Lecture Outline and Learning Objectives

     Sigmund Freud first coined the idea of defense mechanisms in 1894, but it was his daughter, Anna Freud, who perhaps best articulated the concept in her 1936 book, The Ego and The Mechanisms of Defense.  She claimed that everyone, normal as well as neurotic, uses a set of defense mechanisms to varying degrees.  Each theorist posited that most mental processes occur unconsciously - that is beyond our conscious awareness - and that when various drives, wishes, or fantasies become too painful, we must use unconscious processes to ward off what would otherwise be overwhelming psychic anguish.  However, this unconscious resistance has a cost; Sigmund Freud used the analogy of soldiers having to be split from the main body of an army to guard against the unwanted affect or emotion.  The more soldiers diverted, the less are available for the conflicts of everyday life.
     Perhaps the best way to conceptualize defense mechanisms is as a mental abstraction that helps us understand a set of behaviors that otherwise would be incomprehensible.  Defense mechanisms in and of themselves are neither good nor bad; it is only in how appropriately they are used and how adaptive they are that determines if they are problematic.   Defenses are viewed as a means of dealing with anxiety or resolving conflict.

     Acting out:  behavior that symbolically expresses what one is either unwilling or unable to more consciously express.  For example, if someone has unconscious resistance to learning about human behavior, he might simply not show up for class or be late.  The person may seem to have a valid excuse in each instance, but the overall pattern is that the person is disproportionately late for human behavior lectures.

     Denial:  seeing but refusing to acknowledge what one sees.  All of us engage in denial on a daily basis.  For example, when we get into our cars each day, we do so in at least partial denial of the reality that we may be killed or maimed.  Without this denial, we might not be able to function in a dangerous and random world.  However, this can lead to problems if we deny that we are in any way vulnerable, and don't wear seatbelts or drive recklessly.  In a relationship, denial can be destructive if one partner is either unwilling or unable to acknowledge the contributions to the problems in a relationship he or she might be making.  Note that denial, as is true for any of the defense mechanisms, is unconscious, so the person is unaware of the process as it occurs.  This is why it can be so exasperating to try to confront someone with something over which they're in denial.

     Intellectualization:  the control of affect and impulses by thinking about things instead of experiencing them emotionally.  A person who is a victim of a tornado, for example, may read everything about tornadoes and meteorology he can in an attempt to gain some mastery over the traumatic experience.  Although this may be a normal response, it may interfere with the patient's mourning, acceptance, and ability to deal with attendant affect.

     Passive Aggressive Behavior:   this includes behaviors that although prima facie are passive are in actuality aggressive.  The classic example is the secretary who never directly confronts you, but by various acts of omission - failure to return calls, perform duties in a timely manner, or pass along important messages - engages in behavior whose impact is to hurt a supervisor.   It is considered an immature defense and can obviously be very destructive;  the secretary in this case is avoiding the anxiety associated with direct confrontation with the supervisor but ends up creating far more tension and damage over the long-term albeit in an indirect way.

    Projection:  perceiving and reacting to unacceptable inner impulses as though they were coming from outside the self.  For example, one might feel a tremendous hostility toward a group of people, such as Jews, Moslems, or Christians, but experience the hostility as arising from that group, leading to prejudice.  Freud was primarily concerned with intrapsychici defense mechanisms, but clearly these defenses can be seen at the societal or cultural level.
 

     Regression:  returning to a more primitive stage of functioning to avoid the anxieties associated with a more advanced stage.  This is very common among patients admitted to a hospital, who although functioning independently as outpatients become very needy and appear less mature when hospitalized.

     Somatization:  conversion of anxiety into somatic symptoms, such as abdominal pain or diarrhea.  It is often very difficult to determine if the patient is suffering from a bona fide medical illness or is simply experiencing mental pain in somatic form, but it is the clinician's task to sort this out.   Many illnesses are worsened by mental tension or conflict, so the old mind-body dualism is a false dichotomy.   Somatization becomes problematic when the patient becomes so focused on their bowels that they are unable to articulate and deal with their anxiety, depression, or other mental difficulties.  In extreme form, somatization can lead to multiple unnecessary diagnostic and therapeutic interventions, such as exploratory laparotomies or cardiac catheterizations so it is extremely important to identify this defense when it is occurring.  However, it is also important to remember that somatic patients get myocardial infarctions or appendicitis also, which makes the clinician's role a very difficult one.

     Rationalization:  in contrast to intellectualization, the fallacious justification of various attitudes, beliefs, or behaviors.  For example, a person who goes through 6 chaotic relationships in a row because of his rigid personality style may tell himself he's better off without those relationships.  (An intellectualizer, on the other hand, might read every self-help book available about what makes relationships succeed or fail, memorizing statistics on divorce and marriage and filling his head with facts while avoiding any painful emotions.)  Societal and cultural rationalizations include the concept of Manifest Destiny that rationalized the dominance of North America by Europeans or the concept of Lebensraum that Hitler used to rationalize his dominance of Europe.  True rationalization (as a defense mechanism) is unconscious and should be contrasted with the sociopath's calculated, conscious dishonesty (although someone with antisocial personality disorder may also engage in unconcsious rationalization ("I really needed a new car and the person I was stealing it from was probably rich enough to go out and buy another.")

     Reaction formation:  management of unacceptable impulses by creating its polar opposite.  For example, a person who loves alcohol and drinking to intoxication may join a temperance movement, condemning any and all alcohol.  A man who has secret impulses to fondle young boys may become active in a religion with harsh sexual prohibitions and mandates.

     Repression:  expelling from conscious awareness any feelings or ideas that are considered unacceptable.  Psychoanalytic theory holds that repression is usually accompanied by symbolic behavior, showing that repression is not entirely successful.  For example, the person who tells you repeatedly that he is not angry that you forgot to join him for dinner might let slip his displeasure in other ways, such as slips of the tongue ("Where should I beat you - I mean, meet you?").

     Sublimation:  the expression of prohibited or secret impulses or feelings through societally accepted means.  For example, the person filled with homicidal urges may become a movie director of violent movies that are critically acclaimed instead of acting directly on the homicidal impulses and killing someone.  Someone with sadistic impulses may become a surgeon, cutting open flesh and breaking bones in a societally acceptable way.

     Suppression:  the conscious or semi-conscious postponing of dealing directly with painful affect.  This is to be contrasted with repression, which is an unconscious process.  For example, when Scarlett O'Hare in Gone With the Wind says she will think about that tomorrow, she is engaging in suppression, since she is consciously aware of the delay.  One of the ways of viewing psychoanalysis is that it encourages a patient to substitue more mature or adaptive defenses for more primitive or maladaptive ones.

[source:  Kaplan, p. 42]

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