Freud is not dead (nor should we forget any of the old masters). Just as contemplation of Renaissance painters continues to arouse inspiration in modern artists, this foundational figure of organized psychological science deserve reflection.
Today, faster-paced, cognitive -behavioral approaches are all the rage. It seems anything associated with our forefathers is considered obsolete; that Freud and Co. are merely a niche for the erudite. Looking a little deeper, though, they live on in hidden spirit. It’s not unusual that my students inquire about patients’ denial, projection, and other defenses; the unconscious, psychosexual, psychosomatic, and matters of transference and counter-transference. Nowadays, students seem to only consciously know Freud in name, but obviously recognize his contributions. In the next few posts, we’ll examine the still-utilized components of Freud’s legacy, starting with psychological defenses.
Defense mechanisms are many, from the more adaptive approaches of humor and anticipation, to more pervasive experiences like repression and downright psychotic distortions. Freud, spending untold hours with each patient, came to understand many behaviors barricading progress as unconscious manners of protecting the ego. A few of the more common defenses students should be familiar with include:
Who hasn’t heard the joke, “They’re in denial, and it’s not the river”? Perhaps the most commonly-heard defense mechanism, we’ve all been guilty of a little disbelief, like, “it can’t happen to me.” This is normal. However, some people live in denial, or cope with a significant problem by largely disavowing the thoughts, feelings, and external reality factors that are too threatening to acknowledge consciously. Working in the jail, I often head inmates cling to hope with a denial defense. Perhaps the most deluded incident of denial I ever encountered was a suspect in a high- profile murder case with many witnesses. He told me, “I’m going home at my next court date. It was my cousin. We look alike. My lawyer said our DNA can be very close, but they’re holding me because of my record.”
Denial is often obvious to the therapist, but it would be inappropriate to call “bullshit.” Denial is an unconscious defense mechanism that is sometimes reaches delusional proportions; the patient doesn’t realize their defense. It is a therapist’s job to try and bring the patient around to reality, if possible, and at least consider alternative perceptions are possible. With someone who has the “it can’t happen to me” mind frame, we may explore the possibility of “it” happening to them and if it is worth continuing the behavior. For the mentioned inmate, I spent considerable time with him trying to get him to acknowledge the possibility he could be doing life in attempt to prepare him for a transition to state prison.
Have you ever had a nasty boss and felt like letting them have it? Chances are, you checked your impulse, but maybe came home and kicked the dog out of the way when it wanted to be fed or yelled at the kids for no apparent reason. That’s a displacement; your wishes are displaced from the original object to a more acceptable substitute of less consequence. We often see this in children who grossly disrespect teachers. The teacher, an authority figure, represents a parent, which is usually gender-specific. If a kid has a contentious relationship with his father, for instance, it is too dangerous to confront him, so he blows off the steam he harbors towards his father on the male teacher. It may even serve a secondary purpose. Perhaps the kids’ father works second shift, and he doesn’t want to cross paths with him when he gets home. The kid has learned that blowing off steam at the teacher is also likely to get him a detention, so he won’t be home when his father is still there.
Another subconscious process, part of therapy is to help the patient gain insight into where the real problem lays and confront it at the root. I recall a boy with chronic misbehavior at school directed towards female teachers. I asked him if he harbored any animosity towards his mother that he never told her about. He described being disappointed in her for not protecting him when his father would physically abuse him. Given his mother was his only stable attachment, it was obviously not in his best interest to be confrontational towards her. Therefore, the second best thing was to take it out on someone symbolic of his mother. Part of the treatment recommendations was pointed family therapy processing what occurred while his father still lived in the home.
If you’ve ever felt sub-par and assumed that others are seeing you the same way, that is kind of like of projection; assuming that others perceive you the way you perceive yourself. Pathological project, however, is usually a subconscious mechanism. Using Avoidant Personality Disorder as an example, such patients have a strong tendency to harbor negative self-evaluation in comparison to others (leading to their social avoidance). They view themselves very poorly but may not acknowledge it as a way to save face. One way this may play out is they wish they could make friends with a particular person but think, “They’re stuck-up and are going to judge me harshly, I shouldn’t bother with them.” Even though they would like to associate with the peer, the Avoidant person feels vastly inferior to them and it is too anxiety-provoking to try to be accepted by them. Therefore, they try to save face by saying it is the other person that is judging them, instead of acknowledging it is their own feelings of inferiority that are getting in the way.
Projection is very common in depressed patients, also, who similarly assume that others view them as poorly as they see themselves. It is often helpful to confront such irrational thinking by asking the patient to present evidence that this is what others think. More often than not, they can’t. The therapist must introduce the idea that the patient is creating their fear, at least opening the door, for example, to the possibility that others may enjoy their company.
Simply being aware of the three defenses outlined above can help accelerate therapy. Given the complexity of defenses, it is a good idea for new therapists to consult with supervisors about interventions. For those wishing to learn more about psychological defense mechanisms, tho books Psychological Defenses in Everyday Life by Firestone and Catlett, and The Ego and Mechanisms of Defense by Anna Freud can be helpful for more in-depth understandings. On Wednesday, we’ll encounter the item that led Freud from his interest in neurology to psychiatry: psychosomatic illness.