5.01 Ego Defenses
Psychiatry review for the USMLE Step 1 Exam
- Defense mechanisms protect the unconscious part of our personality from anxiety caused by unacceptable thoughts or feelings.
- Ego defenses are categorized into three groups: mature, neurotic, and immature.
- Immature defense mechanisms include projection, regression, denial, acting out, and splitting.
- Projection involves attributing objectionable thoughts or emotions to others.
- Regression is behaving in an age-inappropriate way to avoid tension associated with the current phase of development.
- Denial is not accepting or believing something to protect one's ego.
- Acting out involves giving in to socially inappropriate impulses to avoid anxiety.
- Splitting is viewing people as either all good or all bad, without considering the middle ground.
- Neurotic defense mechanisms include intellectualization, isolation of affect, displacement, rationalization, reaction formation, and repression.
- Intellectualization is overanalyzing situations or focusing on irrelevant details to avoid negative feelings.
- Isolation of affect is unconsciously limiting the experience of emotions associated with a stressful event.
- Displacement involves shifting emotions from one thing to another, which is deemed more acceptable.
- Rationalization is justifying one's behavior or negative feelings through rational explanations.
- Reaction formation is unconsciously acting opposite to an unacceptable impulse.
- Repression involves preventing thoughts or feelings from entering consciousness to avoid negative emotions.
- Mature defense mechanisms include humor, altruism, suppression, and sublimation.
- Humor is used to relieve anxiety and negative thoughts.
- Altruism involves performing beneficial acts for others to experience pleasure and relieve anxiety.
- Suppression is consciously blocking undesirable ideas, thoughts, or impulses.
- Sublimation is transforming anxiety or emotions into socially valued pursuits.
- Sublimation involves channeling negative emotions into productive and socially desirable actions.
