WEEK 4: DEFENSE MECHANISMS POSITIVE DEFENSE MECHANISMS
Mental defense mechanism or ego defense mechanism 1. COMPENSATION:
INTRODUCTION:- Compensation is a pattern by which tension or anxiety
relieved by an individual make up for personal weakness.
Sigmund Freud in the 1904 used the term "defense
mechanism" to refer to the unconscious process that EXAMPLE:
defends or protects a person against anxiety, shame, loss A student who fails in his studies may compensate by
of self-esteem, conflict, or unacceptable feelings. becoming the college champion in atheletics.
According to Freud, when Id is in serious conflict with ego A plain girl, who cannot compete with her more beautiful
and superego, the individual suffers from tension or sisters, may compensate by studying hard and come 1st in
anxiety. her class.
Defense mechanism enables a person to resolve conflict
and reduce the stress and anxiety. 2. SUBSTITUTION:
Usually, all defense mechanisms are operated at
It is a mechanism by which tension or anxiety reduced by
unconscious level.
replacing the unachievable goal with achievable goal.
Most of defense mechanisms are self-deceptive in nature.
EXAMPLE:
A student who has not been able to get admission to the
DEFINITION:
MBBS course may try to substitute it with a course of
Defense mechanism is a pattern of adjustment through which an physiotherapy or nursing.
individual relieves anxiety caused by an uncomfortable situation that A person aspires to become a national level cricket player
threaten self-esteem. and not selected. He may substitute this goal by being a
coach at college level.
When these defense mechanisms are used moderately are harmless
but excessive and persistent defense use is harmful. 3. SUBLIMATION:
It is a mechanism that causes the channelization of socially
unacceptable desires into acceptable forms.
CLASSIFICATION OF DEFENSE MECHANISM:
In this mechanism primitive impulses are transferred or
These defense mechanisms are classified according to its results- directed to a socially useful goal.
Positive defense mechanism EXAMPLE:
Negative defense mechanism
A teenage boy with strong competitive and aggressive
feelings becomes a football player.
A young man who has lost his lover may turn to write
POSITIVE DEFENSE MECHANISMS:
poetry about love.
1. Compensation A person who has aggressive feeling and cannot express in
2. Substitution society can become a soldier or boxer.
3. Sublimation
4. RATIONALIZATION:
4. Rationalization
5. Repression It is a defense mechanism in which an individual justifies
6. Undoing his failures and socially unacceptable feelings and
7. Identification behaviors by making excuses or formulate logical reasons /
8. Transference socially approved reasons.
9. Intellectualization
EXAMPLE:
10. Introjection
A husband does not enjoy the company of wife outside the
NEGATIVE DEFENSE MECHANISMS:
home and usually leave his wife at home. He gives logic
1. Suppression that his wife is social shy.
2. Displacement A girl fails to get admission for the nursing course may
3. Projection point out a number of difficulties of nursing profession.
4. Regression A person without a vehicle says that he does not want to
5. Fixation risk his life by driving.
6. Fantasy
7. Reaction formation 5. REPRESSION:
8. Conversion Repression is a process of unconscious forgetfulness of our
9. Dissociation unpleasant experiences.
10. Denial Repression is the involuntary blocking of unpleasant
feelings and experiences from one's awareness.
EXAMPLE: 10. INTROJECTION:
A man is jealous of his good friend's success but is In introjection the values and characteristics of significant
unaware of his feeling of jealousy. persons are incorporated in one's personality.
6. UNDOING: EXAMPLE:
Undoing is the act symbolically canceling or reversing a Person who dislikes guns becomes an avid hunter, just like
previous act which is unacceptable. a best friend.
While her mother is gone a young girl disciplines his
EXAMPLE:
brother just like her mother would
A daughter shout at her father as there is no petrol in the
car and is getting late for office, brings a favorite film for
her father to watch. NEGATIVE DEFENSE MECHANISMS:
This is an example of undoing her behavior of shouting and
Some defense mechanisms have negative impact over
then bringing a film.
relations or development of person.
7. IDENTIFICATION:
1. SUPPRESSION:
Through this process, an individual attempts to increase
Suppression is the voluntary blocking of unpleasant
self-worth by acquiring certain attributes and
feelings and experiences from one's awareness to avoid
characteristics of an another individual one admires.
discomfort and anxiety.
It plays a large part in the development of personality.
In this individual feels personal satisfaction in the success EXAMPLE:
and achievement of another group or person.
Student consciously decides not to think about her insult
EXAMPLE: in examinations hall that he can study effectively.
A patient may refuse to consider his difficulties by saying
The young son of a famous civil rights worker adopts his
that he does not want to talk about it.
father's attitudes and behavior with the intent of pursuing
similar aspirations. 2. DISPLACEMENT:
An illiterate father often takes his son's higher education as
In this defense mechanism an unconsciously emotional
his own achievement.
feeling is transferred to person or object who are less
8. TRANSFERENCE: dangerous than those who initially aroused the emotion.
An individual who is using displacement is unaware of this
In transference, the image of one person is unconsciously
at that time, but later he can realize it.
identified with that of another.
EXAMPLE:
EXAMPLE:
A person who is angry with his boss but cannot show it for
A patient who is fond of his daughter finds the nurse of the
fear of losing the job may fight with his wife on return from
same age and height as his daughter. So, he transfer his
the office.
positive emotions to the nurse as his daughter.
It is also possible that if he dislikes his daughter he
transfers his negative emotions to the nurse by being rude,
3. PROJECTION:
abusive, or aggressive without any cause.
Placing blame for own difficulties upon others.
9. INTELLECTUALIZATION:
Here, others are seen as responsible for own mistakes.
Intellectualization is an attempt to avoid expressing actual One's own unacceptable feelings and thoughts are
emotions associated with a stressful situation by using the expressed as they are due to others.
intellectual processes of logic, reasoning, and analysis.
EXAMPLE:-
EXAMPLE:
A surgeon who did mistake in operation may insist that it
A young professor receives a letter from his fiancée happened because theatre nurse and ward boy did their
breaking off their engagement. He shows no emotion task badly.
when discussing this with his best friend. A businessperson who values punctuality is late for a
Instead he analyzes his fiancée’s behavior and tries to meeting and states, "sorry I'm late. assistant forgot to
reason why the relationship failed. remind me of the time.”
4. REGRESSION:
Regression means an immature way of responding to a
stress or go backwards.
In this the adult revert back to an earlier developmental
level in order to deal with reality.
An individual does less mature form of behavior when 9. DISSOCIATION:
faced with difficulties, where he finds less conflict hence
Dissociation is involuntary suppression of a mental
less anxiety.
function from rest of personality in a manner that allows
Adults too may regress to the oral stage of development
expression of forbidden unconscious impulse without
and suck their thumb when life gets stressful.
having any sense of responsibility for actions.
EXAMPLE:
EXAMPLE:
Nurse makes an error in giving medication and starts
Partial amnesia
crying.
A person who is depressed may withdraw to his or her 10. DENIAL
room, curl up in a fetal position on the bed.
Any individual refuses to face the reality.
5. FIXATION: It protects the individual from shock of reality.
Person unconsciously uses this mechanism and this
Fixation refers to the point in the individual's development
reaction is for some time.
at which certain aspects of the emotional development do
Denial is quite harmless if practiced in moderation but can
not advance.
lead to serious difficulties in health and life style if
EXAMPLE: practiced in excess.
Thumb sucking continuously till adult age. EXAMPLE:
An unmarried, middle-aged man still depends on his
When some very near and dear one die in the family. Some
mother to provide his basic needs.
people say no, he is still alive.
6. FANTASY:
Fantasy is used to gratify frustrated desires by imaginary
DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS
achievements and wishful thinking.
FIFTH EDITION (DSM-5)
The tendency of day dreaming is most common during
adolescence. What is the DSM-5
EXAMPLE:- The Diagnostic and Statistical Manual of Mental Disorders,
often known as the “DSM,” is a reference book on mental
A young boy who could not help his ailing father due to
health and brain-related conditions and disorders. The
shortage of money, day dreams that he has got lot of
American Psychiatric Association (APA) is responsible for the
money from lottery ticket and his father, mother and
writing, editing, reviewing and publishing of this book.
family members has best of the facilities for everything.
The number “5” attached to the name of the DSM refers to
7. REACTION FORMATION:
the fifth — and most recent — edition of this book. The DSM-
In this defense mechanism the unacceptable real feelings 5’s original release date was in May 2013. The APA released a
are repressed and acceptable opposite feelings are revised version of the fifth edition in March 2022. That
expressed. version is known as the DSM-5-TR, with TR meaning “text
It is defined as unconscious transformation of revision.”
unacceptable impulse into exactly opposite attitudes,
The Diagnostic and Statistical Manual of the American
impulse, feelings, or behaviors.
Psychiatric Association, Fifth Edition (DSM 5) is known as the
EXAMPLE: primary method of classification used by American mental
health clinicians to diagnose patients with mental illnesses
Women who actually dislike her mother in law hide her and conditions
feelings by being always nice to her.
Diagnosis refers to a process of gathering information to
8. CONVERSION: understand a client’s condition, linking that information with
In this pattern of defense mechanism strong emotional knowledge about various cognitive, emotional, and
conflicts which are not expressed are converted into behavioral conditions.
physical symptoms. The DSM is commonly referenced by social workers,
It has two benefits for person- particularly by clinical social workers practicing in the field of
1. It resolves the conflict mental health.
2. It brings him a great deal of attention and sympathy.
DSM diagnoses help social workers and other mental health
EXAMPLE professionals understand clients, guiding their interventions
A student nurse, who is very anxious about her from an evidence-based perspective. Diagnosis helps
examination, may develop a headache. professionals with goal setting, treatment planning, and
determining a client’s prognosis.
IMPORTANCE
The DSM-5 and DSM-5-TR are medical reference books Example: DSM-5 Criteria for Bipolar Disorder
intended for experts and professionals. The content in these
For a diagnosis of Bipolar I disorder, it is necessary to meet the
books is very technical, though people who aren’t medical
following criteria for a manic episode which may have been
professionals may still find it interesting or educational.
preceded by and may be followed by hypomanic or major depressive
However, you shouldn’t use either of these books as a
episodes
substitute for seeing a trained, qualified mental health or
medical provider. Manic Episode
A distinct period of abnormally and persistently elevated,
expansive, or irritable mood and abnormally and persistently
What is the purpose of the DSM-5
increased goal directed activity or energy, lasting at least 1
The first step in treating any health condition — physical or week and present most of the day, neatly every day.
mental — is accurately diagnosing the condition. That’s During the period of mood disturbance and increased energy
where the DSM-5 comes in. It provides clear, highly detailed or activity. (3 or more) of the following symptoms are
definitions of mental health and brain-related conditions. It present.
also provides details and examples of the signs and 1. Inflated self-esteem and grandiosity
symptoms of those conditions. 2. Decreased need for sleep.
3. More talkative than usual of pressure to keep talking.
The purpose of a diagnostic and statistical manual is to
4. Flight of ideas or subjective experience that thoughts
provide clear descriptions of diagnostic categories in order to
are racing
enable clinicians to diagnose, communicate about, study and
5. Distractibility
treat people with various disorders.
6. Increase in goal directed activity.
DSM is used by health care professionals of all disciplines and 7. Excessive involvement in activities that have high
it is cited for insurance reimbursement, disability potential for painful consequences.
deliberations and forensic matters
DSM attempts to describe what the manifestations of mental
disorders are and provides a description of the clinical
features
Importance to Student Nurses
Although student nurses do not use DSM – 5 to diagnose
clients, they will find it a helpful resource to understand
the reason for the admission and to begin building
knowledge about the nature of psychiatric illnesses.
Example Categories in the DSM-5
bipolar and related disorders
depressive disorders
feeding and eating disorders
obsessive-compulsive and related disorders
personality disorders
