Defense Mechanism 683e6n

Elmeida Effendy- Mustafa M Amin Psychiatric Department Medical Faculty-USU

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 At each phase of libidinal development, specific drive

component evoke characteristic ego defenses.

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The Developmental of Ego Defense Born : Projection Denial Introjection

Latent : Sublimation

Oral : Displacement Identification

Anal : Reaction formation Isolation Regression

Phallic : Intelectualization Repression Simbolization

 Defenses can be grouped hierarchically according to

relative degree of maturity associated with them :  1. Narcissistic defenses  2. Immature defenses  3.Neurotic defenses

 4. Mature defenses

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Narcissistic Defenses  Denial : avoiding the awareness of reality by negating

sensory data  eg : patients with malignant tumor insists she does not have cancer  Distortion : grossly reshaping external reality to suit inner needs (including unrealistic megalomania beliefs, hallucinations, wish-fulfilling delusions) and using sustained feelings of delusional superiority or entitlement.  Projection : perceiving and reacting to unacceptable inner impulses and their derivatives as though they were outside the self. 5

Immature Defenses  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, rather than the prohibition against it.  eg : by angry with his friend  punch  Blocking : temporarily or transiently inhibiting thinking. Affects & impulses may also be involved. Closely resembles repression but differs in that tension arises, when the impulse, affect or thought is inhibited 6

 Hypochondriasis : exaggerating or overemphasizing

an illness for the purpose of evasion & regression  Introjection: internalizing the qualities of an object with the goal of closeness to & constant presence of the object eg : fail in exam  didn’t study

 ive-aggressive behavior : expressing aggression

toward others, indirectly through ivity, masochism & turning against the self eg : sorry..I thought you didn’t want the cake…I ate it all

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 Regression: attempting to return to an earlier libidinal

phase of functioning to avoid the tension & conflict evoked at the present level of development. It reflects the basic tendency to gain instinctual gratification at a less-developed period.  eg : 7 year old girl resumes bed wetting when sibling were born  Schizoid fantasy: indulging in autistic retreat to resolve conflict & to obtain gratification. Interpersonal intimacy is avoided, & eccentricity serves to repel others.  eg : man w/ erectile dysfunction daydreams about

orgies party 8

 Somatization : converting psychic derivatives into bodily

symptoms & tending to react with somatic manifestations, rather than psychic manifestation

 eg : afraid of being bullied at school  child develop

stomachache

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Neurotic Defenses  Controlling : attempting to manage or regulate events

or objects in the environment to minimize anxiety & to resolve inner conflicts  eg : Lia wants to the exam for the medical faculty  study hard day & night  Displacement : shifting an emotion or drive cathexis from one idea or object to another that resembles the original in some aspect or quality

eg : a woman is abandoned by her fiance, she quickly finds another man about whom she develops the same feelings 10

 Externalization : tending to perceive in the external

world & in external objects elements of one’s own personality, including instinctual impulses,conflicts, moods, attitudes & style of thinking. Externalization is a more general term than projection

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 Inhibition : consciously limiting or renouncing some

ego functions, alone or in combination, to evade anxiety arising out of conflict with instinctual impulses, the superego or environmental forces or figures  Intellectualization : excessively using intellectual process to avoid affective expression eg : a person who has just been diagnosed with a terminal illness might focus on learning everything about the disease in order to avoid distress and remain distant from the reality of the situation.

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 Isolation : splitting or separating an idea from the

affect that accompanies it but is repressed  . eg : a bank teller appears calm and cool while

frustrating a robbery but afterward is tearful and tremulous

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 Rationalization: offering rational explanations in

attempt to justify attitudes, beliefs, or behavior that may otherwise be unacceptable eg : stating that you were fired because you didn't kiss up the the boss, when the real reason was your poor performance  Dissociation : temporarily but drastically modifying a

person’s character or one’s sense of personal identity to avoid emotional distress eg : hysterical conversion

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 Reaction formation : transforming an unacceptable

impulse into its opposite eg : a married woman who is disturbed by feeling attracted to one of her husband's friends treats him rudely

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 Repression : expelling or with holding from

consciousness an idea or feeling. Primary repression refers to the curbing of ideas and feelings before they have attained consciousness: eg : forbidden sexual impulse Secondary repression excludes from awareness what was experienced at conscious level. eg : forgetting sexual abuse from her childhood due to the trauma and anxiety

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 Sexualization :endowing an object or function with

sexual significance that it did not previously have or possessed to a smaller degree to ward off anxieties associated with prohibited impulses

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Mature Defenses  Altruism: using constructive and instinctually

gratifying service to others to undergo a vicarious experience. eg : government employee  no complaint

 Anticipation: realistically anticipating or planning for

future inner discomfort. eg : planning older life

 Asceticism: eliminating the pleasurable effects of

experiences. 18

 Humor : using comedy to overtly express feelings and

thoughts without personal discomfort or immobilization and without producing an unpleasant effects and others.  Sublimation : achieving impulse gratification and the retention of goals but altering a socially objectionable aim or object to a socially acceptable one. eg : Andy always fight w/ his friends  karate

 Suppression: consciously or semiconsciously

postponing attention to a conscious impulse or conflict.  eg : patient 19