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Question 1
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During a challenging meeting with a teenage client, they express that they feel you are condescending and don't value their opinions. Despite your best efforts, you are able to convince them to stay for the session and continue the assessment. As the session progresses, you start to feel frustrated and annoyed with the client's seemingly trivial issues and regret spending so much time on them.
Which psychodynamic mechanism could be at play in this scenario?Your Answer: Countertransference
Correct Answer: Projective identification
Explanation:Projective identification is a multifaceted mechanism that involves elements of transference, countertransference, and projection. It occurs when a patient’s mistaken belief leads them to behave in a manner that causes the other person in the interaction to adopt the attitudes that the patient wrongly attributed to them.
For instance, a person at an airport who is overly anxious about being perceived as a terrorist may draw the attention of security guards. In a similar vein, a patient’s assumption that a doctor holds them in contempt may prompt them to act in a manner that elicits disrespectful feelings from the doctor.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 2
Correct
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A devoted mother has a son with autism. She spends every free moment researching the latest treatments and therapies, as well as the underlying neurological causes of his condition.
What defense mechanism is she exhibiting?Your Answer: Intellectualisation
Explanation:Intellectualisation involves disregarding the emotional aspect of a situation, such as a daughter’s severe illness, by concentrating solely on factual information and particulars. This behaviour is classified as a neurotic defence mechanism.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 3
Incorrect
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A teenager on a medication for ADHD becomes very upset when you suggest scheduling a follow-up appointment. Afterwards, you receive a formal complaint alleging that you were aggressive and raised your voice. What could be a potential reason for this behavior?
Your Answer: Transference
Correct Answer: Projection
Explanation:Projection is a coping mechanism in which one assigns their own unacceptable emotions and desires onto another person, thereby alleviating the discomfort of having conflicting feelings that do not align with their self-perception.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 4
Correct
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As a teenager, Sarah struggled with her relationship with her mother who was emotionally and verbally abusive. Now, as a young adult, she finds herself constantly quitting relationships within a few weeks of starting, claiming that her partner is controlling and manipulative. What underlying psychodynamic mechanism could be contributing to this pattern of behavior?
Your Answer: Transference
Explanation:Transference: Attributing Characteristics to People in Similar Roles
Transference is a psychological phenomenon where individuals attribute characteristics of important figures from their early life to people who resemble them of have roles echoing theirs. For instance, doctors, teachers, and bosses may be imbued with the characteristics of parents. This can lead to individuals projecting their feelings, attitudes, and expectations onto others, which can impact their relationships and interactions. Understanding transference can help individuals recognize and manage their emotions and reactions towards others.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 5
Correct
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You are interviewing a 70-year-old patient in your ward.
When asked what he had for breakfast, he says toast. You then ask what is your name? and he says toast. When you asked what is your date of birth?, he continues to say toast.
What is the most likely symptom exhibited here?Your Answer: Perseveration
Explanation:Common Motor Symptoms in Neurological Disorders
Perseveration is a symptom where an individual continues to use the same words of concepts even when they are no longer relevant. This is often seen in individuals with impaired consciousness due to acute of chronic organic disorders such as dementia. Automatism, on the other hand, is when an individual exhibits exaggerated cooperation with the examiner’s request of continues to perform a movement even after it has been requested. Mannerisms are repetitive, goal-directed movements, while stereotypy refers to unusual, non-goal directed movements. Finally, stuttering is characterized by the repetition of prolongation of sounds during speech. These motor symptoms are commonly seen in various neurological disorders.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 6
Correct
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What psychological defense mechanism is being used by a woman who was raised in foster care and creates a non-profit organization to offer guidance and assistance to other children in the system?
Your Answer: Altruism
Explanation:The defence mechanism of altruism is considered to be a sign of emotional maturity, as it involves channeling one’s own psychological distress towards aiding others.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 7
Correct
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The woman utilizes the ego defense mechanism of sublimation by channeling her emotional energy into her scientific work instead of seeking a new romantic relationship.
Your Answer: Sublimation
Explanation:Sublimation involves redirecting unfulfilled drives, such as those related to sex and procreation, towards socially acceptable activities. This mechanism is considered mature in terms of ego defense.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 8
Incorrect
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As a teenager, you find yourself feeling an intense connection to one of your classmates. You feel an overwhelming urge to assist them in any way possible.
What psychodynamic mechanism is most likely at play here?Your Answer: Introjection
Correct Answer: Countertransference
Explanation:The term countertransference has two distinct interpretations. The first refers to any emotion that the therapist experiences in response to the patient. The second interpretation pertains to the emotions that the therapist experiences in response to the patient’s transference onto them. In the first interpretation, the patient may trigger the therapist’s transference, such as reminding them of their mother. In the second interpretation, the therapist’s reaction is a result of the patient perceiving them as their mother.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 9
Correct
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What defense mechanisms are present in individuals with obsessive-compulsive disorder (OCD)?
Your Answer: Magical thinking
Explanation:OCD can trigger various defence mechanisms, such as repression, reaction formation, magical thinking, undoing, and isolation.
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This question is part of the following fields:
- Dynamic Psychopathology
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Question 10
Incorrect
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A teenage boy who has experienced trauma in his past has been in the hospital for several weeks. You have developed a rapport with him and often stay after your shift to talk with him. However, he finds it difficult to communicate with the other nurses who do not seem to grasp the severity of his issues. During ward rounds, there are frequent disagreements between staff members about whether he should be discharged of if more support should be provided on the ward.
What is the most appropriate psychodynamic mechanism to explain this scenario?Your Answer: Projective identification
Correct Answer: Splitting
Explanation:The process at play in this situation can be fully described as splitting. While the young woman may experience idealisation and denigration towards staff, these terms do not fully capture the impact on the team. Splitting can lead to a division within the staff team, with those who are idealised wanting to rescue the patient and those who are denigrated wanting to punish of remove them. This process likely involves both transference and projective identification. It is important to note that the concept of black and white thinking, commonly used in cognitive-behavioral therapy, is related but not the most accurate description of this phenomenon.
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This question is part of the following fields:
- Dynamic Psychopathology
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