The Psychodynamic Approach During COVID-19 Emotional Crisis

Conversano, Ciro

doi:10.3389/fpsyg.2021.670196

Cited by 12 publications

(8 citation statements)

References 92 publications

(77 reference statements)

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“…The systematic assessment of defense mechanisms in clinical settings is very important for monitoring the therapeutic process and aiding clinicians in choosing how to intervene in response to defenses used in the session (Fonagy et al, 2008;Gabbard, 2014;Conversano, 2021). The use of valid and reliable measures based on the gold-standard theory is essential for ensuring that what we observe is properly operationalized.…”

Section: Discussionmentioning

confidence: 99%

“…All DMRS-based measures refer to the generally accepted hierarchy of defense mechanisms (American Psychiatric Association, 1994Association, , 2013Hoglend and Perry, 1998;Lingiardi et al, 1999;Drapeau et al, 2003;Hilsenroth et al, 2003;Perry, 2014;Di Giuseppe et al, 2019, 2021Tanzilli et al, 2021). A graphical summary of the hierarchy of defense mechanisms is shown in Figure 1.…”

Section: The Hierarchy Of Defense Mechanismsmentioning

confidence: 99%

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The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the Defense Mechanisms Rating Scales Q-Sort

Giuseppe

Perry

2021

Front. Psychol.

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The psychodynamic concept of defense mechanisms is nowadays considered by professionals with various theoretical orientations of great importance in the understanding of human development and psychological functioning. More than half century of empirical research has demonstrated the impact of defensive functioning in psychological well-being, personality organization and treatment process-outcome. Despite the availability of a large number of measures for their evaluation, only a few instruments assess the whole hierarchy of defenses, based on the Defense Mechanisms Rating Scales (DMRS), which arguably offers an observer-rated gold standard of assessment. The present article illustrates the theoretical and methodological background of the DMRS-Q, the Q-sort version of the DMRS for clinical use. Starting from the definition and function of the 30 defense mechanisms included in the hierarchy, we extracted 150 items that captured a full range of defensive manifestations according to the DMRS theory. The DMRS-Q set is described in this paper with reference to the DMRS manual. Directions are also provided for using the DMRS-Q online software for the free and unlimited coding of defense mechanisms. After each coding, the DMRS-Q software provides a report including qualitative and quantitative scores reflecting the individual’s defensive functioning. Qualitative scores are displayed as the Defensive Profile Narratives (DPN), while quantitative scores are reported as Overall Defensive Functioning (ODF), defensive categories, defense levels, and individual defense mechanisms. Syntax for the scoring is displayed in the results and a clinical vignette of a psychotherapy session coded with the DMRS-Q is provided. The DMRS-Q is an easy-to-use, free, computerized measure that can help clinicians in monitoring changes in defense mechanisms, addressing therapeutic intervention, fostering symptoms decreasing and therapeutic alliance. Moreover, the DMRS-Q might be a valid tool for teaching the hierarchy of defense mechanisms and increase the observer-rated assessment of this construct in several research fields.

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Section: Discussionmentioning

confidence: 99%

Section: The Hierarchy Of Defense Mechanismsmentioning

confidence: 99%

The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the Defense Mechanisms Rating Scales Q-Sort

Giuseppe

Perry

2021

Front. Psychol.

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“…For instance, mature defenses (e.g., anticipation, humor, self-assertion) mitigate negative emotions and representations associated with conflict and distress (MacGregor and Olson, 2005;Martino et al, 2020), whereas immature defenses (e.g., splitting, denial, passive aggression) are linked to maladaptive personality traits at the base of several forms of psychopathology (Zimmerman et al, 2019;Boldrini et al, 2020;Perry et al, 2020). Several studies have shown that defense styles contribute significantly to individual differences in responses to stressful environments (Vaillant, 1992;Schulz et al, 2005;Cramer, 2006;Prout et al, 2020;Conversano, 2021;Di Giuseppe et al, 2021). Individuals with GD may be subject to numerous stressful events, due to social discrimination and stigma.…”

Section: Introductionmentioning

confidence: 99%

Defensive Functioning of Individuals Diagnosed With Gender Dysphoria at the Beginning of Their Hormonal Treatment

et al. 2021

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Defense mechanisms are relevant indicators of psychological functioning and vulnerability to psychopathology. Their evaluation can unveil individuals' unconscious strategies for mediating reactions to emotional conflict and external stressors. At the beginning of their journey toward gender reassignment, individuals diagnosed with gender dysphoria (GD) may experience conflict and stressful experiences that trigger a wide range of defense mechanisms. Mature defenses may strengthen these individuals as they travel along this important path, while neurotic and immature defenses may exacerbate their body dissatisfaction (BD) and hinder their processing of change. Only a few studies have investigated self-reported defensive functioning in transgender people, finding a higher frequency of maladaptive defense mechanisms relative to controls. The present study was the first to apply an in-depth clinician-rated tool to assess the entire hierarchy of defense mechanisms within a sample of transgender people. Defensive functioning and personality organization were assessed in 36 individuals diagnosed with GD (14 trans women, 22 trans men, mean age 23.47 years), using the Defense Mechanisms Rating Scales (Perry, 1990) and the Shedler-Westen Assessment Procedure-200 (Shedler et al., 2014). Body uneasiness was assessed using the Body Uneasiness Test (BUT; Cuzzolaro et al., 2006). The findings showed that defensive functioning correlated positively with healthy personality functioning and negatively with BD. Compared to cisgender controls, participants with GD who presented greater defensive functioning were found to be more immature and to demonstrate significant differences in many levels of functioning. The clinical implications of the results suggest that psychological interventions aimed at improving defensive functioning in individuals with GD will be important in helping them manage the challenges posed by their gender transition.

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“…Defenses - defined as automatic psychological operations that mediate an individual’s reaction to emotional conflicts and to internal or external stressors (APA, 2013) - are important aspects of mental functioning that mediate individual’s resilience and adaptation to life’s demands (Vaillant, 1995 ; Cramer, 2006 ). Adaptive defenses, such as altruism, humour, and sublimation, are in maintaining physical and mental health across the lifespan (Beresford, 2012 ; Conversano, 2021 ; Malone et al ., 2013 ; Metzger, 2014 ). Conversely, over-reliance on immature defenses, such as projective identification and splitting, is associated with greater symptom severity (Boldrini et al ., 2020 ; Prout et al ., 2020), suicide risk (Hovanesian et al ., 2009 ), personality disorders (Lingiardi & Giovanardi, 2017 ; Maffei et al ., 1995 ; Kempe et al ., 2021 ), insecure attachment (Békés et al ., 2021a ; Tanzilli et al ., 2021), negative physical health outcomes (Di Giuseppe et al ., 2018 ) and high level of stress (Aafjes-Van Doorn et al ., 2021 ; Di Giuseppe et al ., 2021 a).…”

Section: Introductionmentioning

confidence: 99%

Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children

Giuseppe

Prout

Ammar

et al. 2021

RES PSYCHOTHER-PSYCH

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Defense mechanisms are unconscious and automatic psychological processes that serve to protect the individual from painful emotions and thoughts. There is ample evidence from the adult psychotherapy and mental health literature suggesting the salience of defenses in the maintenance and amelioration of psychological distress. Although several tools for the assessment of children’s defenses exist, most rely on projective and self-report tools, and none are based on the empirically derived hierarchy of defenses. This paper outlines the development of the defense mechanisms rating scale Q-sort for children (DMRS-Q-C), a 60-item, observer-rated tool for coding the use of defenses in child psychotherapy sessions. Modifications to the Defense Mechanisms Rating Scale Q-Sort for adults to create a developmentally relevant measure and the process by which expert child psychotherapists collaborated to develop the DMRS-Q-C are discussed. A clinical vignette describing the child’s defensive functioning as assessed by the innovative DMRS-Q-C method is also reported. Finally, we provide an overview of forthcoming research evaluating the validity of the DMRS-Q-C.

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The Psychodynamic Approach During COVID-19 Emotional Crisis

Cited by 12 publications

References 92 publications

The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the Defense Mechanisms Rating Scales Q-Sort

The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the Defense Mechanisms Rating Scales Q-Sort

Defensive Functioning of Individuals Diagnosed With Gender Dysphoria at the Beginning of Their Hormonal Treatment

Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children

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