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The Ego And The Mechanisms Of Defence Pdf Download


Anna Freud defined defense mechanisms as "unconscious resources used by the ego" to decrease internal stress ultimately. Patients often devise these unconscious mechanisms to decrease conflict within themselves, specifically between the superego and id. Psychodynamic therapy is used by clinicians to help orient patients to their own unconscious processes. By recognizing and identifying these processes, patients improve their self-awareness and gain a new understanding of their own behaviors. This activity defines major defense mechanisms to increase clinician's understanding of their patients during patient encounters and the role of the interprofessional team in the care of these patients.




The Ego And The Mechanisms Of Defence Pdf Download



Objectives:Identify and define the common psychological defense mechanisms.Describe the goal of psychodynamic therapy in relation to defense mechanisms.Review the clinical significance of defense mechanisms in relation to psychodynamic therapy. Outline interprofessional team strategies for improving coordination and communication in the care of patients with defense mechanisms.Access free multiple choice questions on this topic.


Sigmund Freud, known as the father of psychoanalysis, began the discussion of defense mechanisms in the nineteenth century in relation to the subconscious defenses of the id, ego, and superego.[1] These initial defense mechanisms were more clearly defined and analyzed by his daughter, Anna Freud, in the twentieth century. She created 10 major defense mechanisms, but the number of mechanisms has since been increased by later psychoanalysts.


Anna Freud defined these defense mechanisms as "unconscious resources used by the ego" to decrease internal stress ultimately.[2] Patients often devise these unconscious mechanisms to decrease conflict within themselves, specifically between the superego and id. Psychodynamic therapy is used by clinicians to help orient patients to their own unconscious processes. By recognizing and identifying these processes, patients improve their self-awareness and gain a new understanding of their own behaviors. These insights can be helpful to patients with a variety of mental health disorders, including depression, anxiety, eating disorders, and personality disorders.[3]


As we progress from childhood to adolescence and then progress from adolescence into adulthood, these psychological defense mechanisms can persist from one phase to the next, regress to earlier phases in response to stressors, or can evolve over time.[4] Defense mechanisms can be internalized or externalized, resulting in corresponding behavior problems, which can complicate psychiatric treatment.[5] Having a thorough understanding of defense mechanisms can help clinicians progress through treatment and avoid pitfalls. For example, recognizing the presence of defense mechanisms during a patient encounter can help maintain an appropriate therapeutic and professional relationship.[6]


If defense mechanisms are identified and adolescence, it can help predict further development of personality disorders.[7] Therefore, the early identification of defense mechanisms can have great clinical significance. Depending on the context and the severity, defense mechanisms can be either maladaptive or adaptive.[8]


Recognition and interpersonal communication about any defense mechanisms the patient is using amongst the psychiatrist, psychologist, social worker, primary care provider, nurse, and family can help to orient the team and enhance patient-centered care. Psychodynamic therapy can involve the patient in their own care by achieving greater awareness of their own patterns of psychological defense mechanisms. Some meta-analysis studies have shown psychodynamic therapy to have equal efficacy compared to cognitive behavioral therapy and pharmacotherapy in the treatment of mild to moderate mood disorders. It is important to recognize that therapeutic treatments based on self-awareness and communication will avoid the possible complications of pharmacotherapy, such as side effects and drug-to-drug interactions, and some patients may be more willing to try these therapies compared to pharmacotherapy.[11]


In psychoanalytic theory, a defence mechanism (American English: defense mechanism), is an unconscious psychological operation that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and outer stressors.[1][2][3]


The idea of defence mechanisms comes from psychoanalytic theory, a psychological perspective of personality that sees personality as the interaction between three components: id, ego, and super-ego. These psychological strategies may help people put distance between themselves and threats or unwanted feelings, such as guilt or shame.[4]


Defence mechanisms may result in healthy or unhealthy consequences depending on the circumstances and frequency with which the mechanism is used.[5] Defence mechanisms (German: Abwehrmechanismen) are psychological strategies brought into play by the unconscious mind[6] to manipulate, deny, or distort reality in order to defend against feelings of anxiety and unacceptable impulses and to maintain one's self-schema or other schemas.[7] These processes that manipulate, deny, or distort reality may include the following: repression, or the burying of a painful feeling or thought from one's awareness even though it may resurface in a symbolic form;[5] identification, incorporating an object or thought into oneself;[8] and rationalization, the justification of one's behaviour and motivations by substituting "good" acceptable reasons for the actual motivations.[5][9] In psychoanalytic theory, repression is considered the basis for other defence mechanisms.[5]


According to this theory, healthy people normally use different defence mechanisms throughout life. A defence mechanism becomes pathological only when its persistent use leads to maladaptive behaviour such that the physical or mental health of the individual is adversely affected. Among the purposes of ego defence mechanisms is to protect the mind/self/ego from anxiety or social sanctions or to provide a refuge from a situation with which one cannot currently cope.[10]


Different theorists have different categorizations and conceptualizations of defence mechanisms. Large reviews of theories of defence mechanisms are available from Paulhus, Fridhandler and Hayes (1997)[13] and Cramer (1991).[14] The Journal of Personality published a special issue on defence mechanisms (1998).[15]


In the first definitive book on defence mechanisms, The Ego and the Mechanisms of Defence (1936),[16] Anna Freud enumerated the ten defence mechanisms that appear in the works of her father, Sigmund Freud: repression, regression, reaction formation, isolation, undoing, projection, introjection, turning against one's own person, reversal into the opposite, and sublimation or displacement.[17]


Sigmund Freud posited that defence mechanisms work by distorting id impulses into acceptable forms, or by unconscious or conscious blockage of these impulses.[16] Anna Freud considered defense mechanisms as intellectual and motor automatisms of various degrees of complexity, that arose in the process of involuntary and voluntary learning.[18]


Both Freuds studied defence mechanisms, but Anna spent more of her time and research on five main mechanisms: repression, regression, projection, reaction formation, and sublimation. All defence mechanisms are responses to anxiety and how the consciousness and unconscious manage the stress of a social situation.[19]


Otto F. Kernberg (1967) developed a theory of borderline personality organization of which one consequence may be borderline personality disorder. His theory is based on ego psychological object relations theory. Borderline personality organization develops when the child cannot integrate helpful and harmful mental objects together. Kernberg views the use of primitive defence mechanisms as central to this personality organization. Primitive psychological defences are projection, denial, dissociation or splitting and they are called borderline defence mechanisms. Also, devaluation and projective identification are seen as borderline defences.[20]


In George Eman Vaillant's (1977) categorization, defences form a continuum related to their psychoanalytical developmental level.[21][non-primary source needed] They are classified into pathological, immature, neurotic and "mature" defences.


Robert Plutchik's (1979) theory views defences as derivatives of basic emotions, which in turn relate to particular diagnostic structures. According to his theory, reaction formation relates to joy (and manic features), denial relates to acceptance (and histrionic features), repression to fear (and passivity), regression to surprise (and borderline traits), compensation to sadness (and depression), projection to disgust (and paranoia), displacement to anger (and hostility) and intellectualization to anticipation (and obsessionality).[22]


The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association (1994) includes a tentative diagnostic axis for defence mechanisms.[23] This classification is largely based on Vaillant's hierarchical view of defences, but has some modifications. Examples include: denial, fantasy, rationalization, regression, isolation, projection, and displacement.


Psychiatrist George Eman Vaillant introduced a four-level classification of defence mechanisms:[24][25] Much of this is derived from his observations while overseeing the Grant study that began in 1937 and is on-going. In monitoring a group of men from their freshman year at Harvard until their deaths, the purpose of the study was to see longitudinally what psychological mechanisms proved to have impact over the course of a lifetime. The hierarchy was seen to correlate well with the capacity to adapt to life. His most comprehensive summary of the on-going study was published in 1977.[26]The focus of the study is to define mental health rather than disorder.


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