DEFENSE MECHANISMS IN PSYCHIATRIC DISORDERS

I.

PSYCHOSES:
*In the acute stage there is a complete loss of the egos defense mechanisms, and
disturbing thoughts, feelings, and impulses intrude into the consciousness
*as the individual gradually improves defenses appear

II.

projection
delusional denial
distortion
regression

NEUROTIC CONDITIONS:
(Anxiety Disorders; Somatoform Disorders; Dissociative Disorders in DSM IV R)
*defenses are used non-adaptively in social interaction
*they are stereotyped and repeated
Clinically:

--disturbing thoughts and impulses are controlled by the ego

defenses but
--feelings intrude into consciousness
--patient is anxious, seeks help because he/she feels uncomfortable
with his life experience (ego-alien)

Phobia:

Displacement
Avoidance
Symbolization
Restriction of the Ego

Obsessive Compulsive Disorder:

Undoing
Isolation
Intellectualization
Somatoform Disorders:
Somatization
Conversion
Passivity
Dissociative Disorders:
Dissociation
Denial

Reaction Formation
Magical Beliefs

-2III. PERSONALITY DISORDERS:

Defenses are extremely efficient in controlling anxiety (ego syntonic) so that patient is
not disturbed by any unconscious thoughts or feelings. His/her behavior and impulses,
shaped by his/her ego defenses are maladaptive, and interfere with his interpersonal
and work relationship.
CONCLUSION:

*Everyone uses defenses at times.

*It is their inappropriate, repetitive or excessive use
which lead to maladaptive behavior.

Cluster A:

Paranoid Personality Disorder

--Projection
Schizoid Personality Disorder
--Restriction of ego functions
Schizotypal Personality Disorder
--Distortion
--Identificatin
--Somatization
--Repression
--Acting out
--Fantasy of love and attention
--Dissociation
--Regression

Cluster B:

Histrionic Personality Disorder

--Denial
--Identification
--Somatization
--Repression
--Acting out
--Fantasy of love and attention
--Dissociation
--Regression
Borderline Personality Disorder
--Splitting
--Projective identification
--Acting out

-3Narcissistic Personality Disorder

--Splitting
--Over-idealization and devaluation (envy)
--Projective identification
--Fantasy of grandiosity and behavior
--Acting out
Antisocial Personality Disorder
--Projection
--Externalization
--Rationalization
--Acting out
--(Superego deficits)
Cluster C:

Obsessive-Compulsive Personality Disorder

--Isolation
--Rationalization
--Intellectualization
--Reaction formation
--Fantasy re aggression
Passive-Aggressive Personality Disorder
--Repression
--Denial
Avoidant Personality Disorder
--Displacement
Dependent Personality Disorder
--Passivity

IV. DEPRESSION
--Introjection
--Turning against the self
--Passivity
--Isolation
--Identification
V. MATURE BEHAVIOR
--Suppression
--Humor and wit
--Sublimation
--Intellectualization
--Asceticism