Use of the TAT to measure change in defense mechanisms following intensive psychotherapy.

Changes in the use of defense mechanisms (denial, projection, and identification) were examined over a period of approximately 15 months of intensive treatment of 90 seriously disturbed young adults who were hospitalized in an intensive, open, long-term treatment setting. Patients independently judged to have primarily an anaclitic or an introjective personality configuration (Blatt, 1974; Blatt & Shichman, 1983) were assessed for psychiatric symptoms and aspects of interpersonal behavior both on admission and after an average of 15 months of treatment. Findings based on an independent assessment of TAT protocols at these two times indicated a significant (p less than .05) decline in total use of defenses for the entire sample, but especially for introjective patients. Further, this decline in total use of defenses in the TAT was significantly associated with a reduction in psychiatric symptoms. Also, sex-incongruent patients (anaclitic men and introjective women) were found to use different defenses and to change in ways different from sex-congruent patients (anaclitic women and introjective men).