DEFENSE MECHANISM AND BASIC

HUMAN NEEDS
 Presented to :
Dr. Sukhbir Kaur
Associate professor
Mental Health Nursing

 Presented by :
Sukhpreet Kaur
M.Sc. (N) 1st year
302413
 Introduction

 The term “Defense Mechanism” comes from the compounding of the words
“defense” and “mechanism”.
 Sigmund Frued first used the term in his 1894 paper , The Neuro – Psychoses of
Defense.
 Defense mechanism are those adaptive responses identified by anna frued in
1953 and that are employed by the ego in the face of threat to biological and
psychological integrity.
 Frued’s psychoanalytic theory introduced the idea of defense mechanism as a
way to understand how people cope with anxiety and other negative feelings.
 Usually all defense mechanisms are operated at unconscious level. Most are self
–deceptive in nature.
 Defense mechanism
 Anna Frued defined defense mechanisms as “unconscious resources used by the
ego” to decrease internal stress ultimately.
 Defense mechanism are conscious or unconscious mental processes that help ease or
avoid anxiety. Individuals may or may not realize they utilize these methods , many
of which occur as responses to trauma ,stress, or anger.
 It becomes mal - adaptive when they are used by an individual to such a degree that
there is interference with the ability to deal with reality , with effective interpersonal
relationships or with occupational performance.
 The defense mechanisms are ways and actions which people use in order to hide
their incapability and failure. If they are used too often it could be unhealthy. Ways
of coping with certain issues may temporarily relieve anxiety but do not offer a true
escape from the problem.
 CHARACTERISCTICS OF
DEFENSE MECHANISM
 A major means of managing conflict and effect.
 Often the hallmarks are of major psychiatric syndromes, defenses
are reversible.
 Defenses are adaptive as well as pathological.
 They operate by either masking or disguising our true motives or
by denying the existence of impulses, actions or memories within
ourselves that might provoke anxiety to us.
 Socially acceptable.
 They are not use deliberately; rather they are unconscious.
AIMS OF DEFENSE MECHANISM

 It helps people cope with uncomfortable and traumatic situations

and emotions.
 It can help people navigate painful experiences or channel their
energy more productively.
 People often devise these unconscious mechanisms to decrease
conflict within themselves ,specifically between the superego and
id.
 It also helps people to separate themselves from unpleasant
events , actions , or , thoughts.
 OBJECTIVES OF DEFENSE
MECHANISM
• Protecting the ego: Defense mechanisms can protect
the ego from things a person can't cope with.
• Avoiding feelings: Some people use defense
mechanisms to avoid their feelings and emotions.
• Excusing behavior: Some people use defense
mechanisms to excuse their behavior.
USES OF DEFENSE MECHANISM

 Allows individuals to master changes in self- image according to the change in

reality.
 Help the individual to make adaptations to distressing experiences.
 Help individuals to mitigate unresolved conflicts with important people.
 It can keep anxiety , shame and guilt within bearable limits during sudden
conflicts with conscience and culture.
 Protect one’s self esteem and sense of security.
 When used moderately, they are harmless.
 CLASSIFICATION OF
DEFENSE MECHANISM
CONTI..

 COMPENSATION – It is the coverage

up of a real or perceived weaknesses by
emphasizing a trait one considers more
considerable. It is pattern by which tension or
anxiety relieved by an individual make up for
personal experiences.
- For example : A student who fails in studies
may compensate it by being a great athlete in a
college.
CONTI..

 SUBLIMATION – Rechanneling of drives

or impulses that are personally or socially
unacceptable into activities that are
constructive. In this mechanism primitive
impulses are transferred or directed to a
socially useful goals.
- For example- A mother whose son was killed
by a drunk driver channels her anger and
energy into being the president of the local
chapter of mothers against drunk drivers.
CONTI..

 RATIONALIZATION –
Attempting to make excuses or
formulate logical reasons to justify
unacceptable feelings or behaviors.
- For example – Patient who is
addicted to alcohol tells the
rehabilitation nurse, “I drink because
it’s the only way I can deal with my
bad marriage and my worse job.”
CONTI..
 REPRESSION – Involuntarily
blocking unpleasant feelings and
experiences from one’s awareness. It is a
process of unconscious forgetfulness of
our unpleasant experiences.
- For example – An accident victim can
remember nothing about his accident.
- A person who does not recall abuse in their
early childhood but still has problems with
connection, aggression and anxiety
resulting from the unremembered trauma.
CONTI..

 SUPRESSION- Consciously keeping

unpleasant information from your conscious
mind.
• For example- Being abused as a child but
choosing to push it out of your mind.
• A student consciously chooses not to think
about upcoming exams until a few days
prior to the exams.
CONTI..

 UNDOING – Symbolically negating or

canceling out an experience that one finds
intolerable. It means “making un-happened”,
which is essentially the core of undoing.
- For example- Joe is nervous about his new job
and yells at his wife. On his way home he stops
and buys her some flowers.
CONTI..

 REGRESSION- Using previous

development behaviors when faced with
overwhelming stress. It is a situation where an
individual adapts to earlier levels of
psychosocial development.
• For example – A woman gets in an argument
with someone at work and starts sobbing
uncontrollably.
CONTI..

 DENIAL- Refusing to believe or even

perceive painful realities.
• For example –
1. A partner denies evidence of his loved one’s
affair.
2. Addiction is the one of the best known
example of the denial.
CONTI..

 DISPLACEMENT- It involves taking

out our frustrations, feelings, and impulses on
people or objects that are less threatening.
• For example- Being angry at your boss but
taking it out on your spouse instead.
CONTI..

 TRANSFERENCE- In transference, the image of

one person in unconsciously identified with that of
another.
• For example- A patient who is fond of his daughter
finds the nurse of the same age and height as his
daughter. So he transfer his positive emptions to the
nurse as his daughter. It is also possible that if he
dislikes his daughter he transfers his negative
emotions to the nurse by being rude, abusive, or
aggressive w
CONTI..

 IDENTIFICATION- An attempt to increase

self worth by acquiring certain aspects and
characteristics of an individual one admirers.
• For example- A teenager who required lengthy
rehabilitation after an accident decides to become
a physical therapist as a result of his experiences.
• A teenage girl emulates the mannerisms and style
of dress of a popular female influencer or actress.
CONTI..

 INTELLECTUALIZATION- An attempt to avoid

expressing actual emotions associated with a stressful
situation by using the intellectual processes of logic,
reasoning and analysis.
• For example- Someone’s husband is being transferred
with his job to a city far away from her parents. She hides
anxiety by explaining to her parents the advantages
associated with the move.
• A young psychology professor receives a letter from her
fiancée breaking off their engagement she shows no
emotions when discussing this with her best friend.
Instead she analyzes her fiancée’s behavior and tries to
reason why the relationship failed.
CONTI..

 INTROJECTION- Integrating the beliefs

and values of another individual into one’s own
ego structure.
• For example- Children integrate their parents’
value system into the process of conscience
formation. A child says to friend, “don’t cheat.
It’s wrong”.
• A psychiatric client claims to be the son of god,
drapes himself in sheet and blanket , “performs
miracles” on other clients, and refuses to
respond unless addressed as Jesus Christ.
CONTI..

 PROJECTION- It is a defense mechanism

that involves taking our own unacceptable
qualities or feelings and crediting or blaming
them to other people. Projection works by
allowing the expression of the desire or
impulse, but in a way that ego cannot
recognize, therefore reducing anxiety.
• For example- If you have a strong dislike for
someone, you might instead believe that they
do not like you.
CONTI..

 REACTION FORMATION –
Preventing unacceptable or undesirable
thoughts or behaviors from being expressed by
exaggerating opposite thoughts or types of
behaviors.
• For example- Jane hates nursing. She attended
nursing school to please her parents. During
career day, she speak to prospective students
about the excellence of nursing as a career.
CONTI.

 ISOLATION- Separating a thought or

memory from the felling tone, or emotion
associated with it .
• For example- A young woman describes being
attacked and raped, without showing any
emotion.
• A physician is able to isolate her feelings about
the eventual death of a terminally ill cancer
CONTI..

 FANTASY- Avoiding reality by retreating to a

safe place within your mind. When something in
your life is causing anxiety, you might retreat to
your inner world where the cause of the stress
cannot harm you.
• For example- A young boy who could not help his
ailing father due to shortage of money, day dreams
that he has got lot of money from lottery ticket and
his father, mother and family members has best of
the facilities for everything.
CONTI..

 DISSOCIATION- The unconscious

DETACHMENT OF PAINFUL FEELINGS
separation of painful feelings and emotions from
an unacceptable idea, situation, or object.
• For example- A woman has amnesia for the events
surrounding a fatal automobile accident in which
she was the speeding driver.
CONTI..

 HYPOCHONDRIA- Obsession with the idea of

having a serious but undiagnosed medical condition.
In this person may have long term and intense fear of
having a serious condition and worry that minor
symptoms indicate something serious.
• For example- Person might think: “What if I get
cancer?” or that a lump they find ‘must’ be cancerous.
• They may be sure that there headaches are caused by a
brain tumor.
 ROLE OF A NURSE IN EXCESSIVE
USE OF DEFENSE MECHANISM
 STRESS MANAGEMENT FOR THE NURSE
There are many stressors in nursing. It is essential that nurses learn
to cope successfully with stressors. Nurse must cope successfully
with stress to maintain her own wellness and model healthy
behavior. Nurses first must be able to manage their own stress
before helping clients learn to manage theirs. High stress level
among nurses often leads to burnout, a state of physical and
emotional exhaustion occurring when caregivers use up their
adaptive energy.
CONTI..

 Several Work-related Factors can Contribute to Burnout

• Heavy workload (Critically-ill client)
• Interpersonal conflict in the work environment
• Mandatory overtime and "floating" to other units
• Little work-related social support.
 INTRODUCTION

 Every human being on earth have certain

basic needs which need to be fulfilled. We
must have food, water, air, and shelter to
survive. If any one of these basic needs is
not met, then humans cannot survive
 Basic human needs are the fundamental
requirements that people need to survive
and live a decent life.
 It works to define the absolute minimum
resources necessary for long-term physical
well-being, usually in terms of consumption
goods.
 NEEDS- A lack of something required and
desired.
 BASIC HUMAN NEEDS- A basic human
need is want of something or requirement for
biological, psychological, social and spiritual
functioning experienced by a person without
which a person cannot survive.
 The elements required for survival and normal
mental health and physical health such as food,
water, shelter and protection form
environmental threats.
NINE BASIC HUMAN NEEDS
 Abraham Maslow first introduced his theory in 1943 in his
paper, A Theory of Human Motivation. He refined the theory in
his 1954 book, Motivation and Personality. Maslow's hierarchy
of needs is a popular topic in psychology, management training,
and sociology classes.
 According to Maslow (1943, 1954), human needs were arranged
in a hierarchy, with physiological (survival) needs at the bottom,
and the more creative and intellectually oriented ‘self-
actualization’ needs at the top.
 Maslow argued that survival needs must be satisfied before the
individual can satisfy the higher needs. The higher up the
hierarchy, the more difficult it is to satisfy the needs associated
with that stage, because of the interpersonal and environmental
barriers that inevitably frustrate us.
CONTI..

 Higher needs become increasingly psychological and long-term rather than

physiological and short-term, as in the lower survival-related needs.
 Maslow's hierarchy of needs is a theory of motivation which states that five
categories of human needs dictate an individual's behavior. Those needs are
physiological needs, safety needs, love and belonging needs, esteem needs,
and self-actualization needs.
 Maslow's hierarchy of needs is a theory of psychology explaining human
motivation based on the pursuit of different levels of needs.
 This theory states that humans are motivated to fulfill their needs in a
hierarchical order. This order begins with the most basic needs before moving
on to more advanced needs.
 Maslow's hierarchy of needs is a theory that explains human motivation by
organizing five levels of human needs into a pyramid :↓
 FIVE LEVELS OF MASLOW’S
HIERARCHY ARE :
 Physiological Needs –
• Physiological needs are the most basic of
Maslow’s hierarchy. These are the essentials
people need for physical survival. Examples
include air, food, drink, shelter, clothing,
warmth, sleep, and health.
• If you fail to meet these needs, your body cannot
function properly. Physiological needs are
considered the most essential because you can't
meet the other needs until your physiological
ones are fulfilled. The motivation at this level
comes from a person’s instinct to survive.
 CONTI..

 SAFETY NEEDS-
• Once you meet your physiological needs, you need to need a
safe and secure environment. Safety and security needs are
associated with the need to feel safe and secure in your life and
environment. Safety needs are obvious starting from childhood.
When these needs are not met, children naturally react with fear
and anxiety.
• These needs also involve the desire for order, predictability, and
control. Examples of safety needs include emotional security,
financial security (social welfare and employment), law and
order, social stability, freedom from fear, health, and well-
being.
 CONTI..

 LOVE AND BELONGING NEEDS-

• This is the third and the last of the lower needs in
Maslow's hierarchy of needs. It involves the need to
feel a sense of belonging and acceptance. It's motivated
by the natural instinct of humans to interact.
• This hierarchy level involves romantic relationships
and connections to family and friends. It also includes
the need to feel that you belong to a social group. In
addition, this need includes feeling loved and feeling
love toward others.
• If you fail to meet these needs, you may experience
loneliness and depression.
 CONTI..

 ESTEEM NEEDS-
• This is the first of the higher needs in the hierarchy of needs.
Esteem needs are motivated by the desire to feel good about
yourself.
• There are two categories of esteem needs: Self-esteem, which is
feeling confident and good about yourself, and respect, which is
feeling valued by other people and knowing that they recognize
your achievements.
• When your esteem needs are not met, you may feel unimportant,
less confident, unprotected, and incompetent. According to
Maslow, respect and reputation are vital for children and
adolescents and come before real self-esteem or dignity.
 CONTI..
 SELF ACTUALIZATION-
• Self-actualization needs are the highest level on
Maslow's pyramid of needs. These needs include
realizing your potential, self-fulfillment, self-
development, and peak experiences.
• Self-actualization is the desire to accomplish all that you
can and unleash all your potential. Different individuals
may have different ideas of self-actualization since your
desires differ from other people’s.
• Maslow’s theory states that reaching the self-
actualization level is difficult. The reason is that people
are focused on satisfying the more urgent needs in the
hierarchy of needs first.
 Types of Needs on Maslow’s Pyramid

 There are two types of needs on Maslow’s pyramid:

• Deficiency needs: These are needs you develop due to
deprivation. They include physiological, security, social, and
esteem needs. You have to meet these needs to avoid unpleasant
results.
• Growth needs: The highest level of Maslow's pyramid is
categorized as growth needs. Unlike deficiency needs, self-
actualization needs are motivated by the desire to grow as a
person and reach your full potential.
AS PER AS PER
How to Progress Through the Pyramid
of Needs
 Maslow’s hierarchy of needs is often
presented as a pyramid of needs. The pyramid
is organized from the most basic needs at the
bottom to the most complex at the top.
 Maslow theorized that you have to meet these
needs at the bottom to move to the next level
of needs. Even so, you don’t need to satisfy
one need in order to move to the next one in
the hierarchy. Maslow's theory also advocates
that most people focus on meeting their needs
partly, as a result progressing more in
meeting needs lower on the hierarchy.
 IMPORTANCE OF MASLOW’S
HIERARCHY OF NEEDS
• Maslow’s theory has given rise to a new way to look at people’s needs. For
example, Maslow’s hierarchy of needs is widely used in health and social
work as a framework for assessing clients’ needs.
• Problems or difficult circumstances at one point in a person’s life can cause
them to fixate on a particular set of needs, and this can affect their future
happiness.
• For example, a person who lived through a period of extreme deprivation
and lack of security in early childhood may fixate on physiological and
safety needs. These remain clear even if they are satisfied.
• So even if this person later has everything they need they may nonetheless
obsess over money or keeping enough food in the fridge.
• This, for Maslow, was the root cause of many ‘neurotic’ mental health
problems, such as anxiety or depression.
 IMPLICATION OF HIERARCHY OF
NEEDS IN NURSING

• The hierarchy provides a framework for understanding

patients as multifaceted human beings.
• Patient care should be holistic, not just medical. Nurses
must assess and address the spectrum of patient needs –
physical, mental, emotional, and social.
• Doing so motivates greater engagement in care, faster
healing, and improved outcomes.
CONTI..

 Physiological needs (ABC + D) – Ensure patients have adequate

nutrition, hydration, pain control, sleep, and physical comfort.
Address pain that hinders sleep and recovery.
• A – Airway: Ensure the patient has an open airway.
• B – Breathing: Assess and support adequate breathing and gas
exchange.
• C – Circulation: Evaluate and maintain proper blood circulation.
• D – Decreased level of consciousness: Monitor for any changes
in behavior or mental status.
CONTI..

 Safety needs – Maintain a clean, quiet environment with call

bells for assistance. Prevent injuries through fall precautions,
blood clot prevention, and pressure ulcer avoidance.
• Explain tests, treatments, and medications to patients to relieve
anxiety. Keep patient info confidential. Foster a climate of trust
through compassionate listening. Prevent medication errors.
 Belongingness – Loneliness impedes healing. Make patients feel
welcomed and included. Introduce them to other patients. Allow
for family visitation and spiritual practices.
CONTI..

 Esteem – Show respect through courteous communication and

cultural sensitivity. Maintain dignity and privacy.
• Empower patients in care decisions. Explain care in an easy-to-
understand way. Listen attentively to their concerns. Make them
feel valued.
 Self-actualization— Align care with patient values and
aspirations. Perhaps share motivational stories of those with
similar diagnoses who stayed active or provide resources on
coping with grief over health changes.
CONTI..

 Special Considerations
• Pain Management: While pain is typically considered a
physiological need, its priority can vary. Acute, severe pain or
pain indicating a life-threatening condition should be addressed
immediately.
• Hospice Care: For end-of-life care patients, comfort and quality
of life may take precedence over addressing physiological needs.
ACTIVITIES OF DAILY LIVING

 The Activities of Daily Living (ADL) includes:

• MAINTAINING SAFE ENVIRONMENT – It is important to maintain
a safe environment at all times. Every day activities are aimed at
maintaining a safe environment ego activities(such as bathing, brushing
the teeth) to achieve personal and domestic cleanliness and aimed at
decreasing the number of micro-organisms to maintain a safe
environment.
• COMMUNICATION- It is the process of exchanging thoughts, ideas, or
feelings from one individual to others. Communicating not only involves
the use of verbal language as in talking and writing, but also involves the
non verbal transmission of information by facial expressions, postures
and body gesture. This activity is important for good human relationships.
CONTI..

• BREATHING-
In the breathing process, the cell of the body receives air,
(oxygen) essential for all the body cells, without which
human life will not exist.
• EATING AND DRINKING-
They are essential activities of the daily living. Human
life cannot be sustained for all the body cells, without
eating and drinking. Many people in the world die daily
due to starvation.
CONTI..

• ELIMINATING-
Eliminating (bath, urinary and fecal) likes eating and
drinking is necessary and on integral activity of everyday
life, eliminating is regard as a highly private activity.
• PERSONAL CLEANSING AND DRESSING-
Cleanliness and good grooming are commended in most
cultures. Apart from taking pride in their appearance,
people have a social responsibility to ensure cleanliness
of body and clothing. Activities included are washing,
bathing, care of hair, nails, teeth, mouth and clothing.
CONTI..

• CONTROLLING BODY TEMPERATURE

An individual is able to maintain body temperature of a constant
level irrespective of the degree of heat or cold in the surrounding
environment. Regulation of body temperature is essential for
different biological processes. People have to perform certain
activities to avoid the discomfort of heat and cold by varying
amount of clothing, regulating the physical activity.
• MOBILIZING
It is an essential and highly valued human activity. Mobilizing
includes the movement produced by groups of large muscles
(e.g. facial expression and gestures). All activities of living
involve movement.
CONTI..

• WORKING AND PLAYING

Most people are either working or playing, when not at sleep.
Working provides income from which essential cost and other
activities are financed. Work and play are important for physical
and mental health.
• EXPRESSING SEXUALITY/ REPRODUCTION
It is a component of health. The specific activity which is
directly associated with sex is sexual relationship. This is
essential for the continuation of human race. There are many
other ways in which human sexuality can be expressed. Style of
dress, physical appearance. And in many forms of verbal and
non – verbal communication are other ways in which sexuality
CONTI..

• SLEEPING
Sleep is essential for healthy living. The body process
does not stop during sleep. Therefore, it is considered as
an activity . All individuals have periods of activity and
sleep ; it is an important activity of daily living.
• DYING
Dying is also included in the activities of living. It is the
final act of living.
 Factors Influencing Activities of Daily
Living
 1. Physical Factors:
The body's structure and function have a major influence on how the body functions.
Body's physical ability alters according to the age; e.g. reduced physical ability in the old
age. The physical factor of the body (human biology) has an important influence on the
individual's activities of daily living throughout the life. E.g. Cardio Pulmonary System
with the ADL of breathing, the musculoskeletal system with the ADL of mobilizing.
 2. Psychological Factors:
It includes both intellectual and emotional aspects:
• Intellectual aspects: Intellectual skills like thinking, reasoning and problem solving
are essential for survival and affect all activities of daily living. Intellectual
development continues from childhood to adolescence. During old age overall
intellectual functioning becomes less efficient and may cause problems to the
activities of daily living. e.g. memory loss affect safety.
CONTI..

• Emotional aspects: Like the intellectual aspect,

the emotional aspect is also related with the
activities of the daily living. The development of
one's personality is one of the outcomes of the
emotional development which influences the
activities of the daily living. E.g. Communicating.
 3. Socio-Cultural Factors: They influence the
living life span of an individual. They also
influence the persons individuality in living and
effect the way each person carries out the
activities of the daily living. ego cultural factor (to
eat food under a tree), social factor (Prevalence of
CONTI..

 4. Environmental Factors:
The atmosphere is the immediate environmental factor as it is in contact with the
exposed skin and the outer garments. The temperature and the humidity in the
atmosphere may influence ADL such as controlling body temperature, working
and playing. In many developing societies lack of safe water and proper sanitation
produces an unsafe environment which may lead to health problems.
 5. Politico-Economic Factors:
Every citizen is the subject of a state. The citizen is legally bound to obey the
orders of the state An individual's activities of daily living are
influenced by its norms.
IMPLICATION OF HUMAN NEEDS IN
NURSING PRACTICE
 Knowledge of Human needs helps nurses to:
1. Understand themselves, so that they can meet their personal
needs outside the health care setting, e.g.: maintenance of
body temperature.
2. Set priorities as in giving core. e.g. working and playing will
assume a low priority during a period of critical illness.
3. Better to understand patient's behaviour so that they can
respond therapeutically rather than emotionally e.g.: a patient
putting on his signal light repeatedly may convey the message
of need for safety.
CONTI..

4. Relieve the distress of patients, eg: helping a patient to meet his

unmet need of love and affection.
5. To get used to all ages and in all health core settings both at health
and illness. It is an approach for holistic nursing care.
6. Help client to develop and grow eg: Nurse can help clients to
move towards self actualization by helping them to find meaning on
their illness experience.
7. Provide a frame work and be applied in the nursing process at the
individual and family level.