In this post:
Three categories of defense mechanisms
Seven levels of defense mechanisms in a hierarchy
Psychotic defense mechanisms
Links to measures and additional information
References
By Geoffrey W. Sutton, PhD, 2023
Clinicians and researchers have organized the defenses
in various ways. One long established organization is a seven-part hierarchy
from a High adaptive level of defenses at the top and the lowest level called
the Action Defense Level. See the work of Vaillant (e.g., 1971, 2011) to understand the properties of defense mechanisms and the seven level
hierarchy.
Clinicians and researchers measure defense mechanisms using
The Defense Mechanisms Rating Scales (see Perry, 1990 and Perry &
Bond, 2012). These seven levels were organized into three levels of maturity
reflecting levels of adaptiveness (see for example Di Giuseppe & Perry,
2021).
Below is a description of the seven levels followed by
a listing of the defenses by hierarchical level and within categories (Di
Giuseppe & Perry, 2021). Below the seven levels is a group of six psychotic
defenses presented by Berney and others (2014) who created the Psychotic-DMRS.
SEVEN LEVELS
The seven levels represent a hierarchy of ways people
respond to internal or external stressors.
Level 7.
High-adaptive Defense Level
This level represents positive coping with stress.
There is a realistic and undistorted appraisal of the stressor and one’s
ability to cope. The stressed person may turn to others or other resources for
help.
Level 6: Obsessional Defense Level
In this level, people are aware of undesirable and
stressful feelings associated with an idea or cognition. They respond in ways
to maintain psychological distance from uncomfortable feelings but remain aware
of the thought or idea.
Level 5:
Neurotic Defensive Level
At the neurotic level, people are somewhat aware of an
unacceptable desire, motive, or thought. They experience uncomfortable feelings
but use a variety of ways to block or avoid dealing with the distressing
cognition.
Level 4: Minor
Image-Distorting Defense Level
Minor image-distorting defenses protect one’s
self-esteem by limited but ineffective reframing of experiences of feeling
weak, shames, or powerless in the face of failure, harsh comments, and negative
feedback.
Level 3:
Disavowal Defenses/ Autistic Fantasy Level
In disavowal, a person does not accept or “own” a stressful
problem. They may wrongly attribute the problem to someone else when they
actually had some part in the problem. Effective coping is blocked by not
accepting an appropriate level of responsibility that might lead to a
successful resolution.
Level 2: Major
Image-distorting Defense Level
When faced with a severe threat, people may
oversimplify themselves or the experience into distinct all or nothing
categories(for example all good or evil, powerful or powerless). The distortion
of reality may temporarily protect oneself against severe threats of abuse or
punishment. The reactions may provoke the avoidance or aggression of others.
Level 1:
Action Defense Level
When faced with a threat, defense mechanisms at Level
1 include behavioral reactions commonly referred to as “acting out” or withdrawal
responses.
MATURE DEFENSIVE CATEGORY
Level 7.
High-adaptive Defense Level
Affiliation
Altruism
Anticipation
Humor
Self-assertion
Self-observation
Sublimation
Suppression
NEUROTIC DEFENSIVE CATEGORY
Level 6: Obsessional Defense Level
Isolation of affects
Intellectualization
Undoing
Level 5:
Neurotic Defensive Level
Hysterical
Repression
Dissociation
Other Neurotic
Reaction Formation
Displacement
IMMATURE DEFENSIVE CATEGORY
Immature Nondepressive
Level 4: Minor
Image-Distorting Defense Level
Idealization of self-image
Idealization of other’s image
Devaluation of self-image
Devaluation of other’s images
Omnipotence
Level 3: Disavowal
Defense Level
Denial
Rationalization
Projection
Autistic Fantasy
Immature
Depressive
Level 2: Major
Image-distorting Defense Level
Splitting of self-image
Splitting of other’s image
Projective identification
Level 1:
Action Defense Level
Passive Aggression
Help-rejecting complaining
Acting out
__________________________
Level 0: Psychotic Defense Level
Psychotic Denial
Autistic Withdrawal
Distortion
Delusional Projection
Fragmentation
Concretization
Resources
A- Z List of Defense Mechanisms with descriptions
Psychotic Defense Mechanisms described
Defense Mechanisms Rating Scales
Select References
Berney, S., Roten, Y., Beretta, V., Kramer, U., &
Despland, J. (2014). Identifying psychotic defenses in a clinical
interview. Journal of Clinical Psychology, 70(5),
428–439. https://doi.org/10.1002/jclp.22087
Clark, A. J. (1998). Defense mechanisms in the
counseling process in groups. SAGE Publications, Inc., https://dx.doi.org/10.4135/9781452204901
Cramer, P. (2002). The study of defense mechanisms:
Gender implications. In The psychodynamics of gender and gender role. (pp.
81–127). American Psychological Association. https://doi.org/10.1037/10450-003
Cooper, S. H. (1992). The empirical study of defensive
processes: A review. In Interface of psychoanalysis and psychology. (pp.
327–346). American Psychological Association. https://doi.org/10.1037/10118-014
Di Giuseppe, M., & Perry, J. C. (2021).
The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the
Defense Mechanisms Rating Scales Q-Sort. Frontiers in psychology, 12,
718440. https://doi.org/10.3389/fpsyg.2021.718440
Di
Giuseppe, M., Perry, J. C., Lucchesi, M., Michelini, M., Vitiello, S., Piantanida,
A., Fabiani, M., Maffei, S., & Conversano, C. (2020). Preliminary validity
and reliability of the novel self-report based on the Defense Mechanisms Rating
Scales (DMRS-SR-30). Frontiers in Psychiatry, 11, 870.
https://doi.org/10.3389/fpsyt.2020.00870
Di Giuseppe, M., Perry, J. C., Petraglia,
J., Janzen, J., & Lingiardi, V.(2014). Development of a Q-Sort version of
the Defense Mechanism Rating Scales (DMRS-Q) for clinical use. Journal of
Clinical Psychology, 70(5), 452–465. https://doi.org/10.1002/jclp.22089
Perry, J. C. (1990). The Defense Mechanisms Rating
Scales Manual (5th ed.). Boston: The Cambridge Hospital.
Perry, J. C., & Bond, M. (2012). Change in defense
mechanisms during long-term dynamic psychotherapy and five-year outcome. American
Journal of Psychiatry, 169, 916–925.
Prout, T. A., Di
Giuseppe, M., Zilcha-Mano, S., Perry, J. C. & Ciro C. (2022)
Psychometric Properties of the Defense Mechanisms Rating Scales-Self-Report-30
(DMRS-SR-30): Internal Consistency, Validity and Factor Structure, Journal
of Personality Assessment, 104, 6, 833-843, DOI:
10.1080/00223891.2021.2019053
Vaillant, G. E. (2000). Defense mechanisms. In Encyclopedia
of psychology, Vol. 2. (pp. 454–457). Oxford University Press.
https://doi.org/10.1037/10517-166
Vaillant, G. E. (1971). Theoretical hierarchy of
adaptive ego mechanisms. Archives of General Psychiatry, 24, 107–118.
Vaillant,G. E. (2011). Involuntary coping mechanisms:
A psychodynamic perspective. Dialogues in Clinical Neuroscience, 13,
366–370.
Geoffrey W. Sutton, PhD is Emeritus Professor of Psychology. He retired from a clinical practice and was credentialed in clinical neuropsychology and psychopharmacology. His website is www.suttong.com
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