y y y y

Coping mechanisms involve efforts to decrease the stress response These are task ±oriented reactions, which are classified because of conscious efforts utilized by the concerned individual to allay his anxiety Done consciously Examples are as follows: T ± Turning to a comforting person (significant others) R ± Relying on self -disciple (self-control) I ± Intense expression of feelings (crying to release tension) U ± Using symbolic substitutes M ± Making use of friends to talk it out P ± Privately thinking it through

Defense Mechanism y Protective coping mechanism of the ego, largely unconscious y Attempts to protect the individual from feelings of i nadequacy and worthlessness and to prevent awareness of anxiety y Protect against anxiety caused by undesirable, unacceptable and usually unconscious feelings y Similar to coping mechanisms but they are traditionally defined as being unconscious, intrapsychic processes y Both defense mechanisms and coping mechanisms serve the same protective purpose for clients. y Defense mechanism will provide the nurse with clues about a client¶s feelings motives and behaviours When any of the defenses are used exclusively or excessively by a client, this coping behavior becomes maladaptive and pat hological DEFENSE MECHANISM Purpose: 1. To decrease anxiety 2. To protect ego 3. To increase self-esteem Types of Defense Mechanisms Mechanism Compensation Definition Process by which a person makes up for a perceived weakness by strongly emphasizing a feature that he or she considers more desirable Unconscious expression of mental conflict as a physical symptoms to relieve tension or anxiety Avoidance of disagreeable Example A business man perceived his small physical stature negatively. He tries to overcome this buy being aggressive, forceful and controlling in business dealings Woman experiencing blindness after witnessing a murder



Ms. Halili has just been told that her

³Don¶t scribble in your nursery rhyme books.realities by ignoring or refusing to recognize them. usually neutral or less dangerous. the simplest and most primitive of all defense mechanism Commonly used by client who are substance abuse breast biopsy indicates a malignancy. she told him that she haven¶t received or seen the result Displacement Shift of emotions from a person or object to another. It is one of t he earliest mechanisms of the child. important in formation of conscience Commonly used by client with Depression A woman avoids dealing with her anxiety in shopping malls by explaining that shopping is a frivolous waste of time and money Eight-year-old Hayden tells his sister Vicky. He begins to play war with his soldier toys and has them fight with each other Dissociation The separation of a group of mental or behavioural processes from the rest of the person¶s consciousness or identity Commonly used by client with Amnesia A man is brought to the emergency room by the police and is unable to explain who he is and where he lives or work Fantasy A conscious creation of distortion of unacceptable fears. has her hair styled like that of her young English teacher. wishes and behaviors Use imagination or daydreaming A nursing student dreams that she has identified the cause of mental illness and that all the clients will be cured Identification Process by which a person tries to become like someone he or she admires by taking on thoughts. whom she admires Intellectualization Introjection Intense identification in which person incorporates qualities or values of another person or group into his or her own ego structure. thus expressing his parents¶ values. 15 years old. person or object Commonly used by with Phobic disorder A boy is angry because he has just been punished by his mother for drawing on their wall. When her husband ask her about the laboratory result. . mannerisms or tastes of that person Excessive reasoning or logic is used to avoid experiencing disturbing feeling Lolit. just look at the pretty pictures´.

which may be temporary or long term Attributing one¶s thoughts or impulses to another person. or memory from awareness. He tries out for the football team and becomes a star tackle . who has characteristic of an earlier level of development been toilet trained for over a year. and how much she hates you the next day Sublimation Ed has an impulsive and physically aggressive nature. or motivation to another person Commonly used by client with paranoid Offering asocial acceptable or apparently logical explanation to justify or make acceptable otherwise unacceptable impulses.Isolation Projection Splitting off of emotional components of a thought. feelings. Through this process one can attribute intolerable wishes. It is the primary ego defense. emotional feelings. Kho does not recall hitting his wife when she is pregnant Splitting A friend tells you that you are the most wonderful person in the world one day. begins to wet her pants again Mr. impulse. Failure to integrate the positive and negative qualities of oneself Commonly used by client with borderline Acceptance of a socially approved substitute goal for a drive whose normal channel of expression is blocked Four-year-old Nicole. behaviors and motive Development of conscious attitudes and behavior patterns that are opposite to what one really feels or would like to do Commonly used by client with Bipolar disorder A medical student dissects a cadaver for her anatomy course without being disturbed by thoughts of death A young woman who denies she has sexual feelings about a co worker accuses him without basis of trying to seduce her Rationalization Bistek fails an examination and complains that the lectures were not well organized or clearly presented Reaction Formation A married woman who feels attracted to one of her husband¶s friends treats him rudely Regression Retreat to behavior Repression Involuntary exclusion of a painful or conflictual thought. and other mechanisms tends to reinforce it Commonly used by client Catatonic Viewing people and situations as either all good or all bad.

but really is a conscious counterpart of repression. it may to repression Commonly used by client with Anorexia nervosa Use of external objects to become an outward representation of an internal idea. Neurotic Defenses . He decides to put it out of his mind until he leaves the office for the day Symbolization An engagement ring symbolizes love and a commitment to another person Eric makes a passionate declaration of love to Patricia on a date. Regression ix. Passive-aggressive behavior ± expressing aggression towards other behaviour indirectly through passivity. Denial ii. Denial iii. masochism and turning against self vi. It is intentional exclusion of material from consciousness. Suave iv. At their next meeting he treats her formally and distantly Undoing / Restitution Levels/Classification of Defense Mechanism 1. Distortion ± grossly reshaping external reality to suit inner impulses. needs or emotions with those that are more acceptable A process often listed as a defense mechanism. At times. attitude or feeling Act or communication that partially negates a previous one.Substitution Suppression Unconscious replacement of unacceptable impulses. a primitive defense mechanism Commonly used by client with Obsessive compulsive disorder A student nurse decides to be a teacher because she is unable to master clinical competencies A young man at work finds he is thinking so much about his date that is interfering with his work. Delusional projection ii. Narcissistic Defenses i. Rationalization viii. Psychotic Mechanism i. Dependency ± constantly seeking approval iii. attitudes. Projection vii. Distortion iii. Hypochondriasis ± exaggerating or overemphasizing an illness for the purpose of evasion or regression iv. An ugly person believes he is Mr. Identification v. Projection 3. Splitting 2. Immature Mechanism i. Schizoid fantasy ± autistic retreat 4. use to sustained feelings of delusional superiority or entitlement Ex. Acting-out ± expressing an unconscious wi8sh or impulse through action ii.

Suppression vii. Reaction Formation vi.i. Asceticism ± eliminating the pleasurable effects of experience iv. using comedy to overtly express feelings and thoughts without personal discomfort v. Introjections ii. Altruism . Anticipation ± realistically anticipating or planning for future inner discomfort iii. using constructive and instinctually gratifying service to others ii. Sublimation vi. Humor ± to make light of the situation. Others i. Intellectualization v. Emotional Isolation ± protective withdrawal iv. Displacement ii. Conversion . Mature Mechanism i. Dissociation iii.others first before self. Compensation iii. Repression 5. Undoing 6.

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