concept of signal anxiety</li></li></ul><li>Otto F. Kernberg -theory of borderline personality organization ,based on ego psychological object relations theory.<br />Robert Plutchik-defenses as derivatives of basic emotions.<br />George EmanVaillant-a continuum related to their psychoanalytical developmental level<br />
Projective Techniques-Rorschach ink-blots&TAT</li></li></ul><li>Acting out<br /><ul><li>Expression of an unconscious impulses through actions ,thereby gratifying the impulses rather than prohibiting it
Usually anti-social ,addiction form</li></ul>Clinical illustration:<br /><ul><li>Temper tantrums
Rebellious behaviors</li></li></ul><li>INTROJECTION<br /><ul><li>Unconscious internalization of the qualities of an object or person
When used as a defense, it can obliterate the distinction between the subject and the object
Classic example is identification with the aggressor
Stockholm syndrome</li></ul>Clinical illustration<br /><ul><li>Depression</li></li></ul><li>Passive aggression<br />Hypochondriasis<br /><ul><li>Expressing aggression towards others indirectly through passivity ,masochism and turning against the self
Manifestation -failure,procrastination,illness that affect others
Exaggerating and overemphasizing an illness for the purpose of evasion and regression
responsibility can be avoided ,guilt may be circumvented,and instinctual impulse are warded off </li></li></ul><li>REGRESSION<br /><ul><li>Attempting to return to an earlier libidinal phase of functioning to avoid the tension and conflict evoked at the present level of development
Temporary reversion of the ego to an earlier stage
Essential for relaxation, sleep, and orgasm</li></li></ul><li>Example in normals:<br /><ul><li>Dreams
Adult with tember tantrum</li></ul>Clinical illustration:<br /><ul><li>Neurosis-mild regression
Something which is not real, or cannot be real</li></ul>Example in normals:<br /><ul><li>Seen in adolescence as wish fulfilling daydreams
Strip-tease shows, or by day-dreaming over pornographic material</li></ul>Clinical illustrarion:<br /><ul><li>Schizoid and schizotypal personality disorder
Narcissistic personality disorder</li></li></ul><li>Somatization<br /><ul><li>Converting psychic derivatives in to bodily symptoms and tending to react with somatic rather than psychic manifestation
Unconscious rechannelling of repressed emotions into somatic symptoms</li></li></ul><li>REACTION FORMATION<br /><ul><li>Transforming an unacceptable impulse into its opposite
Where reaction-formation takes place, it is usually assumed that the original, rejected impulse does not vanish, but persists, unconscious, in its original infantile form</li></ul>Clinical illustration:<br /><ul><li>Obsessional character
Phobia</li></li></ul><li>REPRESSION<br /><ul><li>Expelling or withholding an idea or feeling from consciousness</li></ul>Primary repression<br /><ul><li>Refers to the curbing/crushing of ideas and feelings before they have attained consciousness</li></ul>Secondary repression<br /><ul><li>Excludes from awareness what was once experienced at a conscious level
Suppression differs-at conscious level</li></li></ul><li>Example in normals:<br /><ul><li>Forgetting
Slip of tongue</li></ul>Clinical illustration:<br /><ul><li>Psychogenic amnesia
Post traumatic stress disorder</li></li></ul><li>RATIONALIZATION<br /><ul><li>Offering rational explanations in an attempt to justify attitudes, beliefs, or behavior that may otherwise be unacceptable
Ernest jones-contributed the term "rationalization" to psychoanalysis
Simply speaking providing logical explanations for irrational behavior motivated by unacceptable wishes.
Fully conscious to mostly subconscious </li></li></ul><li>Rationalization is very common amongst the <br />medical profession in covering up medical errors. <br />Common excuses made are:<br /><ul><li>"Why disclose the error? The patient was going to die anyway"
"Telling the family about the error will only make them feel worse"
"It was the patient's fault, if he wasn't so (obese, sick etc), this error wouldn't have caused so much harm"
"Well, we did our best. These things happen"</li></li></ul><li>DISPLACEMENT<br /><ul><li>Shifting an emotion or drive cathexis from one idea or object to another that resembles the original in some aspect or quality
Can act in a chain-reaction</li></ul>Example in normals:<br /><ul><li>Some people punch cushions when they are angry at friends
A college student may snap at his or her roommate when upset about an exam grade.</li></ul>Clinical illustration:<br /><ul><li>Phobias in children
Obsessive and compulsive disorder</li></li></ul><li>DISSOCIATION<br /><ul><li>Involuntary splitting or suppression of mental function from rest of the personality in a manner that allows expression of forbidden unconscious impulses without having any sense of responsibility for actions</li></ul>Example in normals:<br /><ul><li>Near death experience
Dissociation can be a response to trauma or drugs</li></li></ul><li>Clinical illustration:<br /><ul><li>Dissociative amnesia
Intellectualization may accompany, but differs from rationalization, which is justification of irrational behavior through cliches, stories, and pat explanation.</li></li></ul><li>UNDOING<br /><ul><li>Unconsciously motivated acts which symbolically counter act unacceptable thoughts ,impulses or acts</li></ul> Example in normals:<br /><ul><li>After thinking about being violent with someone, one would then be overly nice or accommodating to them.
Automatically saying “i am sorry”on bumping into somebody</li></ul>Clinical illustration:<br /><ul><li>Compulsive act in OCD</li></li></ul><li>SEXUALIZATION<br /><ul><li>Endowing an object or function with sexual significance that it didn’t previously have or possessed to a smaller degree to ward off anxieties associated wiyh prohibited impulses or their derivatives</li></li></ul><li>EXTERNALIZATION<br /><ul><li>Tending to perceive in the external world and in external objects elements of ones own personality,including instinctual impulses ,conflicts ,moods,attitudes and style of thinkin.It is more general term than projection.
More general term than projection</li></ul>Example in normals:<br /><ul><li>A patient who is overly argumentative might instead perceive others as argumentative and himself as blameless.</li></ul>Clinical illustration:<br /><ul><li>Neurosis</li></li></ul><li>INHIBITION<br /><ul><li>Involuntary decrease or loss of motivation to engage in some goal directed activity to prevent anxiety arising out of conflicts with unacceptable impulses</li></ul>Example in normals:<br /><ul><li>Writing blocks or work bloks
Social shyness</li></ul>Clinical illustration-OCD &Phobias<br />
ISOLATION<br /><ul><li>Splitting or separating an idea from the affect that accompanies it, thus allowing only the idea but not the associated affect to enter the awareness </li></ul>Example in normals:<br /><ul><li>Grief
Ability to explain traumatic events without the associated disturbing emotions,with passage of time</li></ul>Clinical illustration:<br /><ul><li>Obsessional thoughts</li></li></ul><li>COMPENSATION<br /><ul><li>Unconscious tendency to deal with a fear or conflict by unusual degree of effort in the opposite direction</li></ul>Example:<br /><ul><li>Involvement in dare devil activities like sky diving to counter fear of heights
Excessive preoccupation with body building to counter feeling of inferiority</li></ul>Clinical illustrations:<br /><ul><li>Nymphomania –to counter a sense of sexual inadequacy
Keeping excessive details in a diary in patients with dementia</li></li></ul><li>SPLITTING<br /><ul><li>Viewing of self or others as either good or bad without considering the whole range of qualities</li></ul>Example:<br /><ul><li>Seeing all people without mustache as feminine
Believing personalities as the hero is all good and the villain all bad</li></ul>Clinical illustration:<br /><ul><li>Borderline personality disorder</li></li></ul><li>ALTRUISM<br /><ul><li>Using constructive and instinctually gratifying service to others to undergo a vicarious experience.
Core aspect of various religious traditions for the welfare of others
Opposite of selfishness</li></li></ul><li>ANTICIPATION<br /><ul><li>Realistic thinking and planning about future unpleasurable events.
It is goal directed and implies careful planning or worrying ,premature but realistic affective anticipation of potentially dreadful outcome</li></ul>HUMOUR<br /><ul><li>Overt expression of unacceptable impulses by using humor in a manner ,which doesnot produce unpleasentnessinself or others</li></li></ul><li>SUBLIMATION<br /><ul><li>Achieving impulse gratification and retention of goals,but altering a socially objectionable aim or object to a socially acceptable one
It is nothing but channelizing rather than blocking or diverting a unacceptable infantile or impulse into personally satisfying and socially valuable behavior pattern
Channelization of sexual aggressive impulse into creative activities like diverting forbidden sexual impulse into artistic paintings</li></li></ul><li>SUPPRESSION<br /><ul><li>Consciously or semiconsciously postponing attention to a conscious impulse or conflict.Suppression is the process of deliberately trying to stop thinking about certain thoughts</li></ul>Example in normals:<br /><ul><li>Voluntary decision of not to think about an argument with parents while going for an interview.
Clinical-OCD</li></li></ul><li>ASCETICISM<br /><ul><li>Eliminating the pleasurable effects of experiences and assigning moral values to specific pleasures.Gratification is derived from renunciation</li></li></ul><li>Defense mechanisms in substance abuse<br /><ul><li>Denial
Healthy persons normally use different defenses throughout life. An ego defense mechanism becomes pathological only when its persistent use leads to maladaptive behavior such that the physical and/or mental health of the individual is adversely affected. The purpose of the Ego Defense Mechanisms is to protect the mind/self/ego from anxiety, or to provide a refuge from a situation with which one cannot currently cope
Anna Freud created the field of child psychoanalysis and her work contributed greatly to our understanding of child psychology. She also developed different techniques to treat children. Freud noted that children’s symptoms differed from those of adults and were often related to developmental stages. She also provided clear explanations of the ego's defense mechanisms in her book The Ego and the Mechanisms of Defense in1936.In this book Anna Freud introduced the concept of signal anxiety; she stated that it was ‘not directly a conflicted instinctual tension but a signal occurring in the ego of an anticipated instinctual tension’. The signalling function of anxiety is thus seen as a crucial one and biologically adapted to warn the organism of danger or a threat to its equilibrium. The anxiety is felt as an increase in bodily or mental tension and the signal that the organism receives in this way allows it the possibility of taking defensive action towards the perceived danger. Defense mechanisms work by distorting the id impulses into acceptable forms, or by unconscious blockage of these impulses
Id refers to reservoir of unorganized instinctual drives.Id lacks the capacity to delay the instinctual drives as like an newborn. According to this theory, id impulses are based on the pleasure principle: instant gratification of one's own desires and needs.It is totally unconscious primary process where the thoughts are not organized in a coherent way, the feelings can shift, contradictions are not in conflict or are just not perceived that way, and condensations arise. There is no logic and no time line. Lust is important for this process. Id represents biological instinctual impulses in ourselves, such as aggression and sexuality
Internalized societal and parental standards of "good" and "bad", "right" and "wrong" behavior. It concerned with moral standards,predominantlyunconscious,derived from the parental influence and surrounding environment.Children internalize parental values and standards at about the age of 5-6 yrs. The superego consists of two structures: the conscience, which stores information about what is "bad" and what has been punished and the ego ideal, which stores information about what is "good" and what one "should" do or be.
The moderator between the id and superego which seeks compromises to pacify both. It can be viewed as our "sense of time and place" it was determined by experience of reality therefore guided by reality principle.Predominantly conscious somepart is unconscious. Defense mechanisms reside in the unconscious domain of ego.For example, when the id impulses (e.g. desire to have sexual relations with a stranger) conflict with the superego (e.g. belief in societal conventions of not having sex with unknown persons), unsatisfied feelings of anxiousness or feelings of anxiety come to the surface. To reduce these negative feelings, the ego might use defense mechanisms (conscious or unconscious blockage of the id impulses).
The mechanisms on this level, when predominating, almost always are severely pathological. These are the "psychotic" defenses, common in overt psychosis. However, they are found in dreams and throughout childhood as well
These mechanisms are often present in adults and more commonly present in adolescents. People who excessively use such defenses are seen as socially undesirable in that they are immature, difficult to deal with and seriously out of touch with reality. These are the so-called "immature" defenses and overuse almost always leads to serious problems in a person's ability to cope effectively.
These mechanisms are considered neurotic, but fairly common in adults. Such defenses have short-term advantages in coping, but can often cause long-term problems in relationships, work and in enjoying life when used as one's primary style of coping with the world.
These are commonly found among emotionally healthy adults and are considered mature, even though many have their origins in an immature stage of development. They have been adapted through the years in order to optimize success in life and relationships. The use of these defenses enhances pleasure and feelings of control
Where denial occurs in mature minds, it is most often associated with death, dying and rape. Denial as the first of five stages in the psychology of a dying patient, and the idea has been extended to include the reactions of survivors to news of a death. Thus, when parents are informed of the death of a child, their first reaction is often of the form, "No! You must have the wrong house, you can't mean our child.The kid caught with his hand in the cookie jar will say, when confronted, something like "I was just seeing if any cookies were left" or "No, my hand wasn't in the cookie jar."Understanding and avoiding denial is also important in the treatment of various diseases. The American Heart Association cites denial as a principal reason that treatment of a heart attack is delayed. It is common for patients to delay mammograms or other tests because of a fear of cancer, even though this is clearly maladaptiveThe concept of denial is particularly important to the study of addiction. In addiction, denial gets stronger and more rigid. Alcoholics and addicts consciously believe their own denial to avoid the painful reality that addiction controls their life. We can think of denial as a way of telling the truth about a small part of reality as if it were all of reality. For example, the person who has not had a drink in two hours might focus on those two hours and assert, "I haven't been drinking" leaving out "for the last two hours." Denial blinds addicts to the cause of their problem ,their dependence on drugs or alcohol. It allows them to pretend that their using is not destructive. Denial is so powerful that addicts are often the last to recognize their disease.
Denial of factIn this form of denial, someone avoids a fact by lying. This lying can take the form of an outright falsehood (commission), leaving out certain details to tailor a story (omission), or by falsely agreeing to something (assent, also referred to as "yessing" behavior). Denial of responsibilityThis form of denial involves avoiding personal responsibility by:blaming - a direct statement shifting culpability and may overlap with denial of factminimizing - an attempt to make the effects or results of an action appear to be less harmful than they may actually be, orjustifying - when someone takes a choice and attempts to make that choice look okay due to their perception of what is "right" in a situation.For example:Babu breaks up with his girlfriend because he is unable to control his anger, and then blames her for everything that ever happened.Denial of impactDenial of impact involves a person's avoiding thinking about or understanding the harms his or her behavior has caused to self or others, i.e. denial of the consequences. Doing this enables that person to avoid feeling a sense of guilt and it can prevent him or her from developing remorse or empathy for others. Denial of awarenessThis type of denial is best discussed by looking at the concept of state dependent learning. People using this type of denial will avoid pain and harm by stating they were in a different state of awareness (such as alcohol or drug intoxication or on occasion mental health related). Denial of cycleMany who use this type of denial will say things such as, "it just happened." Denial of denialThis can be a difficult concept for many people to identify with in themselves, but is a major barrier to changing hurtful behaviors. Denial of denial involves thoughts, actions and behaviors which bolster confidence that nothing needs to be changed in one's personal behavior..
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). The impulses may derive from the id or the superego but may undergo transformation in the process. Thus, according to Freud's analysis of paranoid projections, homosexual libidinal impulses are transformed into hatred and then projected onto the object of the unacceptable homosexual impulse.The theory was developed by Sigmund Freud and further refined by his daughter Anna Freud; for this reason, it is sometimes referred to as Freudian Projection.According to Sigmund Freud, projection is a psychologicaldefense mechanism whereby one "projects" one's own undesirable thoughts, motivations, desires, and feelings onto someone else. 'Emotions or excitations which the ego tries to ward off are "spit out" and then felt as being outside the ego...perceived in another person. It is a common process that every person uses to some degree. The related defense of projective identificationdiffers from projection in that the impulse projected onto an external object does not appear as something alien and distant from the ego because the connection of the self with that projected impulse continues.Delusions and halluciationsConsider a person in a couple who has thoughts of infidelity. Instead of dealing with these undesirable thoughts consciously, they unconsciously project these feelings onto the other person, and begin to think that the other has thoughts of infidelity and may be having an affair. Thus one can obtain 'acquittal by his conscience - if he projects his own impulses to faithlessness on to the partner to whom he owes faithProjection is an especially commonly used defense mechanism in people with certain personality disorders: Patients with paranoid personalities, for example, use projection as a primary defense because it allows them to disavow unpleasant feelings and attribute them to others.
The acting done is usually anti-social and may take the form of acting on the impulses of an addiction (eg. drinking, drug taking or shoplifting) or in a means designed (often unconsciously or semi-consciously) to garner attention (eg. throwing a tantrum or behaving promiscuously).In general usage, the action performed is destructive to self or others and may inhibit the development of more constructive responses to the feelings.
According to Freud, the ego and the superego are constructed by introjecting external behavioral patterns into the subject's own person. Although vital to development, introjection also serves specific defensive functions. When used as a defense, it can obliterate the distinction between the subject and the object. Through the introjection of a loved object, the painful awareness of separateness or the threat of loss may be avoided. Introjection of a feared object serves to avoid anxiety when the aggressive characteristics of the object are internalized, thus placing the aggression under one's own control. A person who picks up traits from their friends (i.e. If I say 'Ridiculous!' all the time and my best friend starts saying it too) is participating in introjection. A classic example is identification with the aggressor. An identification with the victim may also take place, whereby the self-punitive qualities of the objects are taken over and established within one's self as a symptom or character trait-Stockholm Syndrome, a hostage or kidnap victim 'falls in love' with the feared and hated person who has complete power over them.
Regression, according to Sigmund Freud, is a defense mechanism leading to the temporary reversion of the ego to an earlier stage of development rather than handling unacceptable impulses in a more adult way. It reflects the basic tendency to gain instinctual gratification at a less-developed period. Regression is a normal phenomenon as well, as a certain amount of regression is essential for relaxation, sleep, and orgasm in sexual intercourse. Regression is also considered an essential concomitant of the creative process.Regressive behavior can be simple and harmless. A person may revert to an old, usually immature behavior to ventilate feelings of frustration. Regression only becomes a problem when it is used frequently to avoid adult situations and causes problems in the individual's life.
Reaction formation depends on the hypothesis that the instincts and their derivatives may be arranged as pairs of opposites: life versus death, construction versus destruction, action versus passivity, dominance versus submission, and so forth. When one of the instincts produces anxiety by exerting pressure on the ego either directly or by way of the superego, the ego may try to sidetrack the offending impulse by concentrating upon its opposite. For example, if feelings of hate towards another person make one anxious, the ego can facilitate the flow of love to conceal the hostility.Where reaction-formation takes place, it is usually assumed that the original, rejected impulse does not vanish, but persists, unconscious, in its original infantile form. Thus, where love is experienced as a reaction formation against hate, we cannot say that love is substituted for hate, because the original aggressive feelings still exist underneath the affectionate exterior that merely masks the hate to hide it from awareness.Obsessional characterReaction formation is characteristic of obsessional neurosis, but it may occur in other forms of neuroses as well. If this mechanism is frequently used at any early stage of ego development, it can become a permanent character trait, as in an obsessional character. A man who is overly aroused by pornographic material who utilizes reaction formation may take on an attitude of criticism toward the topic. He may end up sacrificing many of the positive things in his life, including family relationships, by traveling around the country to participate anti-pornography rallies. This view may become an obsession, whereby the man eventually does nothing but travel from rally to rally speaking out against pornography. He continues to do this, but only feels temporary relief, because the deeply rooted arousal to an unacceptable behaviour such as watching pornography is still present, and underlying the implementation of the defense. At that point he can be said to have developed an obsessional personality above and beyond the defense mechanism
Types:Primary repressionRefers to the curbing of ideas and feelings before they have attained consciousness. Primary Repression then is the process of determining what is self, what is other; what is good, and what is bad.Secondary repressionExcludes from awareness what was once experienced at a conscious level. The repressed is not really forgotten in that symbolic behavior may be present. Secondary repression begins once the child realizes that acting on some desires may bring anxiety. This anxiety leads to repression of the desire. The threat of punishment related to this form of anxiety, when internalized becomes the superego, which intercedes against the desires of the id (which works on the basis of the pleasure principle) without the need for any identifiable external threat. This conflict manifests itself with egoThis defense differs from suppression by effecting conscious inhibition of impulses to the point of losing and not just postponing cherished goals. Conscious perception of instincts and feelings is blocked in repression.Repression, is the psychological attempt by an individual to repel its own desires and impulses towards pleasurable instincts. Such desires, impulses, wishes, fantasies or feelings can be represented in the mind as thoughts, images and memories. The repression is caused when an external force puts itself in contrast with the desire, threatening to cause suffering if the desire is satisfied, thereby posing a conflict for the individual;the repressive response to the threat is to exclude the desire from one's consciousness and hold or subdue it in the unconscious.
Denial: Refusing to admit or acknowledge that our drinking or using has become a problem. (I can quit any time I want to. My using isn't that bad.)Isolation: Removing ourselves from the company of family and friends for the purpose of maintaining a chemical habit.Rationalization: Giving reasons to explain why we drink or use. (I drink because I hate my job.)Blaming: Transferring responsibility for our behavior to other people. (I wouldn't drink if my spouse treated me right.)Projection: Rejecting our own feelings by ascribing them to someone else. (Why is that stupid idiot being so hostile?)Minimizing: Refusing to admit the magnitude of the amount used. (I only have a couple of drinks. It's not a problem
Undoing:This is an attempt to 'undo' the threatening or negative thoughte.g., compulsive handwashing after touching something 'dirty'.Reaction Formation:This is taking a radically opposite point of view to one's negative impulsese.g., an OCD sufferer who has sexual thoughts takes up an obsessively puritan stanceIsolation (intellectualisation):This is isolating thoughts from emotions, keeping the focus on facts and reason in order to protect oneself from something that is upsettinge.g., a person who suffers from OCD may learn a great deal of facts and statistics about something that causes them anxiety.
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