Monday, December 19, 2005

PSYCHOLOGICAL DEFENSE MECHANISMS - A Review

Psychological defense mechanisms are psychological strategies used by individuals (and by extension--groups of indidivuals and even entire nations at times) to cope with reality and to maintain self-image intact.

A healthy person will use many different defenses throughout life, including immature and/or pathological ones. A defense mechanism becomes pathological when it is used persistantly and leads to maladaptive behavior that will eventually threaten the physical and/or mental health of the individual; or, when it distorts reality to such an extent that it puts an individual's life or health at risk.

Since all of the psychological defense mechanisms can be used by adults to adapt to life, the question becomes: When is a defense mechanism considered really "adaptive" and when is it considered "pathological"?

What we call "mental illness" is actually a manifestation of an individual's continued pathological adaptive response to events in his/her life. The following factors make a defense "pathological":

-the defense is used in a rigid, inflexible, and exclusive manner
-the motivation for using the defense comes more from past needs than present or future reality -the defense severely distorts the present situation
-use of the defense leads to significant problems in relationships, functioning, and enjoyment of life
-use of the defense impedes or distorts emotions and feelings, instead of rechanneling them effectively

The use of "mature defenses" generally allow people to channel negative or destructive feelings and/or behaviors into more socially appropriate types of behavior that bring pleasure to both the user and to the world at large.

Art can be a perfect example of the mature sublimation of negative emotions to create something that is beautiful, pleasurable, and/or compelling to experience. Art may also be a way to manifest destructive emotions-- in which case it may bring some temporary relief of those emotions, but rarely brings pleasure either to the artist or his audience. In the latter case, it is a less mature defense called acting-out rather than sublimation. Here is an example of art used as sublimation; and here is one of art as acting-out.

Here is a listing of some of the most common psychological defenses from the Psychotic defenses to Mature defenses:

Level 1 Defense Mechanisms (Psychotic) - Almost always pathological; for the user these three defenses permit someone to rearrange external reality (and therefore not have to cope with reality); for the beholder, the users of these mechanisms frequently appear crazy or insane. These are the "psychotic" defenses, common in overt psychosis, in dreams, and throughout childhood. They include:

Denial - a refusal to accept external reality because it is too threatening. There are examples of denial being adaptive (for example, it might be adaptive for a person who is dying to have some denial (EXAMPLE, EXAMPLE, EXAMPLE, EXAMPLE )

Distortion - a gross reshaping of external reality to meet internal needs (EXAMPLE, EXAMPLE, EXAMPLE)

Delusional Projection - frank delusions and paranoia about external reality, usually of a persecutory nature (EXAMPLE, EXAMPLE, EXAMPLE, EXAMPLE)

Level 2 Defense Mechanisms (Immature) - are seen frequently in adults and are common in adolescents. For the user these mechanism alter distress and anxiety caused by reality or other people; while for the beholder, people who use such defenses are seen as socially undesirable, immature, difficult and out of touch. They are considered "immature" defenses and almost always lead to serious problems in a person's ability to cope with the world. These defenses are seen in severe depression, personality disorders, and adolescence. They include:

Fantasy - tendency to retreat into fantasy in order to resolve inner and outer conflicts (EXAMPLE)

Projection - attributing one's own unacknowledged feelings to others; includes severe prejudice, severe jealousy, hypervigilance to external danger, and "injustice collecting". (EXAMPLE, EXAMPLE, EXAMPLE, EXAMPLE, EXAMPLE , EXAMPLE (remember that projection is a primitive form of paranoia, so it is common in today's world)

Hypochondriasis - the transformation of negative feelings towards others into negative feelings toward self, pain, illness and anxiety (EXAMPLE, EXAMPLE)

Passive Agressive Behavior - aggression towards others expressed indirectly or passively (EXAMPLE)

Acting Out Behavior - direct expression of an unconscious wish or impulse to avoid being conscious of the emotion that accompanies it (EXAMPLE, EXAMPLE)

Level 3 Defense Mechanisms (Neurotic) - are fairly common in adults. They can have short-term advantages in coping, but they often cause long-term problems in relationships, work, and enjoyment of life for people who primarily use them as their basic style of coping with the world. They include:

Intellectualization - separation of emotion from ideas; thinking about wishes in formal, affectively bland terms and not acting on them (EXAMPLE)

Repression - seemingly inexplicable naivete, memory lapse, or lack of awareness of physical status; the emotion is conscious, but the idea behind it is absent (EXAMPLE and, of course, Scarlet "I won't think about that today" O'Hara from Gone With The Wind)

Reaction Formation - behavior that is completely the opposite of what one really wants or feels (e.g, taking care of someone when what one really wants is to be taken care of; studying to be a pilot to cover-up being afraid to fly). Note - this can work in the short term as an effective strategy to cope, but will eventually break down. (EXAMPLE)

Displacement - 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 (EXAMPLE, EXAMPLE, EXAMPLE, EXAMPLE, EXAMPLE)

Dissociation - temporary and drastic modification of one's personal identity or character to avoid emotional distress (EXAMPLE , EXAMPLE, EXAMPLE)

Level 4 Defense Mechanisms (Mature)- are common among most "healthy" adults and are considered the most "mature". Many of them have their origins in the "immature" level, but have been honed by the individual to optimize his/her success in life and relationships. Use of these defenses gives the user pleasure and feelings of mastery. For the user, these defenses help them to integrate many conflicting emotions and thoughts and still be effective; and for the beholder their use by someone is viewed as a virtue. They include:

Sublimation - transformation of negative emotions or instincts into positive actions, behavior, or emotion (EXAMPLE, EXAMPLE, EXAMPLES, art, sports, hobbies, or even one's choice of profession)

Altruism - constructive service to others that brings pleasure and personal satisfaction (EXAMPLE)

Suppression - the conscious decision to delay paying attention to an emotion or need in order to cope with the present reality; able to later access the emotion and accept it. (EXAMPLE)

Anticipation - realistic planning for future discomfort (EXAMPLE)

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 lets you call a spade a spade, while "wit" is actually a form of displacement) (EXAMPLE, EXAMPLE, EXAMPLE)

Research on the use of mature defenses (Level 4) has shown that they lead to:
1) excellent adjustment as an adult,
2) happiness(by self-report),
3) job satisfaction,
4) rich friendships,
5) fewer medical hospitalizations over life,
6) better overall health;and
7) a lower incidence of mental illness.

OTOH, use of immature Defenses (Levels 1, 2, 3) is related to:
1) poor adjustment as an adult,
2) higher divorce rates and marital discord,
3) poor friendship patterns,
4) higher incidence of mental illness,
5) greater number of sick leave days taken,
6) poorer health generally.

You can see from some of the examples of these defenses I have chosen, that defense mechanisms are not limited to individuals. Societies also sometimes need to protect their self-images and cope with events in the world. They need to explain why their society is failing; why the ideologies or religions they embrace aren't successful in relieving their misery; why they are not as important in the world as they feel they should be, etc. etc.

Societies, like individuals, can adopt mature defenses and deal with reality; or they can deny reality and look elsewhere for the source of their problems. Many countries, like individuals, prefer to put the blame for their own failures onto an outside source, since that is safer for the self-image. A "healthy" country, like a healthy individual will evaluate the facts and utilize mature defenses to cope with and change the situation they find themselves in. They are not afraid of their aggressive impulses because those impulses are reigned in by reason and not indulged in lightly. When necessary, healthy societies look inward. When necessary, they focus outward.

In a recent post I focused on the importance of psychological defenses in our lives:

I say this over and over, but it bears repeating: psychological defense mechanisms (which include some relatively primitive psychological responses like projection - the mechanism involved in most forms of racism, for example) are not diagnoses. The very dysfunctional ones might be conceptualized as a process of the psychological self that is somewhat similar to when the physical self experiences a fever.

A mild fever suggests that the body is coping with an intrusion into its physical defenses. Most often the fever itself becomes self-correcting, setting off a series of defensive actions that lead to a return to normal functioning. If the fever persists and becomes too high, it becomes a red flag that something serious might be going on and the underlying cause needs to be found.

It is likewise when the ego deploys a psychological defense (especially one that persists despite reality; or one that is severely dysfunctional and causes great problems in the person's life). We do not say that "fever" is a diagnosis. It is a symptom that when it doesn't go away makes us take action. A defense mechanism is also a symptom that suggests our psychological self is trying to cope with a disturbing reality. If an individual has insight and self-awareness (the ability to objectively observe and be conscious of one's own thoughts, feelings, and behaviors and their meaning), then the defense mechanism can even becomes a valuable tool with which to understand our own fears and prejudices - just as a fever becomes the red flag that leads us to look for an underlying problem.



Feel free to add your own examples in the comments if you think they are applicable.

1 comment:

Anonymous said...

I really love your Blog... I am a medical student and I dream to be a great Psychiatrist someday... :-) hope to get more insights from you... (can't I email you personally, really interested about the field)