Psychiatric Mental Health, part 8: Principles - Defense Mechanisms

Hi. I'm Cathy with Level Up RN, and in this video, we are going to go over defense mechanisms. Defense mechanisms are unconscious or conscious coping mechanisms used to decrease anxiety. And there's a lot to go over here. I'm going to be going over 17 defense mechanisms in alphabetical order. If you have our cards, I highly recommend going through these multiple times, maybe take them for a walk so that you have that repetition, and that will, hopefully, help you remember all the different defense mechanisms. At the end of this video, I will be giving you guys a little quiz, a little name-that-defense mechanism, to see how well you learn them. Okay. So let's go through, starting with A.

So our first defense mechanism is avoidance.

Avoidance is pretty straightforward. So you're avoiding people or situations that cause distressing thoughts or feelings. So you're just staying away from those things.

Then we have compensation.

Compensation is where we focus on our strengths as opposed to our perceived weaknesses. So an individual who struggles academically maybe will focus on their sports instead.

Then we have conversion.

Conversion is the development of physical symptoms in response to stress without an underlying medical cause.

Then we have denial, which is also pretty straightforward. So this is really where you refuse to accept the reality of a situation.

Then we have displacement.

Displacement is where we transfer our feelings or emotions from one target to another.

So, for example, if a patient is given a poor diagnosis and they take it out on their nurse by yelling at them, that would be an example of displacement. Then we have disassociation. This is where someone compartmentalizes or disconnects from reality. So a classic example of disassociation would be a soldier in combat who feels like he's observing himself from the outside.

Next, we have identification. This is where someone adopts the beliefs or behaviors of another person.

And then, after that, we have intellectualization.

Intellectualization is avoiding the emotions associated with a particular situation and instead focusing on the facts and logic.

And then, projection is another defense mechanism. This is where we attribute our own thoughts and feelings onto someone else who may not have those. So it's like a movie projector. You're projecting your own thoughts and feelings on someone else.

Then we have rationalization.

So rationalization is an attempt to justify unacceptable behavior using a logic-based explanation. So let's say there's a student who cheated on a test, and he says, "Well, I didn't have to know that stuff anyway, and that's why I cheated." So he's attempting to justify or rationalize his unacceptable behavior.

Then we have reaction formation.

So with reaction formation, an individual expresses the opposite feelings or behavior from what is actually felt.

So my example of reaction formation is, when I was younger, I used to swim on the swim team, and we would go to practice like every day. And I used to carpool with this boy. His name was Matt. And Matt would tease me all the time. He was so mean to me and tease me, and so I couldn't stand Matt. But I came to find out later on that he really liked me, and that was his way of expressing it when he was young. So, "I like her, but I don't know what to do, so I'm going to just tease her." So that's my example for reaction formation.

Next, we have regression.

Regression is a defense mechanism where an individual reverts to an earlier developmental level in response to a stressor. So let's say a family has a new baby, and that baby's older sibling, who had been potty-trained for a like a year or more, suddenly starts wetting their bed and wetting their pants. They are regressing in response to a stressor, which is that baby.

So that's a classic example of regression.

Then we have repression.

Repression is the subconscious, so involuntary blocking of unpleasant feelings.

It's important to not get repression and suppression confused.

So with repression, you don't realize you're doing it, and that's a little cool chicken hint on our card here, which will, hopefully, help you remember the difference between those two.

Splitting is another defense mechanism.

With splitting, an individual fails to recognize both the positive and negative attributes of an individual. It's kind of like an all-or-nothing mentality. And I've seen that with some patients at the hospital where they're like, "This nurse is terrible, and I hate her, and she's the worst nurse ever. And this nurse is amazing and wonderful and perfect," right? And it's just black and white. No gray. This defense mechanism is very commonly used with a borderline personality disorder.

Next, we have sublimation.

With sublimation, someone takes their unacceptable impulses and transforms them into socially acceptable behaviors. So let's say someone gets in a big fight with someone and wants to punch them, but instead, they go home, and they punch their pillow, or they go to the gym and punch a punching bag.

That would be an example of sublimation.

And the way I remember that one is with sublimation, you substitute an acceptable target.

And then we have suppression, which I kind of mentioned before. But that is the conscious or voluntary blocking of unpleasant feelings. And then, finally, we have undoing. Undoing is where someone attempts to cancel out unacceptable behavior or thought by doing something to kind of reverse it. So let's say a manager is really excessively harsh on an employee during their performance review. And then they kind of feel bad about being so harsh, so then, afterwards, they go out of their way to be excessively nice and do special things for the employee. So they're trying to really undo their acceptable behavior.

All right. That's it. We got through all 17 of those defense mechanisms. All right. Quiz time. So get ready to name that defense mechanism. I have three for you.

Number one: what is the subconscious or involuntary blocking of unpleasant feelings? If you said repression, you are correct.

Number two: what do you call it when unacceptable impulses are transformed into socially acceptable behaviors? The answer is sublimation.

Then number three: what do you call it when someone expresses the opposite behavior or feelings from what is actually felt? That is reaction formation. So I hope you did good on that. If you didn't, don't worry. There's a lot of defense mechanisms. It really takes repetition. Hopefully, this video has been helpful. Take care, and good luck studying.