On Self-Hatred

In my forty years of work as a psychotherapist, I have come across countless people who are extremely unhappy with themselves. Their dissatisfaction varies, but the overall impact is that they feel depressed.

The late Theodore Isaac Rubin, MD, and Psychoanalyst, addressed this self-dissatisfaction in a book entitled Compassion and Self Hate. Dr. Rubin wrote the book “Lisa and David.” which became a Hollywood movie named David and Lisa. It is still a movie worth renting and viewing. 

Dr. Rubin borrows from a great psychoanalyst of the mid-twentieth century, Karen Horney. Horney asserts that we have three selves:

1. Actual Self: Who we are with our physical and emotional abilities and disabilities or limitations.

2. Real Self: Who we could be if we freed ourselves from our self-dislike and unrealistic fears.

3. Despised Self: Self Effacing and very neurotic.

4. Idealized Self: The illusion of glorious goals that are impossible to achieve but that we believe we should achieve.

Dr. Rubin reduces this formula to two selves, the Actual Self and the Real Self.

Actual Self: Who we are with all of our talents, limitations, and illnesses, both physical and psychological.

Real Self: The illusions we believe in about who we should be, being wealthy, powerful, lovable, and independent.

If we hold on to illusions about our Real Self is the extent to which we reject our Actual Self and feel self-hate.

For example: 

An individual may cherish the belief that they should be happy. After all, pursuing happiness is guaranteed in the U.S. Constitution. But what is happiness? As Dr. Rubin states, “For me, happiness is feeling good, nothing more… feeling fairly comfortable and relatively tension-free.” 

He then says that we can sustain happiness only for a limited time. Life is not perfect, and moods change. However, the illusion that one should be happy all the time creates self-hate. If someone clings to the illusion that they should be happy all the time, and they are not, they will condemn themselves for not achieving this goal. The problem is that the goal of feeling happy all the time is not achievable.

Perhaps people hold on to unrealistic beliefs about themselves, which explains the epidemic of addiction. Substances offer a temporary that causes a person to feel joyful and omnipotent. When the drug wears out and reality sets in, the self-hate reasserts itself.

To continue the analogy of the drug abuser, the sense of self-hate and wish for joy that propels the addiction also serves as a powerful source of self-punishment. Drug addiction carries with it lots of physical and emotional abuse.

Looking at the dynamic of self-hate in another way, Dr. Rubin talks about the illusions we have about money. There is a commonly held illusion that money can solve all problems. Many patients have told me they would feel free of their problems and suffering if they had enough money. However, real-life tells us a different story.

Lots of people love to play the lottery, hoping to become millionaires. We read about poor or working people winning the lottery and going home fabulously wealthy. Oh, how many of us wish for the same fate? You know the old saying, “Be careful of what you wish for.” It may come true.” The fact is that the lives of many people who won the lottery ended in tragedy. Some of them spent every dollar they won and became bankrupt. Others committed suicide, became addicted to drugs, or suffered an abysmal fate. Money did not solve their problems. Yet, we convince ourselves that it will solve our problems and beat ourselves for not earning or winning a fortune.

The same phenomenon occurs with marriages. Many people enter into marriage with illusionary expectations. These expectations often have perfect bliss, constant sexual fulfillment, and a regular flow of nurturing and love. However, actual life is not this way. Yes, marriage can bring lots of satisfaction, but it also brings many problems and difficulties. Married couples disagree and quarrel, deal with difficult children, and have work and family issues.

The more significant the gap between expectations and reality, the greater sense of disappointment, bitterness, and failure we will experience.

Dr. Rubin states that to be compassionate to others, we must learn to be compassionate to ourselves. The way to be self-compassionate is to learn to accept the Real Self with its limitations.

Accepting who we are instead of wishing for something or someone else is the road to compassion. It means ending self-hatred. Part of the way to end self-hatred is for a person to identify mistaken beliefs and make changes. 

Grief vs. Depression

Losing a loved one is a jarring and tragic experience. It brings on a period of grief and mourning filled with feelings of sadness, anxiety, guilt, and reliving of the past shared with the deceased going back years. People amid the mourning process have described such feelings as loss of appetite, nausea, tearfulness, restless sleep, guilt about not being able to prevent the death from having occurred, and deep feelings of sadness. Many have described the feelings of grief sweeping over them and then subsiding until the process starts again. 

Reliving and talking about the person who has died can come with laughter, as those grieving remember funny and warm times. However, there is now a controversy over whether grief differs from grieving?

Ultimately, the psychiatrist must use their judgment on whether the patient is grieving or having a major depressive episode. The American Psychiatric Association’s Diagnostic and Statistical Manual shows differences between grief and major depression. Let’s look at the differences and similarities in symptoms of grieving after a loss instead of Major-Depression.

Symptoms of Grief:

1. Sadness, despair, mourning

2. Fatigue or low energy

3. Tears

4. Loss of appetite

5. Poor sleep

6. Poor concentration

7. Happy and sad memories

8. Mild feelings of guilt

Gradually and after an undetermined time, these feelings remain as the individual regains equilibrium as they return to everyday life.

Many of these symptoms are similar to the feeling of people with Major-Depression. Still, significantly different symptoms are part of the profile.

Major Depression:

1. Worthlessness

2. Exaggerated guilt

3. Suicidal thoughts

4. Low self-esteem

5. Powerlessness

6. Helplessness

7. Agitation

8. Loss of interest in pleasurable activities

9. Exaggerated fatigue

In major depression, these feelings are ongoing and carry the real danger of suicide. Daily functioning at work and home is impaired, and the individual feels as if they will never climb out of these feelings.

An essential difference between grief and Major-Depression is that, in major depression, the feelings of loss of the loved one are compensated for by warm memories. One friend recently told me that his beloved childhood people are alive in him as beautiful memories.

The death of a loved one often results in feelings of emptiness. But, for those who suffer from depression, nothing, not even warm memories, compensates for the loss. Freud referred to this in his classic book, “Mourning and Melancholia,” in which he pointed out that the one who is depressed turns their energy into attacking the self rather than integrating loved ones who are now gone.

 Some people hold onto the mistaken belief that mourning last for two weeks. However, who is to say that it takes only two weeks to grieve? The time spent mourning a loved one varies according to each individual. The danger of a mistaken diagnosis is that a physician might prescribe antidepressant medication when none is needed. But, that is where the experience and expertise of the MD are essential. Ultimately, mourning runs its course and resolves itself.

 Of course, where someone has Majord-Depression and is also grieving, the grief process may be complicated by the fact of depression. It is also possible that, for some people, the death of a loved one can turn into a depression.

Diagnosing people with any mental illness is complicated and dangerous if the diagnosis is incorrect.

The reader needs to understand that psychotherapy is always available to help those individuals who are in pain. Help is available.

Contact Dr. Schwartz at dransphd@aol.com.

Please visit his website at http://www.allanschwartztherapy.net.

Journaling and Mental Health

For example:

“You have been through a difficult and traumatizing divorce. When all was over, you felt a sense of relief besides exhaustion and some depression. Several months have passed and you continue to feel the lingering effects of having been through something very stressful. A friend of yours suggests you write about the experience of the divorce as a way of feeling better and putting the episode behind you. You do some investigating and discover that there is solid evidence to support friends’ suggestions.”

Were you among the many young people who kept a diary when you grew up? It’s probably something that more females did as compared to males. Research shows it’s something all of us can benefit from in our adulthood. Rather than a diary, it’s called a journal. Writing a journal can have therapeutic benefits and, perhaps, be a way to change one’s life story or narrative. Clinical Psychologist James Pennebaker, University of Texas, is the leading researcher using physical and mental health journaling. He has completed many controlled research studies documenting the benefits of writing daily. Many other researchers, such as Joshua Smith, Ph.D., and Lauren Smith, Ph.D., have further documented the benefits of writing.

Pam Trachta, owner of Through a Different Lens, a consulting business, reports that “When I journal, or when I teach others to, I strive not to be intellectual and logical and articulate, but to feel the wave, the energy behind an event and to summon images of what that wave feels like, acts like, what it’s saying to me and what I would say to it.” Do not worry about grammar, spelling, or sounding literate. Just write.

According to Pennebaker, developing a deeper understanding of an event and the emotions it generates helps the brain digest the information. Pennebaker thinks that your brain turns it into a more easily stored story when you analyze a traumatic event. “Storytelling simplifies a complex experience,” he says. Turning the memory into a story can be painful at first. It can take weeks or months to notice an improvement. Smyth and Pennebaker report that patients often feel worse when they journal. 

Here are some suggestions for how to journal:

1. Write for yourself

2. Write about all the emotions associated with the event.

3. Set aside 30 minutes at a regular time for three or four days in a row when you won’t be disturbed.

4. Explore how the topic relates to other aspects of your life, such as your childhood and relationships.

5. Write continuously and don’t think about spelling or grammar.

Journal writing about traumatic events can be difficult, time-consuming, and careful. Writing about the worst events of your life can dredge up solid emotions, and healing doesn’t follow. For example, journaling therapy doesn’t seem to work by itself with people who are severely depressed or who have post-traumatic stress disorder. Smyth suggests notifying either your health care professional or someone close to you before attempting this exercise. Let them judge if it’s helping or hurting you.

Also, keep your healing journal private. It’s okay to tear up the pages or burn them once you’ve written about the event. Showing them to anyone who isn’t a therapist or healthcare professional could make matters worse–it could be hazardous for a battered woman to show the pages to her spouse.

Some therapists integrate journaling into their therapeutic practice. Journaling is something you can look for in a therapist if interested. You can certainly do something while in therapy to discuss with your therapist if you are experiencing difficult emotions. Remember, one does not have to be in therapy to write a journal.

Psychotherapy help is available. Email Dr. Schwartz at dransphd@aol.com

What if There’s No Such Thing as Closure?

The New York Times · by Meg Bernhard · December 15, 2021

The basis of this blog is on a New York Times article by writer Meg Bernhard, and a correspondence between myself and my dear friend. My friend is referring to the death of my wife, Pat. We were married for fifty years, and friends assured me that I would heal with time. But, on the contrary, I continue to feel a deep sense of loss. I have a lasting sense of loss of my beloved wife. Then I came across a New York Times article, “What if there is no such thing as closure?

The basis of this article is on Social Scientist Pauline Boss and her book, “Ambiguous Loss: Learning to Live With Unresolved Grief.”

Pauline Boss from the New York Times Article:

” Boss studied and provided therapy to the family members of Alzheimer’s patients, as well as the relatives of people whose bodies were not recovered after natural disasters or in the collapse of the original World Trade Center on 9/11. Theirs were losses without “conclusion,” in the traditional sense of the term, the experience of paradox — a simultaneous absence and presence — that eluded resolution. Can you mourn someone whose body is present, even if the mind isn’t? Or whose death is unconfirmed? Can you grieve a foreclosed future?

The concept, Boss maintains, is inclusive, encompassing a range of moderate to severe losses that we might not perceive as such. Moreover, it can take many forms, often quotidian: an alcoholic parent who, when intoxicated, becomes a different person; a divorced partner, with whom your relationship is ruptured but not erased; a loved one with whom you’ve lost contact through immigration; or a child you’ve given up for adoption. 

These experiences are an accumulation of heartbreaks that we cannot always recognize.”

A dialogue between my friend and me:

“Pat died. You lost her as a companion. You lost her as someone who shored you up.You lost your marriage, your married way of life. Your entire way of life changed, and continues to changein various ways, and each change is an ambiguous loss.”

“And, what I get from the article, is that it’s that way for all of us. What did I lose when Joan(his estranged wife) moved to Oklahoma? My life changed irreparably. What have you and I each lost (and each other person on the planet) with the pandemic that will never return as it was before? What have I lost since developing chronic arthritis pain impacting walking? Lost with Laura’s(his daughter) horrible illness and surgery, though gratefully, seeming to be moving towards a full recovery, but scarred by the ordeal?”

“When I was 11, we moved from the house and neighborhood I’d known since birth. I cried for a year. What did you lose when you moved in with your grandparents?”

“We’re “adapting” to loss all of our lives.”

The basis of this blog is on a New York Times article and a correspondence between myself and my dear friend. My friend is referring to the death of my wife, Pat. We were married for fifty years, and friends assured me that I would heal with time. But, on the contrary, I continue to feel a deep sense of loss. I have a lasting sense of loss of my beloved wife. Then I came across a New York Times article, “What if there is no such thing as closure?

The basis of this article is on Social Scientist Pauline Boss and her book, “Ambiguous Loss: Learning to Live With Unresolved Grief.”

Pauline Boss from the New York Times Article:

” Boss studied and provided therapy to the family members of Alzheimer’s patients, as well as the relatives of people whose bodies were not recovered after natural disasters or in the collapse of the original World Trade Center on 9/11. Theirs were losses without “conclusion,” in the traditional sense of the term, the experience of paradox — a simultaneous absence and presence — that eluded resolution. Can you mourn someone whose body is present, even if the mind isn’t? Or whose death is unconfirmed? Can you grieve a foreclosed future?

The concept, Boss maintains, is inclusive, encompassing a range of moderate to severe losses that we might not perceive as such. Moreover, it can take many forms, often quotidian: an alcoholic parent who, when intoxicated, becomes a different person; a divorced partner, with whom your relationship is ruptured but not erased; a loved one with whom you’ve lost contact through immigration; or a child you’ve given up for adoption. 

These experiences are an accumulation of heartbreaks that we cannot always recognize.”

A dialogue between my friend and me:

“Pat died. You lost her as a companion. You lost her as someone who shored you up.You lost your marriage, your married way of life. Your entire way of life changed, and continues to changein various ways, and each change is an ambiguous loss.”

“And, what I get from the article, is that it’s that way for all of us. What did I lose when Joan(his estranged wife) moved to Oklahoma? My life changed irreparably. What have you and I each lost (and each other person on the planet) with the pandemic that will never return as it was before? What have I lost since developing chronic arthritis pain impacting walking? Lost with Laura’s(his daughter) horrible illness and surgery, though gratefully, seeming to be moving towards a full recovery, but scarred by the ordeal?”

“When I was 11, we moved from the house and neighborhood I’d known since birth. I cried for a year. What did you lose when you moved in with your grandparents?”

“We’re “adapting” to loss all of our lives.”

The basis of this blog is on a New York Times article and a correspondence between myself and my dear friend. My friend is referring to the death of my wife, Pat. We were married for fifty years, and friends assured me that I would heal with time. But, on the contrary, I continue to feel a deep sense of loss. I have a lasting sense of loss of my beloved wife. Then I came across a New York Times article, “What if there is no such thing as closure?

The basis of this article is on Social Scientist Pauline Boss and her book, “Ambiguous Loss: Learning to Live With Unresolved Grief.”

Pauline Boss from the New York Times Article:

” Boss studied and provided therapy to the family members of Alzheimer’s patients, as well as the relatives of people whose bodies were not recovered after natural disasters or in the collapse of the original World Trade Center on 9/11. Theirs were losses without “conclusion,” in the traditional sense of the term, the experience of paradox — a simultaneous absence and presence — that eluded resolution. Can you mourn someone whose body is present, even if the mind isn’t? Or whose death is unconfirmed? Can you grieve a foreclosed future?

The concept, Boss maintains, is inclusive, encompassing a range of moderate to severe losses that we might not perceive as such. Moreover, it can take many forms, often quotidian: an alcoholic parent who, when intoxicated, becomes a different person; a divorced partner, with whom your relationship is ruptured but not erased; a loved one with whom you’ve lost contact through immigration; or a child you’ve given up for adoption. 

These experiences are an accumulation of heartbreaks that we cannot always recognize.”

A dialogue between my friend and me:

“Pat died. You lost her as a companion. You lost her as someone who shored you up.You lost your marriage, your married way of life. Your entire way of life changed, and continues to changein various ways, and each change is an ambiguous loss.”

“And, what I get from the article, is that it’s that way for all of us. What did I lose when Joan(his estranged wife) moved to Oklahoma? My life changed irreparably. What have you and I each lost (and each other person on the planet) with the pandemic that will never return as it was before? What have I lost since developing chronic arthritis pain impacting walking? Lost with Laura’s(his daughter) horrible illness and surgery, though gratefully, seeming to be moving towards a full recovery, but scarred by the ordeal?”

“When I was 11, we moved from the house and neighborhood I’d known since birth. I cried for a year. What did you lose when you moved in with your grandparents?”

“We’re “adapting” to loss all of our lives.”