Defense mechanisms | Behavioral science

Defense mechanisms: They are coping mechanisms used by our ego to manage internal conflicts and stressful situations. They are employed unconsciously. Following types are seen:

Projection: Attribute or project one’s own thoughts and feelings to someone else e.g. an adulterous man accuses his wife of adultery, without there being any evidence of it.
Denial: Denying the truth as it may be too difficult to accept e.g. not accepting a terminal diagnosis like advanced cancer.
Splitting: Looking at things as two extremes or too good and too bad e.g. a patient says that the nurses are very bad while the doctors are very good.
Blocking: Temporary inability to remember e.g. a student is not able to recall an answer although they can remember it at some other time.
Regression: Returning to an earlier stage of development e.g. a 12 year old starts bedwetting , without a prior history of doing so.
Somatization: Feelings are manifested as physical or somatic complaints e.g. abdominal pain when stressed or headache during an exam.
Displacement: Changing the target of an emotion or drive e.g. banging on the door when upset at a person, or an attending yells at a nurse when a patient upsets him.
Repression: Unconscious elimination of an unpleasant feeling, idea or situation e.g. an adult who was abused as a child has no memory of it.
Isolation of affect: Separating the idea or reality from the expected or normal emotional response to it e.g. A father identifies his son’s dead body and shows no emotions.
Intellectualization: Intellectual process is used to replace emotion or affect e.g. a physician explains his mother’s cancer diagnosis with great detail of the sensitivity and specificity of a test used for diagnosis or about the pathogenesis of cancers, without being evidently affected by it.
Acting out: Emotional outburst or extreme behavior to cover up underlying emotions or insecurities e.g. an insecure teen starts abusing drugs to feel better about themselves or a sad child throws temper tantrums.
Reaction formation: Transforming an unacceptable impulse into its opposite like love to hate, aggression to kindness e.g. a mother who bears an unwanted child becomes overprotective of the child to convince herself that she is a good mother.
Passive-aggressive: Covert or passive expression of hostility e.g. saying you will complete the work in 2 days and then deliberately wasting your time so that the work cannot be completed on time.
Dissociation: Separates self from body or own experience or losing touch with one’s surroundings e.g. seen in daydreaming, zoning out or an accident survivor feels as if she was watching it from afar.
Identification with aggressor: A victim adopts the behavior of a person who is or was hostile towards them e.g. a soldier who works for a dictator starts behaving cruel to his subordinates.
Rationalization: Giving a rational explanation to justify attitudes or behavior e.g. giving excuses or e.g. a woman justifies having oral sex with a married man by saying that it is not actual or conventional sex.
Idealization: Thinking of someone as perfect while ignoring their flaws e.g. a teenager idolizes a rockstar even though he is a known drug addict.

Humor, sublimation, suppression and defensive altruism are the mature defense mechanisms.

Humor: Expression of one’s thoughts or feelings without discomfort, stating with a laugh or a joke e.g. a man smiles when he loses his job.
Sublimation: Converting an unacceptable impulse into a socially acceptable one e.g. an aggressive man starts playing ice hockey.
Suppression: Consciously forgetting a painful or unpleasant experience or memory e.g. a wife may be upset at her husband but she decides to suppress her feelings in front of guests.
Defensive altruism: The act of caring or doing good to others with the unconscious motivation of feeling good about themselves e.g. a previously anti-immigrant lawyer sets up a charity to help immigrants.

Transference and countertransference: It represents the unconscious transfer of feelings and attitudes from a person or situation to another. They arise from unresolved or unsatisfactory childhood relationships with parents and other authority figures. Transference is when the patient projects feelings on to the physician/nurse etc. e.g. an old female physician reminds a teenager of his strict mother, invoking feelings of resentment due to which he fails to follow her advice or adhere to therapy. It can also be for good cause e.g. if it reminds the patient of an authority figure in his life that he likes, then he is more likely to follow the physician’s advice. On the other hand, countertransference is the healthcare provider/ physician/nurse etc projecting their feelings on to the patient e.g. if the female physician in the example above sees her defiant teenage son in the patient, and she responds by being stern with him, then that is countertransference.