USMLE and COMLEX Prep: Psychiatry—Coping Mechanisms

Session 14

This week, we’re covering Psychiatry, specifically about coping mechanisms. Once again, we’re joined by Board Vitals, your USMLE and COMLEX test prep company. Help your classmates study for their Step 1 or Level 1. If you have some weaknesses in topics, let us know. Shoot me an email at [email protected].

[02:03] Question of the Week

A 38-year-old male is attending marriage counseling with his 39-year-old wife describes several occasions where after having argued with his wife and becoming very angry, he goes to a local gun range to blow off some stain. Which of the following is the best description of this behavior?

(A) Passive aggression

(B) Acting out

(C) Projection

(D) Reaction formation

(E) Sublimation

[02:48] Thought Process

The answer here s Sublimation. It means you take an unacceptable wish, impulse, or thought/desire, and then you do a similar action in a way that isn’t in conflict with your value systems. Another example is punching a punching bag when you’re angry. So you’re basically finding a substitute object to satisfy your aggression through a socially acceptable way.

Passive aggression is characterized by expressing hostile feelings in a nonconfrontational way. Acting out is a tantrum, just like when a parent says no to a child. Projection is attributing your own unacceptable thoughts to another person. For instance, if the husband had thought about cheating on the wife, but instead, he accuses her of cheating on him. Reaction formation is doing the opposite of what your desired action would be. An example would be someone who has a history of drug abuse would advocate for stronger penalties against drug dealers. So they do something opposite of what they’re unacceptable thought or action might be.

Another term that people should know about, too, is denial. It’s blocking whatever it is that you refuse to experience. Displacement is another term which is a more unacceptable form of sublimation. For example, you’re angry and frustrated by your boss at home. Then you go home and you abuse someone at home.

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