A male client diagnosed with paranoid schizophrenia angrily tells the male nurse "You act like a

Question

homosexual. None of the men trust you or want to be around you.".

The nurse, who is heterosexual,
is perplexed by the client's statements and discusses the event with his mentor. The most likely
analysis of the event is
a. the client was unleashing unconscious, hostile feelings toward the nurse.
b. the client was demonstrating reaction formation in response to feelings of
abandonment.
c. dwelling on others' shortcomings puts them on the defensive.
d. the client was projecting homosexual urges.

Answer 1

D
Clients with paranoid ideation unconsciously use the defense mechanism projection to deal with
unacceptable, anxiety-producing ideas and impulses, in this case homosexual urges. Option A:
Although the behavior seems hostile, the projection is homosexual urges rather than hostility. Option
B: Clients who exhibit paranoid ideation usually fear abandonment, but this situation does not
represent reaction formation to abandonment feelings. Option C: Although this statement about
defensive behavior is true, it is not the correct analysis of the behavior described in the scenario.