The American Journal of Psychoanalysis

, Volume 66, Issue 2, pp 173–194 | Cite as

HOW PSYCHIATRIC TREATMENTS CAN ENHANCE PSYCHOLOGICAL DEFENSE MECHANISMS

Article

Abstract

Psychological defense mechanisms are a powerful and often unappreciated force safeguarding mental health. Although rarely directed in this way, the most common forms of psychiatric treatment—psychotherapy and antidepressants—can enhance psychological defense mechanisms. Psychotherapy, through both specific and nonspecific factors, induces positive perspective shifts favoring positive cognitive distortions, including adaptive classical defense mechanisms and healthy attribution biases. Antidepressants, by altering very basic emotional information processing, such as facial expression recognition and emotional memories, also foster positive cognitive distortions. By shifting perceptions and thoughts in a positive direction, psychotherapy and antidepressants improve the capacity to dissociate from negative emotional stimuli.

Keywords

defense mechanisms psychotherapy antidepressants dissociation cognitive distortions 

References

  1. Ackerman K., Lewin T., Carr V. (1999). Long-term changes in defense style among patients recovering from major depression. Journal of Nervous and Mental Disease 187:80–87CrossRefGoogle Scholar
  2. Alloy L., Abramson L. (1979). Judgment of contingency in depressed and nondepressed students: Sadder but wiser?. Journal of Experimental Psychology: General 108:441–485CrossRefGoogle Scholar
  3. Alloy, L., Abramson, L., Metalsky, G., & Hartlage, S. (1988). The hopelessness theory of depression: Attributional aspects. British Journal of Clinical Psychology, 27(Pt 1), 5–21.PubMedGoogle Scholar
  4. Beck A. (1967). Depression: Clinical, experimental, and theoretical aspects. New York, Harper & RowGoogle Scholar
  5. Beck A. (1976). Cognitive therapy and the emotional disorders. New York, Meridian BooksGoogle Scholar
  6. Beck A. (1991). Cognitive therapy: A 30-year retrospective. American Psychologist 46(4):368–375PubMedCrossRefGoogle Scholar
  7. Beck A., Clark D. (1997). An information processing model of anxiety: Automatic and strategic processes. Behavior Research and Therapy 35(1):49–58CrossRefGoogle Scholar
  8. Bhagwagar Z., Cowen J., Goodwin G., Harmer C. (2004). Normalization of enhanced fear recognition by acute SSRI treatment in subjects with a previous history of depression. American Journal of Psychiatry 161(1):166–168PubMedCrossRefGoogle Scholar
  9. Bond M., Perry J. (2004). Long-term changes in defense style with psychodynamic psychotherapy for depressive, anxiety, and personality disorders. American Journal of Psychiatry 161(9):1665–1671PubMedCrossRefGoogle Scholar
  10. Boucher J., Brandt M. (1981). Judgment of emotion: American and Malay antecedents. Journal of Cross-Cultural Psychology 12(3):272–283CrossRefGoogle Scholar
  11. Boucher J., Carlson G. (1980). Recognition of facial expression in three cultures. Journal of Cross-Cultural Psychology 11:263–280CrossRefGoogle Scholar
  12. Bouhuys A., Geerts E., Gordijn M. (1999). Depressed Patients perceptions of facial emotions in depressed and remitted states are associated with relapse. Journal of Nervous and Mental Disease 187(10):595–602PubMedCrossRefGoogle Scholar
  13. Bowins B. (2004). Psychological defense mechanisms: A new perspective. American Journal of Psychoanalysis 64(1):1–26PubMedCrossRefGoogle Scholar
  14. Calvin, W. (1994). The emergence of intelligence. Scientific American, October, 101–107Google Scholar
  15. Clore, G., & Ortony, A. (2000). Cognition in emotion: Always, sometimes, or never? In Cognitive Neuroscience of Emotion. New York: Oxford University Press.Google Scholar
  16. Cohen L. et al. (1989). Attributional asymmetries in relation to dysphoria and self-esteem. Journal of Personality and Individual Differences 10(10):1055–1061CrossRefGoogle Scholar
  17. Ekman P. (1972). Emotions in the Human Face. New York, Cambridge University PressGoogle Scholar
  18. Ekman, P. (1994). Antecedent events and emotion metaphors. In Nature of emotions. Oxford: Oxford University PressGoogle Scholar
  19. Ekman P., Friesen W. (1971). Constants across cultures in the face and emotion. Journal of Personality and Social Psychology 17:124–129PubMedCrossRefGoogle Scholar
  20. Eley T., Stevenson J. (2000). Specific life events and chronic experiences differentially associated with depression and anxiety in young twins. Journal of Abnormal Child Psychology 28(4):383–394PubMedCrossRefGoogle Scholar
  21. Feinberg T., Rifkin A., Schaffer C., Walker E. (1986). Facial discrimination and emotion recognition in schizophrenia and affective disorders. Archives of General Psychiatry 43:276–279PubMedGoogle Scholar
  22. Finlay-Jones R., Brown G. (1981). Types of stressful life event and the onset of anxiety and depressive disorders. Psychological Medicine 11:803–815PubMedCrossRefGoogle Scholar
  23. Gaston L. (1990). The concept of alliance and its role in psychotherapy: Theoretical and empirical considerations. Psychotherapy: Theory, Research and Practice 27:143–153CrossRefGoogle Scholar
  24. Harmer C., Bhagwagar Z., Perrett D., Vollm B., Cowen P., Goodwin G. (2003). Acute SSRI administration affects the processing of social cues in healthy volunteers. Neuropsychopharmacology 28:142–152Google Scholar
  25. Harmer C., Hill S., Taylor M., Cowen P., Goodwin G. (2003). Toward a neuropsychological theory of antidepressant drug action: Increase in positive emotional bias after potentiation of norepinephrine activity. American Journal of Psychiatry 160(5):990–992PubMedCrossRefGoogle Scholar
  26. Harmer C., Shelley N., Cowen P., Goodwin G. (2004). Increased positive versus negative affective perception and memory in healthy volunteers following selective serotonin and norepinephrine reuptake inhibition. American Journal of Psychiatry 161(7):1256–1263PubMedCrossRefGoogle Scholar
  27. Horvath A., Luborsky L. (1993). The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology 61:561–573PubMedCrossRefGoogle Scholar
  28. Izard C. (1977). Human emotions. New York, PlenumGoogle Scholar
  29. Izard C. (1991). The psychology of emotions. New York, Plenum PressGoogle Scholar
  30. Izard C. (1992). Basic emotions, relations among emotions, and emotion-cognition relations. Psychological Bulletin 99(3):561–565Google Scholar
  31. Izard C. (1994). Innate and universal facial expressions: Evidence from developmental and cross-cultural research. Psychological Bulletin 115(2):288–299PubMedCrossRefGoogle Scholar
  32. Keltner D., Buswell B. (1997). Embarrassment: Its distinct form and appeasement functions. Psychological Bulletin 122(3):250–270PubMedCrossRefGoogle Scholar
  33. Kihlstrom J., Glisky M., Angiulo M. (1994). Dissociative tendencies and dissociative disorders. Journal of Abnormal Psychology 103(1):117–124PubMedCrossRefGoogle Scholar
  34. Klerman G., Weissman M. (1984). Interpersonal psychotherapy of depressive disorders. New York, Basic BooksGoogle Scholar
  35. Konner M. (1982). The tangled wing: Biological constraints on the human spirit. New York, Harper & RowGoogle Scholar
  36. Krupnick J., Sotsky S., Simmens S. (1996). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the National Institute Of Mental Health Treatment of Depression Collaborative Research program. Journal of Consulting and Clinical Psychology 64:532–539PubMedCrossRefGoogle Scholar
  37. Lazarus R. (1984). On the primacy of cognition. American Psychologist 39(2):124–129CrossRefGoogle Scholar
  38. Lazarus R. (1991). Cognition and emotion in motivation. American Psychologist 46(4):352–367PubMedCrossRefGoogle Scholar
  39. Ledoux J. (1994). Cognitive-emotional interactions in the brain. In Nature of emotions. Oxford: Oxford University Press.Google Scholar
  40. Lewinsohn P., Mischel W., Chaplin W., Barten R. (1980). Social competence and depression: The role of illusory self-perceptions. Journal of Abnormal Psychology 89(2):203–212PubMedCrossRefGoogle Scholar
  41. Luten A., Ralph J., Mineka S. (1997). Pessimistic attributional style: Is it specific to depression versus anxiety versus negative affect?. Behavior Research and Therapy 35(8):703–719CrossRefGoogle Scholar
  42. Mathews A., Klug F. (1993). Emotionality and interference with color-naming in anxiety. Behavior Research and Therapy 31(1):57–62CrossRefGoogle Scholar
  43. Morwood, M., Sutikna, T., & Roberts, R. (2005). World of the little people. National Geographic, April, 2–15Google Scholar
  44. Persad S., Polivy J. (1993). Differences between depressed and nondepressed individuals in the recognition of and response to facial emotional cues. Journal of Abnormal Psychology 102:358–368PubMedCrossRefGoogle Scholar
  45. Piper W. (2004). Implications of psychotherapy research for psychotherapy training. Canadian Journal of Psychiatry 49(4):221–228Google Scholar
  46. Rachman S. (1998). A cognitive theory of obsessions: Elaborations. Behavior Research and Therapy 36:385–401CrossRefGoogle Scholar
  47. Rapee R. (1997). Perceived threat and perceived control as predictors of the degree of fear in physical and social situations. Journal of Anxiety Disorders 11(5):455–461PubMedCrossRefGoogle Scholar
  48. Ross C., Joshi S., Currie R. (1990). Dissociative experiences in the general population. American Journal of Psychiatry 147(11):1547–1552PubMedGoogle Scholar
  49. Ross C., Joshi S., Currie R. (1991). Dissociative experiences in the general population: A factor analysis. Hospital and Community Psychiatry 42(3):297–301PubMedGoogle Scholar
  50. Rozin P., Fallon A. (1987). A perspective on disgust. Psychological Review 94(1):23–41PubMedCrossRefGoogle Scholar
  51. Rozin P., Lowery L., Ebert R. (1994). Varieties of disgust faces and the structure of disgust. Journal of Personality and Social Psychology 66(5):870–881PubMedCrossRefGoogle Scholar
  52. Rozin P., Lowery L., Imada S., Haidt J. (1999). The CAD triad hypothesis: A mapping between three moral emotions (contempt, anger, disgust) and three moral codes (community, autonomy, divinity). Journal of Personality and Social Psychology 76(4):574–586PubMedCrossRefGoogle Scholar
  53. Rozin, P., Haidt, J., & McCauley, C. (2000). Disgust. In Handbook of emotions, 2nd ed. New York: Guilford Press.Google Scholar
  54. Scott J. (1995). Psychological treatments for depression. British Journal of Psychiatry 167:289–292PubMedCrossRefGoogle Scholar
  55. Shaver P., Schwartz J., Kirson D., O’Connor C. (1987). Emotion knowledge: Further exploration of a prototype approach. Journal of Personality and Social Psychology 52(6):1086–1091CrossRefGoogle Scholar
  56. Shrout P., Link B., Dohrenwend B., Skodol A., Stueve A., Mirotznik J. (1989). Characterizing life events as risk factors for depression: The role of fateful loss events. Journal of Abnormal Psychology 98(4):460–467PubMedCrossRefGoogle Scholar
  57. Simeon D., Gross S., Guralnik O., Stein D., Schmeidler J., Hooander E. (1997). Feeling unreal: 30 cases of DSM-III-R depersonalization disorder. American Journal of Psychiatry 154(8):1107–1113PubMedGoogle Scholar
  58. Stolorow R., Brandshaft B., Atwood G. (1987). Psychoanalytic treatment: An intersubjectivity approach. Mahwah, NJ, Analytic PressGoogle Scholar
  59. Stravynski A., Greenberg D. (1992). The psychological management of depression. Acta Psychiatric Scandinavia 85:407–414CrossRefGoogle Scholar
  60. Svartberg M., Seltzer M., Stiles T. (1998). The effects of common and specific factors in short-term anxiety-provoking psychotherapy: A pilot process-outcome study. Journal of Nervous and Mental Disease 186(11):691–696PubMedCrossRefGoogle Scholar
  61. Taylor S., Brown J. (1988). Illusion and well-being: A social psychological perspective on mental health. Psychological Bulletin 103:193–210PubMedCrossRefGoogle Scholar
  62. Tian P., Shuttlewood G. (1999). Development of a satisfaction with therapy and therapist scale. Australian and New Zealand Journal of Psychiatry 33:748–753CrossRefGoogle Scholar
  63. Tomkins S. (1962). Affect, imagery, consciousness: The positive effects. Vol. 1. New York, SpringerGoogle Scholar
  64. Tomkins S. (1963). Affect, imagery, consciousness: The negative effects. Vol. 2. New York, SpringerGoogle Scholar
  65. Tomkins, S. (1972). Affect theory. In Emotions in the human face. New York: Cambridge University Press.Google Scholar
  66. Trijsburg R., Spijker A., Van H., Hesselink A., Duivenvoorden H. (2000). Measuring overall defensive functioning with the Defense Style Questionnaire. Journal of Nervous and Mental Disease 188(7):432–439PubMedCrossRefGoogle Scholar
  67. Vaillant G. (1977). Adaptation to life. Boston, Little, BrownGoogle Scholar
  68. Vaillant G. (1994). Ego mechanisms of defense and personality psychopathology. Journal of Abnormal Psychology 103(1):44–50PubMedCrossRefGoogle Scholar
  69. Veljaca K., Rapee R. (1998). Detection of negative and positive audience behaviors by socially anxious subjects. Behavior Research and Therapy 36:311–321CrossRefGoogle Scholar
  70. Vrana S. (1993). The psychophysiology of disgust: Differentiating Negative emotional contexts with facial EMG. Psychophysiology 30:279–286PubMedCrossRefGoogle Scholar
  71. Whitesell, N., & Harter, S. (1996). The interpersonal context of emotion: Anger with close friends and classmates. Child Development, 67(4), 1345–1359.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Brad BowinsTorontoCanada

Personalised recommendations