Psychological Defense Mechanisms & Barriers to Therapeutic Communication

Compensation

Overemphasizing a trait to make up for a perceived or actual failing.

Denial

An unconscious attempt to reject unacceptable feelings, needs, thoughts, wishes, or external reality factors.

Displacement

The unconscious transfer of unacceptable thoughts, feelings, or desires from the self to a more acceptable external substitute.

Dissociation

Disconnecting emotional significance from specific ideas or events.

Identification

Mimicking the behavior of another to cope with feelings of inadequacy.

Introjection

Adopting the unacceptable thoughts or feelings of others.

Projection

Projecting onto another person one's own feelings, as if they had originated in the other person.

Rationalization

Justifying unacceptable behavior, thoughts, and feelings into tolerable behaviors.

Regression

Unconsciously returning to more infantile behaviors or thoughts.

Repression

Putting unpleasant thoughts, feelings, or events out of one's mind.

Substitution

Unconsciously replacing an unreachable or unacceptable goal with another, more acceptable one.

Reassurance

Indicates to the patient that there is no need for anxiety or worry, potentially devaluing the patient's feelings.

Approval

Overtly approving of a patient's behavior, which may lead the patient to strive for praise rather than progress.

Disapproval

Overtly disapproving of a patient's behavior implies judgment on the patient's thoughts and actions.

Agreeing/disagreeing

Overtly agreeing or disagreeing with patients can lead to miscommunication and conflict.

Advising

Telling the patient what should be done, which places the caregiver outside their scope of practice.

Probing

Discussing a topic that the patient has no desire to discuss.

Defending

Protecting oneself or the institution from verbal attack, which may hinder communication.

Requesting an explanation

Asking patients to provide reasons for their behavior, which may be intimidating.

Minimizing feelings

Judging or making light of a patient's discomfort, failing to perceive from the patient's perspective.

Making stereotyped comments

Using meaningless clichés when communicating with patients instead of thoughtful explanations.

Coping Mechanisms

Unconscious strategies developed by patients to protect themselves.