defense mechanism

DEFENSE MECHANISM

Introduction Defense mechanism are used to reduce

anxiety or resolve conflict by modifying or changing one’s behaviors. Use of defense mechanism is a normal process of adjustment. However sometimes use of these defense mechanism, can also interfere with proper decision making which may give rise to mental disorders..

Also known as mental mechanism.

Definition

Defense mechanism are the techniques or mechanism used by an individual to handle tension or reduce anxiety or resolve conflict. These provide initial protection for the personality.

TypesSuccessful mechanismUnsuccessful mechanism

1- Successful mechanism

Repression Rationalization Intellectualization Compensation Substitution Sublimation Identification

2- Unsuccessful mechanism

Suppression Reaction formation Displacement Denial Isolation Projection

Cont… Regression Conversion Fixation Fantasy Withdrawal Transference

1- Successful mechanism

Commonly used normal defense mechanism that help an individual to deal with reality.

a) Repression Unconscious involuntary forgetting of

painful thoughts. Impulses, feelings or acts that are creating conflicts and causing discomfort.According to Freud , repression is basic to all other forms of defense mechanism

Cont.. E.g. A child may full angry with

his mother because she had punished him. If he feel too guilty about his anger he may be shown by the accidental breaking of his favorite things or in his bed wetting or refusal of food.

b) Rationalization

Is the joy and delight of the average human being. It is simply finding a logical reason for the things one wants to do.

Cont.. e.g. The women who overspends to

buy a dress explains its purchase to her husband and herself that the dress was on scale and she may not get it so cheap afterwards. A phrase “grapes are Sour” is another example of rationalization.

c)Intellectualization

It is the distancing from on emotional or threatening situation by talking or thinking about it in intellectual terms

Cont.. e.g. A nurse, doctor or

paramedical worker cannot afford to become emotionally attached to each patient. So they use the technique of detaching themselves from emotions through calm abstract statements about the situation

d)Compensation

Putting forth extra efforts to achieve in an area to affect real, or imagined deficiencies in another area. It means something given to replace a loss to make up defect.

Cont… E.g. A student who fails in his

studies may compensate by becoming the college champion in athletics.

e) Substitution

The individual preplaced one goal for another or involve more acceptable form of activity than displacing the emotion on the another individual

Cont… E.g A student who has not been

able to get admission to the MBBS course may try to substitute it with a course of physiotherapy.

f) Sublimation

Diverting unacceptable drives or urges into a form that is acceptable to society. The most important of these are sexual desires others are aggressive feeling. Agreed and even lying.

Cont..E.g A young man who has lost his lover may turn to write poetry about love.

g)Identification

Attaching to oneself certain qualities associated with others, it operates unconsciously and is significant mechanism in super-ego development.

Cont..E.g Girls identify with their mother. Later perhaps with their teacher, and later still perhaps with a film star.

An illiterate father often takes his son’s higher education as own achievement.

2) Unsuccessful mechanism

These are also called as compensatory type defense in terms of stress, when used in moderation are adaptive, if used to excess they frequently create emotional problems. These patterns of behavior are considered deviation and are usually looked as symptoms of emotional problem.

Suppression

Intentional or conscious, voluntary forgetting of painful or unacceptable thoughts, ideas, feelings and situation that are creating conflict and causing discomfort.

Cont..E.g. A student consciously decides not to think about her weekend so that she can study effectively.

Reaction formation

It is something possible to conceal a motive from ourselves by giving strong expression to its opposite.

Cont..E.g. the mother of an unwanted child may feel guilt and so becomes over indulged and overprotective of the child to assure that she is a good mother.

Displacement

Means substitute the real object of owns feeling which are often aggressive with another object.

Cont…E.g. a person who is angry with his boss, but cannot show it for fear of loosing the job may fight with his wife and children on return from the office or kick his dog.

DenialDenial of reality is when we refuse to accept or believe the existence of something that is very unpleasant to us. We use denial most often when faced with death, serious illness or something painful and threatening. Parents of fatally ill children will also deny the serious nature of illness for some times.

Cont….Denial is quite harmless if practiced in moderation, but can lead to serious difficulties in health and life style if practiced to excess.

Isolation

Separation of thoughts ideas or impulses from its associated affect ensuring that action does occur E.g. If a teenage boy got an accident with his bike he stops riding bike and never talks about it.

ProjectionTransferring the responsibility for unacceptable ideas impulses wishes or thoughts to another person. It is an attempts to deal with our own shortcoming by seeing them in other and denying them in ourselves. E.g. The student who believes that everybody cheats in examination may also cheat in the same way.

RegressionReturning to earlier develop mental level involving less mature behavior and responsibility when stress creates problem at the present stage e.g. An adult behaving like a child as practicing regression or e.g. when the nurse makes an error in giving medicines or nursing care and then starts crying.

Conversion The unconscious expression of mental

conflict by means of physical symptoms that can be expressed openly and without anxiety. E.g. the boy who hates his father and is torn between the desire to strike at him and fear of the consequences if he does so develop a paralyzed arm.

FixationIt refers to the point in the individual development at which certain aspects of the emotional development do not advance. It is inability of the individual to specific phase of development at which progress ceased or stopped. E.g. thumbs sucking in adult age is an example of fixation at oral phase.

FantasyIn this we retire to make belief world where everything is possible, where we are victors or conquerors. This is more pronounced during adolescence.

E.g. when one is having financial problem one can escape from them temporarily by planning how to spend an imaginary fortune.

WithdrawalWhenever an individual suspects that he likely to be criticized, disgraced on account of some prior unfortunate experiences or failure, he resorts to withdrawal. It is a protective devices by which the individual prevents future hurt and damage to his security by withdrawal from people and avoiding all close interpersonal relation.

TransferenceThe image of one person is unconsciously identified with that of another e.g. a patient who is found of his daughter finds the nurse of the same age and height as his daughter. So he transfer his positive emotions to his nurse as his daughter. It may be possible that he dislike his daughter and shows his negative emotions to nurse by being rude aggressive or abusive without any cause.

Defense mechanism and their origin

Origin in oral phase(0-2 years) Compensation Displacement Denial Fixation

Cont.. Origin in habit training

period (1-3 years) Conversion Identification Reaction formation Transference Sublimation

Cont… Origin in later period of

childhood (3-6 years) Repression Regression Rationalization

Cont… Origin in latency period(6-12

years) Projection

Defense mechanism and the nurse

Understanding defense mechanism will enable the nurse to support the patient and his family. Denial e.g. in a common reaction to a serious diagnosis or at the time of death. The patient and his family should be allowed to deny the situation until they are prepared to face the reality. The patient will often practice regression thought tears, trembling or demanding special treatment.

Cont…Some patient may also practice withdrawal and should be allowed to do so.Both well adjusted and maladjusted individual make use of the defense mechanism for their daily life. The well adjusted individual use them sparingly and in socially desirable ways, whereas the maladjusted individual including psychosis and neurotics use them too frequently and inappropriately.

Bibliography Kapoor Bimla. Textbook of psychiatric

nursing;vol-I. Ed-2nd, Pub kumar publication, P.p-19-24.

Baswantappa BT. Fundamental of nursing nursing; Ed-2nd ,pub- jaypee, P.p. 788-789.

Jacob Anthika. Psychology for graduate nurses; Ed-4th, pub-jaypee, P.p. 121-133.

Sethi neeraj. Essential of psychiatry; Ed-2nd, pub- lotus, p.p. 29-31

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