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Unformatted text preview: 2/10/09 11:16:31 AM Anxiety Disorders :// 125 Michael Shaw/Cartoonbank.com •isolation•An ego defense mechanism
in which people unconsciously isolate
and disown undesirable and unwanted
thoughts, experiencing them as foreign
•undoing•An ego defense mechanism
whereby a person unconsciously cancels
out an unacceptable desire or act by
performing another act.
•reaction formation•An ego defense mechanism whereby a person suppresses
an unacceptable desire by taking on
a lifestyle that expresses the opposite
desire. “Is the Itsy Bitsy Spider obsessive-compulsive?” actions. A woman who keeps imagining her mother lying broken and bleeding, for example, may counter those thoughts with repeated safety checks throughout the house.
According to psychodynamic theorists, three ego defense mechanisms are particularly common in obsessive-compulsive disorder: isolation, undoing, and reaction formation.
People who resort to isolation simply disown their unwanted thoughts and experience them as foreign intrusions. People who engage in undoing perform acts that are
meant to cancel out their undesirable impulses. Those who wash their hands repeatedly,
for example, may be symbolically undoing their unacceptable id impulses. People who
develop a reaction formation take on a lifestyle that directly opposes their unacceptable impulses. A person may live a life of compulsive kindness and devotion to others
in order to counter unacceptable aggressive impulses.
Sigmund Freud traced obsessive-compulsive disorder to the anal stage of development
(occurring at about 2 years of age). He proposed that during this stage some children
experience intense rage and shame as a result of negative toilet-training experiences.
Other psychodynamic theorists have argued instead that such early rage reactions are
rooted in feelings of insecurity (Erikson, 1963; Sullivan, 1953; Horney, 1937). Either
way, these children repeatedly feel the need to express their strong aggressive id impulses
while at the same time knowing they should try to restrain and control the impulses.
If this conflict between the id and ego continues, it may eventually blossom into obsessivecompulsive disorder. Overall, research has not clearly supported the psychodynamic
explanation (Fitz, 1990).
When treating patients with obsessive-compulsive disorder, psychodynamic therapists try to help the individuals uncover and overcome their underlying conflicts and
defenses, using the customary techniques of free association and therapist interpretation. Research has offered little evidence, however, that a traditional psychodynamic
approach is of much help (Bram & Björgvinsson, 2004). Thus some psychodynamic
therapists now prefer to treat these patients with short-term psychodynamic therapies,
which, as you saw in Chapter 2, are more direct and action-oriented than the classical
techniques. The Behavioral Perspective
Behaviorists have concentrated on explaining and treating compulsions rather than
obsessions. They propose...
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