Erosion: The Psychopathology of Self-Criticism

Erosion: The Psychopathology of Self-Criticism

Erosion: The Psychopathology of Self-Criticism

Erosion: The Psychopathology of Self-Criticism

Synopsis

Self-criticism is a personality trait that has been implicated in a wide range of psychopathologies and developmental arrests. Defined as the tendency to set unrealistically high standards for one's self and to adopt a punitive stance towards the self once these standards are not met, self-criticism is both active and cyclical. Self-critics actively create the social-interpersonal conditions that generate their distress, and their distress itself exacerbates self-criticism. Erosion offers a comprehensive treatment of self-criticism based in philosophy, developmental science, personality and clinical psychology, social theories, and cognitive-affective neuroscience. Professor Golan Shahar expertly summarizes the most recent research on the topic and synthesizes theory, empirical research, and clinical practice guidelines for assessment, prevention, and treatment. The book rests upon three elements that, as Shahar argues, are central to the maintenance of self-critical vulnerability: the importance of a concept of an authentic self or the need to "feel real"; the importance of intentionality and goal-directedness; and the power of interpersonal relationships and cultural context. Shahar argues that exploring these elements requires an integrated clinical approach that incorporates multidimensional assessment and interventions which reconcile science, practice, and policy. The result is a broad and scholarly volume that is useful to practitioners, researchers, and theorists interested in self-criticism.

Excerpt

In keeping with what some contemporary psychological researchers might find an antiquated commitment to the scientist-practitioner model (it is, after all, over a half-century old), Shahar begins this elegant exploration of self-criticism with a story. I will follow suit. While I think of Shahar’s many creative contributions to clinical science often, it is when I am facing real people dealing with real difficulties that I find his theoretical, empirical, and clinical work most useful and generative. Given the shift to checklists, protocols, and experimental manipulations that dominate the current scene, I can think of few researchers in the field of psychopathology whose work is as directly applicable to clinical situations as Shahar’s. But back to the story.

I was recently a consultant to a case conference during which a psychiatric resident presented a patient she was having difficulty working with on an acute inpatient unit. the patient’s behavior was “inappropriate” and off-putting; he appeared to respond to the female resident as if he were flirting with her in a bar rather than seeking care in a hospital. Hospitalized after a suicide attempt, the patient showed no signs of depression, seemed to have little appreciation for the gravity of his attempt, and was quickly categorized by the group as having a personality disorder. the presenting resident described considerable difficulty in trying to “connect” with the patient, and another resident, in a gesture of solidarity with his colleague, expressed the sentiment that, given what she had described, he was having a really hard time finding anything he could like about this man. Wanting to reinforce this moment of genuine self-disclosure, I thanked this resident for his honesty and suggested that his insight might be a useful clue to what the patient was trying to accomplish. Perhaps, I suggested, the degree to which the resident disliked the patient was only a pale reflection—a hint—of the degree to which the patient disliked himself. Perhaps he was, in this way, offering us an entrée into his experience of self-loathing and we were being challenged to find a way of dealing with his behaviors that would offer him a less destructive alternative. Thank you, Dr. Shahar.

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