A patient accompanied her boyfriend to the emergency department after the two had been in a motorcycle accident. The boyfriend was badly hurt, but the patient had only minor cuts and bruises and was discharged
She mentioned to the nurse that since she was driving, she should have been the one to be injured. Twenty-four hours later, while visiting her boyfriend, the patient reported that she was unable to move from her chair and unable to walk. Diagnostic workup revealed no physical reason for the problem. The anxiety relief behavior the patient is demonstrating is: a. projection.
b. conversion.
c. sublimation.
d. reframing.
B
Conversion is a defense mechanism that involves converting anxiety into a physical symptom that does not have an organic cause. In this instance, the patient is experiencing anxiety related to having injured her boyfriend without herself having been seriously injured. Her conversion involves "creating" a serious injury of her own, which in turn reduces her anxiety about the disparity in their respective injuries. Projection involves attributing unacceptable aspects of oneself (feelings, impulses) to others instead. Sublimation is a constructive defense mechanism that substitutes acceptable behaviors for unacceptable ones. Reframing is rewording a thought to make it more accurate or consistent with reality.
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