Involuntary recall painful or unpleasant thoughts or feelings cause they are automatically & involuntarily pushed into one’s unconsciousness. FORGETFULNESS  Blackout (alcoholic intoxication) blocking (Alzheimer’s/Dementia)  Memory gaps  Confabulation = making story to fill in memory gaps also used by Wernicke’s Korsakoff’s = ↓ Vit. B1-thiamine,  peripheral neuritis (tingling sensation)  ↓ B6 Pyridoxine, B9 folic acid, B12  P. anemia. Ex. Sexually abused as a child blocks the experience from her consciousness and is confused about inability to respond sexually. Willingly or voluntarily putting unacceptable thoughts or feelings out of one’s mind with the ability to recall the thoughts or feelings at will.

SUPPRESSION – used selective inattention (moderate anxiety)

2. CONVERSION #1 Somatic/somatoform disease DISSOCIATION DM:

Ex. Voluntary forgetfulness or “I rather not talk about it, right now!” Transferring of mental conflict or emotional anxiety into physical symptom to release tension. Ex. A soldier experiences sudden blindness after witnessing his best friend dying from a grenade blast; Diarrhea before exam; suppress anger  HPN Act of detaching of separating a strong emotionally charged conflict from one’s consciousness. Ex. A woman raped found wandering a busy highway – traumatic amnesia. An object, idea, or act represents another through some common aspect and carries the emotional feeling associated with the other. Ex. Engagement ring symbol of love; phobias Unconsciously, people use it to identify with the personality and traits of another. To preserve one’s ego or self. Mimics/simulates external behavior , like fashion & fads Ex. Imitator, similar to role playing Attributing to oneself the good qualities of another. Incorporate feelings & emotions, values & beliefs, traits and personality. “ingestion, internalization” Ex. Acting & dressing like Jesus Christ Re-channeling of consciously intolerable or Socially Unacceptable Behaviors or impulses into personally or socially acceptable. Modify the issue, problem is still present and connected Ex. An aggressive person joins debate team (behavior modification)++ The act of making up for a real or imagined deficiency with a specific behavior. Conscious or unconscious. Problem is not connected.

#1 DM: Multiple personality= destruction of ego SYMBOLIZATION – unconscious; #1 DM: Phobias 3. IDENTIFICATION external DM: Preschooler INTROJECTION INTERNAL –

DM: Depression & counter transference 4. SUBLIMATION



Ex. An unattractive girl became a very good tennis player. - + Most common ego DM. Unconsciously used to justify ideas, actions and/or feelings with good acceptable reasons or explanation. Irrational/illogical excuses to escape responsibility. Rationalization is justifying one’s actions which are based on other

#1 DM: Anti-social disorder

motives. It is usually seen among alcoholics. Ex. It wasn’t worth it; anyway, it is all for the best. Student fails an exam, blames it on the poor lectures.

PROJECTION – person #1 DM: Paranoid

Temporarily alleviates anxiety. Person rejects unwanted characteristics of self and assigns them to others.Projection is attributing to others one’s unconscious wishes/fear. Usually it is observed in paranoid patients. – Ex. Blaming others for own faults. “scapegoat” Mechanism that serves to transfer feelings such as frustration, hostility or anxiety from one idea, person or object to another. Ex. Yelling at a subordinate after being yelled at by the boss. Negation of previous consciously intolerable action or experience to reduce or alleviate feelings of guilt. Ex. Sending flowers after embarrassing her in public. Viewing people as all good, and others as all bad Impulsive = poor self-control Ex. Hx of drug addicts & alcoholics DM: Borderline (female)

6. DISPLACEMENT higher to lower

UNDOING OR RESTITUTION – lower to higher DM: Obsessive Compulsive 7. SPLITTING

REACTION FORMATION #1 DM: Passive-aggressive personality disorder 8. REGRESSION

Person exaggerates or overdevelops certain actions by displaying exactly the opposite behavior, attitude, or feeling from what he or she normally would show in a given situation. OVERCOMPENSATION. Conscious intent often altruistic. Procrastinate Ex. Student hating her CI may act very courteously towards her. A. temporary retreat to past levels of behavior that reduce anxiety, allow one to feel more comfortable. Ex. A 27 year old acts like a 17 y.o. on her first date with a fellow employee; smoking at parties  chronic regression Permanent or persistence into later life of interests and behavior patterns appropriate to an early age. Without stressors Ex. Chain smokers, alcoholics = oral fixation The act of transferring emotional concerns into the intellectual sphere. Exaggeration of intellect. Person uses reasoning as a means to avoid confrontation. Ex. “Dear John” Letter the groom is trying to figure out with his room mate why his fiancée changed her mind – to avoid confronting her. Unconscious wish turned into reality Ex. Molested child  wants to be comforted  becomes psychologist = Oprah The unconscious refusal /avoidance to face thoughts, feelings, wishes, needs, and/or reality factors that are intolerable. Blocking the awareness of reality. Ex. “things will get better, soon” 14 y/o girl who is undergoing dialysis says, “What’s good about this, is that after it I will look good & thin.” This shows that the teen is denying her chronic illness Cancer patient saying, “You might have mixed my result with other patients,” is showing denial



ACTING - OUT 10. DENIAL #1DM: Alcoholics, PTSD, incurable illness

FANTASY DM: Schizoid

Imagined events or mental images. Wishful thinking; Temporary flight from reality to ↓ anxiety. Ex. Daydreaming. (permanent flight from reality: autism)

A number of phenomena are used to aid in the maintenance of repression. These are termed Ego Defense Mechanisms (the terms “Mental Mechanisms” and “Defense Mechanisms” are essentially synonymous with this). The primary functions of these mechanisms are: 1. to minimize anxiety 2. to protect the ego 3. to maintain repression Repression is useful to the individual since: 1. it prevents discomfort 2. it leads to some economy of time and effort


Level 1 Defence Mechanisms

The mechanisms on this level, when predominating, almost always are severely pathological. These three defences, in conjunction, permit one to effectively rearrange external reality and eliminate the need to cope with reality. The pathological users of these mechanisms frequently appear crazy or insane to others. These are the "psychotic" defences, common in overt psychosis. However, they are found in dreams and throughout childhood as healthy mechanisms. They include:

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.

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Distortion: A gross reshaping of external reality to meet internal needs. Delusional Projection: Grossly frank delusions about external reality, usually of a persecutory nature.


Level 2 Defence Mechanisms

These mechanisms are often present in adults and more commonly present in adolescence. These mechanisms lessen distress and anxiety provoked by threatening people or by uncomfortable reality. People who excessively use such defences are 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 lead to serious problems in a person's ability to cope effectively. These defences are often seen in severe depression and personality disorders. In adolescence, the occurrence of all of these defences is normal. These include:

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Fantasy: Tendency to retreat into fantasy in order to resolve inner and outer conflicts. Projection: Projection is a primitive form of paranoia. Projection also reduces anxiety by allowing the expression of the undesirable impulses or desires without becoming consciously aware of them; attributing one's own unacknowledged unacceptable/unwanted thoughts and emotions to another; includes severe prejudice, severe jealousy, hypervigilance to external danger, and "injustice collecting". It is shifting one's unacceptable thoughts, feelings and impulses within oneself onto someone else, such that those same thoughts, feelings, beliefs and motivations are perceived as being possessed by the other. Hypochondriasis: The transformation of negative feelings towards others into negative feelings toward self, pain, illness, and anxiety. Passive aggression: Aggression towards others expressed indirectly or passively. Acting out: Direct expression of an unconscious wish or impulse without conscious awareness of the emotion that drives that expressive behavior. Idealization: Subconsciously choosing to perceive another individual as having more positive qualities than he or she may actually have.

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Level 3 Defence Mechanisms

These mechanisms are considered neurotic, but fairly common in adults. Such defences have shortterm 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. These 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. Isolation: Separation of feelings from ideas and events, for example, describing a murder with graphic details with no emotional response. 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 (e.g. rationalizations). Reaction Formation: Converting unconscious wishes or impulses that are perceived to be dangerous into their opposites; behavior that is completely the opposite of what one really

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wants or feels; taking the opposite belief because the true belief causes anxiety. This defence can work effectively for coping in the short term, but will eventually break down.

Repression: Process of pulling thoughts into the unconscious and preventing painful or dangerous thoughts 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.


Level 4 Defence Mechanisms

These are commonly found among emotionally healthy adults and are considered the most mature, even though many have their origins in the immature level. However, these have been adapted through the years so as to optimize success in life and relationships. The use of these defences enhances user pleasure and feelings of mastery. These defences help the users to integrate conflicting emotions and thoughts while still remaining effective. Persons who use these mechanisms are viewed as having virtues. These include:

Altruism: Constructive service to others that brings pleasure and personal satisfaction Anticipation: Realistic planning for future discomfort Humor: Overt expression of ideas and feelings (especially those that are unpleasant to focus on or too terrible to talk about) that gives pleasure to others. Humor, which explores the absurdity inherent in any event, enables someone to call a spade a spade, while "wit" is a form of displacement (see above under Category 3). Wit refers to the serious or distressing in a humorous way, rather than disarming it; the thoughts remain distressing, but they are 'skirted round' by the witticism. Identification: The unconscious modeling of one's self upon another person's character and behavior Introjection: Identifying with some idea or object so deeply that it becomes a part of that person Sublimation: Transformation of negative emotions or instincts into positive actions, behavior, or emotion Suppression: The conscious process of pushing thoughts into the preconscious; the conscious decision to delay paying attention to an emotion or need in order to cope with the present reality; able to later access uncomfortable or distressing emotions and accept them

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