Case Study

Case Study

The Anatomy of Self-Hatred: Learning to Love Our Loathed "Selves"

By Janina Fisher

July/August 2012

As therapists, we often encounter clients who are so mired in self-hatred that our best efforts to support a sense of self-worth only seem to dig the hole of judgment and self-loathing deeper. For some, the very prospect of self-acceptance can feel repulsive and deeply anxiety provoking. In these cases, an intense battle is often going on deep within. The client comes to therapy hoping to feel better, safer, more fulfilled, only to find that emotional vulnerability, self-acceptance, and pleasure or spontaneity feel frightening or shameful. Every step forward leads to a step back-the therapist's compassion and encouragement of self-acceptance is regularly met by the client's "default setting" of alienation and self-hatred. Sometimes the war may be literally between life and death-as when part of the client wants to live while another lobbies for suicide as the ultimate protection against overwhelming feelings.

When clients' stuckness could be repeatedly traced back to these kinds of internal conflicts, I began to wonder if the resulting clinical quagmire might be a reflection of a kind of "internal attachment disorder" mirroring the emotional injuries of early childhood. Was it possible that alienation from self and others had become an essential survival strategy early in life? If we start to look at where these internal battles still leave clients, we typically discover that alienation from self has a crucial adaptive function: by disowning the part of themselves…

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