Ego Defense

Mustafa M. Amin Psychiatry Department Medical Faculty University of North Sumatera

Human body

Physic Psyche Not a divided component Disturbance in physic disturbance in psyche Eg : fever fear & anxiety

Body (physic) if infected calor, rubor, tumor & functio laesa leucosyte Psyche ?????

Ego

Disturbed function

Ego defense

Keeping the ego function normally so there will be harmony between self or conflict of the self

Genesis of Defense Mechanisms

As a results of the egos struggles to mediate pressures of the id Associated drive components evoke characteristic ego defense Eg : introjection, denial, projection (oral), reaction formation (anal) Defense mechanism from the earlier phases of development persist side by side w/ those of later periods When defenses associated w/ pregenital phases of development tend to predominate in adult life over more mature mechanisms the personality retains an infantile cast

Normal : - Temporary - Seldom

Ego defense

Mental emotional patient : - Often - Persist

NARCISSISTIC

Projection : perceiving & reacting to unacceptable inner impulses & their derivatives as though they were outside the self eg : woman represses her own sexual hunger& dismisses all mens sex fiends

Denial : avoids becoming aware of some painful aspects of reality eg : patients w/ malignant tumor insists she does not have cancer

Distortion : grossly reshaping external reality to suit inner needs eg : megalomaniacal beliefs

IMMATURE

Acting out : direct expression of an unconscious wish or impulse in action to avoid being conscious of the accompanying affect eg : by angry with his friend punch

Blocking : an inhibition, usually temporary in nature, of affects especially, but possibly also of thinking & impulses eg : Rudi asks about Andis girlfriend Andi doesnt answer

Hypochondriasis : transformation of reproach toward others arising from bereavement, loneliness, or unacceptable aggressive impulses into self reproach & somatic complaints of pain, illness, and so forth eg : students examination toilet Introjection (internalization) : out of a sense of guilt in which the self punishing introject is attributable to the hostile, destructive component of an ambivalent tie to an object. Internalization of characteristics of the object w/ the goal of closeness to & constant presence of the object eg : fail in exam didnt study

Passive-aggressive behavior : aggression toward an object expressed indirectly & ineffectively through passivity, masochism, and turning against the self eg : sorry..I thought you didnt want the cakeI ate it all

Regression : return to previous stage of development or functioning to avoid the anxieties or hostilities involved in later stages. eg : 7 year old girl resumes bed wetting when sibling were born

Schizoid fantasy : tendency to use fantasy & to indulge in autistic retreat for the purpose of conflict resolution & gratification eg : man w/ erectile dysfunction daydreams about orgies party

Somatization : defensive conversion of psychic derivatives into bodily symptoms eg : afraid of being bullied at school child develop stomachache

Identification : modelling of ones self on another person or group, but w/ less intensity & completeness than w/ introjection eg : soccer mania David Beckham style

NEUROTIC

Controlling : attempting to manage or regulate events or objects in the environment to minimize anxiety & to resolve inner conflicts eg : Lia wants to pass the exam for the medical faculty study hard day & night

 Displacement

: shifting an emotion or drive cathexis from one idea or object to another that resembles the original in some aspect or quality eg : a woman is abandoned by her fiance,
she quickly finds another man about whom she develops the same feelings

Dissociation : temporarily but drastically modifying a persons character or ones sense of personal identity to avoid emotional distress eg : hysterical conversion

 Isolation

: splitting or separating an idea from the affect that accompanies it but is repressed eg : a bank teller appears calm and cool
while frustrating a robbery but afterward is tearful and tremulous.

Rationalization : offering rational explanations in an attempt to justify attitudes, beliefs, or behavior that may otherwise be unacceptable eg : stating that you were fired because you didn't kiss up the the boss, when the real reason was your poor performance

Reaction formation : transforming an unacceptable impulse into its opposite eg : a married woman who is disturbed by feeling attracted to one of her husband's friends treats him rudely.

Repression (primary ego defense) : expelling or withholding from consciousness an idea or feeling Primary repression : curbing of ideas & feelings before they have attained consciousness eg : forbidden sexual impulse

Secondary repression : exludes from awareness what was once experienced at a conscious level eg : forgetting sexual abuse from her childhood due to the trauma and anxiety

Simbolization : An object or act represents a complex group of objects and acts, some of which may be conflictual or unacceptable to the ego; objects or acts stand for a repressed desire. eg : a soldier, when asked why he volunteered, he said, "To defend the flag." He rejects as irrelevant a question about the purpose of the war. Compensation : Encountering failure or frustration in some sphere of activity, one overemphasizes another. The term is also applied to the process of over-correcting for a handicap or limitation. eg : a physically unattractive adolescent becomes an expert dancer.

Undoing : An act or communication which partially negates a previous one. Eg : two close friends have a violent argument; when they next meet, each act as if the disagreement had never occurred.

Intellectualization : avoiding unacceptable emotions by focusing on the intellectual aspects eg : a person who has just been diagnosed with a terminal illness might focus on learning everything about the disease in order to avoid distress and remain distant from the reality of the situation.

MATURE

Altruism : using constructive & instinctually gratifying service to others to undergo a vicarious experience eg : government employee no complaint Anticipation : realistically anticipating or planning for future inner discomfort eg : planning older life

Asceticism : eliminating the pleasurable effects of experience eg : priest Humor : using comedy to overtly express feelings & thoughts without personal discomfort or immobilization & without producing an unpleasant effect on others eg : tukul, benny hill

Sublimation : achieving impulse gratification & the retention of goals but altering a socially objectionable aim or object to a socially accept one eg : Andy always fight w/ his friends karate Suppression : consciously or semiconsciously postponing attention to a conscious impulse or conflict eg : patient

EGO DEFENSE DEVELOPMENT

Born : Projectioni Denial Introjection Oral : Displacement Identification Anal : Reaction formation Isolation Regressoni

Latent : Sublimation

Phallic : Intelectualization Repression Simbolization

Use of Ego Defense

Learning patient personality Psychotherapy Childhood conflict