Mental Mechanisms and their use by people to avoid vaccination, during the covid pandemic.

If we get cold we shiver ,if we get hot we sweat.

If we have emotional dis-ease(anxiety) we use different types of unconscious processes to deal with
the perceived threat. These ways of dealing with anxiety are outside of our awareness(Phoebe
Kramer) and we are blind to them.

The more intense the anxiety the more we exert emotional pressure and control over it, to remain in
psychological homeostasis.

Increasing anxiety occasions the use of more defenses against anxiety, and these defenses may hurt
us. They exist along a spectrum from disbelief of evidence based reality , to conviction we are
correct and an inability to see any other perspective, to neurosis and finally to complete break from
reality(psychosis).

Along the way the flooding of anxiety may cause physical symptoms(somatization).

To recap our individual defenses are conventionally grouped according to their reality distorting
effects.(Perry 2014)

Mature defenses

Are highly adaptive- humour, affiliation, altruism, anticipation, self assertion, self observation
sublimation,suppression

neurotic defenses

are less adaptive. They are in two groups

Obsessional defenses, which keeping emotion away from an idea:intellectulaisation ,isolation of

affect, undoing.These are often expressed through minimization or generalization

Other neurotic defenses are :displacement ,dissociation ,reaction formation, repression

Following this there are minor image distorting defenses: devaluation,idealization

omnipotence .These are used to preserve self esteem, by using distortion, to dismiss threat

At a deeper level of disturbance, disavowal and autistic fantasy are used for protection( such as
denial ,projection ,rationalization , and autistic fantasy)

major distortion of reality occurs with severe threat.

The defenses of splitting of self and others image, and projective identification are used
The final defense is the defense of Action

It is used as a defense against anxiety and expressed as acting out, in behaviours such as the help
rejecting complainer,or passive aggression

At the group level ,defenses against consideration of the severe effects of the pandemic include
groupthink. The work of Janis (1972) in the American Soldier Project” outlined these three types of
collective defenses. Security for the individual against anxiety is maintained by having membership
of a group and group support .It is pf three types.The first type of reassurance comes from an
overestimation of the group power and morality ,with an illusion of personal invulnerability and
unquestioning belief in the morality of the group idea. The second type of reassurance for the
individual derives from the use of rationalisation of any information presented to the group that
contradicts the ethos and beliefs of the group ,while simultaneously stereotyping information from
group outsiders. The third type of group support develops from self censorship of alternative ideas,
believing in the illusion of group unanimity, and perhaps by direct pressure on group members to
adopt attitudes and beliefs using” mind guards “,who contest any other views presented to the
group.

However the main individual defenses against threat are denial , repression ,projection ,somatisation
,dissociation and externalization

Denial exists to avoid or distort threat. It may occur “per se”, in fantasy, in words (selective
inattention) or in deeds. It may be neurotic (to avoid internal conflict )or psychotic (to avoid external
reality).People may ignore ,negate ,minimize, withdraw their attention, ridicule, fantasise ,use
negative hallucination, or reversal to deny objective facts.

Repression and repressive defenses may be character defenses, tactical defenses or regressive
defenses. These defenses are those of avoidance, displacement identification with the object or
aggressor, intellectualization, isolation of affect, rationalization ,suppression or reaction formation

Projection ,well described by Thomas Ogden, may either be without any loss of reality testing ,or it
may be regressive ,with loss of reality. Internal, unacceptable ,personal experiences ( eg self
criticism or lack of internal control )may be projected on to others .

John Sarnos explains the different pathways of anxiety discharge in somatising patients .Either into
the parasympathetic nervous system(nausea, cramps, loose stool, migraine).or striated
muscle(tension headache and cognitive perceptual disruption).The symptoms of somatisation may
be distinguished from symptoms of physical disease as the symptoms vary with the intensity of
emotion ,but the symptoms of physical disease do not

Dissociation from intense anxiety is perceived along a continuum of experiences , of varying severity
.From detachment from feelings(repression or character defenses),to blanking out, derealization,
and amnesia)
Externalisation is used to undo the distress caused by an internal focus of anxiety. Externalising
patients complain and blame others for their situation and use phrases like”” Ï had to””He made me”

How can one respond to these defenses?.

A head on collision achieves nothing except the phenomenom of “reactance.”

Acknowledging and respecting the rights and autonomy of others is paramount in deactivating the
defenses

Asking for permission to offer an alternative perspective, and then simply pointing out others
views”,giving alternative evidence without comment or criticism ,and getting the patient to see the
price of the defense to themselves and others, will help them let go or restructure the defense.

Groupthink may be neutralized in its members by ensuring there is a” critical evaluator’” in the head
of each member of the group, ensuring the leader is absent from meetings to avoid undue
influence, establishing within the group several subgroups to consider alternatives to the problem,
inviting outside experts in, to challenge group ideas ,and nominating one member of the group to
act as a “devils advocate”(Ryan Hartwig)

Sometimes the Äbilene paradox may occur (Harvey J 1974) and this would be advantageous in
meetings of antivaxxer groups to modify ideas

A list of specific objections to pandemic interventions can be made and each objection reasoned
with in a non judgemental way