Defense mechanisms: Nursing

Defense mechanisms are conscious or unconscious psychological processes that individuals can use to protect themselves from anxious, inconvenient, or unpleasant feelings and thoughts. These mechanisms can be classified as adaptive, intermediate, or maladaptive depending on how much they help or harm an individual or the people in their lives.

Let’s start with the adaptive, also known as healthy or mature defense mechanisms, which include altruism, sublimation, humor, and suppression.

With altruism, an individual will provide help to others to help relieve feelings of anxiety. So for example, a billionaire makes a large donation to a hospital. So they can either derive gratification from doing the good deed itself, or from the responses from the receiver or others, such as having a hospital wing named after them. Altruism shouldn’t be confused with self-sacrificing behavior, where they deny their own needs or interests in order to help others.

With sublimation, the person replaces strong and suppressed impulses, such as sexual or aggressive ones, with an activity that is considered more socially acceptable and constructive. So for example, a person who’s very angry about his boss can channel that energy through physical labor or contact sports such as boxing.

Next, humor is commonly used to express uncomfortable feelings, lighten up stressful situations, and relieve tension. An example of using humor as a defense mechanism is when someone trips when entering the room. Feeling embarrassed, they say, “ ’”

Finally, there’s suppression. This is where the individual consciously forces negative and undesirable feelings, ideas, and impulses out of their awareness. An example of suppression would be a student being angry with their roommate about leaving dirty dishes in the sink. Since they need to study for a big exam, they stop thinking about the dishes and focus on studying instead. In this case, suppression is useful for allowing them to focus on more important matters in the present.

In other cases, suppression can delay addressing the negative thoughts or feelings until they are ready to process them.

Moving on to intermediate defense mechanisms, these can be helpful or harmful based on their severity and the situation in which they occur. Intermediate defense mechanisms include repression, displacement, reaction formation, somatization, and rationalization.

Now, with repression, the individual unconsciously pushes away negative feelings, memories, and thoughts out of their awareness.

An example of repression is when the person has no recollection of the time they were attacked as a child by a stray dog. Situations that might trigger and pull back the repressed content are commonly avoided as well, like they might avoid going to the dog park or avoid visiting homes with a pet dog.

However, excluding and keeping content away from the mind requires a lot of energy, which is why repression may lead to health problems over time, such as depression, high blood pressure, heart disease, fatigue, digestive problems, and chronic pain.

Displacement refers to the transfer of negative and undesirable emotions from their original source to another unrelated subject. An example is someone who gets yelled at by their boss at work. After coming home, they shout at their wife and kids for minor perceived faults when they actually want to yell at their boss.

In less extreme cases, it could be something relatively harmless like punching a pillow, but in extreme cases, they may even become hostile and start abusing their family members or animals.

In reaction formation, inappropriate feelings and impulses are dealt with by developing a totally opposite and exaggerated emotional response or behavior. For example, the mother of a newborn might feel no attachment to the baby, and this causes her to feel guilt and stress, so she becomes overprotective to the point where she refuses to let anyone else hold the child.

Somatization occurs when psychological distress manifests as a physical symptom without an apparent organic cause. An example of somatization is throwing up from anxiety before an important interview. This can be a way to evade a situation that would otherwise cause even more anxiety, but it can also represent a way of asking for help.