Psychiatry

Defense MechanismsSigmund Freud

- Founder of Psychoanalysis

When it comes to unraveling the mysteries of the human mind, no body of knowledge approaches that of psychoanalytic theory.

1. The Topographic model: The mind is divided into 3 regions- the conscious, preconscious and unconscious systems

2. Stages of Psychosexual developmentoral phalicanal latencyurethral genital

3. Structural theoryId - reservoir of all instinctual drivesEgo - control motility, perception, contact with reality, and the delay and modulation of drive expressions - essential for self preservationSuperego- the moral conscience based on values and ideals internalized from one’s parents

The Defensive Functions of the Ego“The Ego and the Mechanisms of Defense”

Anna Freud, 1936

Defense Mechanisms: emerge as a reflection of the ego’s attempts to mediate between the pressures of the id and the demands of external reality

Properties of Defense Mechanisms They manage instinct, drive and affect. They are unconscious. They are discrete. They are dynamic and reversible. They can be adaptive, as well as

pathological. They may be used singularly or in tandem

with other defenses.

Classification of Defense Mechanisms Immature Defenses Neurotic Defenses Mature Defenses

Immature Defenses (10)

1. Denial

- Avoiding awareness of some painful aspect of reality by negating sensory data. Painful external reality is abolished.

2. Distortion- Grossly reshaping external reality to

suit inner needsex., megalomanic beliefs, hallucinations, grandiose delusions

3. Projection- Perceiving and reacting to

unacceptable inner impulses and their derivatives as though they were outside the self and subsequent acting on the perception.

4. Acting out- Expressing an unconscious wish or

impulse through action to avoid being conscious of an accompanying affect. The unconscious fantasy is lived out impulsively in behavior thereby gratifying the impulse.

5. Hypochondriasis- Exaggerating or overemphasizing an

illness for the purpose of evasion and regression.

- Responsibility can be avoided, guilt may be circumvented & instinctual impulses are warded off.

6. Introjection- Internalizing the qualities of another

person.ex., introjection of a loved object, identification with the aggressor

7. Passive-aggressive behavior- Expression of aggression toward

others indirectly through passivity, masochism & turning against the self.

Ex., failures, procrastination

8. Regression- Attempting to return to an earlier

psychosexual phase of development to avoid tension & conflict evoked at the present level of development.

- Regression may be needed in relaxation, sleep, orgasm and in the creative process.

9. Schizoid fantasy- Indulging in autistic retreat to resolve

or avoid conflict. Intimacy is avoided and eccentricity serves to repel otrhers.

10. Somatization

- Converting psychic derivatives into bodily symptoms & reacting with somatic, rather than psychic manifestations.

Neurotic Defenses (7)

1. Controlling- Attempting to manage or regulate

events or objects in the environment to minimize anxiety & to resolve inner conflicts.

2. Displacement- Shifting an emotion or drive from one

idea or object to another that resembles the original in some aspect or quality. This permits the symbolic representation of the original idea or object by one that evokes less distress.

3. Dissociation- Temporarily but drastically modifying

a person’s character or one’s sense of personal identity to avoid emotional distress.

4. Intellectualization- Excessively using intellectual

processes to avoid affective expression or experience. Focus is on the inanimate to avoid intimacy with people, to external reality to avoid expression of feelings & on irrelevant details to avoid perceiving the whole.

5. Rationalization- Offering rational explanations in an

attempt to justify attitudes, beliefs, or behavior that may otherwise be unacceptable.

6. Reaction formation- Transforming an unacceptable

impulse into its opposite.Ex. Obsessional neurosis

7. Repression- Expelling or withholding from

consciousness an idea or feeling. Conscious perception of instincts or feelings is blocked.

Mature Defenses (6)

1. Altruism- Using constructive & instinctually

gratifying service to others to undergo a vicarious experience. May include reaction formation.

2. Anticipation- Realistically anticipating or planning

for future inner discomfort.

3. Asceticism- Eliminating the pleasurable effects of

experiences. Gratification is derived from renunciation, and asceticism is directed against all base pleasures perceived consciously.

4. Humor- Using comedy to overtly express

feelings & thoughts without personal discomfort or immobilization & without producing an unpleasant effect on others. A form of displacement that involves distraction from the affective issue.

5. Sublimation- Achieving impulse gratification & the

retention of goals but altering a socially objectionable aim or object to a socially acceptable one.

6. Suppression- Consciously or semiconsciously

postponing attention to a conscious impulse or conflict. Issues may be deliberately cut off but they are not avoided. Discomfort is acknowledged but minimized.