ego and defense mechanism for nursing students

1. Ego and defense
mechanism
Keerthi mohanan

2. STRUCTURE OF PERSONALITY
Id:
• It is based on the pleasure principle, present at birth.
It endows infant with instinctual drives. The
behaviors are impulsive and irrational.
Ego:
• It is based on reality principle, develops between 4-6
months of age. It experiences the reality of the
external world, adapts to it and responds to it.

3. CONT..
Superego:
• It is based on the perfection principle, develops
between 3-6 years of age. Internalizes values and
morals from primary caregivers by rewards and
punishments. Has two components: ego-ideal and
conscience.

4. DEFENSE MECHANISM

5. INTRODUCTION
Anna Freud identified the defense mechanisms
employed by the ego in the face of threat to biological
or psychological integrity.ego copes with anxiety
through rational means. When anxiety becomes too
painful, the individual copes by using defense
mechanisms to protect the ego and diminish anxiety.
They can be helpful when used in very small doses,
and if overused can lead to personality breakdown.
They operate at the unconscious level.

6. BASIC CONCEPT OF FREUD
• Anxiety is an unpleasant inner state that people seek
to avoid. When anxiety occurs the mind first reacts by
problem solving thinking of escaping the situation.
• If this is not helpful ego , the mediator uses its tools
called the defense mechanism.
• They helped shied the ego from the conflicts of id,
superego and reality.

7. DEFINITION
They are patterns of thoughts, feelings or behaviors that
are relatively involuntary. They rise in response to
perceptions of psychic danger, To unexpected change
in the internal or external environment, or in response
to cognitive dissonance.
American Psychiatric Association(1994)

8. PURPOSES
• Allows individuals to master changes in self-image
according to the change in reality.
• It can deflect or deny sudden increases in biological
drives.
• Help individuals to mitigate unresolved conflicts with
important people.
• It can keep anxiety, shame and guilt within bearable
limits during sudden conflicts with conscience and
culture.

10. TYPES OF DEFENSE MECHANISM
• Compensation: covering up a real or perceived
weakness by emphasizing a trait one considers more
desirable.
• E.g. a physically handicapped boy is unable to
participate in football, so he compensates by
becoming a great scholar.

11. DENIAL
 It is the refusal to acknowledge the existence of a
real situation or the feelings associated with it.
E.g. . The mother of a child who is fatally ill may
refuse to admit that there is anything wrong even
though she is fully informed of the diagnosis and
expected outcome because she cannot tolerate the
pain that acknowledging reality would produce.

12. DISPLACEMENT
• The transfer of feelings from one target to another
that is considered less threatening or that is neutral.
• E.g. a husband comes home after a bad day at work
and yells at his wife.

13. RATIONALIZATION
• Attempting to make excuses or formulate logical
reasons to justify unacceptable feelings or behaviors.
• E.g. a student who fails in the examination may
complain that the hostel atmosphere is not favorable
and has resulted in his failure.

14. REACTION FORMATION
• Preventing unacceptable or undesirable thoughts or
behaviors from being expressed by exaggerating
opposite thoughts or types of behaviors.
• E.g. a jealous boy who hates his elder brother may
show exaggerated respect and affection towards him.

15. REGRESSION
• Retreating in response to stress to an earlier level of
development and the comfort measures associated
with that level of functioning.
• E.g. when his mother brings his new baby sister
home from the hospital, 4 year old Tommy, who had
been toilet trained for more than a year, begins to wet
his pants, cry to be held and suck his thumb.

16. IDENTIFICATION
• An attempt to increase self-worth by acquiring certain
attributes and characteristics of an individual one
admires.
• E.g. a teenage girl emulates the mannerisms and style
of dress of a popular female rock star.

17. INTELLECTUALIZATION
• An attempt to avoid expressing actual emotions
associated with a stressful situation by using the
intellectual processes of logic, reasoning and analysis.
• E.g. a young psychology professor receives a letter
from his fiancée breaking off their engagement. He
shows no emotion when discussing this with his best
friend. Instead he analyzes his fiancée’s behavior and
tries to reason why the relationship failed.

18. INTROJECTION
• Integrating the values and beliefs of another
individual into one’s own ego structure.
• E.g. children integrate their parent’s value system into
the process of conscience formation. A child says to
friend,” Don’t cheat. It’s wrong”.

19. ISOLATION
• Separating a thought or memory from the feeling tone
or emotions associated with it.
• E.g. a young woman describes being attacked and
raped by a street gang. She displays an apathetic
expression and no emotional tone.

20. PROJECTION
• Attributing feelings or impulses unacceptable to one’s
self to another person.
• E.g. a surgeon, whose patient does not respond as he
anticipated, may tend to blame the theatre nurse who
helped that surgeon at the time of surgery.

21. REPRESSION
• Involuntarily blocking unpleasant feelings and
experiences from one’s awareness.
• E.g. a woman cannot remember being sexually
assaulted when she was 15years old.

22. SUBLIMATION
• Rechanneling of drives or impulses that are
personally or socially unacceptable into activities that
are constructive.
• E.g. a teenage boy with strong competitive and
aggressive drives becomes the star football player on
his high school team.

23. SUPPRESSION
• The voluntary blocking of unpleasant feelings and
experiences from one’s awareness.
• E.g. A young woman who is depressed about a
pending divorce proceeding tells the nurse,” I just
don’t want to talk about the divorce. There’s nothing I
can do about it anyway”.

24. UNDOING
• Symbolically cancelling out an experience that one
finds intolerable.
• E.g. a man who is anxious about giving a
presentation at work yells at his wife during
breakfast. He stops on his way home from work that
evening to buy her a dozen red roses.

25. INSULATION
• Withdrawing to passivity and becoming never
accessible so as to avoid further threating situation

26. SYMBOLIZATION
• Consciously using an idea or object to represent
another actual event or object.

27. FIXATION
• Never advancing to the next level of emotional
development and organization

28. FANTASY
• Escapes stress by focussing on unreal mental images
in which his or her wishes are fulfilled

29. DISSOCIATION
• Blocking off an anxiety event or period of time from
the conscious mind.
• People who have any kind of childhood abuse often
suffer from some form of dissociation

30. CONVERSION
• It is a expression of emotional conflicts or stress
through physical symptoms

31. NURSING IMPLICATIONS
• To understand our self and our patient
• To identify the maladaptive behavioral
responses among individual.
• To identify the behaviors associated with the
various stages of development.

32. CONCLUSION
• In order to understand the personality disorder in a
person we must know about the development of
normal personality and thus the defense mechanisms
to identify the maladaptive behavior in order to cope
with the anxiety that one faces.

33. SUMMARY
• Ego
• Defense mechanism
• Types of defense mechanism
• Nursing implications