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Psychiatry ` Psychiatry—Psychology Psychiatry ` Psychiatry—Psychology sEctiON iii 555

Ego defenses (continued)
iMMatUrE DEFENsEs DEscriPtioN EXaMPlE
Fixation Partially remaining at a more childish level of A surgeon throws a tantrum in the operating
development (vs regression). room because the last case ran very late.
Idealization Expressing extremely positive thoughts of self A patient boasts about his physician and his
and others while ignoring negative thoughts. accomplishments while ignoring any flaws.
Identification Largely unconscious assumption of the A resident starts putting his stethoscope in his
characteristics, qualities, or traits of another pocket like his favorite attending, instead of
person or group. wearing it around his neck like before.
Intellectualization Using facts and logic to emotionally distance A patient diagnosed with cancer discusses the
oneself from a stressful situation. pathophysiology of the disease.
Isolation (of affect) Separating feelings from ideas and events. Describing murder in graphic detail with no
emotional response.
Passive aggression Demonstrating hostile feelings in a A disgruntled employee is repeatedly late to
nonconfrontational manner; showing indirect work, but won’t admit it is a way to get back at
opposition. the manager.
Projection Attributing an unacceptable internal impulse to A man who wants to cheat on his wife accuses
an external source (vs displacement). his wife of being unfaithful.
Rationalization Asserting plausible explanations for events that A man who was recently fired claims that the
actually occurred for other reasons, usually to job was not important anyway.
avoid self-blame.
Reaction formation Replacing a warded-off idea or feeling with an A stepmother treats a child she resents with
emphasis on its opposite (vs sublimation). excessive nurturing and overprotection.
Regression Involuntarily turning back the maturational A previously toilet-trained child begins
clock to behaviors previously demonstrated bedwetting again following the birth of a
under stress (vs fixation). sibling.
Repression Involuntarily withholding an idea or feeling A 20-year-old does not remember going to
from conscious awareness (vs suppression). counseling during his parents’ divorce 10 years
earlier.
Splitting Believing that people are either all good or all A patient says that all the nurses are cold and
bad at different times due to intolerance of insensitive, but the doctors are warm and
ambiguity. Common in borderline personality friendly.
disorder.
MatUrE DEFENsEs
Sublimation Replacing an unacceptable wish with a course A teenager’s aggression toward his parents
of action that is similar to the wish but socially because of their high expectations is channeled
acceptable (vs reaction formation). into excelling in sports.
Altruism Alleviating negative feelings via unsolicited A mafia boss makes a large donation to charity.
generosity, which provides gratification (vs
reaction formation).
Suppression Intentionally withholding an idea or feeling from An athlete focuses on other tasks to prevent
conscious awareness (vs repression); temporary. worrying about an important upcoming match.
Humor Lightheartedly expressing uncomfortable feelings A nervous medical student jokes about the
to shift the internal focus away from the distress. boards.

Mature adults wear a SASH.

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