Which defence mechanism is being used by a patient with alcoholism who attributes his repeated job terminations to 'bad luck' and his wife's departure to 'her own issues,' while stating that his drinking is 'completely under control'?
- A Denial ✓
- B Projection
- C Rationalization
- D Displacement
Correct answer: A. Denial
Explanation
Denial is the unconscious refusal to acknowledge a painful reality (here, that his alcoholism is causing serious life consequences). The patient's insistence that his drinking is 'completely under control' despite objective evidence of severe social and occupational harm is classic denial. Rationalization involves finding logical-sounding explanations for unacceptable behavior after the fact. Projection involves attributing one's own unacceptable feelings onto others. Displacement involves redirecting an impulse from its original target to a substitute target.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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