When the client presents with pervasive and extreme self-hatred, it presents a terrible conundrum for the psychotherapist.
To try and undermine self-hatred is often experienced by the client as undermining their experience of themselves and creates a schism within the relationship. On theother hand, to collude with the self-hatred is even worse, perpetuating damageto the client and usually experienced as unbearable by the therapist.
This paper will explore the underpinnings and possible causation of client self-hatred and explore the links between self-hatred and shame. This will (hopefully) lead to some tentative offerings about how to manage and treat these difficult clients.