Psychological defense strategies according to the defense mechanism test among patients with severe conversion disorder

Nineteen patients with a diagnosis of conversion disorder (according to DSM -IV criteria), and 32 healthy nonpatients, were assessed using the Defense Mechanism Test (DMT), which is a projective perception test that examines p sychodynamic defense operations according to psychoanalytical theory. The c onversion group was significantly separated from the nonpatient group. The nonpatients showed better reality testing and the ability to perceive the n egative affective element of the stimulus picture when compared to the pati ent group. The conversion group was characterized by a lateness of percepti on, specific constellations of defensive maneuvers, and a much more nonemot ionally adapted pattern compared to the control group. This supports the no tion that conversion symptoms are nonverbal communications inhibiting more articulated verbal expressions of emotions. The results lend support to the theories of psychodynamic self psychology, where the organization of affec t experience is believed to constitute an essential structural aspect of th e self, determining to what degree affects will have (or not have) a disrup ting effect on the individual's capacity to relate to self and to others. I t is suggested that the combination of the DMT and the soft multivariate mo deling of data may have clinical implications in the assessment of patients with conversion symptoms.