TABLE 7.

Major image-distorting defense level: Definition, function and DMRS-Q items of defenses splitting of self-image, splitting of other’s image, and projective identification.

Defense mechanism>	DMRS-Q items>
Splitting of self-image	ITEM 3: The subject has periods of saying highly positive things about him or herself, and other periods saying highly negative things about him or herself, without appearing to notice the contradiction and without addressing it, other than to feel confused about him or herself at moments. ITEM 6: The subject speaks of him or herself in a wholly negative way at times, as if there is nothing positive or redeeming about him or herself. ITEM 98: The subject expresses a series of highly unrealistic positive attributes about him or herself whereas at another point the subject sees only negatives in him or herself. The subject dismisses attempts to see things in a balanced more realistic way. ITEM 142: The subject tends to highlight objects with an emotional meaning that matches his or her own emotional tone at the moment. Any feeling that doesn’t match this is ignored or denied. ITEM 145: Whenever saying something negative about him or herself, the subject rejects others’ attempts to explore positive or more balanced views, and paradoxically becomes even more confirmed in his or her own worthlessness.
Splitting of other’s image	ITEM 35: The subject experiences other people and objects in “black or white” terms, failing to form more realistic views that balance positive and negative aspects of them. ITEM 61: The subject attributes unrealistic positive characteristics to an object, such as being all-powerful, omni-benevolent, a savior. Because of the unrealistic belief that the positive object will take care of one’s problems, the subject ignores the need to take care of some of his or her own needs. ITEM 92: The subject attributes unrealistic negative characteristics to an object, such as being all-powerful, malevolent, threatening. As a result, he or she makes some effort to protect him or herself from its influence, even though this response appears unwarranted or exaggerated. ITEM 94: The subject fails to recognize that someone may be untrustworthy, hurtful, or manipulative and does not draw obvious conclusions based on their behavior. This generally results in using very poor judgment about how others will treat the subject. ITEM 114: The subject expresses hatred toward someone or something and refuses to acknowledge anything that does not confirm the hatred.
Projective identification	ITEM 72: Sometimes the subject gets angry or fearful toward someone for no apparent reason, but then accuses the other person of intending to make him or her feel that way. ITEM 75: At times the subject’s feelings merge with those of another person and the subject assumes the other’s feelings and needs are exactly the same as the subject’s own. He or she then tends to “put words in the other’s mouth.” ITEM 101: In conversations, the subject sometimes seems confused about distinguishing his or her own feelings from those of the other person. ITEM 103: When the subject gets upset at someone, he or she gets very angry and loses control, but then blames the other person for making him or her lose control. Nonetheless, the subject may feel some guilt for losing control. ITEM 113: The subject feels provoked by someone when no obvious provocation is apparent. As the subject becomes angry, accusatory or verbally abusive, the subject provokes the same negative feelings in the other which the subject mistakenly believed the other person had at the outset.