Tag: Psychology

What is Relational Disorder?

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Introduction

According to Michael First of the Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5) working committee the focus of a relational disorder, in contrast to other DSM-IV disorders, “is on the relationship rather than on any one individual in the relationship”.

Relational disorders involve two or more individuals and a disordered “juncture”, whereas typical Axis I psychopathology describes a disorder at the individual level. An additional criterion for a relational disorder is that the disorder cannot be due solely to a problem in one member of the relationship, but requires pathological interaction from each of the individuals involved in the relationship.

For example, if a parent is withdrawn from one child but not another, the dysfunction could be attributed to a relational disorder. In contrast, if a parent is withdrawn from both children, the dysfunction may be more appropriately attributable to a disorder at the individual level.

First states that “relational disorders share many elements in common with other disorders: there are distinctive features for classification; they can cause clinically significant impairment; there are recognizable clinical courses and patterns of comorbidity; they respond to specific treatments; and they can be prevented with early interventions. Specific tasks in a proposed research agenda: develop assessment modules; determine the clinical utility of relational disorders; determine the role of relational disorders in the aetiology and maintenance of individual disorders; and consider aspects of relational disorders that might be modulated by individual disorders.”

The proposed new diagnosis defines a relational disorder as “persistent and painful patterns of feelings, behaviors, and perceptions” among two or more people in an important personal relationship, such a husband and wife, or a parent and children.

According to psychiatrist Darrel Regier, MD, some psychiatrists and other therapists involved in couples and marital counselling have recommended that the new diagnosis be considered for possible incorporation into the DSM IV.

Brief History

The idea of a psychology of relational disorders is far from new. According to Adam Blatner, MD, some of the early psychoanalysts alluded to it more or less directly, and the history of marital couple therapy began with a few pioneers in 1930s. J.L. Moreno, the inventor of psychodrama and a major pioneer of group psychotherapy and social psychology, noted the idea that relationships could be “sick” even if the people involved were otherwise “healthy,” and even vice versa: Otherwise “sick” people could find themselves in a mutually supportive and “healthy” relationship.

Moreno’s ideas may have influenced some of the pioneers of family therapy, but also there were developments in general science, namely, cybernetic theory, developed in the mid-1940s, and noting the nature of circularity and feedback in complex systems. By the 1950s, the idea that relationships themselves could be problematic became quite apparent. So, diagnostically, in the sense not of naming a disease or disorder, but just helping people think through what was really going on, the idea of relational disorder was nothing new.

Types

The majority of research on relational disorders concerns three relationship systems:

  • Adult children and their parents;
  • Minor children and their parents; and
  • The marital relationship.

There is also an increasing body of research on problems in dyadic gay relationships and on problematic sibling relationships.

Marital

Marital disorders are divided into “Marital Conflict Disorder Without Violence” and “Marital Abuse Disorder (Marital Conflict Disorder With Violence).” Couples with marital disorders sometimes come to clinical attention because the couple recognise long-standing dissatisfaction with their marriage and come to the clinician on their own initiative or are referred by a health care professional. Secondly, there is serious violence in the marriage which is “usually the husband battering the wife”. In these cases the emergency room or a legal authority often is the first to notify the clinician.

Most importantly, marital violence “is a major risk factor for serious injury and even death and women in violent marriages are at much greater risk of being seriously injured or killed” (National Advisory Council on Violence Against Women 2000). The authors of this study add that “There is current considerable controversy over whether male-to-female marital violence is best regarded as a reflection of male psychopathology and control or whether there is an empirical base and clinical utility for conceptualizing these patterns as relational.”

Recommendations for clinicians making a diagnosis of “Marital Relational Disorder” should include the assessment of actual or “potential” male violence as regularly as they assess the potential for suicide in depressed patients. Further, “clinicians should not relax their vigilance after a battered wife leaves her husband, because some data suggest that the period immediately following a marital separation is the period of greatest risk for the women.

Many men will stalk and batter their wives in an effort to get them to return or punish them for leaving. Initial assessments of the potential for violence in a marriage can be supplemented by standardised interviews and questionnaires, which have been reliable and valid aids in exploring marital violence more systematically.

The authors conclude with what they call “very recent information” on the course of violent marriages which suggests that “over time a husband’s battering may abate somewhat, but perhaps because he has successfully intimidated his wife.”

The risk of violence remains strong in a marriage in which it has been a feature in the past. Thus, treatment is essential here; the clinician cannot just wait and watch. The most urgent clinical priority is the protection of the wife because she is the one most frequently at risk, and clinicians must be aware that supporting assertiveness by a battered wife may lead to more beatings or even death.

In some cases, men are abuse victims of their wives; there is not exclusively male-on-female physical violence, although this is more common than female-on-male violence.

Parent-Child Abuse

Research on parent-child abuse bears similarities to that on marital violence, with the defining characteristic of the disorder being physical aggression by a parent toward a child. The disorder is frequently concealed by parent and child, but may come to the attention of the clinician in several ways, from emergency room medical staff to reports from child protection services.

Some features of abusive parent–child relationships that serve as a starting point for classification include:

  • The parent is physically aggressive with a child, often producing physical injury;
  • Parent-child interaction is coercive, and parents are quick to react to provocations with aggressive responses, and children often reciprocate aggression;
  • Parents do not respond effectively to positive or prosocial behaviour in the child;
  • Parents do not engage in discussion about emotions;
  • Parent engages in deficient play behaviour, ignores the child, rarely initiates play, and does little teaching;
  • Children are insecurely attached and, where mothers have a history of physical abuse, show distinctive patterns of disorganised attachment; and
  • Parents relationship shows coercive marital interaction patterns.

Defining the relational aspects of these disorders can have important consequences. For example, in the case of early appearing feeding disorders, attention to relational problems may help delineate different types of clinical problems within an otherwise broad category. In the case of conduct disorder, the relational problems may be so central to the maintenance, if not the aetiology, of the disorder that effective treatment may be impossible without recognising and delineating it.

On This Day … 11 April

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People (Births)

David Perrett

David Ian Perrett FBA FRSE (born 11 April 1954) is a professor of psychology at the University of St Andrews in Scotland, where he leads the Perception Lab. The main focus in his team’s research is on face perception, including facial cues to health, effects of physiological conditions on facial appearance, and facial preferences in social settings such as trust games and mate choice. He has published over 400 peer-reviewed articles, many of which appearing in leading scientific journals such as the Proceedings of the Royal Society of London Series B – Biological Sciences, Psychological Science, and Nature.

Perrett received the British Psychological Society President’s Award for Distinguished Contributions to Psychological Knowledge in 2000, the Golden Brain Award of Minerva Foundation in 2002, the Experimental Psychology Society Mid-Career prize (2008), and a British Academy Wolfson Research Professorship (2009-2012).

Book: A Dictionary of Psychology 4/e

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Book Title:

A Dictionary of Psychology 4/e (Oxford Quick Reference).

Author(s): Andrew M. Colman.

Year: 2015.

Edition: Fourth (4th).

Publisher: Oxford OUP.

Type(s): Paperback and Kindle.

Synopsis:

Including more than 11,000 definitions, this authoritative and up-to-date dictionary covers all branches of psychology. Clear, concise descriptions for each entry offer extensive coverage of key areas including cognition, sensation and perception, emotion and motivation, learning and skills, language, mental disorder, and research methods. The range of entries extends to related disciplines including psychoanalysis, psychiatry, the neurosciences, and statistics. Entries are extensively cross-referenced for ease of use, and cover word origins and derivations as well as definitions. More than 100 illustrations complement the text.

This fourth edition has incorporated a large number of significant revisions and additions, many in response to the 2013 publication of the American Psychiatric Association’s latest edition of Diagnostic and Statistical Manual of Mental Disorders, bringing the Dictionary fully up to date with the most recent literature of the subject.

In addition to the alphabetical entries, the dictionary also includes appendices covering over 800 commonly used abbreviations and symbols, as well as a list of phobias and phobic stimuli, with definitions.

Comprehensive and clearly written, this dictionary is an invaluable work of reference for students, lecturers, and the general reader with an interest in psychology.

On This Day … 06 April

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People (Births)

Tanya Byron

Tanya Byron (born 06 April 1967) is a British psychologist, writer, and media personality, best known for her work as a child therapist on television shows Little Angels and The House of Tiny Tearaways. She also co-created the BBC Two sitcom The Life and Times of Vivienne Vyle with Jennifer Saunders, and still contributes articles to various newspapers.

In 2008, she became Professor of the Public Understanding of Science at Edge Hill University and is the first and current Chancellor of the same institution.

Early Life

When Byron was 15 years old, her German-born paternal grandmother was murdered by being battered to death by a woman who abused illicit drugs. Her grandmother knew the woman, who was in pursuit of money. Byron was perplexed by this cruelty, and at about that time she began to try to understand how anyone could do such a terrible thing and began to be interested in psychology.

Education

Byron was educated at North London Collegiate School, University of York (BSc Psychology, 1989), University College London (MSc Clinical Psychology, 1992), and University of Surrey (PhD, 1995). Her PhD thesis was entitled “The evaluation of an outpatient treatment programme for stimulant drug misuse”, and was completed at University College Hospital.

Career

Prior to training in Clinical Psychology, Byron worked as a researcher on the BBC’s Video Diaries documentary series. Once she qualified, Byron worked in the NHS for 18 years in a number of public health areas such as drug addiction, STDs, and mental disorders.

In 2005, Byron was featured on French and Saunders’ Christmas Special as herself, who came in to sort out Dawn and Jennifer’s childish behaviour on the show. Subsequently, she co-wrote the series The Life and Times of Vivienne Vyle with Jennifer Saunders. Byron has also co-authored a book on parenting based on the Little Angels show and two other books on child development and parenting, as well as writing weekly articles for The Times and contributing to several women’s magazines. She has also worked with the Home Office on the current changes to the Homicide Act as it relates to children and young people, and she also works with the National Family and Parenting Institute advising government and ministers on related policy.

In September 2007, it was announced that she would head an independent review in England – supported by the Department for Children, Schools, and Families, as well as the Department for Culture, Media, and Sport – into the potentially harmful effects of both the Internet and video games on children. This was published in March 2008 as “Safer Children in a Digital World”, but is commonly called the Byron Review.

In April 2008, Byron fronted a four-part show called Am I Normal? exploring the boundaries of acceptable behaviour.

In May 2008, she was elected as the first Chancellor of Edge Hill University, in Lancashire and installed at a ceremony in December 2008.[10] Edge Hill University also appointed her to the post of Professor of the Public Understanding of Science, and she delivered her inaugural lecture, “The Trouble With Kids”, in March the following year.

In 2009, Byron was awarded an honorary doctorate by the University of York.

Byron is the patron of Prospex, a charity which works with young people in North London. She is also a partner in a media company, Doris Partnership.

She has published The Skeleton Cupboard: The Making of a Clinical Psychologist in 2015.

Book: Life as a Clinical Psychologist: What is it Really Like?

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Book Title:

Life as a Clinical Psychologist: What is it Really Like?

Author(s): Paul Jenkins.

Year: 2020.

Edition: First (1st).

Publisher: Critical Publishing.

Type(s): Paperback and Kindle.

Synopsis:

Considering a career as a Clinical Psychologist? This book is an ideal, jargon-free introduction for those wishing to find out more about working in this demanding but rewarding mental health profession.

An accessible text that invites you to think critically about whether becoming a Clinical Psychologist is right for you, questioning and challenging your views and providing an honest perspective of life as a clinical psychologist.

Written from personal experience of over 10 years working in applied psychology, with a unique knowledge of the practice, theory, and application of Clinical Psychology, Paul Jenkins provides a first-hand perspective, blending anecdotes with factual advice on the clinical academic culture. It is also packed with case studies which highlight a range of different career pathways (including in other mental health fields) and includes coverage of post-qualification life to gives the reader a sense of the career you can have after training.

What is a Double Bind?

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Introduction

A double bind is a dilemma in communication in which an individual (or group) receives two or more conflicting messages, with one negating the other. In some circumstances (particularly families and relationships) this might be emotionally distressing. This creates a situation in which a successful response to one message results in a failed response to the other (and vice versa), so that the person will automatically be wrong regardless of response. The double bind occurs when the person cannot confront the inherent dilemma, and therefore can neither resolve it nor opt out of the situation.

Double bind theory was first described by Gregory Bateson and his colleagues in the 1950s.

Double binds are often utilised as a form of control without open coercion – the use of confusion makes them difficult both to respond to and to resist.

A double bind generally includes different levels of abstraction in the order of messages and these messages can either be stated explicitly or implicitly within the context of the situation, or they can be conveyed by tone of voice or body language. Further complications arise when frequent double binds are part of an ongoing relationship to which the person or group is committed.

Refer to Family Therapy and the Bateson Project (1953-1963).

Explanation

The double bind is often misunderstood to be a simple contradictory situation, where the subject is trapped by two conflicting demands. While it is true that the core of the double bind is two conflicting demands, the difference lies in how they are imposed upon the subject, what the subject’s understanding of the situation is, and who (or what) imposes these demands upon the subject. Unlike the usual no-win situation, the subject has difficulty in defining the exact nature of the paradoxical situation in which they are caught. The contradiction may be unexpressed in its immediate context and therefore invisible to external observers, only becoming evident when a prior communication is considered. Typically, a demand is imposed upon the subject by someone whom they respect (such as a parent, teacher, or doctor) but the demand itself is inherently impossible to fulfil because some broader context forbids it. For example, this situation arises when a person in a position of authority imposes two contradictory conditions but there exists an unspoken rule that one must never question authority.

Gregory Bateson and his colleagues defined the double bind as follows:

  1. The situation involves two or more people, one of whom (for the purpose of the definition), is designated as the “subject”. The others are people who are considered the subject’s superiors: figures of authority (such as parents), whom the subject respects.
  2. Repeated experience: the double bind is a recurrent theme in the experience of the subject, and as such, cannot be resolved as a single traumatic experience.
  3. A ‘primary injunction’ is imposed on the subject by the others generally in one of two forms:
    • (a) “Do X, or I will punish you”; or
    • (b) “Do not do X, or I will punish you.”
    • The punishment may include the withdrawing of love, the expression of hate and anger, or abandonment resulting from the authority figure’s expression of helplessness.
  4. A ‘secondary injunction’ is imposed on the subject, conflicting with the first at a higher and more abstract level. For example: “You must do X, but only do it because you want to.” It is unnecessary for this injunction to be expressed verbally.
  5. If necessary, a ‘tertiary injunction’ is imposed on the subject to prevent them from escaping the dilemma.
    • See phrase examples below for clarification.
  6. Finally, Bateson states that the complete list of the previous requirements may be unnecessary, in the event that the subject is already viewing their world in double bind patterns. Bateson goes on to give the general characteristics of such a relationship:
    • When the subject is involved in an intense relationship; that is, a relationship in which he feels it is vitally important that he discriminate accurately what sort of message is being communicated so that he may respond appropriately;
    • And, the subject is caught in a situation in which the other person in the relationship is expressing two orders of message and one of these denies the other;
    • And, the subject is unable to comment on the messages being expressed to correct his discrimination of what order of message to respond to: i.e., he cannot make a metacommunicative statement.

Thus, the essence of a double bind is two conflicting demands, each on a different logical level, neither of which can be ignored or escaped. This leaves the subject torn both ways, so that whichever demand they try to meet, the other demand cannot be met. “I must do it, but I can’t do it” is a typical description of the double-bind experience.

For a double bind to be effective, the subject must be unable to confront or resolve the conflict between the demand placed by the primary injunction and that of the secondary injunction. In this sense, the double bind differentiates itself from a simple contradiction to a more inexpressible internal conflict, where the subject really wants to meet the demands of the primary injunction, but fails each time through an inability to address the situation’s incompatibility with the demands of the secondary injunction. Thus, subjects may express feelings of extreme anxiety in such a situation, as they attempt to fulfil the demands of the primary injunction albeit with obvious contradictions in their actions.

This was a problem in United States legal circles prior to the Fifth Amendment to the United States Constitution being applied to state action. A person could be subpoenaed to testify in a federal case and given Fifth Amendment immunity for testimony in that case. However, since the immunity did not apply to a state prosecution, the person could refuse to testify at the Federal level despite being given immunity, thus subjecting the person to imprisonment for contempt of court, or the person could testify, and the information they were forced to give in the Federal proceeding could then be used to convict the person in a state proceeding.

Brief History

The term double bind was first used by the anthropologist Gregory Bateson and his colleagues (including Don D. Jackson, Jay Haley and John H. Weakland) in the mid-1950s in their discussions on complexity of communication in relation to schizophrenia. Bateson made clear that such complexities are common in normal circumstances, especially in “play, humour, poetry, ritual and fiction” (see Logical Types below). Their findings indicated that the tangles in communication often diagnosed as schizophrenia are not necessarily the result of an organic brain dysfunction. Instead, they found that destructive double binds were a frequent pattern of communication among families of patients, and they proposed that growing up amidst perpetual double binds could lead to learned patterns of confusion in thinking and communication.

Complexity in Communication

Human communication is complex, and context is an essential part of it. Communication consists of the words said, tone of voice, and body language. It also includes how these relate to what has been said in the past; what is not said, but is implied; how these are modified by other nonverbal cues, such as the environment in which it is said, and so forth. For example, if someone says “I love you”, one takes into account who is saying it, their tone of voice and body language, and the context in which it is said. It may be a declaration of passion or a serene reaffirmation, insincere and/or manipulative, an implied demand for a response, a joke, its public or private context may affect its meaning, and so forth.

Conflicts in communication are common and often we ask “What do you mean?” or seek clarification in other ways. This is called meta-communication: communication about the communication. Sometimes, asking for clarification is impossible. Communication difficulties in ordinary life often occur when meta-communication and feedback systems are lacking or inadequate or there is not enough time for clarification.

Double binds can be extremely stressful and become destructive when one is trapped in a dilemma and punished for finding a way out. But making the effort to find the way out of the trap can lead to emotional growth.

Examples

The classic example given of a negative double bind is of a mother telling her child that she loves them, while at the same time turning away in disgust, or inflicting corporal punishment as discipline: the words are socially acceptable; the body language is in conflict with it. The child does not know how to respond to the conflict between the words and the body language and, because the child is dependent on the mother for basic needs, they are in a quandary. Small children have difficulty articulating contradictions verbally and can neither ignore them nor leave the relationship.

Another example is when one is commanded to “be spontaneous”. The very command contradicts spontaneity, but it only becomes a double bind when one can neither ignore the command nor comment on the contradiction. Often, the contradiction in communication is not apparent to bystanders unfamiliar with previous communications.

Phrase Examples

  • An example from Gerald M. Weinberg in a non-family situation…. “I suggest you find someone who you feel is more capable in this role”.
    • This requires the recipient to either confirm that the current incumbent in the role is sufficiently capable, or accept that they choose someone else based on their feelings – not an objective assessment of whether the incumbent is capable.
  • Mother telling her child: “You must love me”.
  • The primary injunction here is the command itself: “you must”; the secondary injunction is the unspoken reality that love is spontaneous, that for the child to love the mother genuinely, it can only be of their own accord.
  • Child-abuser to child: “You should have escaped from me earlier, now it’s too late—because now, nobody will believe that you didn’t want what I have done”, while at the same time blocking all of the child’s attempts to escape.
  • Child-abusers often start the double-bind relationship by “grooming” the child, giving little concessions, or gifts or privileges to them, thus the primary injunction is: “You should like what you are getting from me!”
  • When the child begins to go along (i.e. begins to like what they are receiving from the person), then the interaction goes to the next level and small victimisation occurs, with the secondary injunction being: “I am punishing you! (for whatever reason the child-abuser is coming up with, e.g. “because you were bad/naughty/messy”, or “because you deserve it”, or “because you made me do it”, etc.).
  • If child shows any resistance (or tries to escape) from the abuser, then the words: “You should have escaped from me earlier (…)” serve as the third level or tertiary injunction.
  • Then the loop starts to feed on itself, allowing for ever worse victimisation to occur.
  • Mother to son: “Leave your sister alone!”, while the son knows his sister will approach and antagonize him to get him into trouble.
  • The primary injunction is the command, which he will be punished for breaking.
    • The secondary injunction is the knowledge that his sister will get into conflict with him, but his mother will not know the difference and will default to punishing him.
    • He may be under the impression that if he argues with his mother, he may be punished.
    • One possibility for the son to escape this double bind is to realise that his sister only antagonises him to make him feel anxious (if indeed it is the reason behind his sister’s behaviour).
  • If he were not bothered about punishment, his sister might not bother him.
    • He could also leave the situation entirely, avoiding both the mother and the sister.
    • The sister can not claim to be bothered by a non-present brother, and the mother can not punish (or scapegoat) a non-present son.
    • Other solutions exist too, which are based on the creative application of logic and reasoning.
  • An apt reply would be: “Please tell sis the same”. If mother wants to ‘scapegoat’ him, her response will be negative.
    • The command has a negative undertone towards the son.

Positive Double Binds

Bateson also described positive double binds, both in relation to Zen Buddhism with its path of spiritual growth, and the use of therapeutic double binds by psychiatrists to confront their patients with the contradictions in their life in such a way that would help them heal. One of Bateson’s consultants, Milton H. Erickson (5 volumes, edited by Rossi) eloquently demonstrated the productive possibilities of double binds through his own life, showing the technique in a brighter light.

The Science

One of the causes of double binds is the loss of feedback systems. Gregory Bateson and Lawrence S. Bale describe double binds that have arisen in science that have caused decades-long delays of progress in science because the scientific community had defined something as outside of its scope (or as “not science”) – see Bateson in his Introduction to Steps to an Ecology of Mind (1972, 2000), pp.xv–xxvi; and Bale in his article, Gregory Bateson, Cybernetics and the Social/Behavioural Sciences (esp. pp.1-8) on the paradigm of classical science vs. that of systems theory/cybernetics. (See also Bateson’s description in his Forward of how the double bind hypothesis fell into place).

Work by Bateson

Schizophrenia

The Double Bind Theory was first articulated in relationship to schizophrenia, but Bateson and his colleagues hypothesized that schizophrenic thinking was not necessarily an inborn mental disorder but a learned confusion in thinking.

It is helpful to remember the context in which these ideas were developed. Bateson and his colleagues were working in the Veteran’s Administration Hospital (1949-1962) with World War II veterans. As soldiers they’d been able to function well in combat, but the effects of life-threatening stress had affected them. At that time, 18 years before Post-Traumatic Stress Disorder was officially recognised, the veterans had been saddled with the catch-all diagnosis of schizophrenia. Bateson did not challenge the diagnosis but he did maintain that the seeming nonsense the patients said at times did make sense within context, and he gives numerous examples in section III of Steps to an Ecology of Mind, “Pathology in Relationship”. For example, a patient misses an appointment, and when Bateson finds him later the patient says ‘the judge disapproves’; Bateson responds, “You need a defense lawyer”. Bateson also surmised that people habitually caught in double binds in childhood would have greater problems – that in the case of the schizophrenic, the double bind is presented continually and habitually within the family context from infancy on. By the time the child is old enough to have identified the double bind situation, it has already been internalised, and the child is unable to confront it. The solution then is to create an escape from the conflicting logical demands of the double bind, in the world of the delusional system.

One solution to a double bind is to place the problem in a larger context, a state Bateson identified as Learning III, a step up from Learning II (which requires only learned responses to reward/consequence situations). In Learning III, the double bind is contextualized and understood as an impossible no-win scenario so that ways around it can be found.

Bateson’s double bind theory was never followed up by research into whether family systems imposing systematic double binds might be a cause of schizophrenia. This complex theory has been only partly tested, and there are gaps in the current psychological and experimental evidence required to establish causation. The current understanding of schizophrenia emphasizes the robust scientific evidence for a genetic predisposition to the disorder, with psychosocial stressors, including dysfunctional family interaction patterns, as secondary causative factors in some instances.

Evolution

After many years of research into schizophrenia, Bateson continued to explore problems of communication and learning, first with dolphins, and then with the more abstract processes of evolution. Bateson emphasised that any communicative system characterized by different logical levels might be subject to double bind problems. Especially including the communication of characteristics from one generation to another (genetics and evolution).

“…evolution always followed the pathways of viability. As Lewis Carroll has pointed out, the theory [of natural selection] explains quite satisfactorily why there are no bread-and-butter-flies today.”

Bateson used the fictional Bread and Butter Fly (from Through the Looking Glass, and What Alice Found There) to illustrate the double bind in terms of natural selection. The gnat points out that the insect would be doomed if he found his food (which would dissolve his own head, since this insect’s head is made of sugar, and his only food is tea), and starve if he did not. Alice suggests that this must happen quite often, to which the gnat replies: “It always happens.”

The pressures that drive evolution therefore represent a genuine double bind. And there is truly no escape: “It always happens.” No species can escape natural selection, including our own.

Bateson suggested that all evolution is driven by the double bind, whenever circumstances change: If any environment becomes toxic to any species, that species will die out unless it transforms into another species, in which case, the species becomes extinct anyway.

Most significant here is Bateson’s exploration of what he later came to call ‘the pattern that connects’ – that problems of communication which span more than one level (e.g. the relationship between the individual and the family) should also be expected to be found spanning other pairs of levels in the hierarchy (e.g. the relationship between the genotype and the phenotype):

“We are very far, then, from being able to pose specific questions for the geneticist; but I believe that the wider implications of what I have been saying modify somewhat the philosophy of genetics. Our approach to the problems of schizophrenia by way of a theory of levels or logical types has disclosed first that the problems of adaptation and learning and their pathologies must be considered in terms of a hierarchic system in which stochastic change occurs at the boundary points between the segments of the hierarchy. We have considered three such regions of stochastic change—the level of genetic mutation, the level of learning, and the level of change in family organization. We have disclosed the possibility of a relationship of these levels which orthodox genetics would deny, and we have disclosed that at least in human societies the evolutionary system consists not merely in the selective survival of those persons who happen to select appropriate environments but also in the modification of family environment in a direction which might enhance the phenotypic and genotypic characteristics of the individual members.”

Girard’s Mimetic Double Bind

René Girard, in his literary theory of mimetic desire, proposes what he calls a “model-obstacle”, a role model who demonstrates an object of desire and yet, in possessing that object, becomes a rival who obstructs fulfilment of the desire. According to Girard, the “internal mediation” of this mimetic dynamic “operates along the same lines as what Gregory Bateson called the ‘double bind’.” Girard found in Sigmund Freud’s psychoanalytic theory, a precursor to mimetic desire. “The individual who ‘adjusts’ has managed to relegate the two contradictory injunctions of the double bind—to imitate and not to imitate—to two different domains of application. This is, he divides reality in such a way as to neutralize the double bind.” While critical of Freud’s doctrine of the unconscious mind, Girard sees the ancient Greek tragedy, Oedipus Rex, and key elements of Freud’s Oedipus complex, patricidal and incestuous desire, to serve as prototypes for his own analysis of the mimetic double bind.

Far from being restricted to a limited number of pathological cases, as American theoreticians suggest, the double bind – a contradictory double imperative, or rather a whole network of contradictory imperatives – is an extremely common phenomenon. In fact, it is so common that it might be said to form the basis of all human relationships.

Bateson is undoubtedly correct in believing that the effects of the double bind on the child are particularly devastating. All the grown-up voices around him, beginning with those of the father and mother (voices which, in our society at least, speak for the culture with the force of established authority) exclaim in a variety of accents, “Imitate us!” “Imitate me!” “I bear the secret of life, of true being!” The more attentive the child is to these seductive words, and the more earnestly he responds to the suggestions emanating from all sides, the more devastating will be the eventual conflicts. The child possesses no perspective that will allow him to see things as they are. He has no basis for reasoned judgements, no means of foreseeing the metamorphosis of his model into a rival. This model’s opposition reverberates in his mind like a terrible condemnation; he can only regard it as an act of excommunication. The future orientation of his desires – that is, the choice of his future models – will be significantly affected by the dichotomies of his childhood. In fact, these models will determine the shape of his personality.

If desire is allowed its own bent, its mimetic nature will almost always lead it into a double bind. The unchanneled mimetic impulse hurls itself blindly against the obstacle of a conflicting desire. It invites its own rebuffs and these rebuffs will in turn strengthen the mimetic inclination. We have, then, a self-perpetuating process, constantly increasing in simplicity and fervor. Whenever the disciple borrows from his model what he believes to be the “true” object, he tries to possess that truth by desiring precisely what this model desires. Whenever he sees himself closest to the supreme goal, he comes into violent conflict with a rival. By a mental shortcut that is both eminently logical and self-defeating, he convinces himself that the violence itself is the most distinctive attribute of this supreme goal! Ever afterward, violence will invariably awaken desire… (René Girard, Violence and the Sacred: “From Mimetic Desire to the Monstrous Double”, pp.156-157).

Neuro-Linguistic Programming

The field of Neuro-Linguistic Programming (NLP) also makes use of the expression “double bind”. Grinder and Bandler (both of whom had personal contact with Bateson and Erickson) asserted that a message could be constructed with multiple messages, whereby the recipient of the message is given the impression of choice – although both options have the same outcome at a higher level of intention. This is called a “double bind” in NLP terminology, and has applications in both sales and therapy. In therapy, the practitioner may seek to challenge destructive double binds that limit the client in some way and may also construct double binds in which both options have therapeutic consequences. In a sales context, the speaker may give the respondent the illusion of choice between two possibilities. For example, a salesperson might ask: “Would you like to pay cash or by credit card?”, with both outcomes presupposing that the person will make the purchase; whereas the third option (that of not buying) is intentionally excluded from the spoken choices.

Note that in the NLP context, the use of the phrase “double bind” does not carry the primary definition of two conflicting messages; it is about creating a false sense of choice which ultimately binds to the intended outcome. In the “cash or credit card?” example, this is not a “Bateson double bind” since there is no contradiction, although it still is an “NLP double bind”. Similarly if a salesman were selling a book about the evils of commerce, it could perhaps be a “Bateson double bind” if the buyer happened to believe that commerce was evil, yet felt compelled or obliged to buy the book.

What is Coping (Psychology)?

Published on by Andrew Marshall7 Comments

Introduction

Coping means to invest one’s own conscious effort, to solve personal and interpersonal problems, in order to try to master, minimise or tolerate stress and conflict.

The psychological coping mechanisms are commonly termed coping strategies or coping skills. The term coping generally refers to adaptive (constructive) coping strategies, that is, strategies which reduce stress. In contrast, other coping strategies may be coined as maladaptive, if they increase stress. Maladaptive coping is therefore also described, based on its outcome, as non-coping. Furthermore, the term coping generally refers to reactive coping, i.e. the coping response which follows the stressor. This differs from proactive coping, in which a coping response aims to neutralise a future stressor. Subconscious or unconscious strategies (e.g. defence mechanisms) are generally excluded from the area of coping.

The effectiveness of the coping effort depends on the type of stress, the individual, and the circumstances. Coping responses are partly controlled by personality (habitual traits), but also partly by the social environment, particularly the nature of the stressful environment.

Types of Coping Strategies

Hundreds of coping strategies have been identified. Classification of these strategies into a broader architecture has not been agreed upon. Researchers try to group coping responses rationally, empirically by factor analysis, or through a blend of both techniques. In the early days, Folkman and Lazarus split the coping strategies into four groups, namely problem-focused, emotion-focused, support-seeking, and meaning-making coping. Weiten has identified four types of coping strategies:

  1. Appraisal-focused (adaptive cognitive);
  2. Problem-focused (adaptive behavioural);
  3. Emotion-focused; and
  4. Occupation-focused coping.

Billings and Moos added avoidance coping as one of the emotion-focused coping. Some scholars have questioned the psychometric validity of forced categorisation as those strategies are not independent to each other. Besides, in reality, people can adopt multiple coping strategies simultaneously.

Typically, people use a mixture of several coping strategies, which may change over time. All these strategies can prove useful, but some claim that those using problem-focused coping strategies will adjust better to life. Problem-focused coping mechanisms may allow an individual greater perceived control over their problem, whereas emotion-focused coping may sometimes lead to a reduction in perceived control (maladaptive coping).

Lazarus “notes the connection between his idea of ‘defensive reappraisals’ or cognitive coping and Freud’s concept of ‘ego-defenses'”, coping strategies thus overlapping with a person’s defence mechanisms.

Appraisal-Focused Coping Strategies

Appraisal-focused (adaptive cognitive) strategies occur when the person modifies the way they think, for example: employing denial, or distancing oneself from the problem. People may alter the way they think about a problem by altering their goals and values, such as by seeing the humour in a situation: “some have suggested that humor may play a greater role as a stress moderator among women than men”.

Adaptive Behavioural Coping Strategies

People using problem-focused strategies try to deal with the cause of their problem. They do this by finding out information on the problem and learning new skills to manage the problem. Problem-focused coping is aimed at changing or eliminating the source of the stress. The three problem-focused coping strategies identified by Folkman and Lazarus are: taking control, information seeking, and evaluating the pros and cons. However, problem-focused coping may not be necessarily adaptive, especially in the uncontrollable case that one cannot make the problem go away.

Emotion-Focused Coping Strategies

Emotion-focused strategies involve:

  • Releasing pent-up emotions.
  • Distracting oneself.
  • Managing hostile feelings.
  • Meditating.
  • Mindfulness practices.
  • Using systematic relaxation procedures.

Emotion-focused coping “is oriented toward managing the emotions that accompany the perception of stress”. The five emotion-focused coping strategies identified by Folkman and Lazarus are:

  • Disclaiming.
  • Escape-avoidance.
  • Accepting responsibility or blame.
  • Exercising self-control.
  • Positive reappraisal.

Emotion-focused coping is a mechanism to alleviate distress by minimizing, reducing, or preventing, the emotional components of a stressor. This mechanism can be applied through a variety of ways, such as:

  • Seeking social support.
  • Reappraising the stressor in a positive light.
  • Accepting responsibility.
  • Using avoidance.
  • Exercising self-control.
  • Distancing.

The focus of this coping mechanism is to change the meaning of the stressor or transfer attention away from it. For example, reappraising tries to find a more positive meaning of the cause of the stress in order to reduce the emotional component of the stressor. Avoidance of the emotional distress will distract from the negative feelings associated with the stressor. Emotion-focused coping is well suited for stressors that seem uncontrollable (e.g. a terminal illness diagnosis, or the loss of a loved one). Some mechanisms of emotion focused coping, such as distancing or avoidance, can have alleviating outcomes for a short period of time, however they can be detrimental when used over an extended period. Positive emotion-focused mechanisms, such as seeking social support, and positive re-appraisal, are associated with beneficial outcomes. Emotional approach coping is one form of emotion-focused coping in which emotional expression and processing is used to adaptively manage a response to a stressor. Other examples include relaxation training through deep breathing, meditation, yoga, music and art therapy, and aromatherapy, as well as grounding, which uses physical sensations or mental distractions to refocus from the stressor to present.

Reactive and Proactive Coping

Most coping is reactive in that the coping is in response to stressors. Anticipating and reacting to a future stressor is known as proactive coping or future-oriented coping. Anticipation is when one reduces the stress of some difficult challenge by anticipating what it will be like and preparing for how one is going to cope with it.

Social Coping

Social coping recognises that individuals are bedded within a social environment, which can be stressful, but also is the source of coping resources, such as seeking social support from others.

Humour

Humour used as a positive coping strategy may have useful benefits in relation to mental health and well-being. By having a humorous outlook on life, stressful experiences can be and are often minimised.

This coping method corresponds with positive emotional states and is known to be an indicator of mental health. Physiological processes are also influenced within the exercise of humour. For example, laughing may reduce muscle tension, increase the flow of oxygen to the blood, exercise the cardiovascular region, and produce endorphins in the body.

Using humour in coping while processing through feelings can vary depending on life circumstance and individual humour styles. In regards to grief and loss in life occurrences, it has been found that genuine laughs/smiles when speaking about the loss predicted later adjustment and evoked more positive responses from other people. A person of the deceased family member may resort to making jokes of when the deceased person used to give unwanted “wet willies” (term used for when a person sticks their finger inside their mouth then inserts the finger into another person’s ear) to any unwilling participant. A person might also find comedic relief with others around irrational possible outcomes for the deceased funeral service.

It is also possible that humour would be used by people to feel a sense of control over a more powerless situation and used as way to temporarily escape a feeling of helplessness. Exercised humour can be a sign of positive adjustment as well as drawing support and interaction from others around the loss.

Negative Techniques (Maladaptive Coping or Non-Coping)

Whereas adaptive coping strategies improve functioning, a maladaptive coping technique (also termed non-coping) will just reduce symptoms while maintaining or strengthening the stressor. Maladaptive techniques are only effective as a short-term rather than long-term coping process.

Examples of maladaptive behaviour strategies include dissociation, sensitization, safety behaviours, anxious avoidance, rationalisation and escape (including self-medication).

These coping strategies interfere with the person’s ability to unlearn, or break apart, the paired association between the situation and the associated anxiety symptoms. These are maladaptive strategies as they serve to maintain the disorder.

Dissociation is the ability of the mind to separate and compartmentalise thoughts, memories, and emotions. This is often associated with post traumatic stress syndrome.

Sensitization is when a person seeks to learn about, rehearse, and/or anticipate fearful events in a protective effort to prevent these events from occurring in the first place.

Safety behaviours are demonstrated when individuals with anxiety disorders come to rely on something, or someone, as a means of coping with their excessive anxiety.

Rationalisation is the practice of attempting to use reasoning to minimise the severity of an incident, or avoid approaching it in ways that could cause psychological trauma or stress. It most commonly manifests in the form of making excuses for the behaviour of the person engaging in the rationalisation, or others involved in the situation the person is attempting to rationalise.

Anxious avoidance is when a person avoids anxiety provoking situations by all means. This is the most common method.

Escape is closely related to avoidance. This technique is often demonstrated by people who experience panic attacks or have phobias. These people want to flee the situation at the first sign of anxiety.

Further Examples

Further examples of coping strategies include emotional or instrumental support, self-distraction, denial, substance use, self-blame, behavioural disengagement and the use of drugs or alcohol.

Many people think that meditation “not only calms our emotions, but…makes us feel more ‘together'”, as too can “the kind of prayer in which you’re trying to achieve an inner quietness and peace”.

Low-effort syndrome or low-effort coping refers to the coping responses of a person refusing to work hard. For example, a student at school may learn to put in only minimal effort as they believe if they put in effort it could unveil their flaws.

Historical Psychoanalytic Theories

Otto Fenichel

Otto Fenichel summarised early psychoanalytic studies of coping mechanisms in children as “a gradual substitution of actions for mere discharge reactions…[&] the development of the function of judgement” – noting however that “behind all active types of mastery of external and internal tasks, a readiness remains to fall back on passive-receptive types of mastery.”

In adult cases of “acute and more or less ‘traumatic’ upsetting events in the life of normal persons”, Fenichel stressed that in coping, “in carrying out a ‘work of learning’ or ‘work of adjustment’, [s]he must acknowledge the new and less comfortable reality and fight tendencies towards regression, towards the misinterpretation of reality”, though such rational strategies “may be mixed with relative allowances for rest and for small regressions and compensatory wish fulfillment, which are recuperative in effect”.

Karen Horney

In the 1940s, the German Freudian psychoanalyst Karen Horney “developed her mature theory in which individuals cope with the anxiety produced by feeling unsafe, unloved, and undervalued by disowning their spontaneous feelings and developing elaborate strategies of defence.” Horney defined four so-called coping strategies to define interpersonal relations, one describing psychologically healthy individuals, the others describing neurotic states.

The healthy strategy she termed “Moving with” is that with which psychologically healthy people develop relationships. It involves compromise. In order to move with, there must be communication, agreement, disagreement, compromise, and decisions. The three other strategies she described – “Moving toward”, “Moving against” and “Moving away” – represented neurotic, unhealthy strategies people utilise in order to protect themselves.

Horney investigated these patterns of neurotic needs (compulsive attachments). The neurotics might feel these attachments more strongly because of difficulties within their lives. If the neurotic does not experience these needs, they will experience anxiety. The ten needs are:

  • Affection and approval, the need to please others and be liked.
  • A partner who will take over one’s life, based on the idea that love will solve all of one’s problems.
  • Restriction of one’s life to narrow borders, to be undemanding, satisfied with little, inconspicuous; to simplify one’s life.
  • Power, for control over others, for a façade of omnipotence, caused by a desperate desire for strength and dominance.
  • Exploitation of others; to get the better of them.
  • Social recognition or prestige, caused by an abnormal concern for appearances and popularity.
  • Personal admiration.
  • Personal achievement.
  • Self-sufficiency and independence.
  • Perfection and unassailability, a desire to be perfect and a fear of being flawed.

In Compliance, also known as “Moving toward” or the “Self-effacing solution”, the individual moves towards those perceived as a threat to avoid retribution and getting hurt, “making any sacrifice, no matter how detrimental.” The argument is, “If I give in, I won’t get hurt.” This means that: if I give everyone I see as a potential threat whatever they want, I won’t be injured (physically or emotionally). This strategy includes neurotic needs one, two, and three.

In Withdrawal, also known as “Moving away” or the “Resigning solution”, individuals distance themselves from anyone perceived as a threat to avoid getting hurt – “the ‘mouse-hole’ attitude … the security of unobtrusiveness.” The argument is, “If I do not let anyone close to me, I won’t get hurt.” A neurotic, according to Horney desires to be distant because of being abused. If they can be the extreme introvert, no one will ever develop a relationship with them. If there is no one around, nobody can hurt them. These “moving away” people fight personality, so they often come across as cold or shallow. This is their strategy. They emotionally remove themselves from society. Included in this strategy are neurotic needs three, nine, and ten.

In Aggression, also known as the “Moving against” or the “Expansive solution”, the individual threatens those perceived as a threat to avoid getting hurt. Children might react to parental in-differences by displaying anger or hostility. This strategy includes neurotic needs four, five, six, seven, and eight.

Related to the work of Karen Horney, public administration scholars[40] developed a classification of coping by frontline workers when working with clients (see also the work of Michael Lipsky on street-level bureaucracy). This coping classification is focused on the behavior workers can display towards clients when confronted with stress. They show that during public service delivery there are three main families of coping:

  • Moving towards clients:
    • Coping by helping clients in stressful situations.
    • An example is a teacher working overtime to help students.
  • Moving away from clients:
    • Coping by avoiding meaningful interactions with clients in stressful situations.
    • An example is a public servant stating “the office is very busy today, please return tomorrow.”
  • Moving against clients:
    • Coping by confronting clients.
    • For instance, teachers can cope with stress when working with students by imposing very rigid rules, such as no phone use in class and sending everyone to the office when they use a phone.
    • Furthermore, aggression towards clients is also included here.

In their systematic review of 35 years of the literature, the scholars found that the most often used family is moving towards clients (43% of all coping fragments). Moving away from clients was found in 38% of all coping fragments and Moving against clients in 19%.

Heinz Hartmann

In 1937, the psychoanalyst (as well as a physician, psychologist, and psychiatrist) Heinz Hartmann marked it as the evolution of ego psychology by publishing his paper, “Me” (which was later translated into English in 1958, titled, “The Ego and the Problem of Adaptation”). Hartmann focused on the adaptive progression of the ego “through the mastery of new demands and tasks”. In fact, according to his adaptive point of view, once infants were born they have the ability to be able to cope with the demands of their surroundings. In his wake, ego psychology further stressed “the development of the personality and of ‘ego-strengths’…adaptation to social realities”.

Object Relations

Emotional intelligence has stressed the importance of “the capacity to soothe oneself, to shake off rampant anxiety, gloom, or irritability….People who are poor in this ability are constantly battling feelings of distress, while those who excel in it can bounce back far more quickly from life’s setbacks and upsets”. From this perspective, “the art of soothing ourselves is a fundamental life skill; some psychoanalytic thinkers, such as John Bowlby and D. W. Winnicott see this as the most essential of all psychic tools.”

Object relations theory has examined the childhood development both of “[i]ndependent coping…capacity for self-soothing”, and of “[a]ided coping. Emotion-focused coping in infancy is often accomplished through the assistance of an adult.”

Gender Differences

Gender differences in coping strategies are the ways in which men and women differ in managing psychological stress. There is evidence that males often develop stress due to their careers, whereas females often encounter stress due to issues in interpersonal relationships. Early studies indicated that “there were gender differences in the sources of stressors, but gender differences in coping were relatively small after controlling for the source of stressors”; and more recent work has similarly revealed “small differences between women’s and men’s coping strategies when studying individuals in similar situations.”

In general, such differences as exist indicate that women tend to employ emotion-focused coping and the “tend-and-befriend” response to stress, whereas men tend to use problem-focused coping and the “fight-or-flight” response, perhaps because societal standards encourage men to be more individualistic, while women are often expected to be interpersonal. An alternative explanation for the aforementioned differences involves genetic factors. The degree to which genetic factors and social conditioning influence behaviour, is the subject of ongoing debate.

Physiological Basis

Hormones also play a part in stress management. Cortisol, a stress hormone, was found to be elevated in males during stressful situations. In females, however, cortisol levels were decreased in stressful situations, and instead, an increase in limbic activity was discovered. Many researchers believe that these results underlie the reasons why men administer a fight-or-flight reaction to stress; whereas, females have a tend-and-befriend reaction. The “fight-or-flight” response activates the sympathetic nervous system in the form of increased focus levels, adrenaline, and epinephrine. Conversely, the “tend-and-befriend” reaction refers to the tendency of women to protect their offspring and relatives. Although these two reactions support a genetic basis to differences in behaviour, one should not assume that in general females cannot implement “fight-or-flight” behaviour or that males cannot implement “tend-and-befriend” behaviour. Additionally, this study implied differing health impacts for each gender as a result of the contrasting stress-processes.

What is Defence Mechanism?

Published on by Andrew Marshall42 Comments

Introduction

In psychoanalytic theory, a defence mechanism is an unconscious psychological mechanism that reduces anxiety arising from unacceptable or potentially harmful stimuli.

Defence mechanisms may result in healthy or unhealthy consequences depending on the circumstances and frequency with which the mechanism is used. Defence mechanisms (German: Abwehrmechanismen) are psychological strategies brought into play by the unconscious mind 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. 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; identification, incorporating an object or thought into oneself; and rationalisation, the justification of one’s behaviour and motivations by substituting “good” acceptable reasons for the actual motivations. In psychoanalytic theory, repression is considered the basis for other defence mechanisms.

Healthy people normally use different defence mechanisms throughout life. A 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.

One resource used to evaluate these mechanisms is the Defence Style Questionnaire (DSQ-40) (see here for online version).

Refer to Coping (Psychology).

Theories and Classifications

Different theorists have different categorisations and conceptualisations of defence mechanisms. Large reviews of theories of defence mechanisms are available from Paulhus, Fridhandler and Hayes (1997) and Cramer (1991). The Journal of Personality published a special issue on defence mechanisms (1998).

In the first definitive book on defence mechanisms, The Ego and the Mechanisms of Defence (1936), Anna Freud enumerated the ten defence mechanisms that appear in the works of her father, Sigmund Freud: repression, regression, reaction formation, isolation, undoing, projection, introjection, turning against one’s own person, reversal into the opposite, and sublimation or displacement.

Sigmund Freud posited that defence mechanisms work by distorting id impulses into acceptable forms, or by unconscious or conscious blockage of these impulses. Anna Freud considered defence mechanisms as intellectual and motor automatisms of various degrees of complexity, that arose in the process of involuntary and voluntary learning.

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”. The signalling function of anxiety was 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.

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 manage the stress of a social situation.

  • 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”.
  • Projection: possessing a feeling that is deemed as socially unacceptable and instead of facing it, that feeling or “unconscious urge” is seen in the actions of other people.
  • 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.
  • Sublimation: seen as the most acceptable of the mechanisms, an expression of anxiety in socially acceptable ways.

Otto F. Kernberg (1967) developed a theory of borderline personality organisation of which one consequence may be borderline personality disorder. His theory is based on ego psychological object relations theory. Borderline personality organisation 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 organisation. 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.

In George Eman Vaillant’s (1977) categorisation, defences form a continuum related to their psychoanalytical developmental level. 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 intellectualisation to anticipation (and obsessionality).

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

Vaillant’s Categorisation

Psychiatrist George Eman Vaillant introduced a four-level classification of defence mechanisms: Much of this is derived from his observations while overseeing the Grant study that began in 1937 and is on-going. In monitoring a group of men from their freshman year at Harvard until their deaths, the purpose of the study was to see longitudinally what psychological mechanisms proved to have impact over the course of a lifetime. The hierarchy was seen to correlate well with the capacity to adapt to life. His most comprehensive summary of the on-going study was published in 1977.The focus of the study is to define mental health rather than disorder.

  • Level 1: Pathological defences (psychotic denial, delusional projection).
  • Level 2: Immature defences (fantasy, projection, passive aggression, acting out).
  • Level 3: Neurotic defences (intellectualisation, reaction formation, dissociation, displacement, repression).
  • Level 4: Mature defences (humour, sublimation, suppression, altruism, anticipation).

Level 1: Pathological

When predominant, the mechanisms on this level are almost always severely pathological. These 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 “pathological” defences, common in overt psychosis. However, they are normally found in dreams and throughout childhood as well. 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 does not 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. They include:

  • Acting out: Direct expression of an unconscious wish or impulse in action, without conscious awareness of the emotion that drives the expressive behaviour.
  • Hypochondriasis: An excessive preoccupation or worry about having a serious illness.
  • Passive-aggressive behaviour: 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. 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.
  • 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.
  • Intellectualisation: 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 (solitude, rationalisation, 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; 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.

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 are conscious processes, 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. 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.
  • 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

Pathological

  • Conversion:
    • The expression of an intrapsychic conflict as a physical symptom; examples include blindness, deafness, paralysis, or numbness.
    • This phenomenon is sometimes called hysteria.
  • Splitting:
    • A primitive defence.
    • Both harmful and helpful impulses are split off and segregated, 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.

Immature

  • Idealisation:
    • Tending to perceive another individual as having more desirable qualities than he or she may actually have.
  • 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.
  • Projective identification:
    • The object of projection invokes in that person a version of the thoughts, feelings or behaviours projected.
  • Somatisation:
    • 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.
  • Rationalisation (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.
  • 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:
    • Avoidance is a form of defence.
    • It entails removing oneself from events, stimuli, and interactions under the threat of being reminded of painful thoughts and feelings.

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”. In at least one of his books, George Eman Vaillant stated that he “will use the terms adaptation, resilience, coping, and defense interchangeably”.

Refer to Coping (Psychology).

On This Day … 01 April

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People (Births)

  • 1908 – Abraham Maslow, American psychologist and academic (d. 1970).

People (Deaths)

  • 1922 – Hermann Rorschach, Swiss psychologist and author (b. 1884).

Abraham Maslow

Abraham Harold Maslow (01 April 1908 to 08 June 1970) was an American psychologist who was best known for creating Maslow’s hierarchy of needs, a theory of psychological health predicated on fulfilling innate human needs in priority, culminating in self-actualisation.

Maslow was a psychology professor at Brandeis University, Brooklyn College, New School for Social Research, and Columbia University.

He stressed the importance of focusing on the positive qualities in people, as opposed to treating them as a “bag of symptoms”.

A Review of General Psychology survey, published in 2002, ranked Maslow as the tenth most cited psychologist of the 20th century.

Hermann Rorschach

Hermann Rorschach (08 November 1884 to 02 April 1922) was a Swiss psychiatrist and psychoanalyst.

His education in art helped to spur the development of a set of inkblots that were used experimentally to measure various unconscious parts of the subject’s personality. His method has come to be referred to as the Rorschach test, iterations of which have continued to be used over the years to help identify personality, psychotic, and neurological disorders.

Rorschach continued to refine the test until his premature death at age 37.

On This Day … 27 March

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People (Deaths)

  • 1938 – William Stern, German-American psychologist and philosopher (b. 1871).
  • 1946 – Karl Groos, German psychologist and philosopher (b. 1861).
  • 1998 – David McClelland, American psychologist and academic (b. 1917).

William Stern

William Stern (April 29, 1871 to March 27, 1938), born Louis William Stern, was a German psychologist and philosopher. He is known for the development of personalistic psychology, which placed emphasis on the individual by examining measurable personality traits as well as the interaction of those traits within each person to create the self.

Stern also coined the term intelligence quotient, or IQ, and invented the tone variator as a new way to study human perception of sound. Stern studied psychology and philosophy under Hermann Ebbinghaus at the University of Berlin, and quickly moved on to teach at the University of Breslau. Later he was appointed to the position of professor at the University of Hamburg.

Over the course of his career, Stern wrote many books pioneering new fields in psychology such as differential psychology, critical personalism, forensic psychology, and intelligence testing. Stern was also a pioneer in the field of child psychology. Working with his wife, Clara Joeesephy Stern, the couple kept meticulous diaries detailing the lives of their 3 children for 18 years. He used these journals to write several books that offered an unprecedented look into the psychological development of children over time.

Karl Groos

Karl Groos (10 December 1861 to 27 March 1946, in Tübingen) was a philosopher and psychologist who proposed an evolutionary instrumentalist theory of play. His 1898 book on The Play of Animals suggested that play is a preparation for later life.

Groos was full Professor of philosophy in Gießen, Basel and 1911-1929 in Tübingen.

His main idea was that play is basically useful, and so it can be explained by the normal process of evolution by natural selection. When animals ‘play’ they are practising basic instincts, such as fighting, for survival. This is translated from the original as “pre-tuning”. Despite this insight, Groos’ work is seldom read today, and his connection of play with aesthetics has been termed “misguided”. Another area of study was the psychology of literature, including statistical analysis.

Among his scholars is the German philosopher Willy Moog (1888-1935) (doctorate on Goethe supervised by Karl Groos in Gießen 1909).

David McClelland

David Clarence McClelland (20 May 1917 to 27 March 1998) was an American psychologist, noted for his work on motivation Need Theory. He published a number of works between the 1950s and the 1990s and developed new scoring systems for the Thematic Apperception Test (TAT) and its descendants.

McClelland is credited with developing Achievement Motivation Theory, commonly referred to as “need for achievement” or n-achievement theory. A Review of General Psychology survey published in 2002, ranked McClelland as the 15th most cited psychologist of the 20th century.