medical student that she has “the worst psychiatrist and counselor ever” but is now relieved because “You’re the only one who listens to me!”

– Splitting between others

A woman initially regards her new supervisor as “the best boss ever” but after feeling shamed in a meeting reverses her opinion and describes him as “evil.”

– Splitting within a single other personSlide19

Splitting

A young man in therapy alternately refers to himself as “completely worthless” or “the best thing that has ever happened to this town” depending on relatively trivial events that precede each session.

– Splitting of the selfSlide20

Projective Identification

A defense whereby the person induces, by projection, their own feelings in another person and that other person unknowingly acts out those feelings.Slide21

Mature Defenses

Suppression

Sublimation

Humor

AltruismSlide22

Suppression

A deliberate conscious effort to control and conceal disturbing thoughts, feelings, or acts.

A mother who learns that her sister was rushed to the hospital is able to stay calm and call a friend to look after her child before leaving for the hospital and bursting into tears.Slide23

Sublimation

Diverting basic drives or impulses into socially appropriate channels.

A frustrated medical student channels his angry, destructive impulses into contact sports and home improvement projects.Slide24

Humor

Seeing the comic side of situations as a means of diffusing negative affects such as anxiety.

A newly divorced middle aged man jokes about his inability to dance as a way to relieve his insecurity and anxiety.Slide25

Altruism

Taking a negative experience and turning it into a socially positive one.

A wealthy business owner who was raised in poverty donates a large sum of money anonymously to a children’s charity at Christmas.Slide26

Take Home Points

Defense mechanisms are primarily unconscious processes meant to resolve intrapsychic conflict and decrease anxiety.

Some defenses are more adaptive than others.

Defenses can be used to both assess and treat patients, by allowing us to view behavior more objectively and take it less personally.