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DEFENSE MECHANISMSDEFENSE MECHANISMS

Dr. Dr. HerianiHeriani/Dr. Sylvia /Dr. Sylvia DetriDetri ElviraElviraDepartment of PsychiatryDepartment of Psychiatry

Faculty of Medicine Faculty of Medicine -- University of University of IndonesiaIndonesia

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Shinta, female, 23 years old, was shocked 3 Shinta, female, 23 years old, was shocked 3 months ago, by the news that her fiancmonths ago, by the news that her fiancéé had had married another woman because the woman was married another woman because the woman was already pregnant.already pregnant.

Later she vomited, staggered out, and felt as if Later she vomited, staggered out, and felt as if she was going to pass out. During the week she was going to pass out. During the week after, she had difficulty in sleeping, experienced after, she had difficulty in sleeping, experienced multiple awakenings at nights, and when she ate multiple awakenings at nights, and when she ate she often felt nauseous.she often felt nauseous.

Her condition recovered gradually, but her sight Her condition recovered gradually, but her sight was getting worse and now she cannot see at all. was getting worse and now she cannot see at all. The ophthalmologist stated that there was not The ophthalmologist stated that there was not any single problem in her eyes.any single problem in her eyes.

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Adi, male, 46 years old, a once quite successful Adi, male, 46 years old, a once quite successful businessman. businessman.

During the monetary crisis 10 years ago, he During the monetary crisis 10 years ago, he suffered a huge loss and his company went suffered a huge loss and his company went bankrupt. Since then his wife started complaining, bankrupt. Since then his wife started complaining, insulting, frequently asked for divorce, and finally insulting, frequently asked for divorce, and finally left him about two years ago.left him about two years ago.

According to him, he tried to be optimistic, but he According to him, he tried to be optimistic, but he complained of chest pain, as if it was pressed by a complained of chest pain, as if it was pressed by a heavy burden and he often felt short of breath. He heavy burden and he often felt short of breath. He went to see a doctor and was told that his heart went to see a doctor and was told that his heart was rather weak. That really struck him and he was rather weak. That really struck him and he didndidn’’t feel optimistic anymore. For the last t feel optimistic anymore. For the last months he prefers to be alone and sometimes he months he prefers to be alone and sometimes he has suicidal ideas.has suicidal ideas.

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HOW CAN WE EXPLAIN THOSE CASES?HOW CAN WE EXPLAIN THOSE CASES?

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Usually, an organ is mentioned as having a Usually, an organ is mentioned as having a pathologypathology if there is a if there is a deviationdeviation or or destruction. But how about destruction. But how about the mindthe mind??

Symptoms: Symptoms: anatomy = normal, but the function is anatomy = normal, but the function is disturbeddisturbed

Abnormality Abnormality –– related to the related to the situation & situation & cultureculture

Changing in function (expresses in behavior, Changing in function (expresses in behavior, feelings and thoughts), is triggered by:feelings and thoughts), is triggered by: A. ORGANIC Factor A. ORGANIC Factor B. PSYCHOLOGICAL FactorB. PSYCHOLOGICAL Factor C. A + BC. A + B

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SEVERAL ESSENTIAL FACTORSSEVERAL ESSENTIAL FACTORS(RELATIONSHIP OF THE BODILY FUNCTION & (RELATIONSHIP OF THE BODILY FUNCTION &

DISTURBANCES IN MIND)DISTURBANCES IN MIND)

Events which shock the emotion, can trigger Events which shock the emotion, can trigger abnormality in the function of the bodyabnormality in the function of the body or or cause illness in an individual.cause illness in an individual.

Emotional responses are usually followed by Emotional responses are usually followed by physiological changesphysiological changes (disgust, nausea, (disgust, nausea, etc.)etc.)

Physical responses can be prolonged Physical responses can be prolonged resulted in body and mind disorderresulted in body and mind disorder

Attitude, behavior, words of a Attitude, behavior, words of a physicianphysician play play an important role in alleviating & aggravating an important role in alleviating & aggravating a patienta patient’’s condition.s condition.

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DEFENSE MECHANISMSDEFENSE MECHANISMS

Individual:Individual:tries to fulfill the needs tries to fulfill the needs X problemsX problems

Capability ~ limitationCapability ~ limitationThe environment (+) or (The environment (+) or (--))

To achieve the goal:To achieve the goal:Avoid or minimize failureAvoid or minimize failure

Human has a great capacity,Human has a great capacity,if in reality cannot achieve satisfaction if in reality cannot achieve satisfaction shift shift fantasyfantasy

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What does an individual do when he or she What does an individual do when he or she faces a problem ?faces a problem ?

(a) (a) Makes changesMakes changes or or adjustmentsadjustments to the to the situation that he or she is dealing with:situation that he or she is dealing with:-- Has experienced Has experienced knows how to handle knows how to handle -- A new situation A new situation experiment before experiment before

finding the right wayfinding the right way(b) (b) AvoidAvoid or make a distance to the situationor make a distance to the situation

a + b : a + b : -- it might work it might work safe & satisfiedsafe & satisfied-- if it doesnif it doesn’’t work t work sense of sense of

insecurity & dissatisfactioninsecurity & dissatisfaction(c) (c) Try and learn to liveTry and learn to live withwith

insecurity & dissatisfactioninsecurity & dissatisfaction

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To face & overcome the problems of life: To face & overcome the problems of life: there are certain methods & techniques that there are certain methods & techniques that

will be used:will be used: DEFENSE MECHANISMDEFENSE MECHANISM

Broad definition:Broad definition:every method that every method that are used: are used: * rational & irrational * rational & irrational * Cs & Ucs * Cs & Ucs * realistic & fantastic* realistic & fantastic

Narrow definition:mechanism of ego to * eliminate anxiety * shift to fantasy:

several ways, Cs & UCs

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WHAT HAPPENS IF AN INDIVIDUAL WHAT HAPPENS IF AN INDIVIDUAL IS FACED WITH A PROBLEM?IS FACED WITH A PROBLEM?

Disturbances in the equilibrium Disturbances in the equilibrium stressstressuses all of ways, methods & techniquesuses all of ways, methods & techniques: :

* rational & irrational * rational & irrational * Cs & UCs * Cs & UCs * realistic & fantastic* realistic & fantastic

changes (physical & psychological) changes (physical & psychological) A new adjustment A new adjustment : works & doesn: works & doesn’’t workt work

new adaptationnew adaptation new stress new stress

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SEVERAL DEFENSE MECHANISMSSEVERAL DEFENSE MECHANISMS(WHICH ARE POTENTIALLY PATHOGENIC)(WHICH ARE POTENTIALLY PATHOGENIC)

From the most immature or pathological to the From the most immature or pathological to the most mature or healthymost mature or healthy

DenialDenial ProjectionProjection Reaction formationReaction formation Undoing Undoing IsolationIsolation

SplittingSplitting Projective Projective

identificationidentification IntrojectionIntrojection RepressionRepression BlockingBlocking

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DEFENSE MECHANISMSDEFENSE MECHANISMSTHAT ARE THAT ARE POTENTIALLY PATHOGENICPOTENTIALLY PATHOGENIC

DENIAL:DENIAL:refusing to acknowledge, or negating painful refusing to acknowledge, or negating painful realityreality

REPRESSIONREPRESSION: : painful ideas, feelings or unacceptable impulses painful ideas, feelings or unacceptable impulses are pushed out of the Csare pushed out of the Cs--mind.mind.

PROJECTIONPROJECTION: : perceiving and reacting to unacceptable inner perceiving and reacting to unacceptable inner impulses and their derivatives as though they impulses and their derivatives as though they were outside the self; attributing onewere outside the self; attributing one’’s own s own unacknowledged feelings to others.unacknowledged feelings to others.

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DEFENSE MECHANISMSDEFENSE MECHANISMSTHAT ARE POTENTIALLY PATHOGENIC THAT ARE POTENTIALLY PATHOGENIC (2)(2)

INTROJECTION:INTROJECTION:internalization of the object (other person) to internalization of the object (other person) to establish closeness & constant presence of it.establish closeness & constant presence of it.

REACTION FORMATION:REACTION FORMATION:the management of unacceptable impulses by the management of unacceptable impulses by permitting expression of the impulse in permitting expression of the impulse in antithetical form.antithetical form.

UNDOING:UNDOING:ritualistic action that has symbolic meanings to ritualistic action that has symbolic meanings to undo or negate or forget an idea or thought or undo or negate or forget an idea or thought or impulses (the individual doesnimpulses (the individual doesn’’t aware of it)t aware of it)

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DEFENSE MECHANISMSDEFENSE MECHANISMSTHAT ARE POTENTIALLY PATHOGENIC THAT ARE POTENTIALLY PATHOGENIC (3)(3)

ISOLATION:ISOLATION:splitting or separation of affect/emotion splitting or separation of affect/emotion from content e.g. the memory of a from content e.g. the memory of a traumatic experience.traumatic experience.

BLOCKING:BLOCKING:an inhibition of affect, thinking or impulse, an inhibition of affect, thinking or impulse, usually temporary in nature.usually temporary in nature.

DISPLACEMENT:DISPLACEMENT:purposeful, UCs shifting from one object purposeful, UCs shifting from one object to another to solve a conflict.to another to solve a conflict.

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DEFENSE MECHANISMSDEFENSE MECHANISMSWHICH ARE WHICH ARE POTENTIALLY PATHOGENICPOTENTIALLY PATHOGENIC (4)(4)

RATIONALIZATION:RATIONALIZATION:a justification of attitudes, beliefs, or behavior a justification of attitudes, beliefs, or behavior that may otherwise be unacceptable by an that may otherwise be unacceptable by an incorrect application of justifying reasons or the incorrect application of justifying reasons or the invention of a convincing fallacyinvention of a convincing fallacy

REGRESSION:REGRESSION:return to a previous stage of development or return to a previous stage of development or functioning to avoid the anxieties or hostilities functioning to avoid the anxieties or hostilities involved in later stages (in effort to handle or involved in later stages (in effort to handle or adjust to an extremely difficult situation)adjust to an extremely difficult situation)

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DEFENSE MECHANISMSDEFENSE MECHANISMSWHICH ARE WHICH ARE POTENTIALLY PATHOGENICPOTENTIALLY PATHOGENIC (4)(4)

SOMATIZATION:SOMATIZATION:the defensive conversion of psychic the defensive conversion of psychic derivatives into bodily symptoms, derivatives into bodily symptoms, tendency to react with somatic rather than tendency to react with somatic rather than psychic manifestations.psychic manifestations.

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DEFENSE MECHANISMSDEFENSE MECHANISMSWHICH ARE WHICH ARE POTENTIALLY PATHOGENICPOTENTIALLY PATHOGENIC (5)(5)

SPLITTING: SPLITTING: isis an UCs process that an UCs process that actively separates actively separates contradictory feelings, selfcontradictory feelings, self--representations, or representations, or object representations from one anotherobject representations from one another (good (good from bad, love from hate, etc, to preserve from bad, love from hate, etc, to preserve positively colored experiences, affects, self & positively colored experiences, affects, self & object representations, in safely isolated mental object representations, in safely isolated mental compartments, free from contamination by compartments, free from contamination by negative counterpart).negative counterpart).

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DEFENSE MECHANISMDEFENSE MECHANISMWHICH ARE WHICH ARE POTENTIALLY PATHOGENICPOTENTIALLY PATHOGENIC (6)(6)

PROJECTIVE IDENTIFICATION:PROJECTIVE IDENTIFICATION:is an UCs threeis an UCs three--steps process by which steps process by which aspects of oneself are disavowed and aspects of oneself are disavowed and attributed to someone else (e.g. the attributed to someone else (e.g. the therapist).therapist).

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MATURE DEFENSE MECHANISMSMATURE DEFENSE MECHANISMS

SUPRESSION SUPRESSION ALTRUISM ALTRUISM SUBLIMATION SUBLIMATION HUMOR HUMOR

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MATURE DEFENSE MECHANISMSMATURE DEFENSE MECHANISMS

SUPRESSION:SUPRESSION:the Cs banishing unacceptable thoughts or the Cs banishing unacceptable thoughts or feelings from your mindfeelings from your mind

ALTRUISM:ALTRUISM: the vicarious but constructive and instinctually the vicarious but constructive and instinctually

gratifying service to others;gratifying service to others; the subordination of your own needs and the subordination of your own needs and

interests to those of othersinterests to those of others

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MATURE DEFENSE MECHANISMSMATURE DEFENSE MECHANISMS (2)(2)

SUBLIMATION:SUBLIMATION:an UCs process by which consciously an UCs process by which consciously unacceptable drives or wishes are unacceptable drives or wishes are channeled into socially acceptable channeled into socially acceptable alternativesalternatives

HUMOR:HUMOR:the ability to playfully poke fun at yourself the ability to playfully poke fun at yourself and the situation you are in and the situation you are in –– an an invaluable part of mental health.invaluable part of mental health.

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Thank youThank you