Defense mechanisms

What are defense mechanisms? 

All people employ defense mechanisms to cope with internal and external conflicts and stressors.

Some of these mechanisms are adaptive (promote functioning and strengthen relationships) while others are maladaptive.

The clinician should remember that people (the clinician included) are generally trying to do the best they can with the ego resources and skills that they have.

What are the common defense mechanisms

Which defense mechanism may interfere with delivery of care (i.e., which are maladaptive)? 

Generally maladaptive (immature and neurotic) defense mechanisms:

  • Reaction formation—substitution of diametrically opposite thoughts, feelings, behaviors
  • Projection—attribution to others (may be to a delusional extreme)
  • Projective identification—feelings are misattributed as justifiable and attributed also to others often to the point of and inducing projected feeling in others
  • Splitting—“black and white thinking”; compartmentalizing positive and negative attributes rather than integrating them into a cohesive whole
  • Idealization—regarding others as perfect or better than they really are
  • Acting out—unconscious expression in action of a wish or impulse
  • Dissociation—transient loss of or alteration of identity
  • Denial—rejection of reality
  • Displacement—redirection of impulses to a safer target

Generally adaptive (mature) defense mechanisms:

  • Altruism—vicarious gratification through service to others
  • Anticipation—feeling in advance and considering consequences and alternative solutions
  • Humor—finding the humor in a stressful situation
  • Identification—modeling aspects of oneself after another’s example
  • Sublimation—feelings are converted or channeled into more socially acceptable forms
  • Suppression—difficult feelings are intentionally avoided to cope with the present reality
  • Others—mindfulness, acceptance, respect, tolerance
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