Editing Defence mechanism (section)

== Vaillant's categorization ==
{{More citations needed section |date=June 2013}}
Psychiatrist [[George Eman Vaillant]] introduced a four-level classification of defence mechanisms:<ref name="Cramer">{{Cite book|title=Protecting the Self|last=Cramer|first=Phebe|publisher=The Guilford Press|date=May 2006|isbn=9781593855284|page=[https://books.google.com/books?id=FNsmzy-lLagC&pg=PA17 17]}}</ref><ref>{{Cite journal|last=Vaillant|first=George|date=1994|title=Ego mechanisms of defense and personality psychopathology|url=http://web.vu.lt/uki/s.kontrimiene/files/2011/10/Vaillant.-Ego-mechanisms-of-defense.pdf|journal=Journal of Abnormal Psychology|volume=103|issue=1|pages=44–50|doi=10.1037/0021-843X.103.1.44|pmid=8040479}}</ref>  Much of this is derived from his observations while overseeing the Grant study that began in 1937 and is on-going.  In monitoring a group of men from their freshman year at Harvard until their deaths, the purpose of the study was to see longitudinally what psychological mechanisms proved to have impact over the course of a lifetime.  The hierarchy was seen to correlate well with the capacity to adapt to life. His most comprehensive summary of the on-going study was published in 1977.<ref>{{cite book |last1=Vailant |first1=George |title=Adaptation to Life |date=1977 |publisher=Little Brown |location=Boston |isbn=0-316-89520-2}}</ref> The focus of the study is to define mental health rather than disorder.

*Level I – pathological defences (psychotic denial, delusional projection)
*Level II – immature defences (fantasy, projection, passive aggression, acting out)
*Level III – neurotic defences (intellectualization, reaction formation, dissociation, displacement, repression)
*Level IV – mature defences (humour, sublimation, suppression, altruism, anticipation)

===Level 1: pathological===
When predominant, the mechanisms on this level are almost always severely [[Psychopathology|pathological]].  These defences, in conjunction, permit one effectively to rearrange external experiences to eliminate the need to cope with reality.  Pathological users of these mechanisms frequently appear irrational or [[Insanity|insane]] to others. These are the "pathological" defences, common in overt [[psychosis]].  However, they are normally found in dreams and throughout childhood as well.<ref name="Vaillant, G. E. 1986">Vaillant, G. E., Bond, M., & Vaillant, C. O. (1986). An empirically validated hierarchy of defence mechanisms. Archives of General Psychiatry, 73, 786–794. George Eman Valillant</ref>
They include:
*''[[Delusion|Delusional projection]]'': Delusions about external reality, usually of a persecutory nature
*''[[Denial]]'': Refusal to accept external reality because it is too threatening; arguing against an anxiety-provoking stimulus by stating it does not exist; resolution of emotional conflict and reduction of anxiety by refusing to perceive or consciously acknowledge the more unpleasant aspects of external reality
*''[[Cognitive distortion|Distortion]]'': A gross reshaping of external reality to meet internal needs

===Level 2: immature===
These mechanisms are often present in adults. These mechanisms lessen distress and anxiety produced by threatening people or by an uncomfortable reality.  Excessive use of such defences is seen as socially undesirable, in that they are immature, difficult to deal with and seriously out of touch with reality.  These are the so-called "immature" defences and overuse almost always leads to serious problems in a person's ability to cope effectively.  These defences are often seen in [[major depression]] and [[personality disorders]].<ref name="Vaillant, G. E. 1986"/>
They include:
*''[[Acting out]]'': Direct expression of an unconscious wish or impulse in action, without conscious awareness of the emotion that drives the expressive behavior
*''[[Hypochondriasis]]'': An excessive preoccupation or worry about having a serious illness
*''[[Passive-aggressive behavior]]'': Indirect expression of hostility
*''[[Psychological projection|Projection]]'': A primitive form of [[paranoia]]. Projection reduces anxiety by allowing the expression of the undesirable impulses or desires without becoming consciously aware of them; attributing one's own unacknowledged, unacceptable, or unwanted thoughts and emotions to another; includes severe [[prejudice]] and [[Envy|jealousy]], [[hypervigilance]] to external danger, and "injustice collecting", all with the aim of shifting one's unacceptable thoughts, feelings and impulses onto someone else, such that those same thoughts, feelings, beliefs and motivations are perceived as being possessed by the other.
*''[[Fantasy (psychology)|Schizoid fantasy]]'': Tendency to retreat into fantasy in order to resolve inner and outer conflicts
*''[[Splitting (psychology)|Splitting]]'': A primitive defence. Both harmful and helpful impulses are split off and segregated, frequently projected onto someone else. The defended individual segregates experiences into all-good and all-bad categories, with no room for ambiguity and ambivalence. When "splitting" is combined with "projecting", the undesirable qualities that one unconsciously perceives oneself as possessing, one consciously attributes to another.<ref name="McWilliams">{{cite book|title=Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process, Second Edition|last=McWilliams|first=Nancy|publisher=The Guilford Press|year=2011|isbn=978-1609184940|location=New York, NY|pages=60,63,103}}</ref>

===Level 3: neurotic===
These mechanisms are considered [[neurosis|neurotic]], but fairly common in adults. Such defences have short-term advantages in coping, but can often cause long-term problems in relationships, work and in enjoying life when used as one's primary style of coping with the world.<ref name="Vaillant, G. E. 1986"/>
They include:
*''[[Displacement (psychology)|Displacement]]'': Defence mechanism that shifts sexual or aggressive impulses to a more acceptable or less threatening target; redirecting emotion to a safer outlet; separation of emotion from its real object and redirection of the intense emotion toward someone or something that is less offensive or threatening in order to avoid dealing directly with what is frightening or threatening.  
*''[[Dissociation (psychology)|Dissociation]]'': Temporary drastic modification of one's personal identity or character to avoid emotional distress; separation or postponement of a feeling that normally would accompany a situation or thought.
*''[[Intellectualization]]'': Excessively analytical or abstract thought patterns, potentially leading to increased distance from one's emotions. Used to block out conflicting or disturbing feelings or thoughts.<ref>{{Citation |last1=Bailey |first1=Ryan |title=Defense Mechanisms |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK559106/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32644532 |access-date=2022-06-28 |last2=Pico |first2=Jose}}</ref>
*''[[Isolation (psychology)|Isolation]] of [[Affect (psychology)|affect]]'': The detachment of emotion from an idea, making it "flat." Frequently observed in [[obsessive–compulsive disorder]], and in non-disordered people following traumatic events.<ref>{{Cite web |title=isolation of affect |url=https://www.oxfordreference.com/view/10.1093/oi/authority.20110803100012916 |access-date=2022-06-28 |website=Oxford Reference |language=en }}</ref>
*''[[Reaction formation]]'': Converting unconscious wishes or impulses that are perceived to be dangerous or unacceptable into their opposites; behaviour that is completely the opposite of what one really wants or feels; taking the opposite belief because the true belief causes anxiety
*''[[Psychological repression|Repression]]'': The process of attempting to repel desires towards pleasurable instincts, caused by a threat of suffering if the desire is satisfied; the desire is moved to the unconscious in the attempt to prevent it from entering consciousness;<ref name="LaplancheP390">Laplanche pp. 390, 392{{Full citation needed|date=May 2017}}<!-- This is probably "The language of psychoanalysis" 1973 by Jean Laplanche. If someone has access to it, then please check if it does show these things. --></ref> seemingly unexplainable naivety, memory lapse or lack of awareness of one's own situation and condition; the emotion is conscious, but the idea behind it is absent<ref>[http://www.eric.vcu.edu/home/resources/pipc/Other/Personality/Table_Defenses.pdf Psychological Defenses from DSM-IV (see Repression)], Virginia Commonwealth University. Retrieved on December 12, 2014.</ref>

===Level 4: mature===
These are commonly found among emotionally healthy adults and are considered mature, even though many have their origins in an immature stage of development. They are conscious processes, adapted through the years in order to optimise success in human society and relationships. The use of these defences enhances pleasure and feelings of control. These defences help to integrate conflicting emotions and thoughts, whilst still remaining effective.  Those who use these mechanisms are usually considered [[virtue|virtuous]].<ref name="Vaillant, G. E. 1986"/>
Mature defences include:
*''[[Altruism]]'': Constructive service to others that brings pleasure and personal satisfaction
*''[[Anticipation (emotion)|Anticipation]]'': Realistic planning for future discomfort
*''[[Humour]]'': Overt expression of ideas and feelings (especially those that are unpleasant to focus on or too terrible to talk about directly) that gives pleasure to others. The thoughts retain a portion of their innate distress, but they are "skirted around" by witticism, for example, [[self-deprecation]].
*''[[Sublimation (psychology)|Sublimation]]'': Transformation of unhelpful emotions or instincts into healthy actions, behaviours, or emotions; for example, playing a heavy contact sport such as football or rugby can transform aggression into a game<ref name="autogenerated483">Schacter, Gilbert, Wegner (2011), ''Psychology'' (2nd edition), Worth Publishers, p. 483</ref> 
*''[[Thought suppression|Suppression]]'': The conscious decision to delay paying attention to a thought, emotion, or need in order to cope with the present reality; making it possible later to access uncomfortable or distressing emotions whilst accepting them