Resilience in Holocaust Survivors: A Study of Defense Mechanisms in Holocaust Narratives

There is extensive literature examining the psychological adaptation of survivors after the Holocaust, including studies of Holocaust narratives (HN). As a measure of psychological adaptation, defense mechanisms (DM) have been studied in various clinical samples, however, to date, not in Holocaust narratives. Using a standardized observer-rated measure, we assessed DM in Holocaust versus pre/post Holocaust narratives (other narratives [ON]) in 20 in-depth survivor interviews. Regarding individual DM, isolation of affect and self-assertion were statistically more frequent in the HN than the ON. High adaptive (mature) level defenses were more frequent in the HNs than the ON. Furthermore, the overall defensive functioning (ODF) was higher in the HN than the ON, contradicting previous findings showing lower defensive functioning in life-threatening situations. Possible explanations include differences in the nature of trauma, the time elapsed between the trauma and the interview, and the specificity of the sample. A qualitative overview with several examples from the narratives are also presented.     

An empirical approach to the study of defense mechanisms: I. Reliability and preliminary validity of the Rorschach Defense scales

Despite widespread use of the Rorschach for the study of defense mechanisms, few recent Rorschach scales have been developed for the study of defensive functioning. We critically review previous empirical research and describe the Rorschach Defense scales. These scales provide criteria for rating both lower level defense mechanisms, such as splitting and primitive idealization, as well as higher level defenses, such as intellectualization and isolation. The scales utilize a broad range of content including all Rorschach responses, associative content, and verbalization of the tester-patient relationship. Data on interrater reliability and preliminary validity are presented.     

Mental Health and the Prevention of Neurosis by Joachim Flescher

The authors argue that instead of adopting the traditional view that defenses are the “enemy” that impedes therapeutic work, it is generally valuable to conceptualize defense mechanisms as “solutions” to specific intrapsychic or interpersonal conflicts. As such, the defenses offer significant clues to understanding the problems that they presumably alleviate. In the therapy group, the goal of uncovering and interpreting defenses is complicated by the complexity of the source of the defensive operations, either emanating from within the individual patient, the group-as-a-whole, or the group therapist's own countertransference. The group leader must be aware of the three dimensions of defense in order to assist the patients in understanding the effects of their defensive style in both gaining and losing what is sought, promoting insight into the historical incidents that led to the particular defenses, and, finally, facilitating the development of more effective defensive structures.     

Creativity and anxiety: An experimental study

Tested a group of 31 psychiatric patients with anxiety as one of their main symptoms using a percept-genetic (PG) test measuring creativity or willingness to reconstruct subjective interpretations of the stimulus. A control group of 43 from an earlier study was also included. For half of the subjects a threatening motif was presented subliminally during part of the PG series. By means of an interview, an estimation was made of the subjects' urge to create and of the severity of their anxiety. The Meta-Contrast Technique (MCT) was used to describe defenses in the clinical group. Taking into account their urge to be creative, the clinical subjects received relatively few positive scores on the PG test. The subliminal addition to the anxiety level did not facilitate creative functioning as was the case with the normal subjects. The main obstacles to creative functioning seemed to be grave anxiety and rigid defense mechanisms or, to generalize, low tolorance of the anxiety necessarily associated with creative work.     

Defense use and defense understanding in children

This study investigated the relation between children's use of defense mechanisms and their understanding of those defenses. We hypothesized that, once a child understands how a particular defense functions, the use of that defense will no longer be successful and will be replaced by another defense mechanism that is not yet understood. Defense use was assessed from the Thematic Appreception Test (TAT) stories told by 122 children; defense understanding was determined from the children's understanding of stories portraying defenses. The results indicated that younger children (mean age = 7-8) used the defense of denial more than the older children (mean age = 9-11). Older children understood the functioning of denial and projection better than the younger children. A comparison of children who did and did not understand a defense showed that younger children who understood the functioning of denial were less likely to themselves use denial. Likewise, older children who understood the functioning of projection were less likely to use this defense.     

Changing Notions of Defense Within Psychoanalytic Theory

Psychoanalysis began with a focus on how the "intrapsychic" defense mechanisms of the individual helped to reduce and control conflict. More specifically, defenses were seen as helpful in managing the intensity of needs, desires, and affects that inevitably lead to conflict as the individual encounters the needs and desires of others around him. While the earliest theory of defenses focused more on maintaining internal equilibrium, contemporary theories of defense are seen as part of a set of relational and cognitive patterns that develop in the context of close relationships with important others. In the more contemporary psychodynamic approach to defense, many defenses are seen as protecting the self-esteem of an individual rather than axiomatically protecting an individual from becoming conscious of thoughts or ideas that would cause anxiety were they to be remembered or recognized. The shift to more object relational and interpersonal approaches for the understanding of defense has had major implications for clinical treatment, which are examined in this article.     

Development of a Defense Mechanisms Manual for Children’s Doll Play (DMCP)

Researchers have long recognized the richness of children’s fantasy play and the ability of such play to reveal children’s inner worlds and defensive structures. This article describes the development of The Defense Mechanisms Manual for Children’s Doll Play (DMCP), a detailed and comprehensive manual that codes for 32 defense mechanisms in children’s play. The levels of narrative coherence, creativity, and aggression in play narratives are also assessed. The manual draws on contemporary dream theory using the premise that the child narrator will disguise anxiety-provoking impulses through a number of defenses that can be discerned through the choices the child makes in creating the plot of the story. The manual was developed through the analysis of 30 sets of 10 story stems collected from 5- and 6-year-old children using the MacArthur Story Stem Battery, a structured story-completion task. Inter-rater reliability varied with the frequency of occurrence for each defense, ranging from excellent reliability for some measures to too few cases to assess for others. Cluster analyses of measures suggested four main clusters, loosely conceptualized as connecting to others, channeling aggression, avoidance, and symbolization.     

Neural organization of the defensive behavior system responsible for fear

This paper applies the behavior systems approach to fear and defensive behavior, examining the neural circuitry controlling fear and defensive behavior from this vantage point. The defensive behavior system is viewed as having three modes that are activated by different levels of fear. Low levels of fear promote pre-encounter defenses, such as meal-pattern reorganization. Moderate levels of fear activate post-encounter defenses. For the rat, freezing is the dominant post-encounter defensive response. Since this mode of defense is activated by learned fear, forebrain structures such as the amygdala play a critical role in its organization. Projections from the amygdala to the ventral periaqueductal gray activate freezing. Extremely high levels of fear, such as those provoked by physical contact, elicit the vigorous active defenses that compose the circa-strike mode. Midbrain structures such as the dorsolateral periaqueductal gray and the superior colliculus play a crucial role in organizing this mode of defense. Inhibitory interactions between the structures mediating circa-strike and post-encounter defense allow for the rapid switching between defensive modes as the threatening situation varies.     

Defense mechanisms in psychology today. Further processes for adaptation

Although the concept of the defense mechanism was rejected from academic psychology for a number of years, recent empirical studies show renewed interest in defenses. Cognitive psychologists have confirmed the existence of unconscious psychological processes, a requisite for defenses. Developmental, personality, and social psychologists have all found evidence for defense mechanisms that explicate psychological functioning. The relevance of this new information for clinical practice is discussed.     

A content validity study of the defense mechanism inventory

The content validity of the Defense Mechanism Inventory was tested by 20 raters who evaluated each item in terms of which 15 defenses and three ego threats it represented. Items purportedly measuring the global defense categories of principalization, turning against self, and reversal, achieved relatively high rater agreement (over 70%) while projection and turning against Object fared poorly (29% and 39% respectively). Differential content validity was found in the levels and areas of the Inventory, indicating that the context in which items appear affect their representativeness of defensive behaviors. The individual defense mechanisms were disproportionately represented by the Inventory. Ratings suggested that aggressiveness was the major ego threat being measured by the items. Most of the problems appear correctable through rewriting many of the items.     

Parallel-form reliability of the Wechsler Memory Scale in a geriatric population with suspected dementia

The present study examined parallel-form reliability of the Wechsler Memory Scale (WMS) in a population where such forms are particularly useful, that is, among patients who are suspected of having some type of dementing illness. Comparative analyses were made for total raw scores. Memory Quotient (MQ) scores, and individual subtest scores. Thirty geriatric patients originally referred for neuropsychological testing because of suspected dementia were given both Forms 1 and 2 of the WMS. The results yielded high overall reliability coefficients for MQ and total raw scores. Individual subtest scores also yielded rather high coefficients, and only one subtest (Associate Learning) had a significant mean difference. Apparently, the two forms have sufficient parallel-form reliability to be considered clinically interchangeable. Thus, the WMS may be a useful tool for repeat evaluations of memory functioning in a demented population.     

Seven Pillars of Defense Mechanism Theory

Defense mechanisms are cognitive processes that function to protect the individual from excessive anxiety or other negative emotions. They also protect the person from loss of self‐esteem and, in the extreme, the loss of self‐integration. Although past critics questioned the existence of defense mechanisms, recent research has supported seven basic tenets regarding defenses. These include: (1) defenses function outside of awareness; (2) there is a chronology of defense development; (3) defenses are present in the normal personality; (4) defense use increases under conditions of stress; (5) defense use reduces the conscious experience of negative emotions; (6) defense function is connected to the autonomic nervous system; (7) excessive use of defenses is associated with psychopathology. Research supporting the seven pillars of defense mechanism theory is described in this essay.     

A Closer Look at Couple Collusion: Protecting the Self and Preserving the System

Couple collusion is the term used to describe a group of defenses that some spouses use to protect their respective selves and to preserve dyadic equilibrium. Collusive defenses can take a variety of forms, such as conscious agreements, non-verbalized pacts, and unconscious contracts. In this article, the author describes two unconscious collusive defenses: (a) acting out and (b) monitoring and restraining. He offers some suggestions for dealing with these defensive systems in two case studies.     

Sex role attributes, symptom distress, and defensive style among college men and women

Eighty-four male and 90 female college students completed the PRF-Andro masculinity and femininity scales, a symptom checklist, and a defense mechanism inventory. Results indicated that interrelations among sex role attributes, defense preferences, and symptom distress differed for men and women. Cross-sex-typed persons mostly accounted for differences in symptom distress within each sex: Masculine women reported relatively low and feminine men reported relatively high degrees of symptom distress. In addition, sex roles interacted with sex in determining defense preferences. We also explored the possibility that defensive styles mediated between sex role attributes and symptom distress. Among women, an association between masculine attributes and a rejection of self-blaming defenses accounted for the negative relation between masculinity and symptom distress. Among men, sex role attributes and defensive styles, for the most part, contributed independently to symptom distress.     

Defense Mechanisms in Mania,Bipolar Depression and Unipolar Depression

The present study compared the use of defense mechanisms in ten bipolar manic, ten bipolar depressed and ten unipolar depressed patients. The defense mechanisms were assessed by two methods: TAT stories scored by Defense Mechanism Manual and Defense Mechanism Rating Scale ratings of psychodynamic interviews. The severity of symptoms was assessed by Beck Depression Inventory for depressed patients and Young’s Manic Rating Scale for manic patients. Both bipolar manic and depressed groups used the defense mechanism of denial, borderline level defenses and immature defenses significantly more than the unipolar depression group. The manic group showed greater dependence on narcissistic level defenses as compared to the other two groups. Positive relationships were found between severity of manic symptoms and the defense mechanisms of denial as well as the narcissistic level defenses. The bipolar depression group also used more action level defenses as compared to the unipolar depression group. The unipolar depression group scored higher on the defense mechanism of identification and adaptive level defenses as compared to the manic group. A negative correlation was found between the severity of depressive symptoms for unipolar depression group and the defense mechanism of identification. The neurotic level defenses were used most frequently by unipolar depression group, followed by the bipolar depression group and manic group. Some of these findings are in consonance with the psychoanalytic understanding of mania and depression.     

Personal space, anger-arousal, and psychological defense

Personal space was hypothesized to function as a defense mechanism The strength of intrapsychic defense against anger expression was first assessed in 160 college students by the TAT and Word Association Test, and personal space usage was then measured under anger-arousing versus control conditions and under two types of instructions Results were that instructions accounted for a large proportion of the personal space variance, that under one anger-arousing condition some subjects apparently counterattacked by invasion of the experimenter's territory, and that, in that condition, subjects with stronger defenses against anger expression employed larger spatial distances These results suggest that larger distances are used for defensive purposes only under conditions in which closer distances imply impulse expression     

Assessing Level of Personality Organization With the Psychodiagnostic Chart: A Validity Study

Heterogeneity within diagnostic types and comorbidity across diagnostic groups render a specific personality disorder anything but specific, leading researchers and clinicians to increasingly focus on the general severity of personality pathology. Personality pathology severity is reflected in one's level of personality organization (LPO) and research has demonstrated that LPO is a significant predictor of treatment response. This investigation examined the reliability and validity of the Psychodiagnostic Chart (PDC) in assessing the LPO dimension of the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006). Among a sample of 88 urban-dwelling women seeking primary medical care, the LPO dimension of the PDC received fair to good interrater reliability among 6 psychodynamic psychologists. Convergent validity was demonstrated with contrast analysis and individual correlations that yielded statistically significant associations between LPO scores and conceptually related psychodynamic variables (e.g., defensive functioning, object relations) and self-reported personality pathology scores. Support for discriminant validity was limited by the modest power associated with the sample size. Exploratory analyses examining LPO scores and measures of physical health and intimate partner violence were conducted. Our results supported the reliability, validity, and practical use of the LPO dimension of the PDC.     

A preliminary report on defenses and conflicts associated with borderline personality disorder

The authors present preliminary psychodynamic findings from a naturalistic study of borderline personality disorder compared to antisocial personality disorder and bipolar type II (depression with hypomania) affective disorder. An independent psychodynamic interview of each subject was videotaped from which ratings were made of the presence of 22 defense mechanisms and 11 psychodynamic conflicts. A factor analysis of ratings from 81 subjects supported the separation of borderline (splitting, projective identification) from narcissistic defenses (devaluation, omnipotence, idealization, mood-incongruent denial). While certain groups of defenses were associated with each diagnosis, defense ratings did not significantly discriminate the three diagnostic groups, suggesting a limit to their diagnostic value. Among 27 subjects rated, borderline personality was strongly associated with two conflicts: separation-abandonment, and a global conflict over the experience and expression of emotional needs and anger. Antisocial personality was psychodynamically distinct and more heterogeneous. Bipolar type II was associated with two hypothesized depressive conflicts: dominant other and dominant goal. Chronic depression, which was more common in both personality disorder groups than in bipolar type II, was associated with a third depressive conflict, overall gratification inhibition. Overall, conflicts were powerful discriminators of the three diagnostic groups. The heuristic value of these findings is discussed.     

An empirical look at the Defense Mechanism Test (DMT): reliability and construct validity

Although the Defense Mechanism Test (DMT) has been in use for almost half a century, there are still quite contradictory views about whether it is a reliable instrument, and if so, what it really measures. Thus, based on data from 39 female students, we first examined DMT inter-coder reliability by analyzing the agreement among trained judges in their coding of the same DMT protocols. Second, we constructed a "parallel" photographic picture that retained all structural characteristic of the original and analyzed DMT parallel-test reliability. Third, we examined the construct validity of the DMT by (a) employing three self-report defense-mechanism inventories and analyzing the intercorrelations between DMT defense scores and corresponding defenses in these instruments, (b) studying the relationships between DMT responses and scores on trait and state anxiety, and (c) relating DMT-defense scores to measures of self-esteem. The main results showed that the DMT can be coded with high reliability by trained coders, that the parallel-test reliability is unsatisfactory compared to traditional psychometric standards, that there is a certain generalizability in the number of perceptual distortions that people display from one picture to another, and that the construct validation provided meager empirical evidence for the conclusion that the DMT measures what it purports to measure, that is, psychological defense mechanisms.     

Eleventh Annual Meeting of the Society for Projective Techniques

This study assesses the concurrent validity of two Rorschach defense scales designed to identify borderline defensive structure. A Rorschach scale designed by Cooper and his colleagues was systematically compared to a defense scale constructed by Lerner and Lerner. Despite considerable overlap on a conceptual and operational level, the scales are based on divergent theoretical models (developmental arrest and fixation) and Rorschach units of analysis (all responses and human responses). Our results are based on the capacity of each scale to discriminate between independently diagnosed samples (neurotic, outpatient borderline, inpatient borderline, schizophrenic) and the relative discriminatory power of particular defenses within each scale to differentiate between groups.