The Structure and Process of Defense in Diagnosis of Personality and in Psychoanalytic Treatment

Operational Diagnostic Approaches in the Assessment of Defense Mechanisms

“…Recovery from psychological ill ness or upset is associated with a shift from the use of less to more mature defenses [3,39,49], The clinically rated maladjustment corre lates negatively to mature defenses like sup pression, altruism, sublimation, anticipation, and humor [43,50], and positively with de nial, projection, turning against self, hypo chondriasis, and acting out [43], Psychopa thology rated by observers is positively related to denial, projection, and rationalization (dis avowal defenses), whereas self-reported psy chopathology is negatively related to the use of disavowal defenses [14],…”

“…With the CDAM Ehlers [3] examined the process of two patients with different maturi ty levels of functioning with the hypotheses that increased depth of regression with re spect to the functional level will result in less mature defense mechanisms during the psy choanalytic process. The rating was enabled by the psychoanalyst's subjective assessment of the dominant defense mechanisms after each session.…”

“…The CADM is a German manual which was applied to clinical interviews with psy chosomatic and neurotic patients [15][16][17] and to the psychoanalytic process [3], Ehlers [18] followed the suggestion of Suppes and Warren [ 19] to define a defense mechanism as the log ical relation between the behaving subject and the object to which the action of the subject is Delayed affect expression S delays affect expres sion to avoid connec tion between impulse (D) and object (0).…”

“…The new task in clinical psychodynamic research of defense mecha nisms is to look for the rigorous application of the principles of testability and scientific ver ification with the construction of an empiri cally based manual for the rating of defense mechanisms. This method is represented in this article by two methods, the Defense Mechanism Rating Scales (DMRS) [1], and the Clinical Assessment of Defense Mecha nisms (CADM) [2,3].…”