Love in the Face of Hatred

In an earlier post, I talked about how clients sometimes feel anger and hatred for their therapists; I believe this is inevitable on occasion and appropriate.  Today I’d like to discuss how therapists may respond when they’re hated, and how much it can help the people we treat if we’re able to tolerate them and not retaliate in kind.

Often these clients, especially severely troubled individuals, need to express their hatred.  They need to feel they can show what they actually feel and still be accepted.  One of my long-term clients, a man in his early 30s, would scream at me during session after session.  He’d vent in the most vicious tones, week after week, accusing me of any number of crimes even when I might have said very little.  For me as his therapist, it was extremely painful to be in the same room and feel his hatred — hard to be the object of his hostility but also to feel his pain. (See my much later post on countertransference issues in treating depression).  I knew he suffered from profound shame and that venting his hatred was a desperate effort to ward off that shame and hold himself together (see my earlier post on the ways in which hostility can function as a kind of psychic glue).

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Hatred and Anger for Your Therapist

As I discussed in an earlier post on psychological defensiveness, we humans try to protect ourselves from emotional facts too painful to bear – that is, we “lie” to ourselves about them.  That’s our nature and everybody does it.  The job of a good therapist is to make you aware of those things you don’t know about yourself (and probably never wanted to know).

As I listen to my clients talking, they inevitably reveal things about themselves without knowing it, and I try to tell them what I’ve heard.  I rarely get through on the first try (you know, that “resistance” thing).  I keep listening.  If I hear more evidence, I’ll try again to show it to my clients.   If I was right and my view becomes more persuasive, they usually become uncomfortable.  Maybe they’ll get angry.  Sometimes they hate me for telling them what they don’t want to hear.

With all of my patients, at one time or another, they’ve hated me … even when they agreed with what I’d just told them.  In my view, this is an expected part of the relationship, just the way it’s normal for children to hate their parents from time to time.   With severely disturbed clients in long-term treatment, one of the main jobs of a therapist is to allow room for their hatred.  With borderline personality disorder, hatred is often the central focus of early work.  My clients who’ve spent months or years hating me and come through on the other side always feel profoundly grateful that I could bear with them and not retaliate.

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The Rebelliousness of My Inner “Brat”

You’ve heard mention of that “inner child,” the needy, vulnerable part of you that you neglect or criticize.  We therapists often talk about “the baby part of you” or “the child side of you” as a way to address dependency issues.  You know you’ve got a kid inside of you, right?

A lot of the time, mine’s a brat.  He’s very impatient, impulsive and demanding, and when he doesn’t get his way, he gets angry.  He sometimes throws a fit in there, which can be very unpleasant, usually for me alone though sometimes he can be unpleasant to unfortunate bystanders.  [Think Veruca Salt in Willy Wonka and the Chocolate Factory:  “I want an Oompah-Loompah, Daddy.  I want an Oompah-Loompah now!”]  Managing my inner brat can be a major challenge.

Humor aside, I believe this to be a serious issue for many people, and the hardest part in therapy is getting them to realize that the reason they’re struggling is because an immature part of them — a child who can’t tolerate frustration very well and has unreasonable expectations — is having a tantrum.  Sometimes the child gets his or her way and the adult side gives in.  This can lead to impulsive, ill-considered choices followed by shame and regret.

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Breathe More, Think Less

You’re probably familiar with the cognitive-behavior technique known as “thought stopping,” used to cope with stressful and anxiety-intensifying thoughts and ideas during panic attacks, as well as with negative self-statements in depression.  I’ve never found this technique particularly useful, for me or my clients; even worse, its emphasis on replacing such thoughts with verbal affirmations means you’re trying to address a maladaptive mental habit by prescribing that very habit.  In other words, the problem isn’t negative verbal thoughts but verbal thought