A 45-year-old physician who is privately terrified of dying from cancer goes out of his way to reassure patients with terminal cancer that 'everything will be fine' and minimizes their fears. He is never anxious when discussing cancer. Which defence mechanism is MOST likely operating?

• A Repression
• B Reaction formation ✓
• C Suppression
• D Intellectualization

Explanation

Reaction formation involves converting an unacceptable impulse or feeling into its opposite. Here, the physician's private terror of cancer (an anxiety-producing feeling) is converted into excessive reassurance and minimization of others' cancer fears—the exact opposite of fear. This is unconscious (distinguishing it from suppression, which is conscious). Suppression is the conscious decision to postpone distressing thoughts. Intellectualization uses abstract thinking to detach from emotional impact. Repression involves completely pushing threatening thoughts out of conscious awareness without behavioral manifestation.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.