Acting Out

Abstract

Acting out is a type of defense mechanism: an immature, action-level process in which an unconscious impulse or conflict is expressed directly through behavior rather than held in mind, put into words, and reflected upon. Sigmund Freud introduced the idea in 1914 to describe the patient who repeats in action what cannot be remembered, and later empirical psychology placed acting out near the bottom of the maturity hierarchy of defenses, where observer-rated instruments now score it. This article explains what acting out is and how the Medical Subject Headings vocabulary classifies it, how it differs from ordinary misbehavior and from working-through, where it sits among the action-level defenses, and how the Defense Mechanisms Rating Scales weight it in an overall measure of defensive functioning. It reviews the origin of the construct, its measurement, and current research.

Keywords: acting out, defense mechanism, action defenses, defensive functioning, working-through

Acting out is the mind's way of discharging a conflict it cannot face by turning it into behavior, and psychology studies it because the action that relieves the tension also blocks the awareness that would resolve it. The construct began in psychoanalysis, where Sigmund Freud noticed that a patient who could not remember a repressed experience would instead repeat it in action without recognizing the repetition (Freud, 1914). Its lasting scientific value came later, when researchers placed acting out on a maturity hierarchy of defenses and built instruments to rate it, so that a clinical impression became a measurable, action-level marker of how a person defends (Vaillant, 1977; Perry & Cooper, 1989).

What Acting Out Is

Acting out is an automatic psychological process in which an unacceptable impulse, wish, or conflict is expressed through behavior rather than experienced consciously as a feeling or put into words. The person does not decide to behave badly; the action substitutes for awareness, discharging the tension while keeping its source out of mind. Sigmund Freud described the pattern in his 1914 paper on technique, observing that a patient who cannot recall a repressed experience acts it out instead, reproducing it in behavior without, in Freud's phrase, knowing that he is repeating it (Freud, 1914). The German term he used, agieren, marks the essential feature: the past is put into action instead of into memory. Anna Freud later placed acting out within her systematic catalogue of the ego's defenses, among the maneuvers that manage anxiety by altering the person rather than the situation (Freud, 1936/1993).

In the Medical Subject Headings vocabulary acting out is filed as a narrower descriptor of defense mechanisms, which are themselves classified among behavior and behavior mechanisms. That placement is a bibliographic convenience rather than a theoretical claim, but it marks something real: acting out is treated as one specific defense nested under the general heading, a distinct activity of mind that can be described, rated, and related to its outcomes. What separates it from ordinary misbehavior is motive and awareness: the defining criterion is that the governing process is unconscious, which is what modern reviews use to distinguish a defense from a deliberate strategy (Cramer, 2015). A person who shoplifts for the thrill of gain is not necessarily acting out; a person who provokes a rejection in order to discharge, without recognizing it, the grief of an earlier abandonment is. The demonstration below contrasts the acting-out detour with the path of working-through, so the difference between discharging a conflict and resolving it is explicit.

Trace the two routes a conflict can take

The same unconscious conflict can be discharged in action or worked through in reflection. Choose a route to trace its steps: acting out relieves the tension but leaves the conflict intact, so it returns; working-through converts the conflict into memory and resolves it.

Table 1 lists the seven defense levels of the Defense Mechanisms Rating Scales, ordered from the least to the most adaptive, with acting out located at the action level.

The Action Level

The single most productive idea in the empirical study of defenses is that they can be ranked by how adaptive they are, and acting out occupies a fixed place near the bottom of that ranking. George Vaillant, drawing on decades of longitudinal data from the Grant Study of adult development, arranged the defenses into levels from pathological through immature and neurotic to mature, and classed acting out among the immature defenses that distort relationships and externalize conflict (Vaillant, 1977). Because an immature defense discharges tension at the cost of insight and relationship, the level a person habitually uses predicts mental health and life outcomes, and a reliance on action-level defenses forecasts worse adaptation than a reliance on mature ones (Malone et al., 2013). Reviews of empirical defense-style research confirm the pattern across studies: a maladaptive, action-oriented defense style tracks with psychopathology and shifts toward more adaptive defenses as patients improve (Bond, 2004).

The Defense Mechanisms Rating Scales, created by J. Christopher Perry, give this ordering an explicit scale. The scales rank defenses across seven hierarchically ordered levels, and acting out falls at the first, the action level, together with passive aggression and help-rejecting complaining, the defenses that express conflict through behavior directed at the self or others (Di Giuseppe & Perry, 2021). Observer ratings on this scheme were first validated against clinical interviews and life vignettes, which showed that trained raters could identify a defense such as acting out reliably and distinguish it from its neighbors (Perry & Cooper, 1989). Figure 1 shows the seven levels as a ladder, with the action level at the base, and the demonstration that follows lets the reader place individual defenses on it.

Place each defense on the seven-level hierarchy

The Defense Mechanisms Rating Scales order defenses across seven levels, from the action level at the bottom to the high-adaptive level at the top. Open a defense and assign the level you think it occupies; the card turns green when it matches the published scheme and amber when it does not. Acting out belongs at the action level.

Measuring Acting Out

Placing acting out on a scale is only useful if raters can agree on when it is present, and the Defense Mechanisms Rating Scales were built to make that possible. Trained observers rate the defenses a person shows in a recorded interview or session and combine them into an Overall Defensive Functioning score that runs from the action level at the bottom to the high-adaptive level at the top (Perry & Cooper, 1989). The method depends on a careful clinical inference: a rater must read the function a behavior serves in context, because the same action can be acting out in one person and deliberate choice in another, and only the unconscious, tension-discharging function qualifies it as the defense (Perry, 2014). This is why acting out cannot be scored from behavior alone, and why the construct resisted measurement for so long.

Two developments widened access to the measure. Mariagrazia Di Giuseppe and J. Christopher Perry built a Q-sort version of the rating scales that reproduces the seven-level hierarchy while being quicker to apply, keeping acting out anchored at the action level (Di Giuseppe & Perry, 2021). A self-report form, the thirty-item DMRS-SR-30, then let non-experts place their own defensive profile on the same hierarchy, extending the scale to large samples where trained-rater interviews are impractical (Prout et al., 2022). Both preserve the central fact that an action-level defense such as acting out carries the lowest weight toward adaptive functioning. The worked example below shows how that weighting produces an overall score.

Worked Example

Overall Defensive Functioning is a weighted average of the defense levels a person uses, where each level carries a numerical value and the weights are the proportion of that person's defenses falling at each level. To keep the arithmetic clear, consider four of the seven levels and assign each its level number as its value: the action level counts 1, disavowal counts 3, the other-neurotic level counts 5, and the high-adaptive level counts 7. Suppose a patient entering therapy relies heavily on acting out and other action-level defenses, with rated defenses that are 40 percent action, 30 percent disavowal, 20 percent neurotic, and 10 percent high-adaptive. The score is the sum of each value times its proportion: 0.40 times 1 is 0.40, 0.30 times 3 is 0.90, 0.20 times 5 is 1.00, and 0.10 times 7 is 0.70, which total 3.00. Now suppose that after therapy the same patient acts out far less, with defenses that are 15 percent action, 25 percent disavowal, 35 percent neurotic, and 25 percent high-adaptive: the score becomes 0.15 times 1 is 0.15, plus 0.25 times 3 is 0.75, plus 0.35 times 5 is 1.75, plus 0.25 times 7 is 1.75, totaling 4.40. The rise from 3.00 to 4.40 comes largely from the fall in action-level defenses, and it is exactly the kind of shift that tracks improved clinical outcome. The demonstration below uses this weighted-average model, so changing the proportion at each level recomputes the score directly.

Compute an Overall Defensive Functioning score

The ODF is a weighted average of the defense levels a person uses. Taking four levels, the action level counts 1, disavowal 3, the other-neurotic level 5, and the high-adaptive level 7, each weighted by its proportion. Set the proportions below; the high-adaptive share is whatever remains. A shift away from acting out at the action level raises the score.

At 40% action, 30% disavowal, 20% neurotic, 10% high-adaptive the score is 3.00, the worked example’s patient entering therapy; shifting to 15% action, 25% disavowal, 35% neurotic, 25% high-adaptive lifts it to 4.40, the gain that tracked improved outcome.

Key Researchers

Phebe Cramer

(1935-2021). Professor of psychology, emerita, at Williams College; she led the empirical, developmental study of defenses and the unconscious-process criterion that distinguishes a defense such as acting out from deliberate misbehavior. Wikipedia

Anna Freud

(1895-1982). Psychoanalyst at the Hampstead Clinic in London; her 1936 work gave the defenses their first systematic catalogue and placed acting out among the immature, action-level maneuvers. Wikipedia

Sigmund Freud

(1856-1939). Founder of psychoanalysis; his 1914 paper on technique introduced acting out (agieren) as the repetition in action of what cannot be remembered. Wikipedia

Mariagrazia Di Giuseppe

(living). Researcher at the University of Pisa and editor of Research in Psychotherapy; she co-developed the Q-sort and self-report forms of the Defense Mechanisms Rating Scales that anchor acting out at the action level. Research in Psychotherapy

Vittorio Lingiardi

(living). Full professor of dynamic psychology at Sapienza University of Rome and co-editor of the Psychodynamic Diagnostic Manual; he studies defensive functioning, within which acting out is scored, in the therapeutic process. ORCID

J. Christopher Perry

(living). Professor of psychiatry at McGill University; he created the Defense Mechanisms Rating Scales and the empirical method that identifies the specific function of a defense such as acting out. ORCID

Tracy A. Prout

(living). Associate professor of psychology at the Ferkauf Graduate School, Yeshiva University; she studies defenses in child psychotherapy and co-authored the cross-country study relating action-level defenses to mental-health symptoms. ORCID

George E. Vaillant

(living). Professor of psychiatry at Harvard Medical School and long-time director of the Grant Study of adult development; he built the maturity hierarchy that classes acting out as an immature defense. Wikipedia

Discussion

The study of acting out is a case study in how a psychoanalytic observation became a measurable variable. Freud's original notion was embedded in a theory of memory and repetition that was hard to test: the patient who could not remember repeated the past in action, and the clinical task was to convert that repetition back into recollection through working-through (Freud, 1914). For decades acting out was discussed clinically but quantified little. The breakthrough was a measurement move rather than a new theory. Ranking defenses by adaptiveness and training observers to rate them turned acting out from an interpretive label into a reliable, action-level marker that predicts outcomes (Vaillant, 1977; Perry & Cooper, 1989).

Two clarifications keep the construct honest. First, acting out is defined by function, not by appearance: what makes a behavior this defense is that its motive is unconscious and the action forestalls awareness of a feeling, so a rater must infer the function rather than read it off the behavior (Perry, 2014). This is why the term is misused when it is applied to any disruptive conduct. Second, acting out is not a fixed trait but one end of a changeable distribution: because Overall Defensive Functioning is a weighted average, a person can come to rely less on action-level defenses, and that shift is what clinical improvement looks like on the scale (Perry, Metzger, & Sigal, 2015). Together these points explain why acting out survives as a useful, transdiagnostic marker rather than a relic of an older theory.

Current Directions

The most active work extends the measurement of action-level defenses to new populations and settings. A six-country study using the rating-scale framework found that less adaptive defensive functioning was associated with more mental-health symptoms across national samples, evidence that the link between a reliance on defenses such as acting out and distress is not an artifact of one culture (Bekes et al., 2023). A parallel strand develops faster instruments, including the self-report DMRS-SR-30, so that a person's position on the defense hierarchy, acting out included, can be assessed in large samples without a trained-rater interview (Prout et al., 2022). A third strand maps how defenses relate to one another and to symptoms: a network analysis of people with depressive and anxiety symptoms found that passive aggression, the action-level defense neighboring acting out, was a central node linking the defensive system to distress (Di Giuseppe et al., 2024). Across these efforts the goal is to treat acting out as a measurable, changeable feature of defensive functioning rather than a fixed clinical label.

Common Misconceptions

Acting out is just another word for bad behavior.

What makes a behavior acting out is that its motive is unconscious and the action forestalls awareness of a feeling; deliberate misconduct with a known motive is not the defense (Perry, 2014).

Acting out always means aggression or violence.

It names any discharge of conflict through action, from provoking a rejection to self-defeating choices; it is an action-level defense, not a category of violent acts (Di Giuseppe & Perry, 2021).

Acting out is a permanent feature of a person.

Defensive functioning is a changeable distribution, and a person can come to rely less on action-level defenses as functioning improves (Perry, Metzger, & Sigal, 2015).

Glossary

Acting out.

An immature defense in which an unconscious impulse or conflict is expressed through action rather than held in mind and reflected upon.

Action level.

The lowest level of the Defense Mechanisms Rating Scales hierarchy, comprising defenses that discharge conflict through behavior, including acting out.

Agieren.

Freud's German term for acting out: putting a repressed experience into action instead of into memory.

Defense mechanism.

A largely unconscious psychological process that protects the ego from anxiety aroused by unacceptable impulses or external threats.

Defensive functioning.

The overall adaptiveness of the defenses a person characteristically uses, often summarized as a single rated score.

Disavowal.

A defense level, above the action level, whose defenses disown an impulse or its meaning, such as denial and projection.

Ego.

In psychoanalytic theory, the part of the mind that negotiates between impulse and reality and deploys the defenses.

Help-rejecting complaining.

An action-level defense in which a person solicits help and then rejects it, discharging conflict through the interaction.

Immature defenses.

Developmentally earlier defenses, including acting out, that distort relationships and externalize conflict.

Maturity hierarchy.

The ordering of defenses from pathological through immature and neurotic to mature, by how adaptive each is.

Overall Defensive Functioning.

A summary score, computed as a weighted average of the defense levels a person uses, that quantifies defensive functioning.

Passive aggression.

An action-level defense in which hostility is expressed indirectly through resistance, delay, or obstruction rather than openly.

Repetition.

The reproduction of an unremembered experience in present action, the process Freud saw at the core of acting out.

Transference.

The redirection onto a present figure, often the therapist, of feelings tied to an earlier relationship, the arena in which acting out often appears.

Unconscious impulse.

A wish or drive outside awareness that, in acting out, is expressed through behavior rather than recognized as a feeling.

Working-through.

The process of bringing a repressed conflict into awareness and resolving it in reflection, the therapeutic opposite of acting out.

Frequently Asked Questions

What is acting out?

It is an immature defense mechanism in which an unconscious impulse or conflict is expressed through behavior rather than experienced as a feeling or put into words; MeSH classifies it as a type of defense mechanism (Freud, 1914).

Where does the term come from?

Sigmund Freud introduced it in 1914, using the German agieren for the patient who cannot remember a repressed experience and instead repeats it in action without recognizing the repetition (Freud, 1914).

How is acting out different from ordinary bad behavior?

What makes a behavior acting out is that its motive is unconscious and the action forestalls awareness of a feeling; deliberate misconduct with a known motive is not the defense (Perry, 2014).

Where does acting out sit among the defenses?

On the Defense Mechanisms Rating Scales it falls at the first, action level, alongside passive aggression and help-rejecting complaining, the defenses that discharge conflict through behavior (Di Giuseppe & Perry, 2021).

How is acting out measured?

Trained observers rate the defenses a person shows in an interview or session and combine them into an Overall Defensive Functioning score; self-report forms such as the DMRS-SR-30 extend the measure to large samples (Perry & Cooper, 1989; Prout et al., 2022).

Is acting out always aggressive?

No; it names any discharge of conflict through action, from provoking a rejection to self-defeating choices, not a category of violent acts (Di Giuseppe & Perry, 2021).

Can a person act out less over time?

Yes; defensive functioning is a changeable distribution, and a shift away from action-level defenses raises Overall Defensive Functioning and tracks better outcome (Perry, Metzger, & Sigal, 2015).

What is the opposite of acting out?

Working-through: bringing the repressed conflict into awareness and resolving it in reflection rather than discharging it in action (Freud, 1914).

References