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ABHANPUR , RAIPUR

SUBJECT :- NURSING EDUCATION

TOPIC :- LESSON PLAN

DEFENCE MECHANISM

Submitted To: Submitted By:

MRS.ASHA CHATTERJI MR. ABHISHEK SAMSON
st
MSC. NURSING LECTURER (MSN) MSC. NURSING 1 Year
GRACIOUS COLLEGE OF NURSING GRACIOUS COLLEGE OF NURSING
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. NAME OF STUDENT
OBJECTIVES - MR. ABHISHEK SAMSON LEARNING AIDS
ACTIVITY

SUBJECT - NURSING EDUCATION

TOPIC - DEFENCE MECHANISM

NAME OF EVALUATER - MRS ASHA CHATTERJI

DATE - / /2019

TIME - 10:00 am

MEDIAM - ENGLISH

CLASS - MSC. NURSING 1ST YEAR

GROUP - BSC NSG

A.V. AIDS - CHARTS, FLASH CARD, LCD BLACKBOARD,FLIPCARD

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GENERAL OBJECTIVE –
STUDENTS HAVE THE SOME PREVIOUS KNOWLEDGE ABOUT THE DEFENCE MECHANISM

SPECIFIC OBJECTIVE –

AT THE END OF CLASS STUDENT WILL BE ABLE TO :-

 Introduce The topic Defence Mechanism

 Define the topic Defence Mechanism

 List out the Characteristics of Defence Mechanism

 Explain the Evolution of Defence Mechanism.

 Describe the Purposes of Defence Mechanisms.

 Explain the Classification of Defence Mechanism

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1 1 Introduce Explanation LCD Are you able

Min the topic The defence mechanisms most commonly used by a person with unpleasant to introduce
Defence situation or distressing internal affective states constitute a significant component the topic.?
Mechanism of that person’s character. The defence mechanisms may be adaptive and healthy;
as well as pathological. In psychopathological states, one may see various
alterations of normal defensive functioning. An ego defence mechanism becomes
pathological only when its persistent use leads to maladaptive behaviour such that
the physical and mental health of the individual is adversely affected. The purpose
of ego defence mechanisms is to protect the mind/self/ego from anxiety, social
problems or to provide a relief from a situation with which one cannot currently
cope.
In Freudian psychoanalytic theory, defence mechanisms are
unconscious psychological strategies brought into play by various entities to cope
with reality and to maintain self-image of these impulses.

Robert Plutchik's (1979) theory views defences as derivatives of basic emotions.

2 1 Define the “A behaviour motivated by an individual’s attempt to maintain a favourable self Explanation LCD Are you able
Min topic image and to avoid embracement and expected criticism from other people.” to define the
Defence - W. P. Scott topic.?
Mechanism “An intrapsychic process which provides relief from conflicts and anxiety operates
unconsciously.” -VMD Namboodri, 2005

3 2 Characteris 1. Used by almost all individuals in the process of adjustment. Explanation Chart Can you
Min tics of 2. The same individual may use various mechanisms simultaneously. and explain the
Defence 3. Used at all level of the mind either consciously or unconsciously. lecture Characteristic
Mechanism 4. It reduces the anxiety, fear, tension, frustration and emotional distress. s of Defence
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5. The individual feel secure when adjustment mechanisms are in use. Mechanism
6. Use defence mechanisms in limit.
7. Promotes individual’s functioning.
8. Maintain the balance and moulds the personality of an individual.

4 1 Evolution In course of development, defences emerge as a reflection of the ego’s attempts to Explanation Lectur Explain the
Min of Defence mediate between the pressures of the id and the demands of the external reality. At e Evolution of
Mechanism each phase of psychosexual development the specific derive component evoke Defence
specific ego defences. Mechanism?

5 2 Explanation Flip List out the

Min Purposes - Protects the individual. card Purpose of
of Defence - Reduces the distress and anxiety. Defence
Mechanism - Preserves the inner harmony and help the individual to make adaptation. Mechanism?
- To find the justifications in realistic way for a problem.

6 15 Explanation LCD , Explain &

Min Classificati The list of defence mechanisms is huge and there is no theoretical consensus on the Lectur enlist the
on of number of defence mechanisms. Classifying defence mechanisms according to e different
Defence some of their properties has been attempted. Different theorists have different classification
of Defence
Mechanism categorizations and conceptualizations of defence mechanisms. The Journal of Mechanism?
Personality published a special issue on defence mechanisms (1998).

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 positive and negative mental
objects together.
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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.

Classification 1:
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
In George Eman Vaillant's (1977) categorization, defences form a continuum
related to their psychoanalytical developmental level. Vaillant's levels are:

 Level I - pathological defences (i.e. psychotic denial, delusional

projection)
 Level II - immature defences (i.e. fantasy, projection, passive
aggression, acting out)
 Level III - neurotic defences (i.e. intellectualization, reaction formation,
dissociation, displacement, repression)
 Level IV - mature defences (i.e. humour, sublimation, suppression,
altruism, anticipation)

Level 1 - Pathological
The mechanisms on this level, when predominating, almost always are
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severely pathological. These four defences, in conjunction, permit one to

effectively rearrange external experiences to eliminate the need to cope with
reality. The pathological users of these mechanisms frequently appear irrational to
others. These are the "psychotic" defences, common in overt psychosis. However,
they are found in dreams and throughout childhood as well.

They include:

 Delusional Projection: Grossly frank 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.
 Splitting: A primitive defence. Negative and positive impulses are split off
and unintegrated. Fundamental example: An individual views other people as
either innately good or innately evil, rather than a whole continuous being.
 Extreme projection: The blatant denial of a moral or psychological
deficiency, which is perceived as a deficiency in another individual or group.

Level 2 - Immature
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These mechanisms are often present in adults and more commonly present
in adolescents. These mechanisms lessen distress and anxiety provoked by
threatening people or by uncomfortable reality. People who excessively use such
defences are 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 severe depression and
personality disorders. In adolescence, the occurrence of all of these defences is
normal.

They include:

 Acting out: Direct expression of an unconscious wish or impulse in action,

without conscious awareness of the emotion that drives that expressive
behaviour.
 Fantasy: Tendency to retreat into fantasy in order to resolve inner and
outer conflicts.
 Idealization: Unconsciously choosing to perceive another individual as
having more positive qualities than he or she may actually have.[14]
 Passive aggression: Aggression towards others expressed indirectly or
passively such as using procrastination.
 Projection: Projection is a primitive form of paranoia. Projection also
reduces anxiety by allowing the expression of the undesirable impulses or
desires without becoming consciously aware of them; attributing one's own
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unacknowledged unacceptable/unwanted thoughts and emotions to another;

includes severe prejudice, severe jealousy, hypervigilance to external danger,
and "injustice collecting". It is shifting one's unacceptable thoughts, feelings
and impulses within oneself onto someone else, such that those same thoughts,
feelings, beliefs and motivations are perceived as being possessed by the other.
 Projective identification: The object of projection invokes in that person
precisely the thoughts, feelings or behaviours projected.
 Somatization: The transformation of negative feelings towards others into
negative feelings toward self, pain, illness, and anxiety.
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.

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 mother may yell at her child because she is angry
with her husband.
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 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.
 Hypochondriasis: An excessive preoccupation or worry about having a
serious illness.
 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
(e.g. isolation, rationalization,ritual, undoing, compensation, magical thinking).
 Isolation: Separation of feelings from ideas and events, for example,
describing a murder with graphic details with no emotional response.
 Rationalization (making excuses): Where a person convinces him or
herself that no wrong was 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 - making excuses.
 Reaction formation: Converting unconscious wishes or impulses that are
perceived to be dangerous 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. This defence can work effectively for coping in
the short term, but will eventually break down.
 Regression: Temporary reversion of the ego to an earlier stage of
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development rather than handling unacceptable impulses in a more adult way.

 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;[15] 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.
 Undoing: A person tries to 'undo' an unhealthy, destructive or otherwise
threatening thought by engaging in contrary behaviour.
 Withdrawal: Withdrawal is a more severe form of defence. It entails
removing oneself from events, stimuli, interactions, etc… that could remind
one of painful thoughts and feelings.

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 optimize success in life and
relationships. The use of these defences enhances pleasure and feelings of control.
These defences help us integrate conflicting emotions and thoughts, while still
remaining effective. Those who use these mechanisms are usually considered
virtuous.

They include:
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 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) that gives pleasure to others.
The thoughts retain a portion of their innate distress, but they are "skirted
round" by witticism.
 Identification: The unconscious modelling of one's self upon another
person's character and behaviour.
 Introjection: Identifying with some idea or object so deeply that it
becomes a part of that person.
 Sublimation: Transformation of negative emotions or instincts into
positive actions, behaviour, or emotion.
 Thought suppression: The conscious process of pushing thoughts into the
preconscious; the conscious decision to delay paying attention to an emotion or
need in order to cope with the present reality; making it possible to later access
uncomfortable or distressing emotions while accepting them.

Classification 2:
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Oral in origin (0-2 yrs.):

 Compensation
 Displacement
 Denial
 Fixation
 Substitution

Origin in habit training period (1-3yrs.):

 Conversion
 Identification
 Introjection
 Reaction Formation
 Transference
 Sublimation
 Suppression
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CONCLUSION:- Origin in later period of childhood (3-6 yrs.):

 Repression
 Regression
Today We Discuss The Topic Defence Mechanism ,Which Includes:-
 Rationalization
 Introduce The topic Defence Mechanism
Origin in latency period (6-12 yrs.):
  Defence
Define the topic Mechanism
Projection

 A. Oral in origin
List out the Characteristics (0-2 yrs.):
of Defence Mechanism
 Compensation: It is the pattern of adjustive behaviour by which tension or
 anxiety
Explain the Evolution of is relivedMechanism.
Defence as the individual makes up for a personal lack or a feeling
of inadequacy by emphasizing some personal or social attribute that
overshadows the weakness and gains social approval.
  Displacement
Describe the Purposes of Defence Mechanisms.
 Denial: Avoiding the awareness of some painful aspect of reality by
 negating the
Explain the Classification sensory Mechanism
of Defence data.
 Fixation: Fixation refers to the point in the individual’s development at
which certain aspects of the emotional development do not advanced.
 Substitution: To get satisfaction and reduce the anxiety, resulting from
frustration the substitutive action must have certain similarities to the
frustrated one.
B. Origin in habit training period (1-3yrs.):
 Conversion: Conversion of the mental symptoms into physical symptoms.
 Identification
 Introjections
 Reaction Formation
 Sublimation
 Suppression

C. Origin in later period of childhood (3-6 yrs.):

 Repression: repression is more complicated phenomenon in which
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unpleasant and unacceptable emotions, experiences or motivations are

References: actively forced into the unconscious mind and kept there.
 Regression: Attempting to return to an earlier to an earlier libidinal phase
of functioning
1. Ahuja N. A short textbook of psychiatry. to avoid
5th edition. the 2002.
Jaypee. tensions and –conflict
P. 213 216 evoke at present level of
development. It is a normal phenomenon as well, as a certain amount of
2. Boyd Ann M. Psychiatric nursingregression
contemporyispractice. 4th edition.
essential Lippincott.sleep
for relaxation, 2008.and
P. 145-146
orgasm in sexual
intercourse. th
3. Kaplan, sudock’s. Comprehensive textbook of psychiatry. Vol-1. 7 edition. Virginia sadock. P.582-585
 Rationalization
4. http://en.wikipedia.org/wiki/Defence_mechanism ; reviewed on 31 October, 2011
D. Origin in latency period ;(6-12
5. http://psychology.about.com/od/dindex/g/defensemech.htm yrs.):on 31 October, 2011
reviewed
 Projection: Perceiving and reacting to unacceptable inner impulses and their
6. http://psychcentral.com/lib/2007/15-common-defense-mechanisms/all/1/
derivatives as though they were outside; reviewed on 31
the self. On October, level,
a psychotic 2011 this
defence mechanism takes the form of frank
7. http://listverse.com/2007/11/15/top-7-psychological-defense-mechanisms/ delusionon
; reviewed about external 2011
31 October, reality.
7 2
Min Summarize
8. http://www.coldbacon.com/defenses.html ; reviewed on 31 October, 2011
the topic
9. http://www.tutorvista.com/biology/types-of-defense-mechanism ; reviewed on 31 October, 2011
defence
mechanism