Defense mechanisms and coping behavior in terminal illness. An overview.

Psychosomatic medicine is increasingly concerned with illness behavior, a concept which includes defense mechanisms and coping styles. An attempt was made to compare defensive processes and social adaptation in a group of 31 patients suffering from a probable terminal illness of iatrogenic origin. The surprising degree of conformity between the defense profiles towards the illness and those towards general life stress was found. Reaction-formation and stoicism were the defense mechanisms most often associated with successful defense. Interdependence of several ego measures such as defense against general life stress, defense against illness and social adaptation could be shown in various evaluations. Surprisingly, however, aggravators of illness turned out to be psychologically more stable than minimizers, a result which is in contrast to behavior in nonterminal illness. Theoretical implications of the results are discussed.