Self-hate: Theoretical, clinical, and empirical features

This paper aims to provide an overview of self-hate, a concept developed by control-mastery theory (CMT) to describe a set of pathogenic beliefs that share the common core of a deeply negative self-representation and self-evaluation, and that are often at the basis of severe personality pathology. Pathogenic beliefs that support self-hate are developed to adapt to early traumatic relationships that made the person feel unrecognized and unloved for who they are. These pathogenic beliefs make the person feel bad, inadequate, unworthy, and undeserving; in addition, empirical research has shown that they are often associated with relevant transdiagnostic psychopathological factors such as difficulties in mentalization, emotional dysregulation, low self-esteem, deep feelings of shame and guilt, depression, interpersonal problems, and a low level of personality functioning. During psychotherapy, patients with issues related to self-hate can be very challenging, and it can be difficult for therapists to develop a strong alliance with them. We will overview the principal manifestations of self-hate, the features of the traumas at its basis, the empirical research data collected on its psychopathological correlates, and their implications for treatment, stressing the importance of therapists’ attitudes and the centrality of corrective emotional experiences.