Is Defense a Way of Coping?

Types of defense and coping

Many psychoanalysts have presented different classifications of defenses, but it is Vaillant who is one of the most important contributors in this regard. He suggested a developmental hierarchy for defense that goes from mature techniques like sublimation, humor, and altruism to psychotic processes like denial and distortion.^[8] Vaillant’s^[9] classification includes pathological defenses (psychotic denial and delusional projection), immature defenses (fantasy, projection, passive aggression, and acting out), neurotic defenses (intellectualization, reaction formation, dissociation, displacement, and repression) and mature defenses (humor, sublimation, suppression, altruism, and anticipation). He added that the lowest-level defenses distort reality, the intermediate ones helps to alter the subjective distress but could seem to be odd and inappropriate from an outsider’s perspective, and the highest-order defenses help to bring integrity to interpersonal relationships with feelings.^[9–11] Other psychoanalysts have also tried quantifying the defenses such as 22 major and 26 minor mental mechanisms proposed by Laughlin,^[12] 39 by Bibring et al.,^[13] and 44 by Suppes and Warren^[14] and so on.

Similar to defense mechanisms, many researchers have provided different classifications of coping. One of the most widely discussed classifications of coping is based on the dimensions, which include emotion-focused and problem-focused.^[15] Emotion-focused coping deals with altering the emotional and subjective distress, while problem-focused coping deals with altering the distressing situation itself.^[16] Other researchers have also added other dimensions of coping. Krohne^[17] discussed avoidance coping, which includes both behavioral and psychological disengagement from a stressful situation. Roth & Cohen^[18] discussed approach coping which includes confrontation and deliberate attempts to reduce situational stress. Another dimension “appraisal focused coping” has been discussed by Cox and Fergusen^[19] which is re-evaluating the situation to alter its importance. Further, Folkman and Lazarus have divided the coping strategies between active and passive in their coping assessment scale. The active coping strategies include confrontive coping, social support, problem-solving, and positive reappraisal. And the passive strategies are distancing, self-control, accepting responsibility, and escape/avoidance.^[20]

Defense and coping: similarities and differences

The concept of coping is a similar one that overlaps with the concept of defense and both of the concepts have been confused with each other frequently.^[21] The confusion stems from the contributions of various researchers such as Haan^[22], who has included sublimation as a coping strategy which has previously been included in the list of defense^[13] Vaillant^[9] has also included suppression as a defense, which was previously defined as a conscious and purposeful act.^[21] Even though both coping and defense seem to have the primary function to deal with stress^[21] there seems to be a conceptual difference between the two. While defenses are mainly deployed to reduce the subjective sense of distress, coping is the organization of a person’s available resources which may or may not bring the desired outcomes.^[23]

The differentiation between coping and defense can be drawn based on various domains, such as coping being the conscious and unconscious process. According to Cramer^[5,21], coping tends to be the conscious process and is typically related to an individual’s plan and goal, thus signaling the intentionality of the process. While defense being the unconscious process does not revolve around the anticipated outcome in some explicit objective. Another domain that can differentiate coping and defenses is the developmental hierarchy. As stated earlier, according to Vaillant, the defense usually follows a developmental hierarchy, this similar concept does not apply to coping.^[21] However, developmental trajectories in coping have been identified in terms of age differences in using particular types of coping and the types of stress one is dealing with at that particular age.^[24] According to Frydenberg,^[6] the neurological, cognitive, social, and attentional changes could explain the difference in coping patterns and abilities between children and adults. The criteria of normality and pathological is another domain to differentiate between defense and coping. It has usually been believed that defenses are part of the pathological process while coping is a part of the normal process. Anna Freud’s^[2] work is noteworthy to mention in this regard and suggested that several factors could be considered, such as balance (whether different defenses are being used or whether the individual is limited to only one defense.), intensity (how frequently defenses are being used), age adequateness (after a particular age with which the defense is linkedhas passed, the repeated use of any defense mechanism considered to be maladaptive), and reversibility (related to the adaptability; once the defense has served its purpose it should not be employed when perceived dangers subside or become non-existent). On the other hand, coping is not associated with these domains. A further distinction was drawn by Hann between defense and coping. According to Haan,^[22] defenses have more negative qualities, which include rigidity, distortion of present reality, pressure, and gratification of subterfuge as compared to the coping mechanisms, which are flexible, oriented to present reality along with future and also focused on realist compromises between wishes and effects. Thus, defense mechanisms are the way through which the negatively charged emotional input can be addressed and emotional homeostasis can be maintained.^[25]

Defense and coping in various psychiatric disorders

Numerous studies have listed the roles that coping and defense play in a range of psychiatric conditions. In their attempt to link defensive mechanisms to the five-factor model of personality, McCrae and Costa discovered that lower conscientiousness and higher neuroticism are associated with immature and neurotic defense mechanisms.^[26] According to Perry et al.^[27] and Cramer,^[28] there is a positive association between depression and anxiety and immature defense mechanisms such as splitting, projection, and denial, as well as personality traits like neurotic dependency and avoidance. Furthermore, it was discovered that mature defenses had a negative correlation with the disease whereas immature defenses predicted depression.^[23,29] Additionally, many researches have demonstrated the connection between coping mechanisms and various diseases. Self-distraction, disengagement, and escape/avoidance coping have all been linked to personality disorders and self-substance use disorders.^[30,31] Many studies on coping strategies used with recent PTSD diagnoses have found a significant correlation between the use of emotion-focused coping and lower use of problem-focused coping.^[32–34] Thus, apart from the distinct qualities of both coping and defense, many researchers have studied the interconnectedness of these two constructs in various psychiatric conditions, described in the next section.

Interconnection of defense and coping

A growing body of researchers has shown interest in connecting both coping and defense mechanisms across life spans.^[11,8,35] Even though a few of these studies have further aided the confusion of the coping-defense debate due to their inclusion of many previously well-established defenses into coping, it is interesting to see how these researchers have conceptualized the findings. Diehl et al.^[36] reported age-related changes in the type of defense used, such as with increasing age sublimation and suppression being used frequently, while there is a decline in the usage of intellectualization, rationalization, isolation, regression, doubt, and displacement. Kramer and colleagues^[37] studied the changes between coping and defense mechanisms over two years in clients under psychotherapeutic conditions and found a similar pattern of changes in coping and defenses in all the groups who received different therapeutic treatments. One similar study by Kramer et al.^[38] produced a different result. They explored the link between defense and coping among 32 clients who were undergoing short-term dynamic therapy and found that coping remained unchanged after the completion of the therapeutic course while defenses traded up towards more mature functioning.

A study by Price^[39] shows the relation between cognitive schemas and defense mechanisms for post-traumatic stress disorder and found that four schemas (defectiveness, dependency, enmeshment, and failure) and three defense mechanisms (splitting, rationalization, and projection) have been found to be the significant predictor of Post Traumatic Stress Disorder. A similar study by Walburg and Chiaramello^[40] has shown the link between early cognitive schemas with defense mechanisms and reported that most Early Maladaptive Schema domains are not related to mature defenses, except for the “disconnection and rejection” domain, which significantly reduces the likelihood of the use of a mature defense level, and “other-directedness” which on the other hand significantly increases the usage of a mature defense level.

A group of researchers have investigated the role of defense and coping among personality disorders and according to their findings, higher severity of personality pathology was found to be linked with low scores on adaptive coping, self-blame, and overall maturity level of defensive functioning.^[41] One such study has included problematic internet use with personality, psychopathology, coping, and defense. In a large sample of 786 participants, researchers found that problematic internet use was significantly correlated with cluster B and C personality traits, non-adaptive coping strategies, and immature and autistic defensive style.^[42] The important aspect of this study was the correlation of coping and defense, which seems to have a major impact on behavior.