Turning against the self - a literature review with clinical illustrations

Abstract

Turning against the self appears to be a useful term applying to aspects of client behaviour in the clinical setting. There is less extensive literature which integrates the experience of turning against the self into a framework which details differences in the aetiology and expression of the defence within various client groups. Such a framework may provide guidelines for how to understand and approach turning against the self with clients whose diagnoses vary considerably. Based on the diversity of the literature, a beginning framework for thinking about turning against the self in terms of “styles” is presented. The styles which are elaborated upon are “masochistic style” and “depressive style”. Clinical vignettes illustrate various aspects of turning against the self and the impact on the therapeutic relationship. In exploring turning against the self in relation to developmental processes, connection to processes of internalisation and incorporation emerges. Of note is the emergence of a dynamic connection between turning against the self and the internalisation of a “bad object” (Seinfeld, 1990). This connection is explored. Clinical implications for working with turning against the self and the “bad internal object” are explored. Finally, the limitations and findings of the study are discussed, and recommendations are made for clinical practice and further research.