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The delusional formation, which we take to be the pathological product, is in reality an attempt at recovery, a process of reconstruction.

We are what we are, and where we came from, and what we rose above. Those things are exactly the mark of our glory, not our shame.


Defense Mechanisms

When an emotion becomes too overwhelming for the conscious mind to cope with and express, it is altered and expressed through what are called defense mechanisms. Sigmund Freud developed the theory, and his daughter Ana Freud expanded on it, describing defense mechanisms fully and setting forth one of the cornerstone principles in clinical psychology. George Vaillant furthered the discussion on defense mechanisms by stating they should not be thought of as a negative process. They mark the effort of adaptation to continue survival under difficult or threatening circumstances and some defenses can even optimize functioning.

Maintaining a defense, particularly a maladaptive one, requires psychological energy that effectively limits emotional flexibility and true self awareness. It is widely accepted that an adult’s mental health can improve with aging if one develops and uses mature defenses over immature ones.

However, sometimes adaptive mechanisms become maladaptive. In biology, an immune mechanism can have crippling effects on the body if it is sufficiently stressed, and the person is left off worse than they were before. In psychology, a defense mechanism may distort one’s reality to such an extent that life becomes narrowed and controlled by the need to maintain a particular defense in order to avoid place an emotion that is felt to be too painful or frightening. This in turn keeps one’s self image intact. Maintaining a defense, particularly a maladaptive one, requires psychological energy that effectively limits emotional flexibility and true self awareness.

Listed are four levels of defense mechanisms and their brief descriptions presented by Dr. Pat Santy at the University of Michigan:

Level 1 Defense Mechanisms - Almost always pathological; for the user these three defenses permit someone to rearrange external reality (and therefore not have to cope with reality); for the beholder, the users of these mechanisms frequently appear crazy or insane. These are the "psychotic" defenses, common in overt psychosis, in dreams, and throughout childhood. They include:

Denial - a refusal to accept external reality because it is too threatening. There are examples of denial being adaptive (for example, it might be adaptive for a person who is dying to have some denial.

Distortion - a gross reshaping of external reality to meet internal needs.

Delusional Projection - frank delusions about external reality, usually of a persecutory nature.

Level 2 Defense Mechanisms are seen frequently in adults and are common in adolescents. For the user these mechanism alter distress and anxiety caused by reality or other people; while for the beholder, people who use such defenses are seen as socially undesirable, immature, difficult and out of touch. They are considered "immature" defenses and almost always lead to serious problems in a person's ability to cope with the world. These defenses are seen in severe depression, personality disorders, and adolescence. They include:

Fantasy - tendency to retreat into fantasy in order to resolve inner and outer conflicts.

Projection - attributing one's own unacknowledged feelings to others; includes severe prejudice, severe jealousy, hypervigilance to external danger, and "injustice collecting" (remember that projection is a primitive form of paranoia, so it is common in today's world).

Hypochondriasis - the transformation of negative feelings towards others into negative feelings toward self, pain, illness and anxiety

Passive Agressive Behavior - aggression towards others expressed indirectly or passively.

Acting Out Behavior - direct expression of an unconscious wish or impulse to avoid being conscious of the emotion that accompanies it.

Level 3 Defense Mechanisms are often considered "neurotic" but are fairly common in adults. They can have short-term advantages in coping, but they often cause long-term problems in relationships, work, and enjoyment of life for people who primarily use them as their basic style of coping with the world. They include:

Intellectualization - separation of emotion from ideas; thinking about wishes in formal, affectively bland terms and not acting on them.

Repression - seemingly inexplicable naivete, memory lapse, or lack of awareness of physical status; the emotion is conscious, but the idea behind it is absent ( and, of course, Scarlet "I won't think about that today" O'Hara from Gone With The Wind).

Reaction Formation - behavior that is completely the opposite of what one really wants or feels (e.g, taking care of someone when what one really wants is to be taken care of; studying to be a pilot to cover-up being afraid to fly). Note - this can work in the short term as an effective strategy to cope, but will eventually break down.

Displacement - 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.

Dissociation - temporary and drastic modification of one's personal identity or character to avoid emotional distress.

Level 4 Defense Mechanisms are common among most "healthy" adults and are considered the most "mature". Many of them have their origins in the "immature" level, but have been honed by the individual to optimize his/her success in life and relationships. Use of these defenses gives the user pleasure and feelings of mastery. For the user, these defenses help them to integrate many conflicting emotions and thoughts and still be effective; and for the beholder their use by someone is viewed as a virtue. They include:

Sublimation - transformation of negative emotions or instincts into positive actions, behavior, or emotion (art, sports, hobbies, or even one's choice of profession).

Altruism - constructive service to others that brings pleasure and personal satisfaction.

Suppression - the conscious decision to delay paying attention to an emotion or need in order to cope with the present reality; able to later access the emotion and accept.

Anticipation - realistic planning for future discomfort.

Humor - 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; (humor lets you call a spade a spade, while “wit” is actually a form of displacement).

Since all of these defense mechanisms can be used by adults to adapt to life, the question is:

When is a defense mechanism considered really "adaptive" and when is it considered "pathological"? What we call "mental illness" is actually a manifestation of an individual's pathological adaptive resposne to events in his/her life.
Here is what makes a defense "pathological":

Research has shown that use of the "mature defenses" (Level 4) I listed is related to:

  1. excellent adjustment as an adult
  2. happiness(by self-report)
  3. job satisfaction rich friendships
  4. fewer hospitalizations over life
  5. better overall health
  6. a lower incidence of mental illness.

Use of the "immature Defenses" (Levels 1, 2, 3) is related to:

  1. poor adjustment as an adult
  2. higher divorce rates and marital discord
  3. poor friendship patterns
  4. higher incidence of mental illness
  5. greater number of sick leave days taken
  6. poorer health generally.

Studies following individuals throughout their lifetimes have taught us that defense mechanisms can change over time. It is widely accepted that an adult’s mental health can improve with aging if one develops and uses mature defenses over immature ones. George Vaillant’s study of coping mechanisms throughout adult development and aging makes an excellent case for the development of insight and self awareness as means for a fulfilling later life. Emotional development never ceases. Age has no bearing on it, but will and intention do. One must desire greater depth of understanding in order to risk facing the emotions defenses have spent a lifetime avoiding.