I have pasted the entire blog post below and have put what I consider the most relevant parts in bold:

Recently, a number of clients have communicated to me some version of “I hate myself” or “I’ve always hated myself”, while discussing symptoms such as depression, compulsive or addictive behaviors, or self-esteem issues. Often, this powerful self-hatred is accompanied by feelings of being toxic, evil, and inherently prone to “bad things happening”. This “hatred turned against the self” seems to have a much more angry, powerful energy than typical expressions of shame seem to have.

When I try to explore what is “bad” about the person, I often discover that hating oneself is actually a response to feeling helpless in relationships, especially when it comes to preventing other people from hurting them (for example, not being able to get an abusive partner to show love, or feeling constantly rejected in relationships). So, essentially, when a person says “I hate myself” in such situations, they are actually saying something like “I hate not being able to feel effective about getting others to treat me nicely, to love me, or to stop hurting me”. It might also be a way of saying, “People are hurting me but I cannot be angry at them, so I will be angry at myself instead”. In such cases, self hatred seems to be a defense against other feelings, such as helplessness or anger towards others.

A defense is an attempt to protect ourselves. Defenses help us prevent painful experiences from overwhelming us. Defenses help us avoid feelings that we don’t want to feel. For example, denial helps us avoid feelings of pain by pretending that the source of the pain isn’t there or that the feelings of pain don’t exist. Anger may be a defense against feelings of weakness or humiliation because anger is a feeling that fills one up with a sense of power. Other defense mechanisms seem to make sense in some way too. But how does self-hatred help? How does self-hatred protect a person from something even more painful or scary?

I don’t think there is a right or wrong answer to this question; certainly there are different theories about this. But it does seem clear to me that self-hatred does often serve as a defense against feelings of powerlessness, or anger towards attachment figures- people who we feel dependent on for help. Self-hatred might be an example of Fairbairn’s “moral defense” (see the book “The Illusion of Love” for more on this), in which a person would rather believe that his own badness caused his caregivers/attachment figures to mistreat or neglect him, rather than believing that the caregivers he needs for protection are weak, uncaring, or hurtful. In this case, feeling bad about the self (“it’s because I am bad that they are treating me badly; they are good and only responding to my badness…if I were better, this abuse/neglect wouldn’t be happening”) is less painful than feeling good about oneself, but unprotected by failing caregivers. Anger turned against the self may also feel safer than acknowledging anger toward people who we need.

This dynamic is often hard to treat because we focus on the wrong problem. For example, when someone comes in saying “I hate myself”, it’s easy to get caught up in trying to help them become more loving towards themselves; trying to build their self esteem by pointing out their strengths, teaching them to validate themselves, helping them develop more self-loving behaviors. However, this often doesn’t work, because the real issue is not the self-hatred, but the other emotions buried underneath it: feelings of helplessness, hopelessness about getting needs met, or anger toward attachment or authority figures. It then becomes important to help this person process those unconscious experiences, before we can help such a person let go of the need for self-hatred to defend against acknowledging those deeper feelings.

Lost Soul