Recommandé
Contenu connexe
Tendances
Tendances (20)
En vedette
En vedette (20)
Similaire à Defens mechanism
Similaire à Defens mechanism (20)
Dernier
Dernier (20)
Defens mechanism
- 1. DEFENSE MECHANISMS DR.SETHU.P.S JUNIOR RESIDENT DEPT. OF PSYCHIATRY GOVT.T.D.M.C ALAPPEY KERALA INDIA SETHU
- 2. INTRODUCTION • Defense mechanisms are a major component of the psychoanalytic theory • These have been used to understand psychopathology using psychodynamic concepts SETHU
- 3. HISTORICAL ASPECTS • Concept of defense mechanisms began with Sigmund Freud • In his theories of the mind, postulated certain unconscious ego processes that he called defense mechanisms • Considered “repression” as the cornerstone and also considered some other defense mechanisms SETHU
- 4. Concept was further extended by Anna Freud in her book “The ego and the mechanisms of defense” where she described sublimation, displacement, denial, identification, and altruism SETHU
- 5. • Later Kernberg and Klein described splitting, projective identification and psychotic denial • The rise of the object-relations theory further spurred new understanding into the concept SETHU
- 6. DEFINITION The concept of defense mechanisms has not been static and a uniformly acceptable definition has not been arrived at. • Habitual, unconscious and sometimes pathological mental process that is employed to resolve conflict between instinctual needs, internalized prohibitions and external reality. These mechanisms imply integrated, dynamic psychological processes. (Vaillant, 1971) • The ways and means by which the ego wards off displeasure and anxiety, and exercises control over impulsive behavior, affects and instinctual behavior. (A Freud, 1946) SETHU
- 7. • By 1970, the term, defense mechanisms, like many psychoanalytic metaphors, had beenlargely discarded by empirical social scientists. • Consistency of definition and rater reliabilitywere lacking. • Over the last 30 years, however, the idea of involuntary coping has entered the literature of empirical cognitive psychology under such rubrics as “hardiness, “selfdeception,” and “emotional coping” and “illusion.” SETHU
- 8. FROM DSM-IV • Defense mechanisms (or coping styles) are automatic psychological processes that protect the individual against anxiety and from the awareness of internal or external dangers or stressors. • Individuals are often unaware of these processes as they operate. • Defense mechanisms mediate the individual's reaction to emotional conflicts and to internal and external stressors. • The individual defense mechanisms are divided conceptually and empirically into related groups that are referred to as Defense Levels. SETHU
- 9. HIGH ADAPTIVE LEVEL • This level of defensive functioning results in optimal adaptation in the handling of stressors. • These defenses usually maximize gratification and allow the conscious awareness of feelings, ideas, and their consequences. • They also promote an optimum balance among conflicting motives. • Examples of defenses at this level are • •anticipation •affiliation •altruism •humor •self-assertion •self-observation •sublimation •suppression SETHU
- 10. MENTAL INHIBITIONS (COMPROMISE FORMATION) LEVEL • Defensive functioning at this level keeps potentially threatening ideas, feelings, memories, wishes, or fears out of awareness. • Examples are • displacement •dissociation •intellectualization •isolation of affect • reaction formation •repression •undoing SETHU
- 11. MINOR IMAGE-DISTORTING LEVEL • This level is characterized by distortions in the image of the self, body, or others that may be employed to regulate self-esteem. • Examples are •devaluation •idealization •omnipotence SETHU
- 12. DISAVOWAL LEVEL • This level is characterized by keeping unpleasant or unacceptable stressors, impulses, ideas, affects, or responsibility out of awareness with or without a misattribution of these to external causes. • Examples are •denial •projection •rationalization SETHU
- 13. MAJOR IMAGE-DISTORTING LEVEL • This level is characterized by gross distortion or misattribution of the image of self or others. • Examples are •autistic fantasy •projective identification •splitting of self-image or image of others SETHU
- 14. ACTION LEVEL • This level is characterized by defensive functioning that deals with internal or external stressors by action or withdrawal. • Examples are •acting out •apathetic withdrawal •help-rejecting complaining •passive aggression SETHU
- 15. LEVEL OF DEFENSIVE DYSREGULATION. • This level is characterized by failure of defensive regulation to contain the individual's reaction to stressors, leading to a pronounced break with objective reality. • Examples are •delusional projection •psychotic denial •psychotic distortion SETHU
- 16. VAILLANT’S FOUR STAGES • Mature • Narcissistic • Immature • Neurotic SETHU
- 17. MATURE DEFENSES • Altruism • Anticipation • Asceticism • Humor • Sublimation • Suppression SETHU
- 18. MATURE DEFENSES • Altruism • Using constructive and instinctually gratifying service to others to undergo a vicarious experience. It includes benign and constructive reaction formation. • Anticipation • Realistically anticipating or planning for future inner discomfort. The mechanism is goal-directed SETHU
- 19. MATURE DEFENSES • Asceticism • Eliminating the pleasurable effects of experiences. There is a moral element in assigning values to specific pleasures. • Humor • Using comedy to overtly express feelings and thoughts without personal discomfort or immobilization and without producing an unpleasant effect on others. SETHU
- 20. MATURE DEFENSES • Sublimation • Achieving impulse gratification and the retention of goals but altering a socially objectionable aim or object to a socially acceptable one. • Suppression • Consciously or semiconsciously postponing attention to a conscious impulse or conflict. Issues may be deliberately cut off, but they are not avoided. SETHU
- 21. NARCISSISTIC DEFENSES • Denial • Distortion • Projection SETHU
- 22. NARCISSISTIC DEFENSES • Denial • Avoiding the awareness of some painful aspect of reality by negating sensory data. Denial abolishes external reality. Denial may be used in both normal and pathological states. • Distortion • Grossly reshaping external reality to suit inner needs (including unrealistic megalomanic beliefs, hallucinations, wish-fulfilling delusions) SETHU
- 23. NARCISSISTIC DEFENSES • Projection • Perceiving and reacting to unacceptable inner impulses and their derivatives as though they were outside the self. • On a psychotic level, this defense mechanism takes the form of frank delusions about external reality (usually persecutory) and includes both perception of one's own feelings in another and subsequent acting on the perception (psychotic paranoid delusions). SETHU
- 24. IMMATURE DEFENSES • Acting out • Blocking • Hypochondriasis • Introjection • Passive-aggressive • Regression • Schizoid fantasy • Somatisation SETHU
- 25. IMMATURE DEFENSES • Acting out • Expressing an unconscious wish or impulse through action to avoid being conscious of an accompanying affect. • Blocking • Temporarily or transiently inhibiting thinking. Affects and impulses may also be involved. • Hypochondriasis • Exaggerating or overemphasizing an illness for the purpose of evasion and regression. SETHU
- 26. IMMATURE DEFENSES • Introjection • Internalizing the qualities of an object. • Passive-aggressive • Expressing aggression toward others indirectly through passivity, masochism, behavior and turning against the self. • Regression • Attempting to return to an earlier libidinal phase of functioning to avoid the tension and conflict evoked at the present level of development. SETHU
- 27. IMMATURE DEFENSES • Schizoid fantasy • Indulging in autistic retreat in order to resolve conflict and to obtain gratification. • Somatization • Converting psychic derivatives into bodily symptoms and tending to react with somatic manifestations, rather than psychic manifestations. SETHU
- 28. NEUROTIC DEFENSES • Controlling • Displacement • Externalization • Inhibition • Intellectualization • Isolation • Rationalization • Dissociation • Reaction formation • Repression • sexualisation SETHU
- 29. NEUROTIC DEFENSES • Controlling • Attempting to manage or regulate events or objects in the environment to minimize anxiety and to resolve inner conflicts. • Displacement • Shifting an emotion or drive cathexis from one idea or object to another that resembles the original in some aspect or quality. SETHU
- 30. NEUROTIC DEFENSES • Externalization • Tending to perceive in the external world and in external objects elements of one's own personality, including instinctual impulses, conflicts, moods, attitudes, and styles of thinking. • 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. SETHU
- 31. NEUROTIC DEFENSES • Intellectualization • Excessively using intellectual processes to avoid affective expression or experience. • Isolation • Splitting or separating an idea from the affect that accompanies it but is repressed. Social isolation refers to the absence of object relationships. SETHU
- 32. NEUROTIC DEFENSES • Rationalization • Offering rational explanations in an attempt to justify attitudes, beliefs, or behavior that may otherwise be unacceptable. SETHU
- 33. NEUROTIC DEFENSES • Dissociation • Temporarily but drastically modifying a person's character or one's sense of personal identity to avoid emotional distress. Fugue states and hysterical conversion reactions are common manifestations of dissociation. • Reaction formation • Transforming an unacceptable impulse into its opposite. Reaction formation is characteristic of obsessional neurosis, but it may occur in other forms of neuroses as well SETHU
- 34. NEUROTIC DEFENSES • Repression • Expelling or withholding from consciousness an idea or feeling. • Primary repression refers to the curbing of ideas and feelings before they have attained consciousness • secondary repression excludes from awareness what was once experienced at a conscious level. • Sexualization • Endowing an object or function with sexual significance that it did not previously have or possessed to a smaller degree in order to ward off anxieties associated with prohibited impulses or their derivatives. SETHU
- 35. CONTROVERSIES PERTAINING TO DEFENSE MECHANISMS • Defense mechanisms have certain difficulties inherent in them. • They are- • Subjective • Intra-psychic phenomena that needs to be inferred rather than observed. • Accused of lacking psychometric properties of reliability and validity. • Suspect to idiosyncratic interpretation. • Lack of consensually based definitions, common list of defense mechanisms SETHU
- 36. CLINICAL IMPLICATIONS • Pollock and Andrews (1989)- found that there were correlations between anxiety disorders and specific defense mechanisms when compared to general population. • Panic disorder- displacement • Agoraphobia- somatization, displacement, reaction formation, idealization • Social phobia- displacement, less likely to use humor • OCD- undoing, projection, acting out, less likely to use humor SETHU
- 37. • It has been postulated by Vaillant that • Cluster A PD- fantasy and projection • Cluster B PD- acting out, splitting, dissociation and devaluation. • Cluster C PD- passive aggression, hypochondriasis. SETHU
- 38. USES OF DEFENSE MECHANISMS • Defense mechanisms have important bearings in- • Diagnosis • Eliciting and understanding of psychopathology • Treatment planning and execution via various modalities • Assessment of response to treatment • Management of chronic, debilitating illnesses and cancer • Management of non-compliance SETHU
- 39. REFERENCES • Ego Mechanisms of Defense: A Guide for Clinicians and Researchers, G.E.Vaillant • Comprehensive Textbook of Psychiatry, 9th edition • Introduction to psychology, Clifford.T.Morgan, Richard.A.King SETHU
Notes de l'éditeur
- Object Relations Theory is a theory of relationships between people, in particular within a family and especially between the mother and her child. A basic tenet is that we are driven to form relationships with others and that failure to form successful early relationships leads to later problems.
- A self-made millionaire who grew up in poverty sets up a charitable foundation and gains great pleasure from how it helps others get out of the poverty trap. She receives social accolade and public recognition for her good deeds, which she carefully and modestly grateful
- I am angry. I go out and chop wood. I end up with a useful pile of firewood. I am also fitter and nobody is harmed. A person who has an obsessive need for control and order becomes a successful business entrepreneur. SUPP-I want to kick the living **** out of an idiot at the office. Instead, I smile at them and try to feel sorry for their Freudian plight
- A man hears that his wife has been killed, and yet refuses to believe it, still setting the table for her and keeping her clothes and other accoutrements in the bedroom. A person having an affair does not think about pregnancy or sexually transmitted diseases. People take credit for their successes and find 'good reason' for their failures, blaming the situation, other people, etc. Alcoholics vigorously deny that they have a problem.
- An unfaithful husband suspects his wife of infidelity
- An addict gives in to their desire for alcohol or drugs. A person who dislikes another person seeks to cause actual harm to them
- I have to give a presentation but feel scared. I put on the hat of Abraham Lincoln and imagine I am confidently giving an important address to the nation. A child is threatened at school. They take on the strong-defender attributes that they perceive in their father and push away the bully. A business leader sets high moral standards within the company. Many others follow her lead. A sales person uses a persuasive sales patter. The customer agrees that this is just what they want, but when it comes to signing the order, they find reasons why they cannot buy today REGRESSION-A person who suffers a mental breakdown assumes a fetal position, rocking and crying. A child suddenly starts to wet the bed after years of not doing so (this is a typical response to the arrival of a new sibling). A college student carefully takes their teddy-bear with them (and goes to sleep cuddling it).
- A 15-year-old boy dreams of being the world chess champion. He spends nearly all of his time alone studying the game and won’t discuss other topics.
- The boss gets angry and shouts at me. I go home and shout at my wife. She then shouts at our son. With nobody left to displace anger onto, he goes and kicks the dog.
- A person told they have cancer asks for details on the probability of survival and the success rates of various drugs. The doctor may join in, using 'carcinoma' instead of 'cancer' and 'terminal' instead of 'fata
- A person evades paying taxes and then rationalizes it by talking about how the government wastes money (and how it is better for people to keep what they can). A man buys a expensive car and then tells people his old car was very unreliable, very unsafe, etc. A person fails to get good enough results to get into a chosen university and then says that they didn't want to go there anyway. A parent punishes a child and says that it is for the child's 'own good'.
- A person who is angry with a colleague actually ends up being particularly courteous and friendly towards them. A man who is gay has a number of conspicuous heterosexual affairs and openly criticizes gays. A mother who has a child she does not want becomes very protective of the child. An alcoholic extols the virtues of abstinence.
- A child who is abused by a parent later has no recollection of the events, but has trouble forming relationships