A 60-year-old physician is admitted to the hospital for jaundice and weight loss. His medical history is noncontributory. After a detailed workup, advanced pancreatic carcinoma is diagnosed. Although the patient is advised to slow down and spend more time with his family, he insists on continuing to work, saying, "It's a good distraction to think about other people's medical problems." Each day after work, he spends several hours reviewing and analyzing his own diagnostic tests and researching experimental chemotherapy regimens for pancreatic cancer. The patient's family members wish he would take time off to rest, but he insists that would make him feel worse. Which of the following psychological defense mechanisms is the best explanation for this patient's behavior?

Question

A 60-year-old physician is admitted to the hospital for jaundice and weight loss.  His medical history is noncontributory.  After a detailed workup, advanced pancreatic carcinoma is diagnosed.  Although the patient is advised to slow down and spend more time with his family, he insists on continuing to work, saying, "It's a good distraction to think about other people's medical problems."  Each day after work, he spends several hours reviewing and analyzing his own diagnostic tests and researching experimental chemotherapy regimens for pancreatic cancer.  The patient's family members wish he would take time off to rest, but he insists that would make him feel worse.  Which of the following psychological defense mechanisms is the best explanation for this patient's behavior?

Quizplus · Accepted Answer

11ec25c8_d7b1_98b2_bc81_4745cbe3c8fd_MD0003_00 Psychological defense mechanisms are unconscious means of responding and adapting to emotional stressors that serve to decrease anxiety and provide a sense of security or control. This patient is primarily employing intellectualization, a defense mechanism that allows him to avoid anxiety by focusing on the nonemotional aspects of his cancer diagnosis. His decision to keep working serves as an intellectual focus as he spends hours a day analyzing test results and researching experimental therapies rather than confronting the painful emotions associated with his poor prognosis. His overreliance on intellectualization interferes with his ability to deal with his feelings and grieve with his family. (Choice A) Altruism involves managing unpleasant emotions through unselfish devotion or service to others. This patient's decision to keep working is primarily motivated by his need for an intellectual distraction from his own problems rather than a desire to help others. (Choice B) Denial is the failure to accept a disturbing aspect of external reality (eg, if this patient refused to acknowledge his diagnosis and insisted that nothing was wrong in the face of all evidence to the contrary). (Choice C) Displacement is the transfer of feelings or impulses toward a safer, more acceptable person or situation (eg, if this physician displaced his anxiety by becoming excessively worried about his patients instead of his own condition). (Choice E) Rationalization involves attempting to justify or excuse a behavior or decision rather than acknowledging the true motives, significance, or consequences of it. For example, this would occur if the physician rationalized his decision to keep working by saying he was unable to transfer his patients to another caregiver when this was not the case. (Choice F) Reaction formation involves transforming an unacceptable feeling or impulse into its extreme opposite (eg, if this patient feared dying but behaved in an overly optimistic and fearless manner about his treatment and prognosis). Educational objective: Intellectualization is the transformation of a distressing event into a situation devoid of emotion to avoid confrontation of uncomfortable emotional components. References: Understanding defense mechanisms. (http://www.ncbi.nlm.nih.gov/pubmed/26583439)

A 60-Year-Old Physician Is Admitted to the Hospital for Jaundice