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Effectively Treating Pathological Self-Criticism in Depressed & Dysthymic Clients
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On the last track, we discussed the six common consequences of perfectionism. These common consequences were Constant Failure, Demotivation, Disillusionment, Never Beyond Reproach, and Negative Focus. On this track we will discuss the "Hanging Judge" syndrome in depressed or dysthymic clients and its three components. These three components include: self-hatred, injustice, and a lack of compassion for oneself. In many self-critical depressed or dysthymic clients, you may have noticed a tendency to be overly vocal about the criticisms, verbally berating oneself or even condemning their own character. This tendency causes such clients to be what I call the "hanging judge" – like the stereotypical judge of the old Western frontier, this critic extends an extreme punishment, such as death by hanging, for even minor infractions. His interest in punishment is not an interest in rehabilitation; it is an interest solely in retribution. Steve, age 22, was a journalism student at a university. He had developed an addiction to alcohol his first year at college and since that time his outbursts of self-criticism had gotten continually worse, which increased his depression. I have noticed that in depressed or dysthymic clients with the "Hanging Judge" syndrome like Steve that there are three common characteristics: self-hatred, injustice, and a lack of compassion for oneself. 3 Common Characteristics of the "Hanging Judge" Characteristic # 3. Lack of Compassion for Self Technique: Critical List Once he made this list, I asked him to go back and put the date that he began criticizing himself for each behavior or action. Steve had been criticizing himself for each behavior for many years, with some starting while he was still in high school. I used Steve’s list to help him see that the criticism and punishment that he was delivering as a "Hanging Judge" had not had any positive changes on his behavior. Do you have a depressed or dysthymic client who, like Steve, is a hanging judge? Does he criticize him or herself for minor mistakes and punish himself too severely with no intent to benefit himself? Would your Steve benefit from making a "Critical List"? On this track we have discussed the "Hanging Judge" syndrome in depressed or dysthymic clients and its components, self-hatred, injustice, and a lack of compassion for oneself. On the next track we will discuss Eternal Penance in depressed or dysthymic clients.
Reviewed 2023 Peer-Reviewed Journal Article References: Birk, J. L., Kronish, I. M., Moise, N., Falzon, L., Yoon, S., & Davidson, K. W. (2019). Depression and multimorbidity: Considering temporal characteristics of the associations between depression and multiple chronic diseases. Health Psychology, 38(9), 802–811. Katkin, E. S., Sasmor, D. B., & Tan, R. (1966). Conformity and achievement-related characteristics of depressed patients. Journal of Abnormal Psychology, 71(6), 407–412. Lorenzo-Luaces, L., DeRubeis, R. J., & Webb, C. A. (2014). Client characteristics as moderators of the relation between the therapeutic alliance and outcome in cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 82(2), 368–373. Rost, F., Luyten, P., Fearon, P., & Fonagy, P. (2019). Personality and outcome in individuals with treatment-resistant depression—Exploring differential treatment effects in the Tavistock Adult Depression Study (TADS). Journal of Consulting and Clinical Psychology, 87(5), 433–445. Shanok, N. A., Reive, C., Mize, K. D., & Jones, N. A. (2020). Mindfulness meditation intervention alters neurophysiological symptoms of anxiety and depression in preadolescents. Journal of Psychophysiology, 34(3), 159–170. Online Continuing Education QUESTION 6 |
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