Therapeutic Communication and Defense
Mechanisms
Attempting to translate into feelings - When feelings are expressed indirectly, the nurse tries to
desymbolize what has been said and to find clues to the underlying true feelings
Patient- I'm dead
Nurse- Are you suggesting that you feel lifeless? Or is that life seems without meaning?
Compensation - Covering up a real or perceived weakness by emphasizing a trait one considers
more desirable
Example: A physically handicapped boy who is unable to participate in sports, compensates by
becoming a great scholar
Conditions essential to Development of a Therapeutic Relationship - Rapport
Trust
Respect
Genuineness
Empathy
Denial - One completely rejects the thought or feeling (reality) in order to avoid painful or
threatening situation
Example: Dying person refuses to admit what is happening
Drug, alcohol abuse
Diffuse Defense Mechanism - -identify the cause
-why
-increase self-esteem
, -teach how to handle criticism and praise
- teach how to take responsibility
- recognize when using mechanism
Accepting - Conveys an attitude of reception and regard
Yes
UH Humm
I follow what you say
Nodding
Acting out behaviors - Coping with emotional conflicts through action
Example: A child told to share, throws toy across room
When confronted in argument, person storms out of room
Active Listening (SOLER) - S-sit squarely facing the client
O- observe an open posture
L- lean forward toward the client
E- establish eye contact
R- relax
Altriusm - Coping with anxiety, created by trauma or loss by reaching out to others.
Not self-sacrificial: individual receives gratification from response of others
Help cope with reality and maintain self-image
Example: A refugee returning to help fellow countrymen. A woman who miscarried helps out in
daycare
Mechanisms
Attempting to translate into feelings - When feelings are expressed indirectly, the nurse tries to
desymbolize what has been said and to find clues to the underlying true feelings
Patient- I'm dead
Nurse- Are you suggesting that you feel lifeless? Or is that life seems without meaning?
Compensation - Covering up a real or perceived weakness by emphasizing a trait one considers
more desirable
Example: A physically handicapped boy who is unable to participate in sports, compensates by
becoming a great scholar
Conditions essential to Development of a Therapeutic Relationship - Rapport
Trust
Respect
Genuineness
Empathy
Denial - One completely rejects the thought or feeling (reality) in order to avoid painful or
threatening situation
Example: Dying person refuses to admit what is happening
Drug, alcohol abuse
Diffuse Defense Mechanism - -identify the cause
-why
-increase self-esteem
, -teach how to handle criticism and praise
- teach how to take responsibility
- recognize when using mechanism
Accepting - Conveys an attitude of reception and regard
Yes
UH Humm
I follow what you say
Nodding
Acting out behaviors - Coping with emotional conflicts through action
Example: A child told to share, throws toy across room
When confronted in argument, person storms out of room
Active Listening (SOLER) - S-sit squarely facing the client
O- observe an open posture
L- lean forward toward the client
E- establish eye contact
R- relax
Altriusm - Coping with anxiety, created by trauma or loss by reaching out to others.
Not self-sacrificial: individual receives gratification from response of others
Help cope with reality and maintain self-image
Example: A refugee returning to help fellow countrymen. A woman who miscarried helps out in
daycare
