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Elmeida Effendy- Mustafa M Amin

Psychiatric Department
Medical Faculty-USU

At each phase of libidinal development, specific drive
component evoke characteristic ego defenses.

The Developmental of Ego Defense

Born :
Oral : Anal :
Displacement Reaction formation
Identification Isolation

Phallic :
Latent : Repression
Sublimation Simbolization
Defenses can be grouped hierarchically according to
relative degree of maturity associated with them :
1. Narcissistic defenses
2. Immature defenses
3.Neurotic defenses
4. Mature defenses

Narcissistic Defenses
Denial : avoiding the awareness of reality by negating
sensory data
eg : patients with malignant tumor insists she does not
have cancer
Distortion : 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.

Immature Defenses
Acting 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 punch
Blocking : 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

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
eg : fail in exam didnt study
Passive-aggressive behavior : expressing aggression
toward others, indirectly through passivity, masochism
& turning against the self
eg : sorry..I thought you didnt want the cakeI ate it

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
eg : man w/ erectile dysfunction daydreams about
orgies party

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

Neurotic Defenses
Controlling : 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 quality
eg : a woman is abandoned by her fiance, she
quickly finds another man about whom she
develops the same feelings
Externalization : tending to perceive in the external
world & in external objects elements of ones own
personality, including instinctual impulses,conflicts,
moods, attitudes & style of thinking. Externalization is
a more general term than projection

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
Intellectualization : excessively using intellectual
process to avoid affective expression
eg : 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.

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

Rationalization: offering rational explanations in
attempt to justify attitudes, beliefs, or behavior that
may otherwise be unacceptable
eg : stating that you were fired because you didn't kiss
up the the boss, when the real reason was your poor

Dissociation : temporarily but drastically modifying a

persons character or ones sense of personal identity to
avoid emotional distress
eg : hysterical conversion

Reaction formation : transforming an unacceptable
impulse into its opposite
eg : a married woman who is disturbed by feeling
attracted to one of her husband's friends treats him

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

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

Mature Defenses
Altruism: using constructive and instinctually
gratifying service to others to undergo a vicarious
eg : government employee no complaint
Anticipation: realistically anticipating or planning for
future inner discomfort.
eg : planning older life
Asceticism: eliminating the pleasurable effects of

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
eg : patient