Defense MechanismElmeida Effendy- Mustafa M Amin

Psychiatric DepartmentMedical 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 :ProjectionDenialIntrojection

Oral :DisplacementIdentification

Anal :Reaction formationIsolationRegression

Phallic :IntelectualizationRepressionSimbolization

Latent :Sublimation

Defenses can be grouped hierarchically according to relative degree of maturity associated with them :1. Narcissistic defenses2. Immature defenses3.Neurotic defenses4. Mature defenses

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Narcissistic DefensesDenial : avoiding the awareness of reality by

negating sensory dataeg : patients with malignant tumor insists she does

not have cancerDistortion : 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.

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Immature DefensesActing 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 punchBlocking : 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

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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 objecteg : fail in exam didn’t study

Passive-aggressive behavior : expressing aggression toward others, indirectly through passivity, masochism & turning against the selfeg : 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

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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 DefensesControlling : attempting to manage or regulate

events or objects in the environment to minimize anxiety & to resolve inner conflicts

eg : Lia wants to pass 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 qualityeg : a woman is abandoned by her fiance, she quickly finds another man about whom she develops the same feelings

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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 expressioneg : 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 unacceptableeg : 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 distresseg : hysterical conversion

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Reaction formation : transforming an unacceptable impulse into its oppositeeg : 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 DefensesAltruism: 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.

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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

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