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Depression

Turning Against the Self: How it Causes Depressive Cycles

Many depressive moods are maintained by turning against the self.

I was recently reviewing the process of turning against the self with my doctoral students. It is an important phenomena associated with depression and other mental health problems. Turning against the self describes the process by which an individual develops an internal critic that develops strong negative attitudes about the self and especially about how one feels.

Here is a common exchange that highlights what it looks like in the clinic room.

Me: It seems to me like you are feeling very frustrated with yourself.

Client: I absolutely am. I don’t know why I feel this way. It is ridiculous. I should just be happy like everyone else.

Me: So, do you believe that there is something fundamentally wrong with you?

Client: Absolutely. I don’t know why I have these feelings. All of a sudden I am freaking out about something minor or feeling really sad. Who does that? Other people can just let that stuff roll off their backs. Instead, it makes me crazy inside.

Me: And that makes you feel weak and vulnerable?

Client: Completely. It makes me feel I am an emotional wreck. And it is just stupid. There is no point in feeling this way. There are plenty of people who have it a lot worse than I do—why should I feel so bad? It is not like I am living on the street or anything. I just feel that there is this big black hole inside of me.

Me: And you are very frustrated and angry with yourself for having that hole, yes?

Client: Absolutely. There is something very wrong about me and how I feel.

We humans both have feelings and we have beliefs, attitudes and judgments about those feelings. What happens to many people who struggle with negative emotions like depressed or anxious moods or guilty or shameful feelings is that they have a strong negative evaluation of the feelings. So not only do they feel “bad”, they evaluate themselves to be bad because of these feelings (see here).

Why do some people turn against themselves and their negative feelings? There are several reasons. Classically, the idea was that people were angry with others, but could not express this and instead redirected the anger inward (Freud's early conception of depression). This has some validity, but there are many other reasons that folks turn against the self.

First, negative feelings suck to feel. Not only that, many people have beliefs that the negative feelings are horrible which adds to their motive to avoid them. Thus, they want to get the negative feelings off the stage of consciousness as fast as possible.

Second, negative feelings orient us toward actions that might be problematic over time. If I feel irritated with you, it might orient me toward being bitchy, but of course that might threaten our relationship. If I feel sad and I share that with you, then I might be a burden. If I feel shame, and I really allow myself to feel that, then I will act inferior and vulnerable. Because these actions are problematic, the feelings are deemed problematic and thus folks try to suppress them for these reasons.

Third, many folks do have neurotic temperaments, but have not been given a frame for what this means (basically, you have a more sensitive and reactive negative emotional system) and how to cope with it. As such, people experience themselves has hyper-sensitive or overly emotional and they look at others who are calm and let stuff roll of their backs and wish they could be like that. So they try to criticize themselves into being calmer.

Fourth, as one turns against the self (i.e., gets more and more angry or critical of how they feel deep inside), the entire system becomes increasingly conflicted and vulnerable, which of course leads to more and more negative affect, leading to more and more frustration from the inner critic.

So, how do you reverse the cycle of turning against the self? Well there are lots of possible ways. One intervention I like to do is called the “Restaurant Intervention” that a group of us developed when I was back at UPENN working at the center for cognitive therapy. It goes something like this (continuing the conversation above):

Me: So, it seems to me that you have these feelings inside of you, these dark, negative feelings that bubble up from your heart or your body and into your consciousness sending you signals that a part of you is not happy or is suffering.

Client: Yes.

Me: And then there is this self-conscious part of you that has an idea of how you want to feel and you think you should feel. That part of you is very critical of these negative feelings. It does not want them on the stage of consciousness at all.

Client: Yes.

Me: So that judging part gets annoyed and critical and angry, trying to get those feelings to go away.

Client: Yes, I get super frustrated and pissed at myself for having these feelings.

Me: And as you get pissed and criticize yourself for your feelings, what happens?

Client: I usually feel worse. It is hopeless because I know deep down that blackness is really all I am.

Me: I know you feel that way now, but I don’t believe that blackness is all that you are. Granted, it is a part of you. But there is also the part of you that hates those feelings and tries to block them (along with many other parts of you).

Client: Yes. It is like those two parts of me are at war.

Me: Exactly. Some psychologists like to divide our psychology up into three parts. One part is the emotional part, it can be kind of like a child, in the sense that it can be vulnerable and very much in the here-and-now. Then there is a part that is like a critical parent, one that is frustrated with the needs and vulnerability of the child and just wants it to stop whining and grow up and just be happy. Finally, there is the middle part that is trying to navigate the demands of life, as these two parts go at it.

Client: I can see that.

Me: Great. I would like to engage in some imagery, may be to help you get an understanding of how all this is impacting you.

Client: Ok.

Me: I would like you to imagine yourself at a restaurant. This is the observing, middle part of you. Now I want you to imagine the other two parts of you in the form of a child and a parent at the next table. Can you see that?

Client: Yeah, I think so.

Me: Okay, now imagine the child begins to tell the parent they are not feeling well. The child starts to express sadness and tear up. Just as you feel inside.

Client: Okay, I can see that.

Me: Now, take some of the things you say to yourself when you feel this way and now imagine the adult saying those things to the child. Imagine that parent saying things like, “What is wrong with you?”; “Why do you have to be so negative?”; “You are a blackhole of misery”; “Why can’t you be like other kids?”; “You are defective”. Can you see that?

Client (a bit taken aback): Yes…

Me: Can you feel that?

Client: Yes. (emotion welling up). I feel bad for the child.

Me: Sort of makes you want to protect her, huh?

Client: Yes.

Me: Now, how do you think the child will respond to the criticism? Do you think they will all of a sudden become happy-go-lucky, just like the parent wants?

Client: Of course not. They will shrink. They might force a smile, but obviously the parent can’t force the kid to feel differently.

Me: Exactly. Does it now make sense why turning against yourself the way you have is only breaking you down?

Client: Yes. I never thought about it like that before.

Me: It is crucial to realize that, just as most critical parents do in fact want what is good for their kids, most inner critics desire adaptive things for the individual. It is just that the process by which they operate has the opposite effect of what is desired. Instead of decreasing the negative feelings, they instead jack them up and create a vicious psychological cycle.

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When I am working with folks who have turned against themselves, I generally work to have them become a bit more mindful of the process and to develop a different inner attitude, one that is encapsulated by the acronym CALM MO. This stands for an inner observer that is Curious, Accepting, Loving/Compassionate, and Motivated to learn and grow in an adaptive manner. For more on mindfulness and a CALM MO, see here and here.

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