Theme: Defence mechanisms
| A. | Sublimation |
| B. | Repression |
| C. | Reaction formation |
| D. | Displacement |
| E. | Rationalisation |
| F. | Intellectualisation |
| G. | Isolation |
| H. | Regression |
| I. | Acting out |
| J. | Denial |
Select the defense mechanism suggested by each of the scenarios
| NaN. | A newly admitted patient to a hospital ward gets threatened by another patient during a music session. The patient runs back to their room and when the nurse goes to see how they are they find them lying in the foetal position on the floor in the corner of their room. |
| Regression 83% The patient has regressed to an earlier stage of development when faced with a stressful situation. |
| NaN. | A psychiatrist is deeply upset about having failed their end of year review. Despite having had personal issues which resulted in them having to have prolonged periods of time off work they place the blame on their consultant supervisor who they complain was not supportive enough and didn't provide enough time for supervision. This appears odd to the training program director as the consultant has previously had a very good reputation. |
| Rationalisation 34% The psychiatrist is upset and so tries to place the blame elsewhere. This is an attempt to rationalise the reasons for their disappointment to avoid facing the reality of the situation as this may be too painful. This is not intellectualisation as the psychiatrist is in contact with their feelings (even if not the real reasons for them). |
| NaN. | A woman is diagnosed with a terminal cancer. When the specialist sees her in clinic they are struck by the womans apparent lack of concern. The woman has read an impressive amount of literature on the cancer and engages in a rather cold discussion about the prognosis and treatment options. The specialist feels that the woman behaves as if she didn't have the cancer although when asked directly she accepts that she does. |
| Intellectualisation 72% The woman has focused on the more abstract aspects of the diagnosis (prognosis and treatment) in an attempt to avoid facing the emotional reality of the diagnosis. |
Defense mechanisms
| Defense mechanism | Description |
|---|---|
| Denial | Refusal to accept reality |
| Displacement | Redirection of impulses onto a different target (usually less threatening one) to the one who caused the emotion |
| Projection | Involves dealing with stress by falsely attributing your own unacceptable feelings, impulses, or thoughts to another person |
| Projective identification | In projective identification aspects of the ego are projected into another (as in projection). The difference between the two is that projective identification takes into account the emotional impact of the recipient who feels what is projected into them. In projective identification there is often a sense of feeling controlled or manipulated |
| Reaction formation | Dealing with stress by substituting behavior, thoughts, or feelings that are the exact opposite of your own unacceptable thoughts or feelings |
| Suppression | Process of consciously avoiding thinking about something for example by distracting oneself |
| Repression | Involves dealing with stress by removing disturbing wishes, thoughts, or experiences from conscious awareness. The person may still be aware of the feelings associated with the repressed issue, but will not know where the feelings come from |
| Undoing | Involves dealing with stress by using words or behaviors designed to negate or make amends symbolically for unacceptable thoughts, feelings, or actions |
| Acting out | Acting in a way that enables a person to avoid coming into contact with difficult feelings or anxieties. Examples include drug use, missed appointments with therapists, and tantrums. Note that acting out is not akin to acting up which is a term used to describe a range of challenging behaviors |
| Intellectualisation | Focusing on details in an effort to avoid painful thoughts or emotions |
| Rationalization | The creation of false but credible justifications. This is easily confused with intellectualisation but in the latter the patient is not in contact with their emotions. In rationalisation the patient feels the distress but seeks to find alternative reasons for them to avoid the full reality of the situation |
| Sublimation | Involves dealing with stress by channeling potentially disruptive feelings or impulses into socially acceptable behavior |
| Regression | Reverting back to an earlier stage of development when faced with an unpleasant thought or emotion |
| Isolation | The disconnection of an event from the emotion attached to it |
| Splitting | Involves dealing with emotional conflict or internal or external stressors by compartmentalizing opposite affect states and failing to integrate the positive and negative qualities of the self or others into cohesive images. Because ambivalent affects cannot be experienced simultaneously, more balanced views and expectations of self or others are excluded from emotional awareness. Self and object images tend to alternate between polar opposites: exclusively loving, powerful, worthy, nurturing, and kind or exclusively bad, hateful, angry, destructive, rejecting, or worthless |
| Externalisation | Projecting into the external world and in external objects elements of one's own personality, including instinctual impulses, conflicts, moods, attitudes, and styles of thinking. Externalization is a more general term than projection |
