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Textbook
Introduction
1. Medical assistant
2. Electronic records
3. Medical terminology and anatomy
4. The fundamentals of infection control
5. Introduction to vital signs
6. The patient interview and history
6.1 Patient health history and communication
6.2 Therapeutic communication and diverse patient care
6.3 Defense mechanisms
7. The physical examination
8. Appointment scheduling
9. Insurance billing
10. Diagnostic coding and the ICD-10-CM System
11. Procedural coding
12. Medical billing and reimbursement essentials
13. Assisting with medical specialties
14. Assisting with the musculoskeletal system
15. Assisting with the cardiovascular system
16. Assisting with the respiratory system
17. Assisting with the nervous system
18. Anatomy and physiology of the urinary system
19. Assisting in obstetrics and gynecology
20. Assisting in endocrinology
21. Assisting in ophthalmology & otolaryngology
22. Assisting in gastroenterology
23. Assisting in the immune & lymphatic systems
24. Assisting in pediatrics: the developmental stages and care
25. The medical assistant’s role in caring for the older patient
26. The role of the medical assistant in physical therapy examination and assessment
27. Preparing for minor surgery: room, solutions, and supplies
28. Introduction to the clinical laboratory
29. Urinalysis
30. Blood collection
31. Analysis of blood
32. Electrocardiography and heart structure
33. The principles of pharmacology
34. Essential calculations and measurement systems
35. Solid, liquid, & solutions medication doses
36. Administering medications
37. Metabolism and core nutrient roles
38. Medical emergencies in the healthcare setting
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6.3 Defense mechanisms
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6. The patient interview and history

Defense mechanisms

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Patients often arrive anxious, and anxiety changes how people act and react. Some of those reactions are defense mechanisms: mostly unconscious ways people protect themselves from anxiety, fear, or emotional pain. They are especially common in patients facing a new diagnosis or a serious illness, and recognizing one helps you respond with understanding instead of taking the behavior personally.

Common defense mechanisms

Definitions
Denial
Refusing to accept a diagnosis or its seriousness, such as insisting “there’s nothing really wrong with me.”
Displacement
Taking feelings out on a safer target, such as snapping at staff instead of voicing fear about a diagnosis.
Projection
Attributing one’s own feelings to someone else, such as accusing staff of being angry when the patient is the one who feels angry.
Rationalization
Giving a reasonable-sounding excuse for a behavior, such as calling a missed medication dose “not that important.”
Regression
Returning to earlier, childlike behavior under stress, such as crying for a parent during a procedure.
Repression
Unconsciously blocking out a painful memory.
Suppression
Consciously setting a worry aside for later. It is the only deliberate mechanism of the group.
Sublimation
Channeling difficult feelings into an acceptable activity, such as exercise.
Compensation
Making up for a perceived weakness by excelling in another area.

Responding to a defense mechanism

Respond to any of these calmly and without judgment. Don’t argue with the patient or label the behavior; instead, use therapeutic communication to let them express their feelings, and tell the provider when a defense mechanism such as denial is keeping the patient from following the treatment plan.

Defense mechanisms overview

  • Mostly unconscious ways patients protect against anxiety, fear, emotional pain
  • Common with new diagnoses or serious illness
  • Recognizing them helps avoid taking behavior personally

Common defense mechanisms

  • Denial: refusing to accept diagnosis/seriousness
  • Displacement: redirecting feelings onto a safer target
  • Projection: attributing own feelings to someone else
  • Rationalization: excusing behavior with a reasonable-sounding reason
  • Regression: reverting to childlike behavior under stress
  • Repression: unconsciously blocking a painful memory
  • Suppression: consciously setting aside a worry (only deliberate mechanism)
  • Sublimation: channeling difficult feelings into acceptable activity
  • Compensation: excelling in one area to offset perceived weakness

Responding to a defense mechanism

  • Stay calm, nonjudgmental; don’t argue or label the behavior
  • Use therapeutic communication to let patient express feelings
  • Notify provider if mechanism (e.g., denial) blocks adherence to treatment plan

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Defense mechanisms

Patients often arrive anxious, and anxiety changes how people act and react. Some of those reactions are defense mechanisms: mostly unconscious ways people protect themselves from anxiety, fear, or emotional pain. They are especially common in patients facing a new diagnosis or a serious illness, and recognizing one helps you respond with understanding instead of taking the behavior personally.

Common defense mechanisms

Definitions
Denial
Refusing to accept a diagnosis or its seriousness, such as insisting “there’s nothing really wrong with me.”
Displacement
Taking feelings out on a safer target, such as snapping at staff instead of voicing fear about a diagnosis.
Projection
Attributing one’s own feelings to someone else, such as accusing staff of being angry when the patient is the one who feels angry.
Rationalization
Giving a reasonable-sounding excuse for a behavior, such as calling a missed medication dose “not that important.”
Regression
Returning to earlier, childlike behavior under stress, such as crying for a parent during a procedure.
Repression
Unconsciously blocking out a painful memory.
Suppression
Consciously setting a worry aside for later. It is the only deliberate mechanism of the group.
Sublimation
Channeling difficult feelings into an acceptable activity, such as exercise.
Compensation
Making up for a perceived weakness by excelling in another area.

Responding to a defense mechanism

Respond to any of these calmly and without judgment. Don’t argue with the patient or label the behavior; instead, use therapeutic communication to let them express their feelings, and tell the provider when a defense mechanism such as denial is keeping the patient from following the treatment plan.

Key points

Defense mechanisms overview

  • Mostly unconscious ways patients protect against anxiety, fear, emotional pain
  • Common with new diagnoses or serious illness
  • Recognizing them helps avoid taking behavior personally

Common defense mechanisms

  • Denial: refusing to accept diagnosis/seriousness
  • Displacement: redirecting feelings onto a safer target
  • Projection: attributing own feelings to someone else
  • Rationalization: excusing behavior with a reasonable-sounding reason
  • Regression: reverting to childlike behavior under stress
  • Repression: unconsciously blocking a painful memory
  • Suppression: consciously setting aside a worry (only deliberate mechanism)
  • Sublimation: channeling difficult feelings into acceptable activity
  • Compensation: excelling in one area to offset perceived weakness

Responding to a defense mechanism

  • Stay calm, nonjudgmental; don’t argue or label the behavior
  • Use therapeutic communication to let patient express feelings
  • Notify provider if mechanism (e.g., denial) blocks adherence to treatment plan

More from The patient interview and history

  • Patient health history and communication
  • Therapeutic communication and diverse patient care