For several years now I’ve been developing what I like to think of as my own private "religion" to enable me to cope better with negative emotions, especially intense shame. I’ve made up rituals to punish myself symbolically (such as wearing a dunce cap, whipping myself or making little effigies of myself and burning them) and I’m writing a set of "scriptures" enumerating my faults and reminding myself of my worthlessness. Much of the time I’m relatively happy, but little disappointments overwhelm me and leave me worried that I have no right to live. I feel that if I can make up a way to punish myself in advance, regularly, I can protect myself from being hurt by other people and take control of what’s wrong with me. I wish I could stop feeling this way but haven’t found a good way to avoid periodically getting overwhelmed by the feeling that I’m unlovable and obligated to avoid people. How can I know whether I’m objectively worthless and obligated to keep this fact in mind or whether these feelings are something I can and should try to overcome? I’ve tried a couple of different therapists, but I always worry my therapist finds me annoying and my problems ridiculous or too strange to be worth addressing, so I end up quitting.
- Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
- Dr. Dombeck intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
- Questions submitted to this column are not guaranteed to receive responses.
- No correspondence takes place.
- No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Dombeck to people submitting questions.
- Dr. Dombeck, Mental Help Net and CenterSite, LLC make no warranties, express or implied, about the information presented in this column. Dr. Dombeck and Mental Help Net disclaim any and all merchantability or warranty of fitness for a particular purpose or liability in connection with the use or misuse of this service.
- Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
You ask a subtle question. You want to know if you are worthless or if you merely feel worthless. If you are worthless (as a state of being inseparable from everything else you are), then there is no hope for you. If you merely feel worthless, then some large portion of your pain and self-punishing behavior is NOT inevitable. In that later case, there is a possibility that you could overcome these feelings of worthlessness, intense though they are, and ultimately transform your life. My answer to your question is twofold.
The simple but probably unhelpful answer first. I think it can be strongly argued that the meanings that get assigned to things in this word are not inherent in them but rather draped on top of them, as people make appraisals and judgments about what serves their purposes and what does not. My car has no intrinsic meaning, for example. At a certain level it is neither good nor bad; It just is. If I need to drive somewhere, my car becomes something which is good and worthwhile. If I move to the city and cease to need the car to get around, it becomes worth less to me to have it around, and I might decide to sell it. It’s the same car in both situations, but in one context, I value it and in the other I devalue it.
The value of individual people is similarly very much set by the eye of the beholder, I think. If a policeman shows up to help me when I am stranded on the side of the road, he’s a lifesaver and very worthwhile. If that same policeman pulls me over and gives me a speeding ticket, he magically transforms in my mind into a necessary evil; something I have to tolerate, but do not appreciate at all. The policeman doesn’t change, but my context does, and as my context changes, the value I give to that policeman changes too.
In the case of the policeman above there are two people (myself and the policeman). I occupy the role of subject and the policeman occupies the role of object. The policeman is the object of my subjectivity (my judgments as viewed through my eyes). Instead of needing two people to fulfil these two roles, one person can take on both of them. So, I can judge myself harshly if I think I’ve done something ‘wrong’, and praise myself if I’ve done something ‘right’.
Therapists are Standing By to Treat Your Depression, Anxiety or Other Mental Health Needs
It doesn’t really matter if I’m judging myself or someone else. My judgments remain subjective and subject to change as my context changes. I don’t become magically better at judging just because I’m judging myself. In fact, it could be argued, I become worse at making an accurate judgment simply because I have no distance on myself from which to make an effective judgment.
The short answer to your question is that you can’t possibly be objectively worthless. There is no such thing. You are certainly judging yourself to be worthless, but that judgment is being made subjectively based on who knows what questionable data. Since you are not objectively worthless (since that is impossible), it must be the case that you maybe aren’t so worthless after all. You certainly feel worthless, but maybe your judgment is off and you’ve made a mistake and really you’re more worthwhile then you allow yourself to be.
Cognitive Behavioral Therapy (CBT) for Depression is a variety of psychotherapy that uses a systematically rational and logical approach to help people who feel worthless to feel better about themselves. In this therapy patients are taught to identify Automatic Thoughts (which are the sort of thoughts you are having that cause you again and again to identify yourself as worthless), and then to subject those automatic thoughts to a rigorous examination in which you look for the presence of systematic cognitive (thinking) biases that cause you to interpret data in a biased way (so as to confirm what you already know, for instance, that you are worthless no matter what you do. There are many cognitive biases that a CBT therapist will teach you about. One happens when people zero in on evidence that confirms the conclusion they "want" to reach, even when doing so requires that they systematically (and quite without realizing it) ignore lots of other data that would point to an alternative conclusion.
I’ve got the word "want" in quotes above because few people want to see themselves as worthless. There’s no joy in that. It’s a masochistic action to want to see yourself in that way. But there is something that is stronger and more basic and more important than joy, and that is righteousness. It may make you very unhappy to punish yourself as you do, but you’ve got it in your head that it is right that you should do this to yourself, and by golly, that’s what you’re going to do. It’s more important to be right (to do the right thing which in this case you believe is to punish yourself) than to be happy.
With you, being worthless has somehow gotten ingrained deeply into your very identity and self-concept. It’s important to you for some reason that you be a worthless person.
In part it appears to be a defensive reaction. You describe yourself as basically thin skinned, and very easily overwhelmed. You find people to be judgmental and hurtful; they shame you; you are very subject to feeling ashamed; it is very painful for you to feel shame. Many people feel this way, but you do something interesting with it. A lot of people would alternate between feeling shame and being angry with the shamers, as they flipped back and forth between an identification with the aggressors and their own self-concepts (viewing the situation through their own victim eyes). You don’t seem to have victim eyes. Instead, you simply identify with the aggressors. Your point of view is that you look and think about yourself as though you were one of the aggressors; you have not articulated the victim’s point of view. This is why you’re not expressing angry feelings, I think. In order to be angry, you’d have to disagree with the people who shame you. Instead, you agree with them. This could all change in the future but this is how it appears now.
Your tendency to self-punish appears to be a sort of peace offering by way of self-sacrifice. "If I beat the shit out of myself before you get here", you seem to be saying, "Can we then agree that I’ve had enough and skip the punishments you all were planning?" The image in my mind is that you’re going in front of the judge and asking for "time off for good behavior", except in this case, your good behavior is self-punishment.
The whole thing (your wholehearted identification with the perspective of the persecutors to the detriment of yourself and your own perspective) appears to be quite self-reinforcing. You escape from situations that might help you to see how you have become your own jailer and persecutor. For instance, you manage to escape therapy through a good magic trick which seems to have fooled the part of you who wants to get better. You come to view your therapists as persecutors who tolerate you rather than seeing them for what they are more likely to be (e.g., helping professionals who are trying to help you see yourself more accurately and who feel for how trapped in your own cognitive jail you are). By convincing yourself that therapists see you as annoying and pesky, you give yourself permission to escape therapy (which becomes in your mind a way of "doing the therapist a favor") and you simultaneously reinforce your identity as a worthless individual.
The remarkable thing here is that you view yourself from the perspective of someone else who is a persecutor. It is as though you (the person looks out from your own perspective and from your own eyes) are tied up in a closet in your mind with tape on your mouth and hands and feet bound. You’ve been colonized. You can’t respond to the painful situation you find yourself in except through the methods and perspectives of the persecutors. I wonder if you’ve noticed this, and what you think of it, if you’d like it to change, and if so, what is it you find so intolerable about being self-accepting.
While my first impulse was to recommend CBT to you as a therapy, on second thought I wonder how useful you’d find it, or more to the point, whether you’d stick with it all that well. You’ve got a knack for seeing helpers as critics or persecutors, and if you have difficulty forming a good therapeutic relationship, the therapy might not get very far. I’m thinking that before you can address your irrational automatic thoughts (and that is how I see the ones you’ve shared – irrational and biased and in need of a tuneup), you have to work on the identity stuff – the tendency to see everyone as a critic and as a defensive reaction to that to have become a critic of yourself rather than to be yourself. A very skillful CBT therapist might be able to help you, but that would be due to his or her experience and not to the therapy itself. Identity problems are outside the realm of what CBT was designed to handle. Better therapies for you to consider at this early juncture would be traditional psychodynamic psychotherapy (the sort of therapy that relies on the analysis of transference and which is designed to help foster insight), and possibly other post-cognitive therapies like Dr. Steven Hayes’ Acceptance and Commitment Therapy (ACT), or Dr. Jeffrey Young’s Schema Therapy.
In order for ANY therapy to be useful to you you will need to stick with it and commit yourself to continue going for at least a year, and very likely longer then that. Since your problem is with your identity rather than with your symptoms, it is not a superficial thing to change. When you start thinking your therapist is looking at you funny and you conclude that he or she hates you, please tell him or her what you are experiencing rather than running away. If you talk about it, you have the possibility of transforming it. If you run away, you will only confirm what you already "know" (the biased and I think wrong conclusion that you are a worthless human being).
Designed to Help You Feel Better Daily
Download Now For Free