Change in Defense Mechanisms Following Intensive Treatment, As Related to Personality Organization and Gender

Abstract

In this chapter we discuss how defense mechanisms change following intensive treatment and show how different defense mechanisms are related to gender and personality organization in psychiatric patients. In a large-scale study of psychological change following intensive treatment, Blatt, Ford, Berman, Cook, and Meyer (1988) found it useful to differentiate between the anaclitic and the introjective personality configurations. According to theory, there are two parallel developmental lines in personality development (Blatt & Shichman, 1983). One of these—the anaclitic—relates to the development of stable, mutually satisfying interpersonal relationships. The other—the introjective—is concerned with the development of a stable, realistic, and positive self-identity. These two lines interact throughout the course of development. Various forms of psychopathology have been conceptualized as an overemphasis and exaggeration of one of these developmental lines at the expense of the other. Thus, psychiatric patients with an anaclitic personality configuration (e.g., the infantile personality of a hysteric character) show an excessive and distorted preoccupation with establishing satisfying interpersonal relationships and a corresponding neglect of development of self. Patients with an introjective personality configuration (e.g., paranoid, obsessive-compulsive, guilty depression) manifest a peremptory and distorted concern around establishing and maintaining a consolidated definition of self, and a corresponding neglect of establishing meaningful interpersonal relationships. Recent findings (Blatt et al., 1988) indicate that these two groups of patients change in different ways during long-term, individual treatment.