Chapter 6 Secondary Defensive Processes

Secondary Defensive Processes

Virtually any psychological process can be used defensively, and so no summary of the defenses can be complete. In analysis, even free association can be used defensively, to avoid certain topics. Anna Freud's seminal-The Ego and the Mechanisms of Defense covers denial, repression, reaction formation, displacement, rationalization, intellectualization, regression, reversal, turning against the self, identification with the aggressor, and sublimation. Laughlin delineated twenty-two major and twenty-six minor defense mechanisms, Vaillant and Vaillant named eighteen, which they grouped according to inferred maturity, and the DSM-Four enumerates thirty-one, also grouped by level. Cramer contrasts defense mechanism with deliberate coping strategies by noting the unconscious, automatic, nonintentional quality of defenses.

I describe here a selection of operations that is more extensive than Anna Freud's but less comprehensive than Laughlin's and Vaillant's lists. I have chosen the "mature," or "higher-order," defenses to be covered according to two criteria: (one) the frequency with which they are mentioned in psychoanalytic clinical literature and by practicing therapists, and (two) their relevance to particular character patterns. Anyone else's list would probably be different, would emphasize other aspects of defense, and would reflect another writer's distinctive take on analytic theory and practice.

Repression

Repression was one of the first defenses to fascinate Freud, and it has enjoyed a long history of clinical and empirical investigation. The essence of repression is motivated forgetting or ignoring. Its implicit metaphor recalls the early drive model with its idea that impulses and affects press for release and have to be held in check by a dynamic force. Freud wrote that "the essence of repression lies simply in turning something away, and keeping it at a distance, from the conscious." If either an internal disposition or an external circumstance is sufficiently upsetting or confusing, it may be deliberately consigned to unconsciousness. This process may apply to a total experience, to the affect connected with an experience, or to one's fantasies and wishes associated with it.

Not all difficulty in paying attention or remembering constitutes repression. Only when there is evidence that an idea or emotion or perception has become consciously inaccessible because of its power to upset are there grounds for assuming the operation of this defense. Other attentional and memory deficits may result from toxic or organic conditions, or simply from the ordinary mental sifting of the important from the trivial. (Now that I am in my sixties and regularly forgetting what I came upstairs for, it occurs to me that the Freudian theory that memory lapses are always dynamically provoked could only have been developed by a relatively young man.)

Freud saw the operation of repression in traumatic experiences such as rape or torture that the victim later cannot recall. Instances of what were once called the "war neuroses," now known as posttraumatic stress reactions, have been psychoanalytically explained by reference to the concept of repression. In such cases, a person is unable to remember at will certain horrifying, life-threatening events but may be troubled by intrusive flashbacks of them, a phenomenon to which Freud would have attached the colorful label "the return of the repressed." Our current knowledge of brain processes suggests that repression is not an accurate concept for such traumatic memory problems. We now know that under extreme stress, the functioning of the hippocampus, which stores episodic memory (the sense of "it happened to me; I was there"), is shut down by the glucocorticoids secreted during trauma. Thus, the episodic memory is not laid down in the first place. After a trauma there may be semantic memory (third-person facts after the event), procedural memory (physical experience of the event, or "body memory"), and emotional memory (feeling the emotions that were activated in the event when something, such as being in the place it happened, reminds one of it), but there may never be episodic memory. I say more about the clinical implications of these facts in Chapter fifteen.

Later analytic theory applied the term "repression" more to internally generated ideas than to trauma. This is the version of repression that has remained most useful to therapists. Repression is seen as the means by which children deal with developmentally normal but unrealizable and frightening strivings, such as the oedipal wish to destroy one parent and possess the other: They eventually relegate them to unconsciousness. One must have attained a sense of the wholeness and continuity of the self before one is capable of handling disturbing impulses by repression. For people whose early experiences did not foster identity integration, troublesome feelings tend to be handled with more primitive defenses, such as denial, projection, and splitting.

A clinically inconsequential example of repression, the kind that Freud saw as part of the "psychopathology of everyday life," would be a speaker's momentarily forgetting the name of someone he or she is introducing, when there is evidence for the speaker's unconscious negative feeling toward that person. In the developmentally normal repressive processes that allow children to reject infantile love objects and seek partners outside the family, and in trivial (and often entertaining) instances of repression, one can see the adaptive nature of the process. If we were constantly aware of the whole panoply of our impulses, feelings, memories, images, and conflicts, we would be chronically overwhelmed. Like other defenses, repression becomes problematic only when it (one) fails to do its job of keeping disturbing ideas out of consciousness so that we can go about the business of accommodating to reality, or (two) gets in the way of certain positive aspects of living, or (three) operates to the exclusion of other more successful ways of coping. Overreliance upon repression, along with certain other defensive processes that often coexist with it, has classically been considered the hallmark of the hysterical personality.

Freud's early efforts to get hysterical patients to bring into consciousness both the traumatic events of their histories and the urges and feelings they had been raised to consider unacceptable yielded fascinating information. From working with this population Freud originally concluded, as I mentioned in Chapter two, that repression causes anxiety. According to his original mechanistic model, the anxiety that is such a frequent concomitant of hysteria is caused by a repressive bottling up of drives and affects. These feelings press for discharge and hence cause a chronic state of tension (some irreverent commentators have called this the "coitus interruptus" theory of the relationship of repression to anxiety). Later, as Freud revised his theory in light of accumulating clinical observations, he reversed his version of cause and effect, regarding repression and other defense mechanisms as the result rather than the cause of anxiety. In other words, preexisting irrational fear created the need to forget.

This later formulation of repression as an elemental defense of the ego, the automatic suppressor of countless anxieties that are simply inherent in living one's life, became standard psychoanalytic theory in the ego psychology era. Nevertheless, Freud's original postulation of repression as the instigator of anxiety is not without some intuitive appeal, in that excessive repression may ultimately cause as many problems as it solves. This process, labeled by Mowrer the "neurotic paradox," whereby attempts to quell one anxiety only generate others, is the core characteristic of what was once (in a much more comprehensive use of the term than is typical now) called neurosis. Along these lines, Theodor Reik used to contrast the emotionally healthy person, who can stand in front of the window at Tiffany's admiring the jewelry and tolerating a passing fantasy of stealing it, with the neurotic person, who looks in the window and runs in the opposite direction. When psychoanalysis first captured the imagination of the educated public, such popularized examples of the pathological operation of repressive defenses contributed to a widespread overvaluation of the goals of removing repression and shedding inhibitions, and also to the misunderstanding that these processes constitute the essence of all psychoanalytic therapies.

An element of repression is present in the operation of most of the higher-order defenses (although it is arguable that denial rather than repression is operating in instances in which it is unclear whether or not the person was originally aware of something before losing that knowledge). For example, in reaction formation, the turning of an attitude into its opposite, such as hate into love or idealization into contempt, the original emotion can be seen as repressed (or denied, depending on whether it was ever consciously felt). In isolation, the affect connected with an idea is repressed (or denied, as above). In reversal, there is a repression of the original scenario that is now being turned around. And so forth. Freud's original belief that repression was a sort of grandparent of all other defenses can be seen sympathetically in this light, despite current evidence that the processes described in Chapter Five predate repression in the child by at least a year and a half. In Chapter Fifteen I discuss current analytic views that dissociation is a more basic defense than repression, but for purposes of this chapter, I am giving the more classical account.