M05.05.03 Narcissistic defenses

Narcissistic defenses are psychological mechanisms that protect an individual’s self-esteem by distorting reality in certain ways. They help maintain a favorable self-image by denying or projecting unwanted feelings onto others. Narcissistic defenses are typically associated with personality disorders such as paranoid and borderline personality disorder.

1. Projection

Definition:
Projection is the defense mechanism where individuals attribute their undesirable feelings, thoughts, or impulses to someone else. Internal states are perceived as external and projected onto others.

Examples:

• A cheating spouse accuses their partner of infidelity.
• A girl talks about her doll having certain feelings, which in reality reflect her own emotions.

Key Point:
Projection is the primary defense mechanism seen in paranoid personality disorder. The individual’s paranoia often stems from their use of projection, perceiving others as hostile or untrustworthy based on their internal feelings.

2. Denial

Definition:
Denial involves refusing to accept an aspect of reality that is painful or uncomfortable, avoiding acknowledgment of facts that are evident.

Examples:

• After surviving a heart attack, a patient insists on maintaining their unhealthy lifestyle as if nothing has happened.
• A woman continues preparing dinner for her husband, expecting him to return home even though he died a month ago.
• Substance abusers often claim they are not addicted, denying the evidence of their harmful behaviors.

Key Point:
Denial is frequently the first response to distressing news, such as the death of a loved one or a personal health crisis. It is commonly observed in patients facing terminal illnesses or addiction.

3. Splitting

Definition:
Splitting is a defense mechanism where an individual views people or situations in extremes, categorizing them as good or bad. There is no middle ground or realistic integration of positive and negative qualities.

Examples:

• “This doctor is a miracle worker, but that doctor is completely incompetent.”
• A teenage girl idolizes her love interest, describing him as “perfect and wonderful.”
• “No one in that family will ever amount to anything; they are all worthless.”

Key Point:
Splitting is the primary defense mechanism in borderline personality disorder, where individuals oscillate between idealizing and devaluing others. It is also seen in prejudice and stereotypes, where people are judged based on extreme and polarized views.

Table: Narcissistic Defenses Summary

Points to Remember

• Projection involves attributing unwanted internal states to others and is linked to paranoia.
• Denial helps avoid painful realities and is often seen in addiction and grief responses.
• Splitting creates an “all good or all bad” view of the world, common in borderline personality disorder and prejudice.

Bibliography Reference Links

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Cramer, P. (2006). Protecting the self: Defense mechanisms in action. Guilford Press.
• Vaillant, G. E. (1992). Ego mechanisms of defense: A guide for clinicians and researchers. American Psychiatric Pub.