From Self Hatred to Self Compassion Jon Frederickson, MSW

Systems of Resistance Isolation of affect Repression Splitting and projection

Psychological Causes of Depression Isolation of affect: detaching from relationships Repression: protecting others from anger by turning it on oneself Projection: projecting one’s rage onto others, then fearing and being depressed over their imagined rage and wish to attack you.

Inquiry Ask for presenting problem Notice patient’s responses Assess the pathway of anxiety discharge and the system of resistance causing the patient’s depression

Response? Heart palpitations, dry mouth Trouble breathing, weakness in legs Shaking legs

Projection Hypothesis for cause: Projection of will Deactivate projection by reminding her of will Responses that indicate projection has deactivated: “yes” with a sigh, drop in projective anxiety, increased tension in the body, end of weakness in legs, end of shaking in legs, ability to cognize about her desire.

Character Defense Self-neglect: ignoring her anxiety and suppressing it out of a belief that this is what I want her to do. I neglect myself as my caretakers did. I dismiss my anxiety as my caretakers did. Attachment pattern

Message from the Unconscious Th: “Don’t dismiss yourself.” Pt: “I didn’t let me…hide as I usually do.” Inquire about the feelings aroused by my encouraging her not to hide from me.

Superego Pathology Pathological superego: collection of memories. Projection: “You will dismiss me.” Transference resistance: “I dismiss you.” Character defense: “I dismiss myself.” Same object relationship can be enacted in these three ways.

Interventions Projection: Deactivate the patient’s projection so you can have a realistic alliance. Then examine how the patient dismisses herself. Transference resistance: Address how the patient distances from you by this wall. Character defense: Point out how the patient treats herself in a cruel, hurtful way that could only lead to depression.

Character Defense Self-dismissal: I will dismiss and ignore my sadness. Character defense: I treat myself the way I was treated. Interventions: help the patient see how she treats herself and help her see the price she pays for this kind of self-treatment. Undo the identification.

Undoing the Identification Rejection by parents = rage toward people she loves = guilt. To protect parents she loves, she identifies with them and punishes herself. As she sees how she has hurt herself, she dis-identifies with her parents’ DEFENSE. This allows the grief and guilt to pass, which furthers this dis-identification.

Healthy Shame Ego ideal Act and tension due to distance. Internal guidance system leading us back toward our ideals. Shameless: I am the same as the ideal!

Pathological Shame I shame myself for normal, human feelings, thoughts, and desires. Shame is a form of self-attack. Character defense: I shame myself for feeling my feelings as I was shamed in the past. Do not deepen pathological shame; deactivate the self-attack on which it is based.

Emergence of Memory As she disidentifies with the parental defense, unconscious feelings rise, and now her memories can come to the surface. Blocking enactive memory allows verbal/declarative memory to emerge.

Mobilize Will to Disidentify with the Defense Memory conscious Deactivate identification Mobilize will to the therapeutic task

The “good” daughter Who suppresses her feelings as her parents ask. Who agrees with criticisms her parents make. Who agrees that she not be who she is but who her parents wished she were.

Timing Describes instance of self-attack. Inviting feeling possible now. Note any responses that could cause depression and deactivate them.

Defensive Affects Core feelings trigger unconscious anxiety and defense. Defensive affects trigger no defenses because they function as defenses. As defenses, they trigger no unconscious anxiety. Deepening a defensive affect deepens depression. Focus on the feeling defensive sadness wards off.

Outcome After nine hours of therapy: depression gone. She asserts herself effectively with her husband who now listens to her. Self-attack, self-neglect, and self-hatred gone. Reports being happy and has taken up her profession again actively.

References Frederickson, J. (2013) Co-Creating Change: effective dynamic therapy techniques Frederickson, J. (2017) The Lies We Tell Ourselves: how to face the truth, accept yourself, and create a better life. DVDs of sessions and skill building exercises: www.istdpinstitute.com Facebook page for therapists: www.facebook.com/dynamicpsychotherapy Training: jfrederickson@verizon.net