Defense Mechanisms - Human Behavior and Psychiatry PHA 535 PDF

01/28/2025 1  Human Behavior and Psychiatry Dr. Renee Levy PHA 535 01/28/2025 Spring 2025 2  Instructional Objectives Week Unit or...

01/28/2025 1  Human Behavior and Psychiatry Dr. Renee Levy PHA 535 01/28/2025 Spring 2025 2  Instructional Objectives Week Unit or Bloom’s Level Instructional Objectives Remember / Understand, Module Apply/ Analyze, Evaluate/ Create Week 3 Analyze the developmental theories of defense Lecture 5 mechanisms and explain their purpose and use. Apply/ Analyze Week 3 Identify and differentiate various defense Lecture 5 mechanisms Remember/ Understand Week 3 Distinguish between defense mechanisms and Lecture 5 coping skills and illustrate their unique Apply/ Analyze characteristics. Week 3 Demonstrate effective interaction techniques Remember/ Lecture 5 with patients employing defense mechanisms. Understand 01/28/2025 3  What Is “Mental Health?” WHO: ….a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. CDC: “….. includes our emotional, psychological, and social well- being ….how we think, feel, and act….how we handle stress, relate to others, and make healthy choices….important at every stage of life, from childhood…….through adulthood.” 01/28/2025 4  Defense Mechanisms: Definition Sigmund Freud originated terms A process of thinking and acting developed by the “ego” to protect it from physical and/ or emotionally painful/ dangerous situations Unconscious or partially unconscious Automatic Very subtle form of dishonesty or reality distortion Used when one is not able to cope with reality or have not learn effective strategies 01/28/2025 5  The part of the personality with which we are born that demands to be satisfied: “I want” “I need.” Unconscious, but one “knows” Works on the pleasure principal 01/28/2025 6  “Rational” part of personality Based on “reality principle” and is socially sanctioned The ego tries to attain what it wants/ needs through culturally acceptable means Begins around age 18 months 01/28/2025 7  Works on the morality principle Develops around age 4 The “conscience” given from parents/ society to children to know right from wrong and act “right” The “ideal” that people should live by “You can’t have/be” part of the personality 01/28/2025 8  Defense Mechanisms Purpose Protect against anxiety and suffering by helping to tolerate a reality that is too “aggressive” or painful or discordant with an individual’s self image (ego) 01/28/2025 9  What Triggers Defense Mechanisms? Tensions/ conflicts within one’s personality: superego and the ID External pressures – Livelihood – Acceptance Fear of losing respect Other people’s judgment Fear of violence 01/28/2025 10 01/28/2025 11 01/28/2025 12  Defense Mechanisms Everyone uses them Identified as: pathological/ immature/ neurotic (anxiety) vs mature Sporadic use vs extensive use Under duress people tend to use pathologic defense mechanisms more often 01/28/2025 13  Defense Mechanisms Affiliation Turn to others/ organizations for support/ “being right” or superior – “School spirit” – Barry PA – Religions – Military – Political groups – Can be a healthy defense mechanism: front line workers getting support from each other 01/28/2025 14  Defense Mechanism: Acting Out Engage in inappropriate behavior, without consideration of consequences, as a reaction to a situation of control or as an unspoken protest Used for attention/ freedom – Unprotected sex – Rock and roll/ rap persona – Unapproved relationships – Self demeaning, clowning – Dress and adornment – Shoplifting 01/28/2025 15  Defense Mechanism: Autistic Fantasy Excessive day-dreaming, unwilling/ unable to sequester resources to create desired reality – Actor/ musician/ athlete/ fame fantasy – Keeps people from risk and the work it takes to become accomplished 01/28/2025 16  Defense Mechanism: Compensation Build up other aspects of themselves to adjust for any perceived/ real shortcomings – a person who believes that they are not skilled at sports may study and develop their scholastic abilities 01/28/2025 17  Defense Mechanisms Compliance Acquiescing to the desires of someone else to “keep the peace” – Avoids / fears conflict 01/28/2025 18  Defense Mechanism: Controlling Trying to make a person act/ think/ feel a certain way – Arguing – Micromanaging – Domestic violence – Rejected lover homicide 01/28/2025 19  Defense Mechanism: Denial Refusal to acknowledge painful/ inconvenient/ overwhelming aspects of reality – HIV/ STDS – Alcoholism/ drug abuse – Climate change – “ I won the election!” 01/28/2025 20  Defense Mechanism: Displacement Transfer negative feelings about one object to another – Kicking the dog or yelling at spouse after being ridiculed at work 01/28/2025 21  Defense Mechanism: Dissociation Lack of connection in a person’s thoughts, memory and sense of identity – Movies – Post Traumatic Stress Disorder (PTSD) – De-realization/ Dissociative Identity Disorders – Severe abuse – Hypnosis 01/28/2025 22  Neurotic Defense Mechanism: Externalization Inaccurately blame problems on another person, thing, or situation – Applicants attributing their low grades to their instructors 01/28/2025 23  Defense Mechanism: Intellectualization Rely excessively on details/ facts to maintain distance from painful emotions – “a great case” 01/28/2025 24  Defense Mechanism: Inhibition Involuntary decrease/ loss of motivation to engage in goal directed activity to prevent arising anxiety from conflicts with “unacceptable” impulses – Religious prohibitions against sex – Become a lawyer instead of an actor 01/28/2025 25  Defense Mechanism Introjection (or Identification) Internalizing the qualities of an object or person – a child developing the behavior of his or her parents without conscious realization – Advertising strategy – Being a “fan” of an actor – Can be healthy if the quality is integrated 01/28/2025 26  Defense Mechanisms Isolation: being alone to avoid uncomfortable feelings and interactions with others – “I need some down time” – Mature coping: solitude Passive-aggressive: Indirectly express aggressive feelings/ anger towards others – “Why didn’t you pick up the groceries?” “I forgot.” – Walking in late to an appointment/ class 01/28/2025 27  Defense Mechanisms Projection: falsely assign unacceptable/ difficult to accept feelings or character traits to another: positive or negative – Falling in love – Scapegoat/ group persecution – Racism Projective identification: the person accepts and “takes on” the projection of another: positive of negative – Doctor/ PA has a “god complex” – “Dumb blonde” self reference 28  Defense Mechanisms Rationalization – Justifying difficult or unacceptable feelings with seemingly logical reasons and explanations – Not getting that job: “It did not pay enough” – Not getting that date: “They probably have herpes.” – Childhood abuse: “Children need to be disciplined!” Regression: acting like a younger, less mature person – Baby talk, thumb sucking, whining, bed wetting – Throwing a tantrum or sticking out their tongue and running away during conflict 29  Defense Mechanisms Repression Expel disturbing thoughts and feelings from consciousness – Repressed memories of sexual abuse – Can lead to somatization: physical expression of repression 01/28/2025 30 01/28/2025 31  Defense Mechanisms Ritual and Undoing Superstitious behavior and thoughts – Pregame rituals – Full moon – “You’re gonna jinx it” – Bible dropping Different than spiritual/ healing rituals 01/28/2025 32  Defense Mechanism: Sexualization Inappropriate imposition of sexuality upon a person, through objectification, overvaluing or emphasizing the person’s appearance and/or sexual behavior – Defense against uncomfortable emotions – A form of projection: certain characteristics in need of relating – Advertising 01/28/2025 33  Defense Mechanism Splitting Compartmentalize opposite affective states: “good” or “bad”, no middle ground – Politics – Self or others – Hallmark of borderline personality disorder 01/28/2025 34  Healthy (Mature) Defense Mechanisms or Coping Skills Examples Objectivity Integration Sublimation Altruism/ Anticipation/ Affiliation Suppression Humor “Oh, I have a healthy SA3SH.” or “iOS2HA3” Usually conscious or somewhat conscious 01/28/2025 35 01/28/2025 A Muse 36  Mature Defense Mechanisms Altruism Dedication to meeting other’s needs rather than focusing on themselves and concerns – Advisor – Sponsor in Alcoholic’s Anonymous – Improves depression – Volunteer, live longer 01/28/2025 37  Mature Defense Mechanisms Anticipation Think about and prepare for possible adversity instead of worrying – Boy Scout motto: “Be prepared.” – Hurricanes 01/28/2025 38  Mature Defense Mechanisms Suppression Temporarily avoid thinking about stressor until one is better able to process – Trauma patient 01/28/2025 39  Mature Defense Mechanism Humor Deal with stress by seeing irony, dark humor, but also not denying the reality – Medical talk – Could also be immature 01/28/2025 40  When Defense Mechanisms Are “Pathological” Age inappropriate Have a high intensity Continuous and inappropriate usage of defenses even when uncalled for The quantity exceeds the quality 01/28/2025 41  When Defense Mechanisms Are “Pathological” Over-reliance leading to: – Chronic suppression of feelings physical symptoms (somatization) – Damage to the self and increased dependency on habits and fantasy: lacking authenticity – Impairment of one’s functioning and attainment of goals – Lack of honesty and intimacy in relationships – Psychiatric illnesses and personality disorders 01/28/2025 42  Managing Self check “Go with Patients and processin the resistance Demonstrating g ” Defense Mechanisms Gentle “Coping exploratio skills” are n conscious 01/28/2025 43 Managing Patients Using Defense Mechanisms Problem solving: what pain is being avoided by using (this) defense mechanism? Understand the patient and respect their denial; gives the patient time to build up energy to face adversity – Reality can be very painful Reframing: “Is it possible that….?” Courage and mirroring and therapeutic self disclosure 01/28/2025 44  Coping Mechanisms Conscious and intentional –M&Ms Flexible Health promoting: +well being, +quality of life, +net reduction of suffering, better able to handle future conflicts, honest Deals with the source of anxiety 01/28/2025 45  Defense Mechanisms vs Coping Defense mechanism: what parts of the distressing events, feelings, and “self” story must be distorted Coping: how the events/ feelings can be managed effectively 01/28/2025 46 Defense Mechanism Coping Mechanism Projection Integration Ritual and undoing Anticipation Repression Suppression Reaction formation Sublimation Unconscious humor, Conscious humor angry sarcasm Intellectualizing Objectivity Displacement Appropriate expression of anger Denial Altruism 01/28/2025 48  References https://www.slideshare.net/ajujose142/defence-mechanisms https://depts.washington.edu/psyclerk/lectures.html https://www.psychologytoday.com/blog/fulfillment-any-age/201110/ the-essential-guide-defense-mechanisms Cramer, P. (2008). Seven Pillars of defense mechanism theory. Social and Personality Psychology Compass, 2008, 2, 1963- 1981. 01/28/2025 49