265: Primitive Defense Mechanisms Explained: Sexualization, Dissociation, Acting Out, Withdrawal, Denial, Splitting, Omnipotent Control, Projective Identification

[on-hold music] All right.

Welcome to the Psychiatry and Psychotherapy podcast.

I am your host, Dr. David Puder, and today I'm gonna be talking with one of my cohorts on primitive defense mechanisms.

One of the great pleasures and joys of my week is leading psychotherapy cohorts.

We have been diving into Nancy McWilliams' Psychoanalytic Diagnosis, and one of the chapters that jumped out to me and I thought would be very helpful to do a deep dive with this cohort is on primitive defenses.

We'll be talking about things like extreme withdrawal, denial, omnipotent control, extreme idealization, devaluation, splitting, somatization, sexualization, projective identification, extreme dissociation, acting out, projection, and interjection.

And we will be going through definitions, developmental origins, countertransference implications, and i-- this is a great opportunity for me to bring this group of amazing mental health professionals for you guys to meet and see that this is going on, this is happening.

Uh, this is starting up again in September, and I, um, I'm excited to continue teaching and in this, in this way.

So we usually do it twice a, you know, once a week for about two hours.

We have some special people come on as well throughout the year and give extra two-hour lectures.

And so people who are in this, I'm gonna go through their names so you can hear them once and then you'll hear them again or see them if you're on YouTube watching this.

Dr. Erica L. Reynolds is a talented psychiatrist in North San Diego County who is kind of the mother of the group with 30 years of experience, uh, more experience than me, and comes with a lot of warmth and empathy for the group members.

She will be talking about extreme withdrawal and denial.

Ariel Schatz Wilderman is an MA LSW who is a psychotherapist founder of the Wilderman Fund for Maternal Mental Health and an expert in reproductive psychiatry.

She is someone who has been a great joy of having on the podcast, and I think you'll really enjoy her dive into omnipotent control.

Michelle Zitnick is a psychiatric nurse practitioner in Southern Florida with over 17 years of pediatric nursing experience and does a great job of somatization, which is something that she shows is high in alexithymia, childhood trauma, uh, insecure attachment, personality styles like histrionic, narcissistic, or neurotic.

And, um, I'm excited for you to hear a little bit of her take on that.

Evan Sumasup from Canterbury, New Hampshire will deliver a candid, thoughtful presentation on erotization and sexualization, which is a defense in which unconsciously people try to master things like anxiety, self-esteem, shame, and terror with sexuality.

Sheila Coles is an integrative psychotherapist from England who Zooms in once a week from England.

She's part of the NHS and private practice and will be talking about projective identification with the, a lens of a, a master clinician, and I'm really excited for you to hear from her.

Dr. Johan Ortizo is a PsyD MSW who has a special interest in psychodynamic psychotherapy.

He is going to be delivering a very clinically rich, informed, trauma-informed approach of extreme dissociation.

Also joined with us is Heidi Lynn, a psychiatric nurse practitioner and co-founder of Halen Mental Health.

She has advanced training in EMDR, psychotherapy, integrative psychiatry, and delivers outpatient care for children, adolescent, and adults.

She is presenting on splitting, offering warm and reflective clinically grounded exploration in the all good versus all bad, its use in borderline narcissistic and OCPD presentations, and she presents powerful real-world examples of societal and team splitting.

Dr. April Staples, a PsyD, is a licensed psychologist and member of the Kumeyaay Nation and does thoughtfully clinically grounded work and very reflective, highly reflective person.

We will be listening to her talk about acting out or enactment, and she'll jump into other people's stuff as well.

Grant Lamone is a new psychiatric nurse practitioner who is a energetic, enthusiastic learner and will be talking about projection and interjection.

Finally, Danny Martino is a physician assistant with a certificate in, um, psychiatry who will bring a sharp focus on extreme idealization and devaluation, and he has been a joy to work with this last year.

Sadly, one of our other members who you may have remembered from a previous episode, Daniel Smith, will not be joining us.

He was unable to make these recording sessions.

But you can go back and you can listen to our prior episode together on his recent book and his expertise on things like shame and envy and annoyance.

So, all right.

Let's, uh, let's start the episode, and I hope that this gives you an increased level of psychological mindedness.

Erica Reynolds, you're gonna start us off talking about extreme withdrawal.