Therapeutic Comm Q 36
A patient admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting. “Let me out. There’s nothing wrong with me. I don’t belong here.” What defense mechanism is the patient implementing?
A. Denial
B. Projection
C. Regression
D. Rationalization
Correct Answer: A. Denial.
Denial is a refusal to admit to a painful reality, which was treated as if it does not exist. It involves blocking external events from awareness. If some situation is just too much to handle, the person refuses to experience it. This is a primitive and dangerous defense – no one disregards reality and gets away with it for long! It can operate by itself or, more commonly, in combination with other, more subtle mechanisms that support it.
Option B: In projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other persons, objects, or situations. Projection is a psychological defense mechanism proposed by Anna Freud in which an individual attributes unwanted thoughts, feelings, and motives onto another person.
Option C: Regression allows the patient to return to an earlier, more comforting, although less mature, way of behaving. This is a movement back in psychological time when one is faced with stress. Regression functions as a form of retreat, enabling a person to psychologically go back in time to a period when the person felt safer.
Option D: Rationalization is justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener. Rationalization is a defense mechanism proposed by Anna Freud involving a cognitive distortion of “the facts” to make an event or an impulse less threatening.