Always severely pathological, seen in overt psychosis (but also in personality disorders, normal childhood, and dreams) Denial: Refusal to accept external reality
Distortion: Grossly reshaping external reality
Projection: Persecutory delusions about reality (ie: homophobia taking the form of gay-bashing)
Splitting: Disintegration of negative and positive impulses. ie: a person is either all good or all bad.