Relational and defensive patterns

Denial

Not acknowledging a distressing aspect of reality or experience.

Psychodynamic constructClinically reviewed

Defence

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Do not confuse the hypothesis with lack of information, memory impairment, anosognosia, disagreement or deliberate non-disclosure.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Psychodynamic construct
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed

Evidence

S40The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the Defense Mechanisms Rating Scales Q-Sort

Frontiers in Psychology · 10.3389/fpsyg.2021.718440 · Full HTML text. Defence hierarchy and construct definitions.

Methods/theory paper by instrument developers, not proof a defence is present in a given patient or that one intervention follows uniquely.

Link withheld: this source remains held and is cited as metadata only.

Evidence references only. Each source's own limitations still apply.

Relational and defensive patterns

Acting out Attachment anxiety / hyperactivation Displacement Family/system accommodation Idealisation / devaluation Intellectualisation

Guide modules

Rapid clinical formulation guide Foundations, terminology and evidence limits Practical assessment-to-formulation workflow Risk formulation and management linkage Documentation templates and worked examples

How to use this

Record the case evidence yourself. Nothing here is a patient finding, and no factor becomes a cause because it appears in the formulation.

Relational and defensive patterns

Denial

Not acknowledging a distressing aspect of reality or experience.

Psychodynamic constructClinically reviewed

Defence

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Do not confuse the hypothesis with lack of information, memory impairment, anosognosia, disagreement or deliberate non-disclosure.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Psychodynamic construct
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed

Evidence

S40The Hierarchy of Defense Mechanisms: Assessing Defensive Functioning With the Defense Mechanisms Rating Scales Q-Sort

Frontiers in Psychology · 10.3389/fpsyg.2021.718440 · Full HTML text. Defence hierarchy and construct definitions.

Methods/theory paper by instrument developers, not proof a defence is present in a given patient or that one intervention follows uniquely.

Link withheld: this source remains held and is cited as metadata only.

Evidence references only. Each source's own limitations still apply.

Relational and defensive patterns

Acting out Attachment anxiety / hyperactivation Displacement Family/system accommodation Idealisation / devaluation Intellectualisation

Guide modules

How to use this

Record the case evidence yourself. Nothing here is a patient finding, and no factor becomes a cause because it appears in the formulation.