The defense mechanism of splitting: developmental origins, effects on staff, recommendations for nursing care

Splitting as a predominant defense mechanism is used by a large number of people. It is characterized by projection of good and bad qualities onto people in the environment and malformed ego functioning. Nurses need to understand the developmental origins, formation of ego deficits and defense mechanism of splitting so that they can care for these people. Effective nursing care is dependent on leadership which anticipates splitting, maintains a cohesive staff group and intervenes appropriately. Limit setting provides the most effective treatment modality as it supplies the missing internal function of the deficient ego. With this use of limit setting staff will prevent splitting and foster socially acceptable behavior. This will have a dual effect of beginning ego reconstruction and increasing self-esteem for the patient and treatment success for the staff.