Twelve aspects of ego functions (coping skills)
*useful for treatment planning, some are included in MSE, will need for next semester*
When doing case conceptualizations later, we'll be looking at defenses, theories, ego strengths
1.
Reality Testing
2.
Judgment
3.
Sense of Reality
The assessment of the level of self-esteem and separateness (how separate you are)
from the world and others (ex: you blame yourself, but there's an external reason
for it).
4.
Regulation of
Control (Drive of
Control)
How directly the client expresses their impulses and their ability to delay impulses
or expressions of affect. Impulse control, emotional regulation. Q: Examining their
frustration tolerance will give a good idea of their regulation of control.
5.
Object Relations
The assessment of the degree of relatedness the client has with others in their life,
past and present. Basically looking at relationship patterns. (separate from the theory)
6.
The ability to distinguish between internal and external stimuli.
The ability to anticipate consequences of behavior, and awareness of
consequences.
Thought Processes Attention, concentration, anticipation, organization of thoughts, concept formation,
thinking, memory, language; the cognitive side of thought.
7.
Adaptive
Regression
How well the client is able to relax perceptions and increase their ability to access
unconscious material. Q: How well can the client look at the past / thinking about
the past (regress), without anxiety?
8.
Defensive
Functioning
The degree to which defenses are adaptive or maladaptive, and how they influence
thought, affect, and behavior. Q: How do they handle stress?
9.
Stimulus Barrier
10.
Autonomous
Functioning
The client's ability to function independently based upon physiological status.
Secondary autonomous functioning consists of habits and patterns.
11.
Synthetic
Integration of
Functioning
The capacity to reconcile or integrate discrepancies in attitude, affect, behavior,
values, self-representations. How the client handles unexpected changes;
flexibility. Cognitive dissonance and rationalization.
12.
Mastery
Competence
Self-efficacy. Conscious statements of feeling adequate or successful; ability to
perform.
The client's threshold for sensitivity to and awareness of stimuli impinging on
sensory modalities and how they cope with that. E.g., Hypervigilance, paranoia.
Q: Can they tune out noise / distractions in the environment?
Definition: "psychological techniques to protect ourselves from anxiety, stress, and conflict, and to maintain
self-esteem." We all have them and use them; they don't develop out of trauma, only anxiety. The healthier
the person, the less reliant they are upon defense mechanisms.
Pathology occurs when you use the same defenses but they aren't helpful.
Defense Mechanism
Description
Example
Repression
Involuntary exclusion from conscious awareness of
conflictual or painful impulses, thoughts, or memories (aka
motivated forgetting) so you don't have to deal with it.
Battered child has no memory
before age 7.
Projection
Attributing your feelings/impulses/characteristics, things you
don't like about yourself, onto someone else instead of
acknowledging they're yours. [part of transference]
Woman represses her own sexual
hunger and dismisses all men as sex
fiends.
Introjection
(internalization)
Assimilation of characteristics of an object into yourself. Can
occur as part of or during a trauma.
Man envies his boss so he adopts his
politics and tastes. Client will say
they did something to cause the
trauma, abandoned because "I'm
not good enough."
Displacement
Affect originally focused on one target is transferred to
another innocuous target. [part of transference]
Kid gets in trouble at school, comes
home and gets mad at parents.
Symbolization
An object or act represents a complex group of objects or
"Sometimes a cigar isn't just a
acts which may create conflict or unacceptable feelings in the cigar…"
person. The symbol stands for some repressed desire.
Soldier in Vietnam War has internal
"Representation of affect-laden person, thing, or thought in
conflict. When asked why he
the form of another person, thing, or thought that has some participated in the war, he responds,
similarity of association."
"I did it for the flag."
Conversion
Somatization
Deflection
Anxiety, stress, conflict, is transformed and expressed
through physical symptoms involving portions of the body
that are supplied by sensory or motor nerves. Usually
impacts a major body part that is sensory or used for motor
function.
This and somatization are the only two considered to be
pathological.
Actual example: During the Vietnam
War, women were out in the rice
fields collecting rice. As they were
walking back, the village was
bombed. All of the women went
blind; but had nothing wrong with
their eyes.
Expression of conflict by production of physical symptoms
Child is afraid of being bullied at
involving illness and pain, sometimes symbolic of the conflict. school, develops a stomachache
before school.
Person draws attention away from the real source of anxiety
or conflict by distracting or confusing actions, statements,
etc.
Group therapy, person deflects by
moving attention onto another
participant instead of talking about
themselves.
Isolation
Denial
Acting Out
Dissociation
Person separates or closes off from others. Could be
physically and/or emotionally. May push people away and
engage in seclusion and solitude.
"I'm upset, leave me alone."
Failure to recognize external reality; refusing to believe
information that's anxiety producing.
Patient with malignant tumor insists
she does not have cancer.
Engaging in actions rather than reflecting on internal feelings
or the real reason for the anxiety/stress conflict.
Where the person loses track of time and/or person and
instead find another representation of the self in order to
continue in the moment.
A child who has been sexually
abused may create an imaginary
friend who takes the abuse, so they
won't have to.
Intellectualization
Avoid unacceptable or difficult emotions by focusing on the
intellectual aspects. Overuse of reasoning or logic to avoid
awareness of feelings and impulses.
Adolescent talks at great length
about social issues to avoid
confronting his own aggressive
impulses. Parent passes away, child
focuses on the planning of the
funeral instead of the thoughts and
feelings.
Idealization
Overestimation of positive qualities and underestimation of
limitations of a desired object.
Widower is unable to recall any of
the things he ever resented about
his wife.
Regression
Return to an earlier, less mature stage of behavior, usually
associated with the person's most fixated stage.
Transference is a regressive phenomena because it's
transferred from the past.
Five-year-old boy begins wetting his
bed again when sibling is born.
Rationalization
Elaboration of socially acceptable reasons to justify behavior,
rather than to expose the true motive.
Splitting
Having an attitude about the self and others that is black and
white; perceiving of things as all good or all bad.
Substitution
An unobtainable goal or object is replaced by one that can be
achieved.
Sublimation
Partial gratification of an impulse by altering the aim or
object to make it socially more acceptable
Man channels aggressive urges into
athletic competition.
Reaction formation
Reversal of an impulse to its opposite
Jealous older sister becomes very
protective and affectionate toward
infant sibling.
Affiliation
Turning to other people for support.
Aim Inhibition
Avoidance
Help-Rejecting
Complaining
Accepting partial gratification of an impulse. Accepts a
modified form of their original goal so there's a change in
focus.
Settling for being just friends.
Refusal to deal with or encounter unpleasant objects or
situations.
The individual complains or makes repetitious requests for
help that disguise covert feelings or hostility or reproach
toward others. The negative feelings then expressed by
rejecting the suggestions/advice/help that others offer.
Compartmentalizing
Process of separating parts of the self from awareness of
other parts and behaving as if one had separate sets of
values.
Compensation
Overachieving in one area to compensate for failures in
another.
Omnipotence
Dealing with conflict by feeling or acting as if he or she
possesses special powers or abilities and is superior to
others.
Fantasy
When used as a defense mechanism, the person is
channeling unobtainable desires into imagination.
Fan-fiction.
Altruism
Satisfying internal needs by helping others.
Volunteering for homeless shelter
helps man recognize his situation
isn't so bad.
Humor
Pointing out the funny or ironic aspects of a situation in order
to deal with it. Often self-deprecating humor or poking at
someone else's inadequacy.
Self-Assertion
(Assertiveness)
Person deals with conflicts by expressing their feelings and
thoughts directly, in a way that is not coercive or
manipulative.
Passive-Aggression
Indirectly express anger and instead of vocally expressing
displeasure, they remain quiet.
Undoing
Person engages in behavior to make up for an undesirable
behavior.
Resistance
Person feels uncomfortable with the situation and they
engage in opposition.
Client is reluctant to participate in
therapy. Even though they're
miserable, it's the comfort of
familiarity.
Suppression
Conscious exclusion from awareness of painful impulses,
thoughts, or memories
"I choose not to think about that."
Isolation (of affect)
Repression of affect away from a thought, or a thought away
from its affect
Medical student dissects cadaver
without any feelings about death.
Identification
Modeling of one's self on another person or group, but with
less intensity and completeness than with introjection
Conscious emulation of an admired
public figure; early life- parents.
Identification with the
aggressor
Incorporation of aspects of another person who is perceived
as serious threat or cause of frustration
Boy in Oedipal stages assumes
characteristics of his father.
Self-destructive thoughts or actions replace aggression
toward other objects
Woman blocks anxiety over fight
with husband by getting into minor
auto accident.
Action in anticipation of being acted upon
Patient misses therapy session just
before therapist's announced
vacation.
Turning (aggression)
against the self
Turning passive into active