The Development of Defense Mechanisms

Phebe Cramer

The Development of Defense Mechanisms Theory, Research, and Assessment

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Phebe Cramer Department of Psychology Williams College Williamstown, Massachusetts 01267 USA

Library of Congress Cataloging-in-Publication Data Cramer, Phebe,

The development of defense mechanisms: theory, research, and assessment/Phebe Cramer.

p. cm. Includes bibliographical references. I. Defense mechanisms (Psychology) 2. Defense mechanisms

(Psychology)-Testing. I. Title. BFI75.5.D44C73 1990 155.2-dc20 90-34602

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© 1991 Springer-Verlag New York Inc. Softcover reprint of the hardcover 1st edition 1991

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ISBN-13: 978-1-4613-9027-5 e-ISBN-13: 978-1-4613-9025-1 001: 10.1007/978-1-4613-9025-1

Preface

The idea that the human mind-that faculty of the intellect which we use to define and discern the truth-might also be used to deceive itself is not new. The classic orator Demosthenes warned of this possibility in 349 B.C.

when he wrote that "Nothing is more easy than to deceive one's self; what a man wishes he generally believes to be true." 1

Even Jean Jacques Rousseau, who suggested the possibility of man as "noble savage," alerts us to this paradox, when he writes "Jamais fa nature ne nous trompe; c'est toujours nous qui nous trompons" ("Nature never deceives us; it is always we who deceive ourselves). 2

But it was Sigmund Freud who placed this idea firmly into the field of psychopathology and then, later, into a general psychological theory. According to Freud, understanding the function of a defense mechanism means not only fathoming the origin of pathological symptoms but also comprehending a model of the mind that includes both conscious and unconscious mental processes. From this initial focus on the general process of defense, Freud and his followers went on to identify various forms this process might take, with the result that today we have a list of more than 37 defense mechanisms described in the literature. 3

The published scholarly work that discusses defense mechanisms is of two sorts. On the one hand, theoretical discussions of the concept of defense and of individual defenses are found in the psychoanalytic literature from Freud to the present time. Empirical studies, on the other hand, are more likely to appear within the context of academic psychology. Typically, these studies have focused on developing measures that would assess the use of defense mechanisms and relate this use to other personality variables. A smaller group of studies has attempted to investigate defenses experimentally. Currently, the concept, if not the theory, of defense mechanisms is seen in studies of self-deception.

There is, then, a large body of scholarly work that discusses defense mechanisms. In reviewing this literature, some 58 different measures of defense were encountered. These measures, and the work carried out using them, are reviewed in Chapters 6, 7, 8, and 9, and summarized in

v

VI Preface

Chapter 10. Experimental studies of defense are discussed in Chapter 11. It is hoped that bringing this sometimes diverse information together, and organizing the concordant and discordant findings under topical headings, will prove to be a useful reference for those who want to understand this body of research and who will carry out further work in this area of study.

It is the first five chapters, however, that present the raison d'etre for the book. The idea that defense mechanisms serve an adaptive function in the lives of children, adolescents, and adults, and that, like other ego processes, defenses might develop as part of normal maturation, has long intrigued me. Reading the extant literature, I encountered related ideas, such as the suggestion that defenses might be organized into hierarchical levels, depending on their degree of complexity or maturity. This approach has generally been used to assess the defense status of adults, with some adults using higher-level and some using lower-level defenses. Occasional­ly in the literature a case study appears in which the vicissitudes of a particular defense over time are discussed. In addition, within the psychoanalytic literature, several theorists have raised the idea that there are precursors or prototypes of defense that appear early in development, although the application of this idea to the development of actual defenses over the lifespan and the construction of a chronology of defense mechanisms have been lacking.

The literature, then, provides pieces of support, gleaned from here and there, for the general conception of defense development. In the present work, a theory of defense mechanism development is proposed in which the development of defenses is considered from two points of view. First, there is a chronology of defense development-that is, different defenses are predominant at different points in development-and, second, each defense has its own developmental history, which can be traced from birth onward. The general form of this theory is discussed in Chapter 2. Its application to three specific defenses is illustrated in Chapters 3,4, and 5. To illustrate the different components of the defense mechanisms, examples are drawn from folktales, myths, and world literature, as well as from clinical case studies.

In the third section of the book, the theory of defense development has been used to create a new method for assessing the use of defenses. This method is based on stories told to the Thematic Apperception Test, and relies on the developmental components of the defenses of denial, projection, and identification, as discussed in the earlier chapters. Evidence for the reliability and validity of this new method and illustrations of its use in both published and unpublished research are provided. The Appendix provides the complete scoring manual, with examples.

In writing this book, I have benefitted from several sources of support. My family-husband John and daughters Mara and Julia-have each in their own way offered encouragement and enthusiasm, as well as

Preface vii

intellectual content that has enriched the text in numerous ways. My friends and colleagues-especially Dr. Sidney J. Blatt, Dr. Leslie Brody, and Dr. Richard Q. Ford-have discussed parts of my work and improved it through their comments. Ms. Sarah McFarland, former head of reference services at the Williams College library, was extremely helpful over a number of years in locating references, information, and copies of journals and books not readily available. Also, my students at Williams College have contributed to my work, and have helped carry out the research to support the theory. Finally, sabbatical leave time granted me by Williams College made possible the writing of the manuscript. To all of these, I am thankful for their support.

Contents

Preface v

Part 1. Theory

Chapter 1 The Concept of Defense ........................... 3 Defense mechanisms, defense behavior, and consciousness... ....... .......... .............. 3 History ofthe concept of defense . . . . . . . . . . . . . . . . . . 5 The motives for defense: Anxiety, guilt, and loss .... 5 Controversial issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Defenses as part of normal development ........... 9 Successful versus unsuccessful defenses ............ 12 Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Chapter 2 The Concept of Defense Mechanism Development .... 15 The conception of defense mechanism development. 15 A developmental continuum of defenses ........... 17 The development of individual defenses . . . . . . . . . . . . 22

Origins of defense mechanisms ............... 23 Precursors and prototypes ................... 23 Case study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 The developmental course of defense mechanisms ............................... 27

Research findings: Developmental changes in defense use .................................... 28

Defense mechanisms and age ................. 28 Defense mechanisms and ego development ..... 29 Defense mechanisms and cognitive development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Defense mechanisms and psychosocial development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Developmental changes in the understanding of defense mechanisms ...................... 31 Summary of developmental research studies .... 32

Concluding remarks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

ix

x Contents

Chapter 3 Denial 36 Components of denial ........................... 36 Denial as seen in folktales . . . . . . . . . . . . . . . . . . . . . . . . 39

Perceptual denial ........................... 39 The imposition of a personal fantasy ........... 41

Denial and pathology ........................... 42 The development of two forms of denial . . . . . . . . . . . . 44

Perceptual denial ........................... 44 Denial through fantasy ...................... 50

Anotherfolktale ............................... 54 Clinical examples ............................... 55 The use of denial in projective stories .............. 58 Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Chapter 4 Projection....................................... 62 Components of projection ....................... 62 Projection as seen in folktales .................... 65

The generalization of psychological attributes ... 66 Attribution of responsibility .................. 66 Projection proper . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

The development of projection ................... 71 Another folktale ............................... 77 Clinical example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 The use of projection in projective stories .......... 81 Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

Chapter 5 Identification .................................... 84 Components of identification ..................... 86 Identification as seen in folktales .................. 88 The development of identification ................. 90

The development of primary identifications ..... 92 The development of secondary identifications ... 98

Examples of identification in world literature ....... 102 Henry IV .................................. 102 Don Quijote ............................... 106

Clinical example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 The use of identification in projective stories ........ 108 Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

Part II. Research: A Review of the Literature

Chapter 6 Approaches to Measuring Defenses: The Defense Mechanism Inventory ............................. 115

Description ofthe DMI . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Reliability ..................................... 116 Validity ....................................... 116

Content validity ............................ 116 Concurrent validity ......................... 119

Contents xi

The relationship between DMI scales and cognitive measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

Field dependence-independence ............. 123 Memory constriction ........................ 124

The relationship between DMI scales and clinical measures ............................... 124

Questionnaire pathology . . . . . . . . . . . . . . . . . . . . . 124 Clinically diagnosed pathology . . . . . . . . . . . . . . . . 125

The relationship between DMI scales and subject variables .................................... . . 126

Sex...... . .... . ..... .. . . . . . . . . .. .... ... . . . 126 Sexual orientation .......................... 127 Age, education, birth order, and ethnic group. . . . . .... ....... . . . . . . . . . . ..... . .... . 127

Reactions to experimental intervention ............ 128 Predicting the response to intervention . . . . . . . . . 128 Measuring intervention effectiveness .......... 128

Conclusion .................................... 129

Chapter 7 Other Approaches to Measuring Defenses: Derived Questionnaires, Self-Report Inventories, and Self-Other Ratings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136

Defense measures derived from existing personality inventories .......................... 136

Byrne's R-S scale .......................... 136 Haan's MMPI-based defense scales. . . . . . . . . . . . 138 Joffee and Naditch's CPI-based scales. . . . . . . . . . 141 Other MMPI-based scales. . . . . . . . . . . . . . . . . . . . 142

Self-report measures ............................ 144 The Life-Style Index ....................... 145 The Defense Style Questionnaire ............. 146 Self-report measures for children. . . . . . . . . . . . . . 147 Other measures ............................ 149 Comment ................................. 149

Self-other ratings ............................... 150 Heilbrun's work ............................ 151 Additional self-other studies ................. 154

Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155

Chapter 8 Other Approaches to Measuring Defenses: Story Completion and Clinical Interviews ................. 156

Story completion measures of defense ............. 156 The Defense Preference Inquiry .............. 157 Other story completion measures ............. 159 Studies of defense understanding . . . . . . . . . . . . . . 161

Measures of defense derived from clinical interviews ..................................... 164

xii Contents

Hackett and Cassem: Denial ................. 165 Further studies with clinical patients ........... 166 The Ego Profile Scale ....................... 169 Haan's studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Vaillant's work ............................. 173 The Defense Mechanism Rating Scales. . . . . . . . . 178

Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Chapter 9 Other Approaches to Measuring Defenses: Projective

Tests and Perceptual Defense Paradigms ............. 180 Measures of defense in projective tests ............. 180

The Children's Apperception Test (CAT) ...... 181 The Thematic Apperception Test (TAT) ....... 182 The Rorschach ............................. 183

Measures of defense in perceptual defense paradigms ........... :......................... 189

The Defense Mechanism Test ................ 189 The Meta-Contrast Technique ... . . . . . . . . . . . . . 191

Conclusion .................................... 193 Chapter 10 Summary of Research: Defense Mechanisms and Their

Relationship to Other Psychological Variables ........ 195 Defense mechanisms and personality characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Defense mechanisms and psychopathology ......... 198 Defense mechanisms and physical pathology ...... . . 200 Defense mechanisms and gender or gender orientation .................................... 200 Defense mechanisms and family background . . . . . . .. 201 Defense mechanisms and relationship with mother . .. 202 Defense mechanisms and relationship with father . . .. 202 Defense mechanisms and cognitive functioning . . . . .. 202 Defense mechanisms and occupations/nationality . . .. 204 Conclusion .................................... 205

Chapter 11 Experimental Studies of Defense . . . . . . . . . . . . . . . . . . . . 206 Intervention to arouse a specific emotion ........... 208 Intervention to provide a threat to self-esteem ...... 210 Intervention to introduce an unpleasant physical stimulus ...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 211 Intervention to provide instructions or modeling . . . . . 211 Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 211

Part III. A New Approach to Measuring Defenses

Chapter 12 The Defense Mechanism Manual ................... 215 Assessment of Denial with the DMM .............. 216

Scoring categories for Denial ................. 216 Using the scoring categories for Denial . . . . . . . .. 216

AssessIl1ent of Projection with the DMM ........... 220

Contents xiii

Scoring categories for Projection .............. 221 Using the scoring categories for Projection ..... 221

Assessment of Identification with the DMM ........ 229 Scoring categories for Identification ........... 230 Using the scoring categories for Identification ... 230

Concluding remarks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234 Chapter 13 Psychometric Features ............................ 235

Reliability ..................................... 236 Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236 Reliability based on the subject's responses ..... 237 Split-half method ........................... 238 Reliability based on the consistency of observer's ratings of subjects' responses ........ 241

Validity ....................................... 244 Criterion-related validity' .................... 244 Construct validity . . . . . . . . . . . . . . . . . . . . . . . . . . . 246

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258 Chapter 14 Research Findings ................................ 259

DMM research studies with children and adolescents 259 DMM studies with college students ................ 263 DMM studies with psychiatric patients ............. 264 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267

References ....... ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269 Notes ..................................................... 293 Appendix: Manual for Scoring Defenses .... . . . . . . . . . . . . . . . . . . . . 307 Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327 Subject Index .............................................. 335