Defense Mechanisms
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Outline
Overview
- When anxiety gets worse, patients attempt to cope by utilizing defense mechanisms
Nursing Points
General
- Common defense mechanisms
- Compensation – trying to make up for a deficiency
- Conversion – using physical symptoms to express emotional issues
- Denial – refusal to acknowledge something as truth
- Fantasy – escaping to ‘another world’ that is more ideal
- Fixation – getting ‘stuck’ on a phase or idea that is comfortable and not progressing
- Intellectualization – excessive use of thinking or generalizations
- Isolation – separating emotions from actions
- Rationalization – offering a socially acceptable or somewhat logical explanation instead of the truth
- Regression – loss of emotional development
- Repression – involuntary exclusion of a painful thought or memory
- Sublimation – replacing something socially unacceptable with something acceptable
- Undoing – doing the opposite of a past unacceptable behavior
Nursing Considerations
- Remember! Defense mechanisms are used to decrease anxiety
- PRIORITY – Help patient identify source of anxiety – that is where the focus should be, not the defense mechanism itself
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Transcript
So, one more thing to understand before we dive into various mental health disorders is that many clients will exhibit behaviors known as defense mechanisms or coping mechanisms. It’s important that you understand what they are and why they exist.
These behaviors are specifically used as a way to cope with increasing anxiety. We will see anxiety as a common component of most mental health diagnoses, but even in those not officially diagnosed with a mental health disorder, you will see these behaviors used as a way to decrease anxiety. Since we know that the purpose of these defense mechanisms is to decrease anxiety, the number one priority should be to help the client identify that source of anxiety. What is going on deep down that is causing them to behave the way they are? It’s important that this is where our focus is, not on the behavior itself. This can be very challenging, especially for a new nurse – we need to learn how to de-code their behavior. But if you at least recognize that there is some source of anxiety at the root of it, it helps you to approach the situation differently.
Now, there are dozens of examples of coping mechanisms. In your outline, we’ve given you 12 more common ones, and here I just want to touch on some of the most common ones you’ll see. First is compensation, this is when they’re trying to make up for a deficiency – someone who’s anxious about their intelligence may compensate by trying to be super funny. Conversion is when physical symptoms are used to express emotional issues, like getting a headache or a tummy ache. Denial is when a client refuses to acknowledge something as truth so they don’t have to deal with the anxiety or emotions of that situation.
Undoing is when someone tries to do the exact opposite of a past unacceptable behavior, almost to try to make up for it. So, for example, if someone had very bad thoughts about a person, or even if they were mean towards them – they’ll try to decrease their anxiety about that by being overly nice to them. We see this a lot in abusers who buy their victim flowers or gifts after a bad episode. Regression is when someone reverts to an earlier stage of maturity or development to avoid having to deal with the emotions. Repression is the involuntary loss of a painful thought or memory – this is seen frequently in abuse victims who may not even remember being abused or will ‘lose’ years of their lives. And finally, one that is extremely common even in people without mental health disorders – rationalization. This is when someone tries to give a socially acceptable or somewhat logical explanation for something, instead of acknowledging the truth. My mother always says “there’s a fine line between rational and rationalization”. Let me give you an example. A woman goes out and spends $200 on a new outfit for a job interview. When confronted with her bank statement she says “But, I had an interview and I had absolutely nothing to wear”. Except she has plenty of clothes! Turns out, she’s rationalizing her behavior because the truth is that she was feeling anxious about her upcoming interview and worried she wouldn’t be good enough.
So those are some of the major defense mechanisms. Just remember that the #1 priority is to address the source of anxiety. Now, go out and be your best selves today. And, as always, happy nursing!
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05.02 Liver Overview and Disease for CCRN Review
Airway Suctioning
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Cirrhosis Case Study (45 min)
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Day in the Life of a Hospice, Palliative Care Nurse
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Defense Mechanisms
Defense Mechanisms
Dementia Nursing Mnemonic (DEMENTIA)
Depression
Depression Assessment Nursing Mnemonic (SIGNS)
Depression Concept Map
Diazepam (Valium) Nursing Considerations
Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)
Dissociative Disorders
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Encephalopathy Case Study (45 min)
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Head to Toe Nursing Assessment (Physical Exam)
Homicidal and Suicidal Ideation for Certified Emergency Nursing (CEN)
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Phytonadione (Vitamin K) for Newborn
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Quetiapine (Seroquel) Nursing Considerations
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Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
03.02 Diabetes Insipidus for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.03 Hypoglycemia for CCRN Review
03.04 DKA vs HHNK for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
Absolute Neutrophil Count (ANC) Lab Values
ACE (angiotensin-converting enzyme) Inhibitors
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Airway Suctioning
Anion Gap
Calcium Channel Blockers
Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
Coagulation Studies (PT, PTT, INR)
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Cushings Assessment Nursing Mnemonic (STRESSED)
Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Management
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Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
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Diabetic Ketoacidosis (DKA) Case Study (45 min)
Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
DKA Treatment Nursing Mnemonic (KING UFC)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
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Hypoglycemia for Progressive Care Certified Nurse (PCCN)
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Insulin
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Intake and Output (I&O)
Iron (Fe) Lab Values
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Leukemia Case Study (60 min)
Lymphoma
Metformin (Glucophage) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Multiple Myeloma
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan for Cirrhosis (Liver)
Nursing Case Study for Type 1 Diabetes