Sometimes clients feel anger and hatred for their therapists; I believe this is inevitable on occasion and appropriate. In this article, 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. 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.
After months of bearing with him, I said in session one day that I thought he felt horrible about himself. He knew on some level that I didn't deserve to be abused, but in truth, he couldn't help it. I talked about the reasons why hatred felt to him like a kind of refuge, better than feeling small and horribly damaged. He began to sob. The kind of body-wracking sobs that seem to come up from the depths, also painful to endure. He couldn't tell me so for a while, but he felt profound gratitude. In truth, nobody in his life had ever been able to understand and tolerate him. His father was weak and absent; his borderline mother made him feel he had to suppress himself and his own needs in order to look after hers.
Bearing the hatred and hostility of a child without getting angry back is what good parents do, an expression of their love. Although I was not his father, I felt a kind of paternal love for my client -- countertransference. I've had the pain and privilege of doing long-term work with a number of very troubled people; I find that you can't do the work, can't tolerate the way they need to abuse you if you don't feel some kind of love for them.
Love in the face of occasional hatred - it's what good parents do for their children, and what we therapists in our own way do for our clients.
In my family of origin, explosions of anger and hatred were rare but terrifying, never discussed afterward and never understood. What was it like in your family? If you have your own children, do you have rules about what can and cannot be expressed? How do you react when your children become angry or hateful? Did your parents instill shame if you expressed hatred? Do you do the same for your own children?
Hatred is a central and misunderstood feeling that's at the heart of many psychological difficulties. What is your opinion as to the acceptability of hatred, in yourself and in other people? Do you think it's a "bad" feeling, one we should try to get rid of? We live in a society that discourages the expression of hatred in personal relations; I'll admit it can be problematic, but do you see any value in acknowledging hatred?
In my opinion, hatred is inevitable. The challenge is to acknowledge and make room for it without at the same time letting it destroy your feelings of love.
Joseph Burgo PhD is a clinical psychologist with 30+ years experience in the mental health profession. He writes two blogs, one called 'After Psychotherapy' where he discusses psychotherapy issues such as depression, anxiety, bipolar disorder and borderline personality disorder from a psycho-dynamic perspective; on the other blog, 'Movies and Mental Health' hosted by PsychCentral, he uses classic and contemporary films to illustrate his ideas. Dr. Burgo also offers online counseling via Skype. His forthcoming book on psychological defense mechanisms will be released by New Harbinger Publications in Spring 2013.
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