Defense Mechanisms

Theoretical, Research and Clinical Perspectives

Uwe Hentschel, Gudmund Smith, Juris G Draguns, Wolfram Ehlers

• Publisher: North Holland
• Year: 2004
• Print ISBN: 9780444512635
• eBook ISBN: 9780080477077
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

The book is focused on defense mechanisms as theoretical constructs as well as the possibilities of their empirical registration by different methods, and the application of these constructs in different fields of psychology with special regard to concurrent and predictive validity. It is argued that defense mechanisms are in many ways to be seen as integrative constructs, not necessarily restricted to psychoanalytic theory and that the potential fields of their application have a wide ranging scope, comprising many fields of psychology. Consequently empirical studies are presented from the fields of clinical and personality psychology, psychotherapy research and psychosomatic phenomena and diseases. Methodological questions have a heavy weight in most of these studies.- Provides coverage of relevant literature- Covers different fields of application- Attempts an integration of the contstruct of defense mechanisms into mainstream psychology- Provides explanations of the theoretical basis of the construct of defense mechanisms

Defence mechanisms inpsychotherapy and clinical research

Chapter 16

Clinical Evaluation of Structure and Process of Defense Mechanisms Before and During Psychoanalytic Treatment

Wolfram Ehlers

Introduction

Freud (1917d) regarded the psyche as a hierarchy of superordinate and subordinate formations, comprising a multitude of drives and links with the external world. Very often there are divergent and incompatible relations among these diverse components. Freud attributed the defense process and the object of id, containing that which is defended against, to separate systems according to their diverging function and conceptual meaning. The defense process is activated in the ego (A. Freud, 1936) whereas the targets of defense are generated in the id and superego. For conscious observation of defense mechanisms, the ego is the medium through which images of the two other structures are apprehended. The ego senses oncoming urges, increased tensions with concomitant feelings of displeasure, and, finally, the resolution of the tension through a gratifying experience of pleasure. These structures can be observed through their effects on images, affects, and social relations.

In contemporary psychoanalysis this structural theory of the psyche remains highly controversial because of the complex and ambiguous implications of its metapsychological concepts for clinical thinking. Thus, one of the prominent representatives of American ego psychology concluded: “It is anything but agreeable to have to realize that one has dedicated most of one’s career to a worthless theory as which metapsychology has itself proven” (Holt, 1989, p.327). On the other hand, Arlow and Brenner (1988) have devoted their efforts to construct and elaborate ego psychology, which they consider clinically useful and theoretically essential. Many psychoanalysts (e.g. Edelson, 1988) regard research as the only possible way out of the unresolved dilemmas of structural theory. This chapter is based on three empirical clinical studies of the application of defense mechanisms in the diagnostic phase of inpatient psychoanalytic treatment of severely disturbed patients and on two case studies of outpatient treatment with analytical psychotherapy.

The diagnostic data were gathered by psychoanalysts at a residential clinic in Stuttgart, Germany, a facility for approximately 120 patients with neurotic and personality disorders, many of them borderline. Many of the patients exhibited some psychotic symptoms. For research on the psychoanalytic process, the author selected two patients from among his outpatients in analytic psychotherapy and rated their defense mechanisms by himself after each therapy session.

The aim of these studies is to attempt to identify through clinical exploration those structures of defense mechanisms which can be described by quantitative methods and to compare with these instruments the two proposed metapsychologies which underlie defense mechanisms.

The Defense Model of Ego Psychology

The classical psychoanalytical conceptualisation of defense developed by Anna Freud (1936) describes the defense process as a self-protective activity of the ego. In this formulation, the ego was construed and described in line with Freud’s (1923b) structural theory. Whenever conflicts arise between the ego, id, and superego, defense mechanisms act to enable the ego to banish unconscious desires and affects from consciousness (see Figure 16.1). In a discussion with a group of members of the British Psychoanalytic Association in London (Sandler & A. Freud, 1989), Anna Freud shared a revised explanation of her model of defense.

Figure 16.1 Psychoanalytic model of defense processes in symptom formation through the repetition compulsion of conflicts (based on A. Freud, 1936)

Psychoanalysis sets itself the task of acquiring as much knowledge as possible about the structural model of a given patient’s personality. In this model, the ego serves as a medium for observing the effects of the id and superego upon a patient’s experience and behavior. The ego never impinges upon behavior through subordinate id emotions, such as drive wishes. Invariably, its effects stem from the defense activities of the ego. In treatment, the psyc...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright page
• Preface
• General issues
• Percept-Genetic, Projective, and Rating Techniques for the Assessment of Defense Mechanisms
• Defence mechanisms inpsychotherapy and clinical research
• Defense mechanisms inPsychomatic Research
• Defense mechanisms in neuropsychological contexts
• Index
• Contributors