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Coping is the way one adapts to a stressor psychologically,physically and behaviorally.Our body
protect us against physical danger or distress.Similarly the individual has devices for protecting
himself against psychological danger and distress..Freud believed that when the ego feels it may be
unable to control impulses from the id.They reduce the distress caused by frustations and
conflicts.when anxiety is too painful ,the individual copes by using defense mechanisms to protect
the ego and diminish anxiety.

Definition : Defense mechanisms are methods of attempting to protect self and cope with basic
drives,emotionally painful thoughts,feelings or events.
The term ego defense mechanism refers to the automatic ,involuntary and unconsciously instituted
psychological activity by which unacceptable urgues or impulses are excluded from the conscious
Defense mechanism are unconscious responses to external stress as well as to anxiety arising from
internal conflict.


To minimize anxiety.
To protect the ego from anxiety.
To prevents discomfort.
To protect the mind.
To provide a refuge from a situation with which one cannot currently cope.

Historical review:Sigmund frued (1961) identified the ego as the reality component of the personality that governs problem
solving and rational the level of anxiety increases ,the strength of the ego is tested ,and energy is
mobilized to comfront the threat .Anna Frued (1953 ) idenfied a no of defence mechanism employed by the
ego in the face of threat to biological and psychological integrity. Some of these ego defence mechanism are
more adaptive than others,but all are used either consciously or unconsciously as protective device for the
ego in a effort to relief mind to moderate anxiety.


In 1923 Freud divided the mental apparatus into three dynamics structure:


ID: The Id is the original state of human mental apparatus with which a new born baby is born.It is totally
unconscious ,containing the basic drives instincts,concerned with survival,sexual drive and agreesion.It is
characterized by primary process thinking and is based on pleasure principle,lacking any direct link with
relity.The only argue of this drives is immediate gratification.
EGO: The ego also called the rational self or the reality principle, begins to develop between the ages of 46 months. The ego experiences the reality of the external world,adapts to it and response to it.As the ego
develops and gains,strength ,it seeks to bring the influences of the external world to bear upon the ID,to
substitute the reality principle for the pleasure principle. Ego maintains abalance between the id and the
super-ego on one hand and the reality on other hand.
For example,The Individual observes a pleasure object surrounded by a barrier.The id wants immediate
gratification by obtaining the objects without seeing of a barrier around it.The super ego on the other hand
proclaims that it is sinful to derive pleasure of an objects surrounded by a barrier.The ego maintain a balance
between the two,as well as the real world and decides to wait and find a way to climb the barrier and derived








SUPER EGO : The Super-ego is predominantly unconscious subdivision of mental apparatus that develops
from the ego.It is specially concerned with moral standards and has two parts.:a punitive conscience and a
non punitive ego ideal.

Both derive from the effect of parental influence on the ego.This parental influence not only includes
the effect of actual parents but also of the important family members, religion and important people in the
surrounding environment .when a child is consistently punished for a bad behavior is conscience.when a
child is consistently rewarded for good behavior,self-esteem is enhanced and the behavior becomes part of
the egoideal.

Levels of Defense Mechanism;

The psychiatrist George Eman Vaillan introduced a four level Classification of Defense mechanism.
Level 1-Pathological Defences
The mechanism on this level ,when pre-dominating,almost always are severely pathological.


defenses ,in conjunction permit one effectively to re-arrange external experiences to eliminate the need to
cope with reality.These are PSYCHOTIC defenses common in over psychosis.They include
Level-2 Immature defences:
These mechanism are often present in adults.These mechanism lessen distress and anxiety produced by
threatening people or by an uncomfortable reality.Excessive use of such defenses is seen as socially
undesirable,in that they are immature,difficult to deal with reality.These defenses are often seen in major






thinking,idealisaton .

Level-3 Neurotic defenses:

These mechanism are considered neurotic but fairly common in adults.Such defenses have short term
advantages in coping but can often cause long term problem in relationship ,work and in enjoying life.
They include displacement., dissociation, hypochondriasis,intellectualization, ,isolation,,rationalization
,reaction formation,regression,repression,undoing,withdrawl

Level-4 Mature Defenses:These are commonly found among emotionally healthy adults and are considered as mature. Even though
many have their origin in an immature stage of development they have been adapted through the years in







,anticipation,humor,suppression, identification,gratitude.







Unconscious and involuntary forgetting of painful ideas,events,conflict and experiences from ones
awareness. It is often referred to as selective forgetting.It is widely used mechanism in which
unacceptable thoughts and feelings are unconsciously kept out of awareness .Requires considerable
energy to keep material repressed.It is unconscious blocking rom awareness material that is threatening
or painful.
o EXAMPLE: A teenage boy cannot remember driving the car that was involved in an
accident in which his best friend was killed.
A woman cannot remain being sexually assaulted when she was 15 years old.
The mother seems unaware of the date or events surrounding her child death and shows no emotions
when the death is discussed.
Forgetting a loved ones birthday after a fight.
2) DENIAL: Unconscious refusal to admit an unacceptable ideas or behavior. It is refusal to acknowledge
the existence of real situation or the feeling associated with in.
An individual refuses to face reality.The person usually denial is unaware of doing so.He\she fails
to recognize an unacceptable impulse,but obvious thought ,fact,behavior,conflict or situation or its
consequency.It is failure to acknowledge an unbearable condition .failure to admit reality situation.

EXAMPLE: spending money freely when broke or lost all in life.

The alcoholic person believes that he has no problem with drinking even though family and work

colleagues observe the classic sign .

The mother of a child who is fatally ill may refuse to admit that there is anything wrong even though

she is fully informed of the diagnosis and expected outcome.

The individual continue to smoke cigarettes even though they have been told health risk is involved .
An woman has been told by her family doctor that she has a lump in her breast.An appointment is
made for her with a surgeon.however ,she doesnot keep the appointment and goes about her activities
of daily living with no evidence of concern.

It is transfer of feeling,reaction evoked by one topic or event to another that is less threatening.It is
transfer of emotions from its original odjects to a substitute objects.
EXAMPLE: A husband comes home after a bad day at work and yells at his wife.
4) COMPENSATION: It is covering up of a real or perceived weakness by emphasizing a traits one
consider more desirable.

EXAMPLE: A student who fails in his studies may compensate by becoming the college champion
in atheletics.
5) REACTION FORMATION: It preventing unacceptable or undesirable thoughts or behaviors from
being expressed by exaggerating opposite thoughts or types of behavior.
EXAMPLE: A girl hates Nursing ,she attended nursing school to please her parents During career
day she speaks to prospective students about the excellence of Nursing as a career.

6) RATIONALIZATION: It is a process in which an individual justifies his failures and socially

unacceptable behavior by giving socially approved reasons.
EXAMPLE: A student who fails in the examination may complain that the hostel environment is not
favourable and has resulted in his failure.

7) REGRESSION: Retreating in response to stress to an earlier level of development and the comfort
measures associated with that level of functioning.
EXAMPLE:- An adult throws a temper tantrum when he doesnot get his own way

8) CONVERSION: The unconscious expression of intra-psychic conflict symbolically through physical

EXAMPLE: A student awakens with a migraine headache the morning of final examination and feels ill
to face the test.
9) DISOCIATION: The unconscious separation of painful feelings and emotions from an unacceptable
idea,situation or object.
o EXAMPLE: Amnesia that prevent recall of previous days auto-accident.
o Adults remember nothing of child hood sexual abuse,
10) FANTASY: It is gratifying frustrated desires by imaginary achievement and wishful thinking to meet
ones need.
EXAMPLE: A young boy who couldnot help his ailing father due to shortage of money,daydreams

that he has got lot of money from lottery ticket and his father,mother and family members has best of the

facilities for everything.

. .
11) IDENTIFICATION: An attempt to increase self-worth by an acquiring certain attributes and
characteristics of an individual one admires

EXAMPLE: After hospitalization for a minor surgery,a girl decides to become a nurse
because she develops an admiration for the nurse who look after her.
An individual often develops a desirable attribute found in people whom he respects and
admires. Through the process of identification he integrates this trait into his own ego.
12) INTROJECTION: Integrating the beliefs and values of another individual into ones own ego structure.
EXAMPLE: A woman who like to live in a simple way introjects in her sophisticated way of
living likes her husband.
o Children intoject their parents value system in the process of conscience formation.A
child says to friend Dont cheat,its wrong.
13) INTELLECTUALIZATION: An attempt to avoid expressing actual emotions associated with a
stressful situation by using the intellectual process of logic,reasoning and analysis.
EXAMPLE: A man who lost his wife and children during Tsunami explains philosophically
about birth and death and doesnot express this feeling about loss of his family members.
14) ISOLATION: It is the separartion of a thought or a memory from the feeling tone or emotions
associated with it.
o Mother lost her daughter in accident she does every as a last rights in a mechanical ways.
o A young women describes being attacked and raped by a street gang.This displays an
apathetic expression and no emotional tone.
15) PROECTION: It is an unconscious blaming of un acceptable thoughts or feelings from one;s self to
another person.
EXAMPLE: A business person who values punctuality is late for a meeting and states
Sorry I am late,my assistant forget to remind me of the time,its so hard to find good
help these days
A surgeon whos patient donot respond as he anticipated ,may tend to blame the theatre
nurse who help the surgeon at the time of operation.
16) SUBLIMATION: Rechanelling of drives or impulses that are personally or socially un-acceptable into
activities that are constructive.

EXAMPLE: we cannot give direct expression to our sexual ,maternal,or agrressive

impulses duemto social restriction,laws and regulations.These impulses have to be

repressed and the energy associated with them may produce tension and maladjustment.
An unmarried women interested in children may give expression to her repressed
maternal urgue by engaging herself in orphanage work or any child welfare institution.

17) SUPRESSION: The voluntary blocking of unpleasant feelings and experiences from ones awareness.

EXAMPLE: Voluntarily not to think about an argument with parents while going to an interview.
18) UNDOING: Symbolically neglecting or cancelling out an experience that one find intolerable.It is the
voluntary blocking o unpleasant feelings and experiences from ones awareness.
EXAMPLE: Giving a treat to a child who is being punished for a wrong doing.
19) ACTING OUT: Expression of an unconscious impulse,through action thereby gratifying the impulse.
EXAMPLE: A child temper tantrum is a form of acting out when he or she doesnot get his or
her way with her parents.
20) SPLITTING: Unconscious viewing of self or others as either good or bad without considering the
whole range of qualities.
EXAMPLE: You think you best friend is absolutely worthless because she forgot a lunch date
with you.
21) ANTICIPATION: Realistic thinking and planning about future unpleasurable events.
EXAMPLE: A person with a phobia of dentist might anticipate an appointment to have a
tooth-feeeling by telling themselves that the procedure will be over in just a few minutes.
22) WITHDRAWAL: Withdrawal is the severe form of defense it entails removing oneself from events
,stimuli and interaction under therapy of being reminded of painful thoughts and feeling.
EXAMPLE: An easily observable example is an anxious or over stimulated baby that protects itself by
going to sleep.
23) HUMOR: Overt expression of unacceptable impulses using humor in a man which doesnot produce
unpleasant inself or others.
EXAMPLE: A persons treatment for cancer makes him loose his hair so he makes jokes about
being bald..
24) WISHFUL THINKING: Making decisions according to what might be pleasing to imagine instead of
by appealing to evidence or reality.
EXAMPLE: A person who is scared of the hospital environment may imagine some pleasing view or
smell,to divert from the hospital environment.
25) SUBSTITUTION: Substitution is a mechanism which may be employed to reduce tension resulting
from frustration by replacing the unachievable goal with achievable goal.To get satisfaction and reduce
tention,resulting from frustration the substitutive action must have certain similarities to frustrated one.
EXAMPLE: A student who has not being able to get admission to mbbs course may try to substitute it with
a course of Nursing.

26) TRANSFERENCE: In transference the image of one person is unconsciously identified with that of
EXAMPLE: A patient who is fond of his daughter finds the nurse of the same age and height as his
daughter.So he transfer his positive emotion to the nurse as his daughter.It is also possible that he dislikes his
daughter he transfer his negative emotion to the nurse by being rude,abusive or agreesive without any cause

In response to stressful circumstances the most frequent defense mechanism are repression, denial,
displacement, proection and regression.The concept of defense mechanism has proved useful in
understanding many aspects of the day to day behavior of people under stress,specially those with
psychiatric and physical illness.


An empirical study of defense mechanism (2000) shows that the notion that individual utilize ego
mechanisms of defense is seminal both classical psychoanalytic theory and object relations
theory.Moreover the concept of defense mechanism is one of the most influential Freudian ideas
in non-psycho analytic models of personality and psychopathology.
Recent studies in social psychology are reviewed for evidenced relevant to 7th Freudian defense
mechanism.These work emphasizes normal population,moderate rather than extreme forms of
defense and protection and self esteem against threat. Reaction formation.isolation and denial have
been amply shown in studies ,and they do seem to serve defensive functions.Undoing in the sense of
counter factual thinking,is also well document but doesnot serve to defend against the threat.
Projection is evident but the projection itself may be a by product of defense rather than part of
defense response itself. Displacement is not well supported in any meaningfull sense,although
emotions and physical arousal states do carry over from one situation to the next, no evidence of


Defense mechanism is an unconscious psychological mechanism that reduces anxiety arising rom
unacceptable or potentially harmful stimuli.The purpose o deense mechanism is to reduce or eliminate
anxiety.They become maladaptive when they are used by an individual to such a degree that there is
interference with the ability to deal with reality.To overcome from anxiety a persons behavior is directed to
reduce the threat .This method o self protection is known as defense mechanism.

1) Mary C.Townsends, Psychiatric Mental health Nursing 5th edition Jaypee Publication p-1922.
2) Dr.Bimla Kapoors, Textbook of psychiatric Nursing VOL-I kumar Publishing House.p-3139.
3) Neeraj Ahujas , A short textbook of Psychiatry 6th edition Jaypee publication.p-220-225
4) R Sreevanis A guide to mental health and psychiatric Nursing 3rd edition.Jaypee publication

BT Basavanthappas Psychiatric Mental health Nursing Jaypee publication p-21-27.
Robert A.Barons peasrson Psychochology p-456
Philip Cower , Paul Harrison, Shorter oxford text book of Psychiatry 6th edition P-154-155.
Net reference: available from .com mechanism