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Ruhama Aschalew Asfaw

Understanding Defense Mechanisms



In psychiatry defense mechanisms are strategies used by the ego so as to cope with stressors and avoid unpleasant feelings. These strategies are mostly unconscious (can be normal to pathologic) and are classified into 4 groups.


Pathological or Narcissistic – these mechanisms are usually seen in children and in people with personality disorders and are the least mature of all the defense mechanisms. This group includes

  • Splitting - is an all or nothing view that tends to manifest as extreme stereotyping.

  • Projection - ascribing one’s own unwanted feeling or thought to another person for example a person saying my friend is jealous of me when in reality he is the jealous one.

  • Denial - completely dismissing or not accepting external reality.

  • Distortion - an altered perception of reality in order to satisfy inner feeling of superiority.


Immature (primitive) – these are common in people with anxiety, personality disorders and patients with psychosis. Defense mechanisms in this category include

  • Regression- reverting into childlike state or earlier developmental level.

  • Blocking- temporary inability to think in stressful or embarrassing moment.

  • Identification (introjection)- internalization and imitation of another person’s behaviors.

  • Undoing - doing the opposite of a negative thought to avoid guilt about it.

  • schizoid fantasy - withdrawing into one’s imagination to resolve stressful situations.

  • Hypochondriasis - exaggeration of an illness so as to avoid guilt or responsibility.

  • Fixation - the cessation of development at a specific childhood stage,

  • somatization, acting out, primitive idealization and passive aggression are also under immature defense mechanisms.


Neurotic – common in patients suffering from OCD and anxiety. Defense mechanisms under neurotic are numerous and incorporate

  • Displacement - which is transferring an emotion to a less threatening entity.

  • Intellectualization - that is over analyzing a situation to distance one’s self emotionally.

  • Isolation of affect - meaning to separate emotion from the associated situation.

  • Repression - which is an unconscious blocking of undesired thoughts.

  • Externalization - placing blame on others for one’s on behavior.

  • Dissociation – being detached from one’s self to avoid emotional distress

  • Inhibition – limiting… to avoid conflict which may lead to anxiety

  • Other mechanisms included in this category are rationalization, controlling, reaction formation, sexualization.


Mature (sophisticated) this are mechanisms used by normal adults.

  • Sublimation – directing an undesirable thought to a socially acceptable activity.

  • Altruism – serving other people to resolve guilty feeling or cope with difficult stressors.

  • Suppression – consciously blocking stressful thoughts temporarily.

  • Humor – using comedy to lessen negative emotions.

  • Anticipation - premature planning about future trouble.


References

  1. Amboss - https://www.amboss.com/us/knowledge/psychotherapy-and-defense-mechanisms/

  2. Bailey, R. and Pico, J. (2020). Defense Mechanisms. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK559106/.


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