Cultic Studies Review, Vol. 7, No. 3, 2008, Page 56
Treatment addresses this pathological split between mind and body. In promoting this,
Farber again emphasizes the necessity for the therapist to recognize the meaning of this
behavior and the understanding that patients do what they do, no matter how hurtful, to
feel better.
To begin to change this course of action, the therapist needs to moderate each patient‘s
harsh judgments about the self. For example, the patient might feel disgust at feeling turned
on by the self-harming behavior. The tendency to have harsh attitudes toward these
regressive episodes will need to be challenged, and it is an important step for the patient to
develop empathy toward herself. If the therapist can explore all of this in a nonjudgmental
fashion and begin to look at the connection to the past, the patient‘s harsh attitude might be
modified. Helping the patient link present behavior with repressed or dissociated feelings can
not only aid in awareness of the full meaning of the behavior, but also increase awareness of
feelings and the ability to put emotions into words rather than express them through
enactments. Furthermore, Farber points out that the therapist‘s attitude of strength, vitality,
and humor is needed in order to tolerate the patient‘s aggression (and seductiveness), and
to resist either rescuing the patient (who might demand to be rescued), or getting pulled into
retaliating during dramatic enactments that might occur. If the therapist can recognize and
reflect on what has occurred, enactments that generate from the patient‘s intense
sadomasochistic relationship style developed in the past can be a positive and useful force
that involves a corrective experience for the patient. In the process of recognizing and
reflecting, the therapist must be able to contain powerful affects, listening to her own inner
states and taking responsibility for her own feelings. Farber does an excellent job illustrating,
with her own case material, how the therapist might handle all of these highly charged
situations. She also suggests the need for taking on a body ―caring‖ role in focusing on how
the patient abuses or neglects the body. This focus can become a corrective experience for
the patient while it also might lessen body alienation. Farber returns to concentrating on the
adaptive role of the behavior. She suggests that the therapist might question, ―What does
the self-harm do for you? How does it help you?‖
Themes of victimization and narcissistic entitlement, as well as boundary violations, might
be played out by the patient with the therapist in treatment sessions. I particularly feel that
Farber‘s discussion on a patient‘s sense of specialness and entitlement is quite helpful for
therapists. For example, she wisely suggests that patients might need to look at how
getting others to do what she wants might not always be to her advantage.
Farber encourages the therapist to use supervision or peer-group support, as well as to
work collaboratively with other professionals, such as medical doctors, for the therapist‘s
benefit as well as the patient‘s. In addition to a psychodynamic focus, it is important for the
patient to be armed with a variety of coping mechanisms—i.e., cognitive-behavioral
strategies for tolerating impulses to self-harm and to better manage the dysphonic affect
associated with the impulse. Having these skills will lead to a patient‘s feeling more in
control of her impulses.
Farber has given those of us who work in the cult field a scholarly and clinically informative
work about our patients who suffer and affect us in powerful ways. Many of our patients
who are former cult members enter treatment and don‘t initially reveal self-harming
behaviors, either because of discomfort and shame or because these behaviors are habitual
and dissociated. However, in time, patients often begin to share their secrets with us.
Farber‘s book not only contributes directly to our understanding of self-harm, but also
indirectly increases our understanding and management of potentially harmful symptoms
Treatment addresses this pathological split between mind and body. In promoting this,
Farber again emphasizes the necessity for the therapist to recognize the meaning of this
behavior and the understanding that patients do what they do, no matter how hurtful, to
feel better.
To begin to change this course of action, the therapist needs to moderate each patient‘s
harsh judgments about the self. For example, the patient might feel disgust at feeling turned
on by the self-harming behavior. The tendency to have harsh attitudes toward these
regressive episodes will need to be challenged, and it is an important step for the patient to
develop empathy toward herself. If the therapist can explore all of this in a nonjudgmental
fashion and begin to look at the connection to the past, the patient‘s harsh attitude might be
modified. Helping the patient link present behavior with repressed or dissociated feelings can
not only aid in awareness of the full meaning of the behavior, but also increase awareness of
feelings and the ability to put emotions into words rather than express them through
enactments. Furthermore, Farber points out that the therapist‘s attitude of strength, vitality,
and humor is needed in order to tolerate the patient‘s aggression (and seductiveness), and
to resist either rescuing the patient (who might demand to be rescued), or getting pulled into
retaliating during dramatic enactments that might occur. If the therapist can recognize and
reflect on what has occurred, enactments that generate from the patient‘s intense
sadomasochistic relationship style developed in the past can be a positive and useful force
that involves a corrective experience for the patient. In the process of recognizing and
reflecting, the therapist must be able to contain powerful affects, listening to her own inner
states and taking responsibility for her own feelings. Farber does an excellent job illustrating,
with her own case material, how the therapist might handle all of these highly charged
situations. She also suggests the need for taking on a body ―caring‖ role in focusing on how
the patient abuses or neglects the body. This focus can become a corrective experience for
the patient while it also might lessen body alienation. Farber returns to concentrating on the
adaptive role of the behavior. She suggests that the therapist might question, ―What does
the self-harm do for you? How does it help you?‖
Themes of victimization and narcissistic entitlement, as well as boundary violations, might
be played out by the patient with the therapist in treatment sessions. I particularly feel that
Farber‘s discussion on a patient‘s sense of specialness and entitlement is quite helpful for
therapists. For example, she wisely suggests that patients might need to look at how
getting others to do what she wants might not always be to her advantage.
Farber encourages the therapist to use supervision or peer-group support, as well as to
work collaboratively with other professionals, such as medical doctors, for the therapist‘s
benefit as well as the patient‘s. In addition to a psychodynamic focus, it is important for the
patient to be armed with a variety of coping mechanisms—i.e., cognitive-behavioral
strategies for tolerating impulses to self-harm and to better manage the dysphonic affect
associated with the impulse. Having these skills will lead to a patient‘s feeling more in
control of her impulses.
Farber has given those of us who work in the cult field a scholarly and clinically informative
work about our patients who suffer and affect us in powerful ways. Many of our patients
who are former cult members enter treatment and don‘t initially reveal self-harming
behaviors, either because of discomfort and shame or because these behaviors are habitual
and dissociated. However, in time, patients often begin to share their secrets with us.
Farber‘s book not only contributes directly to our understanding of self-harm, but also
indirectly increases our understanding and management of potentially harmful symptoms
