Ego & defences

1. Ego and defence mechanisms
Under guidance of Dr. Gaurav Rajendra
By – Dr. Wasim

2. Ego psychology
• Ego psychology is a school of psychoanalysis rooted in
Sigmund Freud's structural id-ego-superego model of the
mind.
• Proponents of ego psychology focus on the ego’s normal
and pathological development, its management of libidinal
and aggressive impulses, and its adaptation to reality

3. How does the ego develop?
• Ego development occurs as result of:
• meeting basic needs
• identification with others
• learning
• mastery of developmental tasks
• effective problem-solving
• successful coping
• The ego develops capacities to function in the world,
known as “ego functions”
• Enable people to function in coherent, organized manner

4. Bellack's list of ego functions:
 Reality testing
 Judgment
 Sense of reality of the world & the self
 Modulating & controlling drives, affects, & impulses
 Object or interpersonal relations
 Thought processes
 Adaptive regression in the service of the ego
 Defensive functioning
 Stimulus barrier
 Autonomous functioning
 Mastery-competence
 Synthetic-integrative function

5. What is a crisis?
 An upset in psychological equilibrium triggered by:
 outside harm or threat from the environment
 internal developmental or biological changes
 interpersonal challenges, conflicts, or losses
 Symptoms may include anxiety, guilt, shame, sadness,
envy, disgust, fear
 “Traumatic stress”—actual or threatened severe injury or
death of oneself or significant others

6. Coping and Adaptation
 Our efforts to manage stress & meet new challenges
 Biological coping (demands on nervous & hormonal systems)
 “fight-or-flight”
 “tend-and-befriend”
 Psychological coping
 Defense mechanisms (internal, unconscious traits)
 Coping styles or capacities (fluid states, changeable)
 Problem-focused—change environment
 Emotion-focused—change internal self

7. Defense mechanisms
• Defence mechanisms are brought to use to prevent the
development of anxiety
• Anxiety develops when the conflict between the drives of
the ‘id’ and the super-ego get excessive
• It can feel threatened or overwhelmed, there are many
types of anxiety which can develop
• realistic anxiety or fear
• moral anxiety: threat comes not from the outer, physical
world, but from the internalized social world of the
superego
• neurotic anxiety. This is the fear of being overwhelmed
by impulses from the id (losing control e.g. Temper,
rationality, peace of mind)

8. How defenses operate:
 Defense mechanisms operate outside of conscious
awareness, while coping mechanisms are conscious
 Defenses protect individuals from intolerable or
unacceptable impulses
 Effective defenses enable optimal functioning without
undue anxiety, while maladaptive defenses distort reality
& impair overall ego functioning

9. Involuntary coping Mechanisms
• Id’s unconscious demands are instinctual, infantile and amoral .
They must be blocked by ego and superego.
• Super ego , the conscience , prohibitions learned from parents &
authorities.
• Because of this conflict and persistence of unsatisfied demands,
anxiety and guilt are aroused.
• Defence mechanisms resides in the unconscious domain
of ego.

10. George Valliant’s Classification
•
• Narcissistic Defences : Most primitive. In children and
adults who are psychotically disturbed.
• Immature Defences: adolescents and some non neurotic
patients.
• Neurotic Defences: in OCD and hysterical patients and in
adults under stress.
• Mature defences

11. Commonly used ego defenses
A] PSYCHOTIC/ NARCISSISTIC --
1] denial
2] projection
3] distortion
B] IMMATURE
1] acting out 6] regression
2] blocking 7] schizoid fantasy
3] hypochondriasis 8] somatization
4] introjection
5] passive aggressive behavior

12. C] NEUROTIC/ ---
1] controlling
2] dissociation
3] displacement
4] externalization
5] inhibition
6] isolation of affect
7] reaction formation
8] rationalization
9] intellectualization
10] repression
11] sexualization
C] NEUROTIC/ ---
1] controlling
2] dissociation
3] displacement
4] externalization
5] inhibition
6] isolation of affect
7] reaction formation
8] rationalization
9] intellectualization
10] repression
11] sexualization

13. D] MATURE ----
1] sublimation
2] suppression
3] anticipation
4] humour
5] ascetism
6] altruism

14. A] PSYCHOTIC/ NARCISSISTIC
Denial - involuntary exclusion of unpleasant
or painful reality from conscious awareness
• E.g. grief, children 3-6 yrs old
• Clinical – psychosis, terminal illness
• The king of defence mechanisms. We refuse
to accept reality because it hurts, or we don’t
like it, it doesn’t suit us . So , we low our
stress levels simply by refusing the situation.
It is the most common reaction in case of
illness. ” I don’t have cancer. You gave me
the wrong results. that’s not me”. However,
when the denial is over, and we accept
reality no matter what, we are closer to solve
the problems.

15. Projection --- unconscious attribution of
one’s own attitudes & urges to other person
because of intolerance or painful affect
aroused by them
• E.g. universal phenomenon though occurs
more commonly in children
• Clinical– persecutory delusions and
hallucinations
• Sometimes the anxiety is great and it all
comes from our behaviour, our actions. But it
sucks to admit it. So, we project our failure or
thoughts to the external world. ” It ‘s not my
fault, you made me do it !”
Distortion --- unconscious gross reshaping
of external reality to satisfy inner needs
E.g.
Clinical – hallucinations, wish fulfilling ,
delusions esp. of grandiosity , unrealistic
megalomania.

16. B] IMMATURE
• Acting out - Expressing an unconscious wish or impulse through action
to avoid being conscious of an accompanying affect.
• Involves chronically giving in to an impulse to avoid the tension arising
from postponement of expression.
• Instead of saying, “I’m angry with you,” a person who acts out may
throw a book at the person, or punch a hole through a wall.
• When a person acts out, it can act as a pressure release, and often
helps the individual feel calmer and peaceful once again.
• E.g. destruction of property in a fit of rage
• Clinical – impulse control disorders , temper tantrums.

17. Hypochondriasis - unconscious transformation of unacceptable
impulses into inappropriate somatic concern
E.g. abnormal illness behavior in physically disordered or normal
individuals
Clinical – hypochondriasis
Passive aggressive behavior - Expressing aggression towards others
indirectly through passivity ,masochism and turning against the self .
These patients turn their anger against themselves. This phenomenon
is called masochism, includes procrastination, silly or provocative
behaviour, self demeaning ,clowning and frankly self destructive acts.
Manifestation –failure , procrastination ,illness that affect others

18. • Schizoid fantasy - withdrawal into self to gratify frustrated wishes by
fantasy
• Indulge in Autistic retreat to resolve conflict and to obtain gratification.
• Inter personal intimacy is avoided and eccentricity serves to repel
others.
• The person doesnot fully believe in fantasies and doesnot insist on
acting them out.
• E.g. seen in adolescence (wish fulfilling daydream disorder)
• Clinical – schizoid personality disorder, schizotypal personality,
Narcissistic Personality Disorders
Somatization - Converting psychic derivatives in to bodily symptoms
and tending to react with somatic rather than psychic manifestation
Unconscious rechannelling of repressed emotions into somatic
symptoms

19. Introjection - unconscious internalization of the qualities of an object or
person
• E.g. identification with the aggressor (e.g. stockholm syndrome), grief
reaction
• Clinical – depression
• Regression --- reversion to modes of psychological functioning which
are characteristic of earlier stages of life, esp. childhood years
• E.g. dreams, regression in the service of ego
• Clinical– neuroses (mild regression), psychosis (more severe pervasive
regression)
• How many times haven’t you thought that life was much simpler when
we were kids? How many times in the case of an anxiety haven’t you
dreamt of your old bedroom and homemade cookies? No worries.
Nothing ‘s wrong with you. It is just regression.Our fear to act like adults
and our wish to return to our childhood where everything was taking
care of magically.

20. C] NEUROTIC
• Displacement --- unconscious shifting of emotions, usually aroused by
perceived threat, from an unconscious impulse to a less threatening
external object which is then felt to be a source of threat
• The motive remains unaltered but the person substitutes a different goal
object for the original one.
• E.g. normal day to day deflection of anger on a substitute target
• Clinical – phobia (esp. in children) , OCD
• It usually starts from the office and ends in the house. It occurs when
we cannot deal directly with whatever or whoever threatens us an we
express out anxiety to someone less threatening. For example,It is
easier for us to be angry to our child who is younger, innocent than to
deal our problems with our boss who is just pissing off every day.
• Controlling- Attempting to manage or regulate events or objects in the
environment to minimize anxiety and to resolve inner conflicts.

21. • Dissociation – involuntary splitting or suppression of a mental function
or a group of mental functions from rest of the personality in a manner
that allows expression of forbidden unconscious impulses without
having any sense of responsibility for actions
• E.g. near death experience
• Clinical – dissociative disorders i.e. psychogenic amnesia, psychogenic
fugue, multiple personality, somnambulism, possession
• Intellectualization - excessive use of intellectual (logic) process to
avoid affective expression (emotion)
• E.g. when faced with stressful situation, use of logic to focus closely on
external reality and avoiding expression of inner feelings or fear
• Isolation of affect -separation of the idea of an unconscious impulse
from its appropriate affect, thus allowing only the idea and not
associated affect to enter the awareness
• E.g. grief, ability too discuss the traumatic events without their
associated disturbing emotions, with passage of time
• Clinical – obsessional thoughts

22. • Rationalization - providing logical
explanations for irrational behavior
motivated by unconscious unacceptable
wishes.
• Substituting an acceptable conscious
motive for an unacceptable unconscious
one.
• It is a method to support an attitude with
false reasons
• E.g. a universal phenomenon
• Clinical – usually used to explain
behaviors resulting from use of other
defense mechanisms
• We do it often when we convince
ourselves that it’s ok when it’s not and
we use false reasoning. Simply, it’s
making excuses. ” Oh, it’s ok!! I really
hate this place that my friends brought
me but it is a new experience actually. I
like it”.

23. Reaction formation - unconscious transformation of unacceptable
impulses into exactly opposite attitudes, feelings, impulses or behaviors
If this mechanism is frequently used at any early stage of ego
development it can become a permanent character trait, as in
obsessional character.
Thus love may cover up unconscious hate, shyness serves as defence
against exhibitionism.
E.g. normal character formation in childhood ( from 3yrs onwards)
when a 2nd child is born in a family the first child may show
extraordinary concern for the welfare of the Newborn. This way his
unconscious hate and aggression for his little brother is covered up.
Clinical – obsessive compulsive personality traits and disorder, OCD

24. Repression - Repression is the unconscious blocking of
unacceptable thoughts, feelings and impulses.
Ego excludes from the consciousness all the psychological contents
which it cannot fit in harmoniously.
Primary Repression: Curbing of ideas and feelings before they have
attained consciousness.
Secondary repression : Excluding from awareness what was once
experienced at the conscious level.
Repressed feelings do not cease to exist by mere expulsion from the
consciousness.
Ego takes further steps to deal with these pent up impulses :
a) Further reinforcement of repression
b) Finding out substitute channels for outlet of impulse
E.g. forgetting, slips of tongue

25. When a child finds out about the birth of a
2nd baby, he may feel his love is divided. He
feels jealousy and rivalry towards his little
brother. He represses his aggression for
fear of punishment or further loss of love.
But may channelize his aggression through
some other activity, ex. By breaking his
brothers toys.
Clinical – psychogenic amnesia
Inhibition - involuntary decrease or loss of motivation to engage in
some goal directed activity to prevent anxiety arising out of conflicts
with unacceptable impulses
E.g. writing blocks or work blocks, social shyness
Clinical –OCD, phobias

26. Sexualisation - Endowing an object or function with a sexual
significance that it did not previously have or possessed to a smaller
degree, to ward off anxieties associated with prohibited impulses or
their derivatives.
Externalization - Tending to perceive in the external world and in
external objects elements of ones own personality , including instinctual
impulses ,conflicts , moods , attitudes and style of thinking.It is more
general term than projection.
E.g. in normals :
A patient who is overly argumentative might instead perceive others as
argumentative and himself as blameless.
Clinical illustration:
Neurosis

27. D] MATURE
Anticipation - realistic thinking and planning about future
unpleasurable events .
• Involves careful planning or worrying and premature, but realistic
anticipation of dire and potentially dreadful outcomes.
• Eg. Moderate amount of anxiety before surgery promotes post surgical
adaptation.
anticipation is an universal phenomenon occurring in all intelligent
individuals.
• Humour - Using comedy to overtly express feelings and thoughts
without personal discomfort and without producing an unpleasant effect
on the others.
• Freud suggested that “Humour can be regarded as the highest of these
defensive processes”
• Mature humour allows individuals to look directly at what is painful
• E.g. an universal phenomenon

28. Sublimation - unconscious gradual channelization of unacceptable
infantile impulses into personally satisfying and socially valuable
behaviour patterns.
Freud believed that much of our cultural heritage is the product of
sublimation.
Eg. A writer may divert his libido to creation of poem/ novel. Thus
indirectly satisfying drives.
Rejection by lover may induce one to divert hi energy to human welfare
or artistic and literary activities.
Channelization of sexual or aggressive impulses into creative activities
(diverting forbidden sexual impulses into artistic paintings)
It’s when we transform our negative emotions or instincts, mainly, to
acceptable behaviour and positive actions. For example artistic
impressions of the female form.

29. • Suppression (voluntary) - voluntary postponement of focussing of
attention on an impulse which has reached conscious awareness.
• Consciously or semi consciously postponing attention to a conscious
impulse or conflict.
• Issues may be deliberately cut off but they are not avoided.
• E.g. voluntary decision not to think about an argument with the parents
while going for an interview
• Ok. You are in the middle of an exam. Too much pressure. But
tomorrow there will be this great party. No not now! Don’t think about
the party now . Concentrate on the exam. Suppress it!!! It is a kind of
voluntary repression . It is a way to control yourself and reduce the
anxiety by pushing away any thoughts .

30. • Ascetism -Eliminating the pleasurable effects of experiences and
assigning moral values to specific pleasures . Gratification is derived
from renunciation.
Altruism - Using constructive and instinctually gratifying service to
others to undergo a vicarious experience . It is a selfless concern.
Core aspect of various religious traditions for the welfare of others
Opposite of selfishness.
Involves an individual getting pleasure from giving to others what the
individual would have liked to receive.
Ex. Using Altruism a former alcoholic serves as an Alcohol Anonymous
sponsor to a new member, achieving transformation process that may
be life saving.

31. I. PSYCHOSES:*In the acute stage there is a complete loss of the
ego’s defense mechanisms, and disturbing thoughts, feelings, and
impulses intrude into the consciousness
*as the individual gradually improves defenses appear
• projection
• delusional denial
• distortion
• regression
II. NEUROTIC CONDITIONS:(Anxiety Disorders; Somatoform
Disorders; Dissociative Disorders )
*defenses are used non-adaptively in social interaction
*they are stereotyped and repeated
DEFENSE MECHANISMS IN PSYCHIATRIC DISORDERS

32. Clinically:--disturbing thoughts and impulses are controlled by the ego defenses but
--feelings intrude into consciousness
--patient is anxious, seeks help because he/she feels uncomfortable
with his life experience (ego-alien)
Phobia: Displacement
Avoidance
Symbolization
Restriction of the Ego
Obsessive Compulsive Disorder:
Undoing Reaction Formation
Isolation Magical Beliefs
Intellectualization
Somatoform Disorders:
Somatization
Conversion
Passivity
Dissociative Disorders:
Dissociation
Denial

33. III. PERSONALITY DISORDERS: Defenses are extremely efficient in controlling
anxiety (ego syntonic) so that patient is not disturbed by any unconscious thoughts or
feelings. His/her behavior and impulses, shaped by his/her ego defenses are
maladaptive, and interfere with his interpersonal and work relationship.
CONCLUSION: *Everyone uses defenses at times.
*It is their inappropriate, repetitive or excessive use which lead to
maladaptive behavior.
Cluster A: Paranoid Personality Disorder
--Projection
Schizoid Personality Disorder
--Restriction of ego functions
Schizotypal Personality Disorder
--Distortion
--Identification
--Somatization
--Repression
--Acting out
--Fantasy of love and attention
--Dissociation
--Regression

34. Cluster B: Histrionic Personality Disorder
--Denial
--Identification
--Somatization
--Repression
--Acting out
--Fantasy of love and attention
--Dissociation
--Regression
Borderline Personality Disorder
--Splitting
--Projective identification
--Acting out
Narcissistic Personality Disorder
--Splitting
--Over-idealization and devaluation (envy)
--Projective identification
--Fantasy of grandiosity and behavior
--Acting out
Antisocial Personality Disorder
--Projection --Rationalization
--Acting out --Externalization

35. Cluster C: Obsessive-Compulsive Personality Disorder
--Isolation
--Rationalization
--Intellectualization
--Reaction formation
--Fantasy re aggression
Passive-Aggressive Personality Disorder
--Repression
--Denial
Avoidant Personality Disorder
--Displacement
Dependent Personality Disorder
--Passivity
IV. DEPRESSION
--Introjections
--Turning against the self
--Passivity
--Isolation
--Identification

36. THANK YOU!!!
V. MATURE BEHAVIOR
--Suppression
--Humor and wit
--Sublimation
--Intellectualization
--Asceticism