Ego defense mechanisms

1. EGO DEFENSE MECHANISMS DR.A.GODSON

2. DEFINITION Defense mechanisms are defined as unconscious psychological strategies brought into play by various entities to cope with reality and to maintain self-image. purpose of the Ego Defense Mechanisms is to protect the mind/self/ego from anxiety.

3. HISTORY Sigmund Freud Founder of psychoanalysis. Theory of Psychosexual Development The Id, Ego, and Superego Dream interpretation. Free association Anna freud Child psychonalysis Clear explanations of defense mechanism concept of signal anxiety

4. Otto F. Kernberg -theory of borderline personality organization ,based on ego psychological object relations theory. Robert Plutchik - defenses as derivatives of basic emotions. George Eman Vaillant -a continuum related to their psychoanalytical developmental level

5. Structural model of mind

6. THE ID Reservoir Of Unorganized Instinctual Drives Based On The Pleasure Principle Unconscious Primary Process No Logic And No Time Line

7. SUPER EGO Internalized Societal And Parental Standards Predominantly Unconscious The Conscience The Ego Ideal Children Internalize Parental Values And Standards At About The Age Of 5-6 Yrs

8. EGO The Moderator Between The Id And Superego Sense Of Time And Place Based on reality principle Predominantly Conscious ,Some part Is Unconscious Defense Mechanisms Reside In The Unconscious Domain Of Ego.

9. CLASSIFICATION( vaillant’s ) Pathological/ Narcistic Defenses Denial Distortion Projection Regression

10. IMMATURE DEFENCES Acting out Hypochondriasis Introjections Passive aggressive behavior Regression Schizoid fantasy Somatization

11. NEUROTIC DEFENCES Intellectualization Reaction Formation Dissociation Displacement Repression Externalization Inhibition Isolation Rationalization Sexualization Compensation Splitting

12. MATURE DEFENCES Humour Sublimation Suppression Altruism Anticipation Asceticism

13. DENIAL Involuntary exclusion of unpleasant or painful reality from conscious awareness Postulated by sigmund freud Simple denial - deny the reality of the unpleasant fact altogether Minimization - admit the fact but deny its seriousness Projection - admit both the fact and seriousness but deny responsibility

14. Example in normals Grief Children of 3-6 yrs Clinical illustration Terminal illness Addiction

15. TYPES OF DENIAL Denial of fact Denial of responsibility Denial of impact Denial of awareness Denial of cycle Denial of denial

16. DISTORTION Grossly reshaping external reality to suit inner needs Clinical illustration : Hallucinations Delusions especially grandiose

17. PROJECTION Perceiving and reacting to unacceptable inner impulses and their derivatives as though they were outside the self Freudian Projection projective identification -connection of the self with that projected impulse continues. Examlple -Blaming Clinical-Delusions and halluciations Paranoid personality Projective Techniques - Rorschach ink- blots&TAT

18. Acting out Expression of an unconscious impulses through actions ,thereby gratifying the impulses rather than prohibiting it Usually anti-social ,addiction form Clinical illustration: Temper tantrums Rebellious behaviors

19. INTROJECTION Unconscious internalization of the qualities of an object or person When used as a defense, it can obliterate the distinction between the subject and the object Classic example is identification with the aggressor Stockholm syndrome Clinical illustration Depression

20. Passive aggression Hypochondriasis Expressing aggression towards others indirectly through passivity ,masochism and turning against the self Manifestation - failure,procrastination,illness that affect others Exaggerating and overemphasizing an illness for the purpose of evasion and regression responsibility can be avoided ,guilt may be circumvented,and instinctual impulse are warded off

21. REGRESSION Attempting to return to an earlier libidinal phase of functioning to avoid the tension and conflict evoked at the present level of development Temporary reversion of the ego to an earlier stage Essential for relaxation, sleep, and orgasm

22. Example in normals : Dreams Adult with tember tantrum Clinical illustration: Neurosis-mild regression Psychosis-more pervasive regression Severe and prolonged physical illness

23. SCHIZOID FANTASY Withdrawal in to self to resolve conflict and gratify frustrated wishes. Conscious and unconscious Something which is not real, or cannot be real Example in normals : Seen in adolescence as wish fulfilling daydreams Strip-tease shows, or by day-dreaming over pornographic material Clinical illustrarion : Schizoid and schizotypal personality disorder Narcissistic personality disorder

24. Somatization Converting psychic derivatives in to bodily symptoms and tending to react with somatic rather than psychic manifestation Unconscious rechannelling of repressed emotions into somatic symptoms

25. REACTION FORMATION Transforming an unacceptable impulse into its opposite Where reaction-formation takes place, it is usually assumed that the original, rejected impulse does not vanish, but persists, unconscious, in its original infantile form Clinical illustration: Obsessional character Phobia

26. REPRESSION Expelling or withholding an idea or feeling from consciousness Primary repression Refers to the curbing/crushing of ideas and feelings before they have attained consciousness Secondary repression Excludes from awareness what was once experienced at a conscious level Suppression differs-at conscious level

27. Example in normals : Forgetting Slip of tongue Clinical illustration: Psychogenic amnesia Post traumatic stress disorder

28. RATIONALIZATION Offering rational explanations in an attempt to justify attitudes, beliefs, or behavior that may otherwise be unacceptable Ernest jones -contributed the term "rationalization" to psychoanalysis Simply speaking providing logical explanations for irrational behavior motivated by unacceptable wishes. Fully conscious to mostly subconscious

29. Rationalization is very common amongst the medical profession in covering up medical errors. Common excuses made are: "Why disclose the error? The patient was going to die anyway" "Telling the family about the error will only make them feel worse" "It was the patient's fault, if he wasn't so (obese, sick etc), this error wouldn't have caused so much harm" "Well, we did our best. These things happen"

30. DISPLACEMENT Shifting an emotion or drive cathexis from one idea or object to another that resembles the original in some aspect or quality Can act in a chain-reaction Example in normals : Some people punch cushions when they are angry at friends A college student may snap at his or her roommate when upset about an exam grade. Clinical illustration : Phobias in children Obsessive and compulsive disorder

31. DISSOCIATION Involuntary splitting or suppression of mental function from rest of the personality in a manner that allows expression of forbidden unconscious impulses without having any sense of responsibility for actions Example in normals : Near death experience Dissociation can be a response to trauma or drugs

32. Clinical illustration: Dissociative amnesia Dissociative fuge Multiple personality disorder Somnambulism Possession attack post-traumatic stress disorder

33. INTELLECTUALIZATION Excessively using intellectual processes to avoid affective expressions or experiences. One of freud's original defense mechanisms Intellectualization may accompany, but differs from rationalization, which is justification of irrational behavior through cliches , stories, and pat explanation.

34. UNDOING Unconsciously motivated acts which symbolically counter act unacceptable thoughts ,impulses or acts Example in normals : After thinking about being violent with someone, one would then be overly nice or accommodating to them. Automatically saying “ i am sorry”on bumping into somebody Clinical illustration : Compulsive act in OCD

35. SEXUALIZATION Endowing an object or function with sexual significance that it didn’t previously have or possessed to a smaller degree to ward off anxieties associated wiyh prohibited impulses or their derivatives

36. EXTERNALIZATION Tending to perceive in the external world and in external objects elements of ones own personality,including instinctual impulses ,conflicts , moods,attitudes and style of thinkin.It is more general term than projection. More general term than projection Example in normals : A patient who is overly argumentative might instead perceive others as argumentative and himself as blameless. Clinical illustration : Neurosis

37. INHIBITION Involuntary decrease or loss of motivation to engage in some goal directed activity to prevent anxiety arising out of conflicts with unacceptable impulses Example in normals : Writing blocks or work bloks Social shyness Clinical illustration- OCD &Phobias

38. ISOLATION Splitting or separating an idea from the affect that accompanies it, thus allowing only the idea but not the associated affect to enter the awareness Example in normals : Grief Ability to explain traumatic events without the associated disturbing emotions,with passage of time Clinical illustration : Obsessional thoughts

39. COMPENSATION Unconscious tendency to deal with a fear or conflict by unusual degree of effort in the opposite direction Example: Involvement in dare devil activities like sky diving to counter fear of heights Excessive preoccupation with body building to counter feeling of inferiority Clinical illustrations: Nymphomania –to counter a sense of sexual inadequacy Keeping excessive details in a diary in patients with dementia

40. SPLITTING Viewing of self or others as either good or bad without considering the whole range of qualities Example: Seeing all people without mustache as feminine Believing personalities as the hero is all good and the villain all bad Clinical illustration : Borderline personality disorder

41. ALTRUISM Using constructive and instinctually gratifying service to others to undergo a vicarious experience. It is a selfless concern Core aspect of various religious traditions for the welfare of others Opposite of selfishness

42. ANTICIPATION Realistic thinking and planning about future unpleasurable events. It is goal directed and implies careful planning or worrying ,premature but realistic affective anticipation of potentially dreadful outcome HUMOUR Overt expression of unacceptable impulses by using humor in a manner ,which doesnot produce unpleasentness inself or others

43. SUBLIMATION Achieving impulse gratification and retention of goals,but altering a socially objectionable aim or object to a socially acceptable one It is nothing but channelizing rather than blocking or diverting a unacceptable infantile or impulse into personally satisfying and socially valuable behavior pattern Most productive Channelization of sexual aggressive impulse into creative activities like diverting forbidden sexual impulse into artistic paintings

44. SUPPRESSION Consciously or semiconsciously postponing attention to a conscious impulse or conflict. Suppression is the process of deliberately trying to stop thinking about certain thoughts Example in normals : Voluntary decision of not to think about an argument with parents while going for an interview. Clinical-OCD

45. ASCETICISM Eliminating the pleasurable effects of experiences and assigning moral values to specific pleasures.Gratification is derived from renunciation

46. Defense mechanisms in substance abuse Denial Isolation Rationalization Blaming Projection Minimizing

47. Some defence mechanisms that are common in OCD Undoing Reaction Formation Isolation

48. THANK YOU