04 - Neurotic defences

Neurotic defences:

© SPMM Course Painful event or sexual impulse Postponement of painful problems and feelings Intentional blocking of recall (this is NOT unconscious forgetting – contrast from repression)

Neurotic defences: Neurotic defences act at the level of mental inhibition. As a result the patient is deprived of some degree of freedom in decision-making, but retains insight. Displacement: The process by which interest and/or emotion is shifted from one object onto another less-threatening, often less-retaliating one. For example one who is told off by her consultant during clinical supervision may displace the anger felt onto her spouse or dog (though the reaction may be extremely different from these two objects!) DISPLACEMENT Conflict Result Process Fear/threat by an object; love or hate for an object Expression of love/hate/anger or fear against an unprovoking stimulus (clinically: phobias) Transfer of feelings from one object to a substitute

Dissociation: Temporarily but drastically modifying one's sense of personal identity to avoid emotional distress. Fugue states and hysterical conversion reactions are common manifestations of dissociation. Dissociation may also be found in counter-phobic behaviour; here a person with fear of heights takes up parachute diving and experiences dissociation during the act. DISSOCIATION Conflict Result Process Promiscuous, hostile or irresponsible behaviour (clinically: Multiple personalities, fugue, amnesia) Temporary alteration of identity including consciousness, memory and perception.

Isolation: Splitting or separating an idea from the affect that accompanies it normally but is now repressed. Noted in OCD. ISOLATION Conflict Result Process Painful emotions or memories Talking about emotional events without feeling (clinically: obsessions) Separate content from affect, remove affect completely

Rationalisation: Offering rational explanations in an attempt to justify attitudes, beliefs, or behaviour that may otherwise be unacceptable. Such underlying motives are usually instinctually

© SPMM Course determined. It often involves finding excuses that will justify unacceptable behaviours when selfesteem is threatened, often seen in teenagers and those who abuse alcohol and drugs. RATIONALISATION Conflict Result Process Low self-esteem along with socially unacceptable behaviours

Self-serving explanations and justification of behaviours False but socially acceptable explanations are offered for unacceptable behaviours

Reaction formation: This involves transforming an unacceptable impulse into its exact opposite. Reaction formation is characteristic of obsessional neurosis, but it may occur in other forms of neuroses as well. If this mechanism is frequently used at any early stage of ego development, it can become a permanent character trait, as in an obsessional personality. REACTION FORMATION Conflict Result Process Feelings of hostility and disinterest Devotion, self-sacrificing behaviour, cleanliness, correctness Substituting wishes/feelings that are exactly opposite to true feelings

Repression: This refers to expelling or withholding from consciousness an idea or feeling. Primary repression refers to the curbing of ideas and feelings before they have attained consciousness: secondary repression excludes from awareness what was once experienced at a conscious level. Note that this differs from suppression – suppression is mere postponement not the loss of thoughts from conscious perception. Repression is the primary defence. Other defences reinforce it. REPRESSION Conflict Result Process Threatening feelings / memories/ fears Gaps in memory; often unnoticed Banning thoughts and feelings from recall; subject unaware (not conscious)

Intellectualisation: This refers to excessively using intellectual processes to avoid affective expression or experience. Here the needless emphasis is focused on the inanimate to avoid intimacy with people; attention is paid to external reality to avoid the expression of inner feelings, and irrelevant details are emphasised to avoid perceiving the whole. Intellectualization is closely allied to rationalization but unlike rationalisation, intellectualisation is not an attempt to substantiate one’s instinctual impulses.

© SPMM Course INTELLECTUALISATION Conflict Result Process Disturbing feelings and thoughts (‘dissonance’) Abstract thinking, doubting, indecisiveness, generalizations Removing personal and emotional components of an event and focusing only on factual aspects

Intellectualisation Rationalisation No instinctual impulses/drives involved Instinctual impulses/urges involved Avoid experience of unpleasant affect Might experience the affect, but attempts to reduce the impact Deals with inanimate objects i.e. emphasize details and facts instead of feelings Provides ‘excuses’: e.g. alcohol, teenage conduct

Identification with the aggressor: Observed where the victim of aggression begins to assume the qualities of the proponent of aggression. IDENTIFICATION WITH THE AGGRESOR Conflict Result Process Sexual threat or life / limb threatening violence Perpetrates violent acts Identify with aggressor, may reduce direct resistance and aid in survival during acute trauma

Undoing: This is seen in OCD and is associated with magical thinking and rituals. A student might think that if he taps his table three times before the start of his exam, he will surely succeed! UNDOING Conflict Result Process Sadistic wishes, unacceptable impulses Superstitions (compulsive behaviour clinically) Symbolic negating of an impulse