Psychological Defense Mechanisms Over the Course of the COVID-19 Pandemic

Defense mechanisms are psychological strategies, which could result in any behaviors developed consciously or unconsciously by individuals in the face of incidents/stimuli that cause apprehension or do harm.

Based on the fundamental psychoanalytic theory, defense mechanisms have currently gone beyond being solely a psychoanalytic concept, finding themselves a place in various branches of psychiatry as well. For instance, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), defines defense mechanisms as “mechanisms that mediate the reactions of an individual to emotional conflicts and external stressors”.

Defense mechanisms usually develop unintentionally, except for those that have already matured. They diminish the upsetting effects of both emotional and cognitive dissonances, and they can be defined under four independent categories.

1. Psychotic defenses enable an individual to rebuild any external experiences and to let them eliminate the urge to cope with reality.
2. Immature defenses reduce the discomfort and apprehension triggered by a threat received, or by a disconcerting reality.
3. Neurotic defenses let an individual avoid the feelings of guilt and apprehension in regards to aggressive tendencies and sexual desires in particular.
4. Mature defenses are conscious processes that increase the control, and positive emotions.

Conducted in this current period where COVID-19 is taking the entire world by storm, a study (Walker & McCabe, 2020) qualitatively researched the defense mechanisms that the people use in order to reduce the apprehension caused by the pandemic. The authors observed the methods of coping with stress, used by a group of colleagues in psychiatry, including themselves, and they concluded that the following defense mechanisms stood out:

1. Denial:It stands for the rejection of the reality of a situation that is hard to accept. As per the study, one employee starts to think that such a virus would not pose a threat, although he finds it concerning that the COVID-19 virus threat could be real. He gives speeches to his colleagues regarding the unnecessity of the precautions taken. Annoyed with this situation, his colleagues cannot comprehend his reluctance about the implementation of these precautions.
2. Hypochondria:According to the definition in the DSM-V, it stands for a condition in which a person is worried that he has or will have a serious illness. As per the study, a psychiatry resident is highly concerned about getting infected with COVID-19. Having asthma, as well as family members of advanced ages, this employee considers the advices insufficient, and he does not follow such advises when he concludes that his colleagues have not been affected by this situation as much as he has, even though he has asked what precautions he should take in order not to be infected with the virus. He checks the precaution-oriented official directives published, more than once a day. He is forced to resign once the level of stress that he has been experiencing, reaches a point where he cannot cope anymore.
3. Self-sacrificing: It stands for the solution of any inner conflicts caused by selfish emotions, through self-sacrificing. A psychiatrist undertakes overtime work for his colleagues who have been isolated due to the virus. Following the cancellation of his trip to Europe due to the pandemic, he suddenly has more time, and so he does not have to exhaust himself for the shifts. Consequently, he achieves emotional satisfaction by fighting the virus and helping his colleagues throughout the pandemic.
4. Sublimation:Sublimation is the process of deflecting the primitive urge-based energy into another field that is more acceptable by the society. One employee feels uncomfortable that his wife works from home and gets paid during the pandemic, while he has to go to work. Instead of letting this situation demoralize him, he helps create a new working order in order to eliminate the lack of personnel at work due to COVID-19. He deflects his initial negative mood into the job he does, therefore changing that into a positive emotion by creating a difference for others.
5. Humor:Humor is the avoidance of apprehension and pain through the humorous expression of feelings and thoughts in an uncomfortable situation that cannot be coped with. In an attempt to draw attention to the directive prepared for COVID-19 precautions, an employee puts on a fully encapsulating personal protective equipment. He tries to draw attention to a serious subject matter at his workplace by dancing in an unusual outfit. Nevertheless, as he attempts to achieve this in an amusing manner, it reduces the stress experienced by his colleagues to a certain extent, making them laugh in the end.

The aforementioned examples of troubling incidents experienced by psychiatry staff, as well as the methods to cope with them, are not unique to this field, and they can be experienced by anyone throughout this period. The first two conditions mentioned (denial and hypochondria) indicate nonadaptive defense mechanisms, while the last three conditions (self-sacrificing, sublimation, and humor) are high-adaptive mechanisms. Nonadaptive mechanisms mostly develop in an unconscious manner and can lead to pathological problems in the long run. High-adaptive mechanisms, however, usually help individuals remain in a positive mood by letting them be more conscious about their feelings, ideas, as well as their results. For instance, while one study associated hypochondria with anxiety and depression, in another study that was conducted on cancer patients, it was observed that patients with high-adaptive mechanisms (self-sacrificing, sublimation, and humor, etc.) showed lower levels of anxiety and depression symptoms.

The greatest benefit of defense mechanisms is that they can protect the individual against any stress that his mind and character cannot cope with under the current conditions. Nonetheless, it must be kept in mind that the permanent use of defense mechanisms could lead to pathological problems on the social, physical, or mental health of the individual by causing nonadaptive behaviors. In such cases, one must seek professional help. As a consequence of the clinical studies, it has been set forth that psychotherapies, accompanied by medication, help individuals manage their defense mechanisms.

REFERENCES:
Walker, G., & McCabe, T. (2020). Psychological defence mechanisms during the COVID-19 pandemic: A case series. The European Journal of Psychiatry.