Case Study

The Anatomy of Self-Hatred

Learning to Love Our Loathed "Selves"

Magazine Issue
July/August 2012
Case Study 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 holding the pain of rejection or physical and sexual abuse, or distancing from the part that was too emotional or free-spirited to be tolerated in their families of origin, they could more easily display just those aspects of self likely to win any available crumbs of attachment or praise from their caretakers.

This coping approach is practical during childhood, but it eventually comes up short once the demands of adult life call for qualities and behaviors that couldn’t be part of our earlier repertoire. Worse yet, we later pay an even more insidious price for this self-alienation. It means that inside us, the seeds of a pervasive and enduring sense of danger have been laid-a profound, nonverbal sense that some parts of us are to be feared and would be totally unacceptable if anyone knew about them. No matter what’s happening on the outside, no matter how much we’re loved and valued in our adult lives, judgmental parts within us are standing ready to condemn us as inadequate or undeserving, feeding a global sense of anxiety and shame, filling us with the constant expectation that rejection, defeat, and humiliation lie ahead. Inaccessible to reason or reassurance, our inner parts that are primed for shame stand in fear of the parts conditioned to condemn them.

A Crisis from Out of Nowhere

Marcia didn’t know that her childhood experience of abuse and neglect had led to the self-alienation that was now causing mayhem in her otherwise normal suburban life. She arrived in my office as a 29-year-old housewife with an announcement that jolted even a long-time therapist like me: “I want to give up my children and leave my husband.”

Ten years before, after graduating from high school, marrying her childhood sweetheart, and having three children in quick succession, she thought she’d arrived at a happily-ever-after life. Then without warning, after the birth of her youngest daughter, she suddenly became someone she didn’t know anymore, and certainly didn’t like. She’d erupt with rage at her children one day, hide in the closet or be unable to get out of bed the following day, drink too much the next. She had no way to know that giving birth to a youngest girl, the role she’d occupied in her own family of origin, would trigger deeply unsettling feelings and sensations she thought she’d left behind-“where they belong,” as she said. Appalled by her behavior, she sought my help because, as she put it, she was becoming “as crazy as the family who raised her.”

As I listened to her story, I could hear the attachment-related internal conflicts as different “voices” in her narrative. As she talked about her drinking, her body language projected rebellious teenager, while a judgmental voice was horrified by the behavior. This voice was quickly followed by a sense of deep shame and the thought that she should “give up the children” as an act of penance. There was another voice, too: the angry part, which periodically erupted at her husband, perceiving him as a “user.”

Once I’d begun to form a coherent picture of the turmoil Marcia was experiencing, I gave her both the “good news and the bad news.” The good news was that she didn’t have to give up her children to save them, and the bad news was that the trauma she thought she’d left behind was still very much with her, manifesting in a furious inner battle being waged by her various “parts.” I began to explore with her how unresolved internal attachment issues can surface as otherwise normal life stresses evoke the fears and feelings of our disowned, abandoned inner parts.

Using Sensorimotor Psychotherapy, the bedrock of my therapeutic work, I began to help Marcia differentiate between the impulses, thoughts, and feelings of her traumatized inner parts and the actions and reactions of her “wise adult self.” The felt sense of “who I am” as a compassionate, thoughtful adult is palpably different from the experience of a hard, scathingly judgmental part or a young child yearning for care or an angry part fighting for justice. I began by focusing Marcia on sensing those differences and mindfully noticing the parts within her rather than reacting to them. From there, I began to guide her in “befriending” the parts she’d unconsciously disowned so many years ago, even as they were causing havoc in her current life.

But how do we actually “befriend” parts of ourselves? The answer is: the same way we befriend anyone else. We show interest and curiosity. I invited Marcia to learn what made her parts tick as if they were people she was getting to know for the first time. What were their likes and dislikes, fears and fantasies, habits and growing edges? That meant teaching her to listen, to really hear what these parts were trying to tell her, even though that meant making a radical leap of faith, believing that all these distressing feelings, thoughts, behavior, impulses, images, and dreams represented communications from parts of her own self. In doing this kind of work, I find myself repeating certain phrases and instructions again and again: “Notice that feeling of shame as the ashamed part is trying to talk to you. Notice what she’s trying to tell you. Is she feeling responsible for the angry part? Or is the judgmental part making her feel bad about herself? What is she saying? If that dream were a communication from some part of you, what would that part be trying to say?”

Despite my best efforts to translate her inner experience into “parts language,” it was almost impossible at first for Marcia to accept that her mood and behavioral swings represented communications from parts of her. “I have to be responsible for my behavior,” she protested. Then, in the midst of her therapy, she experienced a crisis so intense that it moved our work together into another level of intensity and clarified issues she’d been struggling with all along.

Losing Control

One Sunday afternoon, as her husband was once again engrossed in watching a football game, completely unresponsive to her, she felt a sudden surge of rage and, in a moment of depersonalizing horror, watched herself lift up their television set and hurl it across the room while her children screamed in fear.

“That’s unforgiveable: that’s not me,” she said at her next appointment. “I’d never do something like that!” Aided now by her willingness to do anything to avoid repeating that scene, I asked her to go back to the moment when her husband had failed to respond to her and notice what had come up inside her: “I’m looking at him, and I can feel the rage roiling inside.”

“OK, now assume that this rage belongs to some part of you. Separate from it a little bit, so you can notice it instead of ‘being’ it. See what happens if you say, ‘She’s furious.'”

“It’s easier to manage the intensity if I say ‘she’ instead of ‘I’. But I just want her to stop it! She’s ruining my life and my marriage.”

I challenged her: “So you’re telling me that you want to tell this badly abused child to just stop being angry? Is that right?”

Marcia paused and had to think: “Well, I guess that’s not very realistic, is it?”

“If this child were your foster child living in your home, would you tell her to get over it? Or would you try to help her? Would you understand why she got so angry at your husband?”

She paused again: “I would. And of course I’d want to help her.”

“Of course you would; that’s the kind of person you are. OK, now ask that part if there’s a picture or memory that goes with this feeling of rage.”

The image that came up was a childhood scene: her father and brothers are watching a football game while she and her two younger sisters are playing together. Perhaps uninhibited in their play, perhaps wanting attention from someone, they inadvertently run in front of the television. There’s a shout that startles them, then her father grabs a piece of plastic pipe from under the sofa and starts to beat them with it, and the older brothers join in. Suddenly, it’s much more exciting for these men to listen to the screams of three little girls than to watch the football game.

“And when you see that scene, what happens in your feelings and your body?”

“I feel scared, but even more, hurt. Why do they hate me so much?”

“Notice that feeling of scared and hurt and the question, ‘Why?’ coming from this young girl. Where do you feel it in your body?”

“Around my heart. It’s so heavy and sad.”

I asked her to notice what happened if she placed her hand just where she could feel the heaviness and sadness. “Notice what happens when she feels your hand there. Let that little girl know you’re here with her.” Her tears began to flow.

“She was so alone. My mother and older sisters just tried to placate them. No one was there for her.”

“Yes, no one was there: she was so little and so alone,” I echo, “and what happens inside if you turn toward your heart and say the words, ‘I’m here now’?”

“Do I say that to myself? Or to her?”

“See what happens if you say it to her directly so she knows you’re really there.”

Marcia turned slightly as if talking to the child and then said, “I can feel her relaxing-not so tight. Before, she was so tense-scared, I guess.”

“Yes, it was pretty scary to be a little girl all on her own in your family.” By echoing her words in a tone of warmth and compassion, I helped her connect to her innate capacity for care and connection. By helping her find the words and gestures that “speak” to this child part, I helped her deepen the capacity to connect internally to disowned parts that would otherwise act out or “act in” (implode). Her face was soft as she continued to sit with her hand over her heart, lost in conversation with her little-girl self, whose normal needs for loving attention had become so dangerous in her troubled family.

We ended the session with some “parenting tips” from me about the importance of thinking of this part like a small foster child she’d just taken into her home. I reminded Marcia that if she were this child’s foster parent, she’d be continuously aware of her vulnerability to feeling frightened and alone, and would keep her close by at all times. To capitalize on her motivation to work with the anger, I emphasized that the angry part wouldn’t have to come to the little girl’s defense, like a protective older sibling, as long as Marcia was taking care of her.

Awakening the Inner Adult

The next week, it was a much softer Marcia who arrived for our appointment, with none of the usual depression, wary resignation, or bitterness I’d become accustomed to seeing in her. When I reported on my immediate impression of the shift in her, Marcia laughed and drew the outline of a baby carrier across the front of her body: “Think it might have anything to do with the fact I’ve been carrying the little part with me all week? She’s always right here now-over my heart.”

Despite days when her judgmental part berated her efforts to connect to the child part and others when the teenager thought this whole baby carrier thing was “bullshit,” Marcia continued when she could to imagine carrying her younger self across her heart day after day, and a gradual transformation unfolded. Rather than being traumatically triggered by her husband and children, her family now evoked a new level of gratitude and caring. The feeling of failure as a mother had been connected more to a depressed, hopeless part of her than to a resourceful, wise adult who could use her own mistakes to grow into a more caring and resourceful parent. She began to take delight in making each child feel special, whether by teaching her son to play tennis or taking her 11-year-old daughter shopping or cuddling the youngest one and reading her stories. Aspects of her younger selves began to emerge as adult capacities and creativity: the purchase of a “fixer-up” home led her to begin designing interior spaces, as she’d once done as a child, cutting out pictures from magazines; taking golf and tennis lessons connected her to once longed-for athletic accomplishments; developing friendships with other mothers counteracted the shame and sense of “not belonging” of her depressed part. Embracing the most wounded part of her had transformed her relationship to herself and those she loved.

Marcia’s story tells us much about what can happen when we welcome parts we’ve disowned, dissociated, or designated as enemies. Perhaps because she was a mother, it was easier to attune to the attachment needs of her parts and meet them. Many other clients have similar moving moments of connection to their younger selves, followed by backlash hostility or intellectualization; some fail to recall such moments at all; some become scathing or skeptical. But when we’re clear that their self-hatred and alienation from themselves is nothing more than a survival strategy held by younger selves, that deep within them lives a compassionate heart and a wise mind, capable of embracing these wounded parts, most can be gradually persuaded. In the meantime, I patiently model warmth and openness to each and every part, even the ones who threaten, like suicidal or devaluing parts, welcoming all their voices in therapy like honored guests.

Whatever the range of variation among clients in their resilience and ability to make use of the transformational possibilities of therapy, experience has shown me that when it comes to awakening self-compassion and self-love, simpler and more repetitive is usually better. Just the other day, my client Dan asked, “Do I have to love myself to get better? Because if I do, I think it’s hopeless.”

“Do you love animals?” I asked.

“Of course.”

“Do you hate children or do you feel for them?”

“Of course, I feel for children-what kind of monster would I be if I hated kids?”

“OK, then there’s no obstacle to your becoming the person you were meant to be. All you have to do is to be open to the young, wounded children inside you instead of hating them or ignoring them. Are you up for that?”

“Yes,” and then there was a pause: “but I don’t have to love myself, do I?”

“No, just the kids inside you.”

Case Commentary

By Steve Andreas

Janina Fisher describes a successful case, based on a useful approach. My comments only highlight a few ways in which it might have been conducted even more efficiently and effectively.

Fisher begins by describing Marcia’s announcement, “I want to give up my children and leave my husband.” Below is an initial response to that announcement that would directly accept what the client initially presents, while shifting the focus to the underlying positive intention.

Therapist: “OK, great; you want to give up your children and leave your husband. What would that do for you? What would you accomplish by doing that?” (The words, “OK, great” may sound strange to some readers, but I’ve found that they effectively convey an unconditional acceptance of whatever the client has just said. The second part of the response redirects attention to the positive intent underlying her stated goal.)

Client: “I’ve been terrible to my kids. I erupt with rage at them and sometimes I get drunk or hide in the closet instead of taking care of them.” (Most clients will describe the problem behavior rather than the positive intention, because the problem is what they’re primarily attending to.)

Therapist: “OK, so you’ve done some terrible things with your kids. What would be positive about giving them up?” (This again redirects the client’s attention from the problem in the present to the solution in the future, a useful reorientation even when the solution doesn’t seem very appropriate.)

Client: “They wouldn’t have to experience my outbursts. Someone else would take better care of them.”

Therapist: “OK, so you want your kids to have a better life. You must really love them a lot.” (At this point the client would likely cry loving tears-a useful change in state, which lays a “strengths-based” foundation for exploring alternate solutions, and for addressing her anger, judgment, and shame.)

In this case, the pivotal intervention involves Fisher’s inviting Marcia to respond to the angry/abused part of herself as she would a foster child-locating the feeling of hurt and sadness in her chest, placing her hand there, and saying, “I’m here now.” This is clearly helpful to Marcia, who goes on to imagine this part of herself in “a baby carrier across the front of her body,” developing a feeling of tenderness and welcome toward a previously denied aspect of her experience.

However, at this point, Marcia still experiences the hurt child as separate from her, while the ultimate goal of parts work is integration. The next step would be to invite the hurt child to fully become a part of her. One way to accomplish that would be to say something like the following, in a soft, slow, hypnotic tone of voice:

“Marcia, I want you to close your eyes. As you feel the warmth of that younger you there on your chest, comfort her: tell her anything that seems appropriate, and respond fully and honestly to anything she says or asks . . . . Now, ask her if she’d like to become fully a part of you, so that you’d always be with her and able to protect her. Remind her that you’re from her future, so you can guarantee that she survived those horrible events. When you’re sure, by observing her responses, that she’s ready for this, slowly reach out with both of your hands and gently bring her into your body so she becomes fully a part of you, from the hair on your head all the way down to your toenails.”

In doing this kind of “parts work,” it’s important to emphasize to skeptical clients that no “leap of faith” is required. The intervention can be offered simply as something to try, to find out whether or not-or to what extent-it’s useful. As was true in this case, clients will soon find that there’s a positive, useful shift in their relationship with previously negative and rejected aspects of their inner experience.


Illustration © Sally Wern Comport

Janina Fisher

Janina Fisher, PhD, is a licensed clinical psychologist and former instructor at The Trauma Center, a research and treatment center founded by Bessel van der Kolk.  Known as an expert on the treatment of trauma, Dr. Fisher has also been treating individuals, couples and families since 1980.

She is past president of the New England Society for the Treatment of Trauma and Dissociation, an EMDR International Association Credit Provider, Assistant Educational Director of the Sensorimotor Psychotherapy Institute, and a former Instructor, Harvard Medical School.  Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of the neurobiological research and newer trauma treatment paradigms into traditional therapeutic modalities.

She is author of the bestselling Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists (2021), Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation (2017), and co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma.(2015).

Steve Andreas

Steve Andreas, MA, was a developer of NLP methods and the author of Six Blind Elephants, Transforming Your Self, and Virginia Satir: the Patterns of Her Magic. He was coauthor, with his wife Connirae, of Heart of the Mind and Change Your Mind—and Keep the Change.