Defence mechanisms

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A defence mechanism is an unconscious psychological mechanism that reduces anxiety arising from unacceptable or potentially harmful stimuli.[1]


Defence mechanisms may result in healthy or unhealthy consequences depending on the circumstances and frequency with which the mechanism is used.[2] In psychoanalytic theory, defence mechanisms (German: Abwehrmechanismen) are psychological strategies brought into play by the unconscious mind[3] to manipulate, deny, or distort reality in order to defend against feelings of anxiety and unacceptable impulses and to maintain one's self-schema or other schemas.[4] These processes that manipulate, deny, or distort reality may include the following: repression, or the burying of a painful feeling or thought from one's awareness even though it may resurface in a symbolic form;[2]identification, incorporating an object or thought into oneself;[5] and rationalization, the justification of one's behaviour and motivations by substituting "good" acceptable reasons for the actual motivations.[2][6] In psychoanalytic theory, repression is considered as the basis for other defence mechanisms.[2]


Healthy persons normally use different defences throughout life. An ego defence mechanism becomes pathological only when its persistent use leads to maladaptive behaviour such that the physical or mental health of the individual is adversely affected. Among the purposes of ego defence mechanisms is to protect the mind/self/ego from anxiety or social sanctions or to provide a refuge from a situation with which one cannot currently cope.[7]


One resource used to evaluate these mechanisms is the Defense Style Questionnaire (DSQ-40).[8][9]




Contents





  • 1 Structural model: Id, ego, and superego

    • 1.1 Definitions of individual psyche structures


    • 1.2 Primary and secondary processes


    • 1.3 The reality principle


    • 1.4 Formation of the superego


    • 1.5 The ego's use of defence mechanisms



  • 2 Theories and classifications


  • 3 Vaillant's categorization

    • 3.1 Level 1: "Psychotic"


    • 3.2 Level 2: Immature


    • 3.3 Level 3: Neurotic


    • 3.4 Level 4: Mature



  • 4 Other defence mechanisms

    • 4.1 Pathological


    • 4.2 Immature


    • 4.3 Neurotic


    • 4.4 Mature



  • 5 Relation with coping


  • 6 See also


  • 7 References




Structural model: Id, ego, and superego




Sigmund Freud


The concept of id impulses comes from Sigmund Freud's structural model. According to this theory, id impulses are based on the pleasure principle: instant gratification of one's own desires and needs. Sigmund Freud believed that the id represents biological instinctual impulses in humans, such as aggression (Thanatos or the Death instinct) and sexuality (Eros or the Life instinct).


For example, when the id impulses (e.g., desire to have sexual relations with a stranger) conflict with the superego (e.g., belief in societal conventions of not having sex with unknown persons), unsatisfied feelings of anxiousness or feelings of anxiety come to the surface. To reduce these unpleasant feelings, the ego might use defence mechanisms (conscious or unconscious blockage of the id impulses).


Freud believed that conflicts between these two structures resulted in conflicts associated with psychosexual stages.



Definitions of individual psyche structures




The iceberg metaphor is often used to explain the psyche's parts in relation to one another.


Freud proposed three structures of the psyche or personality:



  • Id: The id is the unconscious reservoir of the libido, the psychic energy that fuels instincts and psychic processes. It is a selfish, childish, pleasure-oriented part of the personality with no ability to delay gratification.


  • Superego: The superego contains internalised societal and parental standards of "good" and "bad", "right" and "wrong" behaviour. They include conscious appreciations of rules and regulations as well as those incorporated unconsciously.


  • Ego: The ego acts as a moderator between the pleasure sought by the id and the morals of the superego, seeking compromises to pacify both. It can be viewed as the individual's "sense of time and place".


Primary and secondary processes


In the ego, there are two ongoing processes. First, there is the unconscious primary process, where the thoughts are not organised in a coherent way; the feelings can shift, contradictions are not in conflict or are just not perceived that way, and condensations arise. There is no logic and no time line. Lust is important for this process. By contrast, there is the conscious secondary process, where strong boundaries are set and thoughts must be organised in a coherent way. Most conscious thoughts originate here.



The reality principle


Id impulses are not appropriate in a civilised society, so there is societal pressure to modify the pleasure principle in favour of the reality principle; that is, the requirements of the external world.



Formation of the superego


The superego forms as the child grows and learns parental and social standards. The superego consists of two structures: the conscience, which stores information about what is "bad" and what has been punished, and the ego ideal, which stores information about what is "good" and what one "should" do or be.



The ego's use of defence mechanisms


When anxiety becomes overwhelming, it is the ego's place to protect the person by employing defence mechanisms. Guilt, embarrassment, and shame often accompany anxiety. In the first definitive book on defence mechanisms, The Ego and the Mechanisms of Defence (1936),[10]Anna Freud introduced the concept of signal anxiety; she stated that it was "not directly a conflicted instinctual tension but a signal occurring in the ego of an anticipated instinctual tension".[10]


The signalling function of anxiety is thus seen as crucial, and biologically adapted to warn the organism of danger or a threat to its equilibrium. The anxiety is felt as an increase in bodily or mental tension, and the signal that the organism receives in this way allows for the possibility of taking defensive action regarding the perceived danger. Defence mechanisms work by distorting the id impulses into acceptable forms, or by unconscious or conscious blockage of these impulses.[10]



Theories and classifications


The list of defence mechanisms, with no theoretical consensus on the exact number.[citation needed] Classifying defence mechanisms according to some of their properties (like underlying mechanisms, similarities or connections with personality) has been attempted. Different theorists have different categorizations and conceptualizations of defence mechanisms. Large reviews of theories of defence mechanisms are available from Paulhus, Fridhandler and Hayes (1997)[11] and Cramer (1991).[12] The Journal of Personality published a special issue on defence mechanisms (1998).[13]


In 1936, Anna Freud enumerated the ten defence mechanisms that appear in the works of her father, Sigmund Freud: 1. Repression, 2. Regression, 3. Reaction formation, 4. Isolation, 5. Undoing, 6. Projection, 7. Introjection, 8. Turning against one's own person, 9. Reversal into the opposite, 10. Sublimation or displacement.[14]


A. Freud considered defense mechanisms as intellectual and motor automatisms of various degrees of complexity, that arose in the process of involuntary and voluntary learningRomanov, E.S. (1996). Mechanisms of psychological defense: genesis, functioning, diagnostics..mw-parser-output cite.citationfont-style:inherit.mw-parser-output .citation qquotes:"""""""'""'".mw-parser-output .citation .cs1-lock-free abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png")no-repeat;background-position:right .1em center.mw-parser-output .citation .cs1-lock-limited a,.mw-parser-output .citation .cs1-lock-registration abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Lock-gray-alt-2.svg/9px-Lock-gray-alt-2.svg.png")no-repeat;background-position:right .1em center.mw-parser-output .citation .cs1-lock-subscription abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Lock-red-alt-2.svg/9px-Lock-red-alt-2.svg.png")no-repeat;background-position:right .1em center.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registrationcolor:#555.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration spanborder-bottom:1px dotted;cursor:help.mw-parser-output .cs1-ws-icon abackground:url("//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/12px-Wikisource-logo.svg.png")no-repeat;background-position:right .1em center.mw-parser-output code.cs1-codecolor:inherit;background:inherit;border:inherit;padding:inherit.mw-parser-output .cs1-hidden-errordisplay:none;font-size:100%.mw-parser-output .cs1-visible-errorfont-size:100%.mw-parser-output .cs1-maintdisplay:none;color:#33aa33;margin-left:0.3em.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-formatfont-size:95%.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-leftpadding-left:0.2em.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-rightpadding-right:0.2em


Both Freuds studied defence mechanisms, but Anna spent more of her time and research on five main mechanisms: repression, regression, projection, reaction formation, and sublimation. All defence mechanisms are responses to anxiety and how the consciousness and unconscious handle the stress of a social situation.[15]



  • Repression: when a feeling is hidden and forced from the consciousness to the unconscious because it is seen as socially unacceptable.


  • Regression: falling back into an early state of mental/physical development seen as "less demanding and safer".[15]


  • Projection: possessing a feeling that is deigned as socially unacceptable and instead of facing it, that feeling or "unconscious urge" is seen in the actions of other people.[15]


  • Reaction formation: acting the opposite way that the unconscious instructs a person to behave, "often exaggerated and obsessive". For example, if a wife is infatuated with a man who is not her husband, reaction formation may cause her to – rather than cheat – become obsessed with showing her husband signs of love and affection.[15]


  • Sublimation: seen as the most acceptable of the mechanisms, an expression of anxiety in socially acceptable ways.[15]

Otto F. Kernberg (1967) developed a theory of borderline personality organization of which one consequence may be borderline personality disorder. His theory is based on ego psychological object relations theory. Borderline personality organization develops when the child cannot integrate helpful and harmful mental objects together. Kernberg views the use of primitive defence mechanisms as central to this personality organization. Primitive psychological defences are projection, denial, dissociation or splitting and they are called borderline defence mechanisms. Also, devaluation and projective identification are seen as borderline defences.[16]


In George Eman Vaillant's (1977) categorization, defences form a continuum related to their psychoanalytical developmental level.[17][non-primary source needed] They are classified into pathological, immature, neurotic and "mature" defences.


Robert Plutchik's (1979) theory views defences as derivatives of basic emotions, which in turn relate to particular diagnostic structures. According to his theory, reaction formation relates to joy (and manic features), denial relates to acceptance (and histrionic features), repression to fear (and passivity), regression to surprise (and borderline traits), compensation to sadness (and depression), projection to disgust (and paranoia), displacement to anger (and hostility) and intellectualization to anticipation (and obsessionality).[18]


The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association (1994) includes a tentative diagnostic axis for defence mechanisms.[19] This classification is largely based on Vaillant's hierarchical view of defences, but has some modifications. Examples include: denial, fantasy, rationalization, regression, isolation, projection, and displacement.



Vaillant's categorization


Psychiatrist George Eman Vaillant introduced a four-level classification of defence mechanisms:[20]


  • Level I – pathological defences (psychotic denial, delusional projection)

  • Level II – immature defences (fantasy, projection, passive aggression, acting out)

  • Level III – neurotic defences (intellectualization, reaction formation, dissociation, displacement, repression)

  • Level IV – mature defences (humour, sublimation, suppression, altruism, anticipation)


Level 1: "Psychotic"


When predominant, the mechanisms on this level are almost always severely pathological. These six defences, in conjunction, permit one effectively to rearrange external experiences to eliminate the need to cope with reality. Pathological users of these mechanisms frequently appear irrational or insane to others. These are the "psychotic" defences, common in overt psychosis. However, they are normally found in dreams and throughout childhood as well.[21]
They include:



  • Delusional projection: Delusions about external reality, usually of a persecutory nature.


  • Denial: Refusal to accept external reality because it is too threatening; arguing against an anxiety-provoking stimulus by stating it doesn't exist; resolution of emotional conflict and reduction of anxiety by refusing to perceive or consciously acknowledge the more unpleasant aspects of external reality.


  • Distortion: A gross reshaping of external reality to meet internal needs.


Level 2: Immature


These mechanisms are often present in adults. These mechanisms lessen distress and anxiety produced by threatening people or by an uncomfortable reality. Excessive use of such defences is seen as socially undesirable, in that they are immature, difficult to deal with and seriously out of touch with reality. These are the so-called "immature" defences and overuse almost always leads to serious problems in a person's ability to cope effectively. These defences are often seen in major depression and personality disorders.[21]
They include:



  • Acting out: Direct expression of an unconscious wish or impulse in action, without conscious awareness of the emotion that drives the expressive behavior.


  • Hypochondriasis: An excessive preoccupation or worry about having a serious illness.


  • Passive-aggressive behavior: Indirect expression of hostility


  • Projection: A primitive form of paranoia. Projection reduces anxiety by allowing the expression of the undesirable impulses or desires without becoming consciously aware of them; attributing one's own unacknowledged, unacceptable, or unwanted thoughts and emotions to another; includes severe prejudice and jealousy, hypervigilance to external danger, and "injustice collecting", all with the aim of shifting one's unacceptable thoughts, feelings and impulses onto someone else, such that those same thoughts, feelings, beliefs and motivations are perceived as being possessed by the other.


  • Schizoid fantasy: Tendency to retreat into fantasy in order to resolve inner and outer conflicts.


Level 3: Neurotic


These mechanisms are considered neurotic, but fairly common in adults. Such defences have short-term advantages in coping, but can often cause long-term problems in relationships, work and in enjoying life when used as one's primary style of coping with the world.[21]
They include:



  • Displacement: defence mechanism that shifts sexual or aggressive impulses to a more acceptable or less threatening target; redirecting emotion to a safer outlet; separation of emotion from its real object and redirection of the intense emotion toward someone or something that is less offensive or threatening in order to avoid dealing directly with what is frightening or threatening. For example, a parent may yell at their child because they are angry with their spouse.


  • Dissociation: Temporary drastic modification of one's personal identity or character to avoid emotional distress; separation or postponement of a feeling that normally would accompany a situation or thought.


  • Intellectualization: A form of isolation; concentrating on the intellectual components of a situation so as to distance oneself from the associated anxiety-provoking emotions; separation of emotion from ideas; thinking about wishes in formal, affectively bland terms and not acting on them; avoiding unacceptable emotions by focusing on the intellectual aspects (isolation, rationalization, ritual, undoing, compensation, and magical thinking).


  • Reaction formation: Converting unconscious wishes or impulses that are perceived to be dangerous or unacceptable into their opposites; behaviour that is completely the opposite of what one really wants or feels; taking the opposite belief because the true belief causes anxiety.


  • Repression: The process of attempting to repel desires towards pleasurable instincts, caused by a threat of suffering if the desire is satisfied; the desire is moved to the unconscious in the attempt to prevent it from entering consciousness;[22] seemingly unexplainable naivety, memory lapse or lack of awareness of one's own situation and condition; the emotion is conscious, but the idea behind it is absent.[23]


Level 4: Mature


These are commonly found among emotionally healthy adults and are considered mature, even though many have their origins in an immature stage of development. They have been adapted through the years in order to optimise success in human society and relationships. The use of these defences enhances pleasure and feelings of control. These defences help to integrate conflicting emotions and thoughts, whilst still remaining effective. Those who use these mechanisms are usually considered virtuous.[21]
Mature defences include:



  • Altruism: Constructive service to others that brings pleasure and personal satisfaction.


  • Anticipation: Realistic planning for future discomfort.


  • Humour: Overt expression of ideas and feelings (especially those that are unpleasant to focus on or too terrible to talk about directly) that gives pleasure to others. The thoughts retain a portion of their innate distress, but they are "skirted around" by witticism, for example self-deprecation.


  • Sublimation: Transformation of unhelpful emotions or instincts into healthy actions, behaviours, or emotions, for example, playing a heavy contact sport such as football or rugby can transform aggression into a game.[24]


  • Suppression: The conscious decision to delay paying attention to a thought, emotion, or need in order to cope with the present reality; making it possible later to access uncomfortable or distressing emotions whilst accepting them.


Other defence mechanisms




Diagram of selected ego defence mechanisms



Pathological



  • Conversion: The expression of an intrapsychic conflict as a physical symptom; some examples include blindness, deafness, paralysis, or numbness. This phenomenon is sometimes called hysteria.[25]


  • Splitting: A primitive defence. Both harmful and helpful impulses are split off and unintegrated, frequently projected onto someone else. The defended individual segregates experiences into all-good and all-bad categories, with no room for ambiguity and ambivalence. When "splitting" is combined with "projecting", the undesirable qualities that one unconsciously perceives oneself as possessing, one consciously attributes to another.[26]


Immature



  • Idealization: Tending to perceive another individual as having more desirable qualities than he or she may actually have.[27]


  • Introjection: Identifying with some idea or object so deeply that it becomes a part of that person. For example, introjection occurs when we take on attributes of other people who seem better able to cope with the situation than we do.


  • Passive aggression: Aggression towards others expressed indirectly or passively, often through procrastination.


  • Projective identification: The object of projection invokes in that person a version of the thoughts, feelings or behaviours projected.


  • Somatization: The transformation of uncomfortable feelings towards others into uncomfortable feelings toward oneself: pain, illness, and anxiety.


  • Wishful thinking: Making decisions according to what might be pleasing to imagine instead of by appealing to evidence, rationality, or reality.


Neurotic



  • Isolation: Separation of feelings from ideas and events, for example, describing a murder with graphic details with no emotional response.


  • Rationalization (making excuses): Convincing oneself that no wrong has been done and that all is or was all right through faulty and false reasoning. An indicator of this defence mechanism can be seen socially as the formulation of convenient excuses.


  • Regression: Temporary reversion of the ego to an earlier stage of development rather than handling unacceptable impulses in a more adult way, for example, using whining as a method of communicating despite already having acquired the ability to speak with an appropriate level of maturity.[24]


  • Undoing: A person tries to 'undo' an unhealthy, destructive or otherwise threatening thought by acting out the reverse of the unacceptable. Involves symbolically nullifying an unacceptable or guilt provoking thought, idea, or feeling by confession or atonement.


  • Upward and downward social comparisons: A defensive tendency that is used as a means of self-evaluation. Individuals will look to another individual or comparison group who are considered to be worse off in order to dissociate themselves from perceived similarities and to make themselves feel better about themselves or their personal situation.


  • Withdrawal: Withdrawal is a more severe form of defence. It entails removing oneself from events, stimuli, and interactions under the threat of being reminded of painful thoughts and feelings.


Mature



  • Acceptance: A person's assent to the reality of a situation, recognizing a process or condition (often a difficult or uncomfortable situation) without attempting to change it, protest, or exit. Religions and psychological treatments often suggest the path of acceptance when a situation is both disliked and unchangeable, or when change may be possible only at great cost or risk.


  • Courage: The mental ability and willingness to confront conflicts, fear, pain, danger, uncertainty, despair, obstacles, vicissitudes or intimidation. Physical courage often extends lives, while moral courage preserves the ideals of justice and fairness.


  • Emotional self-regulation: The ability to respond to the ongoing demands of experience with the range of emotions in a manner that is socially tolerable. Emotional self-regulation refers to the processes people use to modify the type, intensity, duration, or expression of various emotions.


  • Emotional self-sufficiency: Not being dependent on the validation (approval or disapproval) of others.


  • Forgiveness: Cessation of resentment, indignation or anger as a result of a perceived offence, disagreement, or mistake, or ceasing to demand retribution or restitution.


  • Gratitude: A feeling of thankfulness or appreciation involving appreciation of a wide range of people and events. Gratitude is likely to bring higher levels of happiness, and lower levels of depression and stress. Throughout history, gratitude has been given a central position in religious and philosophical theories.


  • Humility: A mechanism by which a person, considering their own defects, has a humble self-opinion. Humility is intelligent self-respect which keeps one from thinking too highly or too meanly of oneself.


  • Identification: The unconscious modelling of one's self upon another person's character and behaviour.


  • Mercy: Compassionate behavior on the part of those in power.


  • Mindfulness: Adopting an orientation (characterized by curiosity, openness, and acceptance) toward one's experiences in the present moment.


  • Moderation: The process of eliminating or lessening extremes and staying within reasonable limits. It necessitates self-restraint which is imposed by oneself on one's own feelings, desires etc.


  • Patience: Enduring difficult circumstances (delay, provocation, criticism, attack etc.) for some time before responding negatively.


  • Respect: Willingness to show consideration or appreciation. Respect can be a specific feeling of regard for the actual qualities of a person or feeling being and also specific actions and conduct representative of that esteem. Relationships and contacts that are built without the presence of respect are seldom long term or sustainable. The lack of respect is at the very heart of most conflict in families, communities, and nations.


  • Tolerance: The practice of deliberately allowing or permitting a thing of which one disapproves.


Relation with coping



There are many different perspectives on how the construct of defence relates to the construct of coping; some writers differentiate the constructs in various ways, but "an important literature exists that does not make any difference between the two concepts".[28] In at least one of his books, George Eman Vaillant stated that he "will use the terms adaptation, resilience, coping, and defense interchangeably".[29]



See also



  • Coherence therapy § Symptom coherence

  • Cognitive dissonance

  • Experiential avoidance

  • List of cognitive biases

  • List of maladaptive schemas

  • Motivated forgetting

  • Motivated reasoning

  • Narcissistic defences

  • Psychological resistance

  • Self-enhancement



References




  1. ^ Schacter, Daniel L. (2011). Psychology Second Edition. 41 Madison Avenue, New York, NY 10010: Worth Publishers. pp. 482–483. ISBN 978-1-4292-3719-2.


  2. ^ abcd Utah Psych. "Defense Mechanisms" 2010. Retrieved on 05 October 2013.


  3. ^ Defense+Mechanisms at the US National Library of Medicine Medical Subject Headings (MeSH)


  4. ^ "archive of: www.3-S.us What is a self-schema?". Info.med.yale.edu. Archived from the original on February 4, 2013. Retrieved 2013-05-05.


  5. ^ Chalquist, Craig. "A Glossary of Freudian Terms" 2001. Retrieved on 05 October 2013.


  6. ^ Contributor: GeorgeT. "Top 7 Psychological Defense Mechanisms". Listverse. Retrieved 2013-05-05.


  7. ^ "defence mechanisms -- Britannica Online Encyclopedia". www.britannica.com. Retrieved 2008-03-11.


  8. ^ Ruuttu T, Pelkonen M, Holi M, et al. (February 2006). "Psychometric properties of the defense style questionnaire (DSQ-40) in adolescents". J. Nerv. Ment. Dis. 194 (2): 98–105. doi:10.1097/01.nmd.0000198141.88926.2e. PMID 16477187.


  9. ^ Hovanesian S, Isakov I, Cervellione KL (2009). "Defense mechanisms and suicide risk in major depression". Arch Suicide Res. 13 (1): 74–86. doi:10.1080/13811110802572171. PMID 19123111.


  10. ^ abc Freud, A. (1937). The Ego and the Mechanisms of Defence, London: Hogarth Press and Institute of Psycho-Analysis. (Revised edition: 1966 (US), 1968 (UK))


  11. ^ Paulhus, D.L., Fridhandler B., and Hayes S. (1997). Psychological defense: Contemporary theory and research. In Briggs, Stephen; Hogan, Robert Goode; Johnson, John W. (1997). Handbook of personality psychology. Boston: Academic Press. pp. 543–579. ISBN 978-0-12-134646-1.


  12. ^ Cramer, P. (1991). The Development of Defense Mechanisms: Theory, Research, and Assessment. New York, Springer-Verlag.


  13. ^ Special issue [on defense mechanisms], Journal of Personality (1998), 66 (6): 879–1157


  14. ^ Lipot Szondi (1956) Ego Analysis Ch. XIX, translated by Arthur C. Johnston, p. 268


  15. ^ abcde Hock, Roger R. "Reading 30: You're Getting Defensive Again!" Forty Studies That Changed Psychology. 7th ed. Upper Saddle River: Pearson Education, 2013. 233–38. Print.


  16. ^ Kernberg O (July 1967). "Borderline personality organization". J Am Psychoanal Assoc. 15 (3): 641–85. doi:10.1177/000306516701500309. PMID 4861171.


  17. ^ Vaillant, George E. (1977). Adaptation to life. Boston: Little, Brown. ISBN 978-0-316-89520-0.


  18. ^ Plutchik, R., Kellerman, H., & Conte, H. R. (1979). A structural theory of ego defences and emotions. In C. E. Izard (Ed.), Emotions in personality and psychopathology (pp. 229–-257). New
    York: Plenum Press.



  19. ^ American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.


  20. ^ Cramer, Phebe (May 2006). Protecting the Self. The Guilford Press. p. 17. ISBN 9781593855284.


  21. ^ abcd Vaillant, G. E., Bond, M., & Vaillant, C. O. (1986). An empirically validated hierarchy of defence mechanisms. Archives of General Psychiatry, 73, 786–794. George Eman Valillant


  22. ^ Laplanche pp. 390, 392[full citation needed]


  23. ^ Psychological Defenses from DSM-IV (see Repression), Virginia Commonwealth University. Retrieved on December 12, 2014.


  24. ^ ab Schacter, Gilbert, Wegner (2011), Psychology (2nd edition), Worth Publishers, p. 483


  25. ^ Carlson, Neil R.. "Chapter 14." Psychology: the science of behaviour. Fourth Canadian Edition ed. Toronto, Ont.: Pearson Education Canada Inc., 2010. 456. Print.


  26. ^ McWilliams, Nancy (2011). Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process, Second Edition. New York, NY: The Guilford Press. pp. 60, 63, 103. ISBN 978-1609184940.


  27. ^ Vaillant, George Eman (1992). Ego Mechanisms of Defense: A Guide for Clinicians and Researchers. American Psychiatric Publishing. p. 238. ISBN 978-0-88048-404-6.


  28. ^ Kramer, Ueli (June 2010). "Coping and defence mechanisms: What's the difference? - Second act". Psychology and Psychotherapy: Theory, Research and Practice. 83 (Pt 2): 207–221. doi:10.1348/147608309X475989. PMID 19883526.


  29. ^ Vaillant, George E. (2012). Triumphs of experience: the men of the Harvard Grant Study. Cambridge, MA: Belknap Press of Harvard University Press. p. 262. doi:10.4159/harvard.9780674067424. ISBN 9780674059825. OCLC 792887462.








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