Jason is a 31-year-old man in recovery for substance use disorder for methamphetamines. He states that he can stay sober for a few months but always relapses due to boredom. He finally was able to stay sober after he got involved in extreme sports (e.g., hang gliding, windsurfing, and parachuting). He told his nurse practitioner, “I had to literally get high in order to stop getting high.” This is an example of:

Choice A reason: Sublimation is a mature defense mechanism where socially unacceptable impulses are transformed into socially acceptable actions. Jason’s shift from drug use to extreme sports channels his need for stimulation into a constructive outlet, making this a textbook example of sublimation. Choice B reason: Suppression involves consciously choosing to delay or avoid dealing with distressing thoughts or feelings. Jason is not avoiding his impulses; he is redirecting them, which is more consistent with sublimation. Choice C reason: Projection involves attributing one’s own unacceptable thoughts or feelings to someone else. Jason is not externalizing blame or emotions onto others, so this does not apply. Choice D reason: Transference refers to redirecting feelings about significant others onto the therapist. Jason’s statement is about his own coping strategy, not about the therapeutic relationship.