Intellectualization

To avoid the problematic emotional implications of a topic, some patients in therapy avoid words for emotions and substitute phases that intellectualize their problems at a theoretical level. A related defense, generalization, involves dealing with a topic on an abstract, rather than a personal level. For example, in a therapy conversation about having cheated while in an honored position of responsibility, a patient may leap to expression of only general philosophical thoughts about human imperfection in order to distance himself from the potential feelings of shame and guilt.

In intellectualization, patients may express emotions regarding a personal experience using a broad social context rather than a personalization (“Ahh, these are the times we live in”). The patient aims to have a social conversation about general ideas rather than giving concrete and specific instances of how he or she is having problems with emotional responses. For instance, a person might report having hit his child, but then sidetrack the conversation by providing views that the therapist might share about the general social values about how punishment and discipline should be provided as part of a child’s education

Rationalization

A patient may be observed to maintain self-esteem by rationalization of unhealthy actions such as giving in to intense cravings that ought to have been restrained. Rationalization is also used to avoid unpleasant duties, for example, not completing a chore because of having potentially great, creative thoughts while sitting on the couch watching television.

Reaction formation

By reaction formation, a buried set of ideas or feelings is replaced by an unconsciously derived—but consciously felt—emphasis on its opposite. For example, an older boy who is jealous of a baby brother might harbor a hateful unconscious fantasy that if the baby died, he would again be the center of his parent’s attention. He has been told by his parents to love his baby brother. He protects against the dangerous “badness” of self by replacing the wish to be rid of his little brother with an exaggerated kindly concern for the baby’s welfare. If the feelings of rivalry are too intense, the reaction formation may lead to problematic symptoms. For instance, the boy might feel a compulsion to check on his baby brother every 15 minutes throughout the night to make sure he is safe from suffocation or rodent attacks. A lifelong trait of over-solicitousness might be developed to ward off envy and jealous hostility.

Disavowal

Denial is one of the most frequent ways of trying to control upsetting ideas and to prevent unbearable emotional states. Denial involves withholding the conscious understanding of meanings and implications of new information. We discussed this as an early general reaction to experiencing a major stressor. Disavowal as a trait means a tendency to use many denials, or protracted denials. For example, upon hearing that company bankruptcy has been declared imminent, a patient might try to achieve peace of mind by assuming, “It can’t happen to us,” and on hearing that a friend has cancer might say, “Glad it cannot happen in my family.”

Idealization

Idealization results from an excessive need to have a relationship, an ideal, or an institution that inflates the patient’s sense of worth. This defensive style can counteract a tendency to enter enfeebled self-states. A fragile self-image is inflated by a sense of union with the ideal. Attributing exaggerated positive qualities to an affiliated person or a group, whether real or imagined, gives that patient a rationalization for their enhanced self-esteem and excitement from the reflected glory.

The results can be serious, as in zealotry and self-sacrifice. Various totalitarian political organizations have profited from this defensive maneuver. When in treatment, such character types are likely to develop positive idealizing transferences that, paradoxically, may interfere with evolving a genuine therapeutic alliance.

Displacement

Displacement occurs when a patient transfers impulses, emotions, or judgments from the actual target person to someone else. It is a “kick the dog” response, for example, when anger is aroused at another family member. For instance, after being reprimanded at work, a person may tactfully submit to the reprimand, yet go home and yell at a child for a minor infraction. The result is a defensive move from the actual target of hostility, who is dangerously stronger than self in power, to choosing a target for aggressive discharge who is weaker than self.

Undoing

Undoing expresses both an impulse and its opposite, such as being domineering one minute and deferential the next. Used in rapid repetition, undoing can lead to a series of flip-flops resulting in a personality trait of indecisiveness. For example, instead of complaining about the frustrating actions of another person, and trying to negotiate an agreement, a patient might start complaining about the other person to the therapist and then too quickly retract the emergent expressions of emotion by saying, “I didn’t mean to say that, they meant well.”