Defense Mechanisms

INTRODUCTION-When people experience difficulties, they have different ways of handling

their pain. These different ways of dealing with pain are called defense mechanisms. Originally
conceived by Sigmund Freud, much of the development of defense mechanisms was done by his
daughter, Anna Freud. Defense mechanisms can be healthy or unhealthy depending on the
circumstances and how much a person uses them. If you slam down your briefcase because you
are mad at your wife one time, that's not a big deal. But if you frequently take your anger out by
throwing or breaking things, there might be a better way of dealing with your anger

DEFINITION-A defence mechanism is a coping technique that reduces anxiety arising from
unacceptable or potentially harmful impulses. Defence mechanisms are unconscious and are not
to be confused with conscious coping strategies. Sigmund Freud was one of the first proponents
of this construct.

Defence mechanisms may result in healthy or unhealthy consequences depending on the

circumstances and frequency with which the mechanism is used.

Defence mechanisms may result in healthy or unhealthy consequences depending on the

circumstances and frequency with which the mechanism is used.

FUNCTIONS OF DEFENSE MECHANISM-

 Protecting individuals from dangerous situations.

 To deal with minor hurt, pain, anger, anxiety, sadness and self devaluation.
 Removing anxiety and hurt.
 Plays an important role in normal adjustment mechanism.

CHARACTERSTICS OF DEFENSE MECHANISM-

 The purpose of defense mechanism is to reduce anxiety.

 Defense mechanisms are compromise solutions.
 The pattern of defense mechanism depends on one’s ability.
 The same individual may use varied mechanisms as per his need.
 Defense mechanisms may be used consciously but usually act at unconscious or
subconscious level.
 Defense mechanisms are healthy when one

 is able to form new acceptable behavior.

 Is able to change the external environment positively.
 Is able to modify his needs.
 Uses mechanisms like rationalization, sublimation ,compensation etc.
  Defense mechanisms are unhealthy when one

 Do not develop ability to change or modify one’s abnormal behavior.

 Retreats the problem of reality
 Repeatedly uses the specific mechanisms that may interfere with maintenance of
self image. E.g. in undoing, one repeatedly offers excuses but keeps making the
same mistakes.
 Uses mechanisms like regression, denial, projection etc.

Defense mechanisms are a type of process or coping that results in automatic psychological
responses exhibited as a means of protecting the individual against anxiety.

Structural model: Id, ego, and superego

The concept of id impulses comes from Sigmund Freud’s structural model. According to this
theory, id impulses are based on the pleasure principle: instant gratification of one's own desires
and needs. Sigmund Freud believed that the id represents biological instinctual impulses in
humans, such as aggression (Thanatos or the Death instinct) and sexuality (Eros or the Life
instinct).

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
unpleasant feelings, the ego might use defence mechanisms (conscious or unconscious blockage
of the id impulses).

Freud believed that conflicts between these two structures resulted in conflicts associated with
psychosexual stages.

The iceberg metaphor is often used to explain the psyche's parts in relation to one another.

Definitions of individual psyche structures

Freud proposed three structures of the psyche or personality:

 Id: The id is the unconscious reservoir of the libido, the psychic energy that fuels
instincts and psychic processes. It is a selfish, childish, pleasure-oriented part of the
personality with no ability to delay gratification.

 Ego: The ego acts as a moderator between the pleasure sought by the id and the morals of
the superego, seeking compromises to pacify both. It can be viewed as the individual's
"sense of time and place".
  Superego: The superego contains internalised societal and parental standards of "good"
and "bad", "right" and "wrong" behaviour. They include conscious appreciations of rules
and regulations as well as those incorporated unconsciously.

Primary and secondary processes

In the ego, there are two ongoing processes. First there is the unconscious primary process,
where the thoughts are not organised 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. By contrast, there is the conscious secondary
process, where strong boundaries are set and thoughts must be organised in a coherent way. Most
conscious thoughts originate here.

The reality principle

Id impulses are not appropriate in civilised society, so there is societal pressure to modify the
pleasure principle in favour of the reality principle; that is, the requirements of the external
world.

Vaillant's categorization of defence mechanisms

The psychiatrist George Eman Vaillant introduced a four-level classification of defence
mechanisms:

 Level I - pathological defences (psychotic denial, delusional projection)

 Level II - immature defences (fantasy, projection, passive aggression, acting out)
 Level III - neurotic defences (intellectualization, reaction formation, dissociation,
displacement, repression)
 Level IV - mature defences (humour, sublimation, suppression, altruism, anticipation)

Level 1: Pathological
.

The mechanisms on this level, when predominating, almost always are severely pathological.
These six defences, in conjunction, permit one to effectively rearrange external experiences to
eliminate the need to cope with reality. The pathological users of these mechanisms frequently
appear irrational or insane to others. These are the "psychotic" defences, common in overt
psychosis. However, they are normally found in dreams and throughout childhood as well. They
include:
  Conversion: The expression of an intrapsychic conflict as a physical symptom; some
examples include blindness, deafness, paralysis, or numbness. This phenomenon is
sometimes called hysteria.
 Delusional projection: Delusions about external reality, usually of a persecutory nature.
 Denial: Refusal to accept external reality because it is too threatening; arguing against an
anxiety-provoking stimulus by stating it doesn't exist; resolution of emotional conflict
and reduction of anxiety by refusing to perceive or consciously acknowledge the more
unpleasant aspects of external reality. You are arrested for drunk driving several times
but don't believe you have a problem with alcohol
 Distortion: A gross reshaping of external reality to meet internal needs.
 Extreme projection: The blatant denial of a moral or psychological deficiency, which is
perceived as a deficiency in another individual or group.
 Splitting: A primitive defence. Both harmful and helpful impulses are split off and
unintegrated, frequently projected onto someone else. The defended individual segregates
experiences into all-good and all-bad categories, with no room for ambiguity and
ambivalence. When "splitting" is combined with "projecting", the undesirable qualities
that one unconsciously perceives oneself as possessing, one consciously attributes to
another. Ex.You think your best friend is absolutely worthless because he forgot a lunch
date with you.

Level 2: Immature

These mechanisms are often present in adults. These mechanisms lessen distress and anxiety
produced by threatening people or by an uncomfortable reality. Excessive use of such defences is
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" defences and overuse almost always leads
to serious problems in a person's ability to cope effectively. These defences are often seen in
major depression and personality disorders. They include:

 Acting out: Direct expression of an unconscious wish or impulse in action, without

conscious awareness of the emotion that drives that expressive behavior.
 Fantasy or day dreaming: Tendency to retreat into fantasy in order to resolve inner and
outer conflicts.for ex. When one is having financial problems,one can escape from them
temporarily by planning how to spend an imaginary fortune.Patient who are very ill may
fantasize that when they recover,many good things will happen to them.
 Idealization: Tending to perceive another individual as having more desirable qualities
than he or she may actually have.
 Introjection: Identifying with some idea or object so deeply that it becomes a part of that
person. For example, introjection occurs when we take on attributes of other people who
seem better able to cope with the situation than we do.
 Passive aggression: Aggression towards others expressed indirectly or passively, often
through procrastination.
 Projective identification: The object of projection invokes in that person a version of the
thoughts, feelings or behaviours projected.
 Projection: A primitive form of paranoia. Projection reduces anxiety by allowing the
expression of the undesirable impulses or desires without becoming consciously aware of
 them; attributing one's own unacknowledged unacceptable or unwanted thoughts and
emotions to another; includes severe prejudice and jealousy, hypervigilance to external
danger, and "injustice collecting", all with the aim of shifting one's unacceptable
thoughts, feelings and impulses onto someone else, such that those same thoughts,
feelings, beliefs and motivations are perceived as being possessed by the other. For ex.
The student who believes that everybody cheats in examinations may also cheat in the
same way.
 Somatization: The transformation of uncomfortable feelings towards others into
uncomfortable feelings toward oneself: pain, illness, and anxiety.
 Wishful thinking: Making decisions according to what might be pleasing to imagine
instead of by appealing to evidence, rationality, or reality.

Level 3: Neurotic

These mechanisms are considered neurotic, but fairly common in adults. Such defences 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. They include:

 Displacement: defence mechanism that shifts sexual or aggressive impulses to a more

acceptable or less threatening target; redirecting emotion to a safer outlet; separation of
emotion from its real object and redirection of the intense emotion toward someone or
something that is less offensive or threatening in order to avoid dealing directly with what
is frightening or threatening. For example, a mother may yell at her child because she is
angry with her husband.
 Dissociation: Temporary drastic modification of one's personal identity or character to
avoid emotional distress; separation or postponement of a feeling that normally would
accompany a situation or thought.
 Hypochondriasis: An excessive preoccupation or worry about having a serious illness.
 Intellectualization: A form of isolation; concentrating on the intellectual components of
a situation so as to distance oneself from the associated anxiety-provoking emotions;
separation of emotion from ideas; thinking about wishes in formal, affectively bland
terms and not acting on them; avoiding unacceptable emotions by focusing on the
intellectual aspects (isolation, rationalization, ritual, undoing, compensation, and magical
thinking).
 Isolation: Separation of feelings from ideas and events, for example, describing a murder
with graphic details with no emotional response.
 Rationalization (making excuses): Convincing oneself that no wrong has been done and
that all is or was all right through faulty and false reasoning. An indicator of this defence
mechanism can be seen socially as the formulation of convenient excuses.ex. I always
study hard for tests and I know a lot of people who cheat so it's not a big deal I cheated
this time.
 Reaction formation: Converting unconscious wishes or impulses that are perceived to be
dangerous or unacceptable into their opposites; behaviour that is completely the opposite
of what one really wants or feels; taking the opposite belief because the true belief causes
anxiety. Ex.When you say you're not angry when you really are.
  Regression: Temporary reversion of the ego to an earlier stage of development rather
than handling unacceptable impulses in a more adult way, for example, using whining as
a method of communicating despite already having acquired the ability to speak with
appropriate grammar.
 Repression: The process of attempting to repel desires towards pleasurable instincts,
caused by a threat of suffering if the desire is satisfied; the desire is moved to the
unconscious in the attempt to prevent it from entering consciousness; seemingly
unexplainable naivety, memory lapse or lack of awareness of one's own situation and
condition; the emotion is conscious, but the idea behind it is absent.
 Undoing: A person tries to 'undo' an unhealthy, destructive or otherwise threatening
thought by acting out the reverse of the unacceptable. Involves symbolically nullifying an
unacceptable or guilt provoking thought, idea, or feeling by confession or atonement.
You have feelings of dislike for someone so you buy them a gift.
 Upward and downward social comparisons: A defensive tendency that is used as a
means of self-evaluation. Individuals will look to another individual or comparison group
who are considered to be worse off in order to dissociate themselves from perceived
similarities and to make themselves feel better about themselves or their personal
situation.
 Withdrawal: Withdrawal is a more severe form of defence. It entails removing oneself
from events, stimuli, and interactions under the threat of being reminded of painful
thoughts and feelings.For ex. Such a person is seen as avoiding all work saying he
cannot do this or he cannot do that.

Level 4: Mature
.

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 optimise success in human society and relationships. The use of
these defences enhances pleasure and feelings of control. These defences help to integrate
conflicting emotions and thoughts, whilst still remaining effective. Those who use these
mechanisms are usually considered virtuous. Mature defences include:

 Acceptance: A person's assent to the reality of a situation, recognizing a process or

condition (often a difficult or uncomfortable situation) without attempting to change it,
protest, or exit. Religions and psychological treatments often suggest the path of
acceptance when a situation is both disliked and unchangeable, or when change may be
possible only at great cost or risk.
 Altruism: Constructive service to others that brings pleasure and personal satisfaction.
Ex.After your wife dies, you keep yourself busy by volunteering at your church.
 Anticipation: Realistic planning for future discomfort.
 Courage: The mental ability and willingness to confront conflicts, fear, pain, danger,
uncertainty, despair, obstacles, vicissitudes or intimidation. Physical courage often
extends lives, while moral courage preserves the ideals of justice and fairness.
 Emotional self-regulation: The ability to respond to the ongoing demands of experience
with the range of emotions in a manner that is socially tolerable. Emotional self-
 regulation refers to the processes people use to modify the type, intensity, duration, or
expression of various emotions.
 Emotional self-sufficiency: Not being dependent on the validation (approval or
disapproval) of others.
 Forgiveness: Cessation of resentment, indignation or anger as a result of a perceived
offence, disagreement, or mistake, or ceasing to demand retribution or restitution.
 Gratitude: A feeling of thankfulness or appreciation involving appreciation of a wide
range of people and events. Gratitude is likely to bring higher levels of happiness, and
lower levels of depression and stress. Throughout history, gratitude has been given a
central position in religious and philosophical theories.
 Humility: A mechanism by which a person, considering their own defects, has a humble
self-opinion. Humility is intelligent self-respect which keeps one from thinking too
highly or too meanly of oneself.
 Humour: Overt expression of ideas and feelings (especially those that are unpleasant to
focus on or too terrible to talk about directly) that gives pleasure to others. The thoughts
retain a portion of their innate distress, but they are "skirted around" by witticism, for
example self-deprecation.ex. A person's treatment for cancer makes him lose his hair so
he makes jokes about being bald.
 Identification: The unconscious modelling of one's self upon another person's character
and behaviour.
 Mercy: Compassionate behavior on the part of those in power.
 Mindfulness: Adopting a particular orientation toward one’s experiences in the present
moment, an orientation that is characterised by curiosity, openness, and acceptance.
 Moderation: The process of eliminating or lessening extremes and staying within
reasonable limits. It necessitates self-restraint which is imposed by oneself on one's own
feelings, desires etc.
 Patience: Enduring difficult circumstances (delay, provocation, criticism, attack etc.) for
some time before responding negatively. Patience is a recognized virtue in many
religions.
 Respect: Willingness to show consideration or appreciation. Respect can be a specific
feeling of regard for the actual qualities of a person or feeling being and also specific
actions and conduct representative of that esteem. Relationships and contacts that are
built without the presence of respect are seldom long term or sustainable. The lack of
respect is at the very heart of most conflict in families, communities, and nations.
 Sublimation: Transformation of unhelpful emotions or instincts into healthy actions,
behaviours, or emotions, for example, playing a heavy contact sport such as football or
rugby can transform aggression into a game.
 Suppression: The conscious decision to delay paying attention to an emotion or need in
order to cope with the present reality; making it possible to later access uncomfortable or
distressing emotions whilst accepting them. For ex. You are attracted to someone but say
 Tolerance: The practice of deliberately allowing or permitting a thing of which one
disapproves.

DEFENSE MECHANISM AND NURSE

 Understanding defense mechanisms will enable the nurse to support the patient
and his family.Denial, for example, is a common reaction to serious diagnosis or
at the time of death.The patient and his family should be allowed to deny the
situation until they are prepared to face the reality.
 The patient will often practice regression through tears, trembling or demanding
special treatment.
 Some patients may also withdrawal and should be allowed to do so. Many
patients intellectualize about a serious sickness or prognosis just like the nurse
and other members of the health team.
 Patient who must deal with stress of serious illness may shift to blame for their
condition onto the nurse(projection).They may complain of poor nursing care to a
nurse who is actually skilful. Nurse should not show anger and retaliate but
should encourage the patients to explore the realistic aspect of their situation.
Both well adjusted and maladjusted individuals make use of defense
mechanism for their daily life.
 BIBLIOGRAPHY

 Jacob Anthikd ,’Psychology for Nurses , Jaypee publishers, EDITION-2ND , page no 80-
90.
 Jacob Anthikd ,Psychology for Graduate Nurses,Jaypee brothers publisher,Edition
4th,Page no 121-126.
 Clifford T.Morgan,INTRODUCTION TO PSYCHOLOGY”,Pulblished by Mcgraw Hill
education private limited,edition 7th ,Page no.515-523.
 WWW.WIKIPEDIA.COM
 www.Simplypsychology.com
 www.Psychocenteral.com