Sublimation — MRCPsych Paper B MCQ

Correct answer: C — Sublimation

The answer is C, sublimation. Sublimation is a mature defence mechanism in which an unacceptable impulse is transformed into constructive or socially acceptable activity. Here, aggressive energy is expressed through disciplined competitive sport and mentoring rather than harmful aggression. Displacement redirects an emotion towards a substitute person or object without necessarily transforming it constructively. Projection involves attributing one’s own unacceptable feelings to someone else. Reaction formation produces attitudes or behaviour opposite to the underlying impulse, such as exaggerated gentleness concealing hostility. Intellectualisation uses abstract reasoning to avoid experiencing the associated emotion. The socially valued transformation of the aggressive impulse therefore makes sublimation the single best answer.

Reference: Gibbons R. The mourning process and its importance in mental illness: a psychoanalytic understanding of psychiatric diagnosis and classification. Table 1: Psychic defences. BJPsych Advances. 2024;30:80–88. https://www.rcpsych.ac.uk/docs/default-source/events/2025-events/faculties/psychodynamic-psychiatry-day-2025/article---the-mourning-process---rachel-gibbons.pdf?sfvrsn=1e044d20_3