IN 1945， while working as a<br >psychotherapist with my first group of adult patients at the<br >Western Reserve University clinic in Cleveland， Ohio， I was<br >impressed and puzzled by their tendency to be either too<br >hard or too easy on themselves. This initial impression has<br >been borne out through nearly four decades of clinical prac-<br >tice. As I look back on my work with over four thousand indi-<br >viduals I cannot recall a single case that did not involve to<br >some degree an inner struggle between extremes of self-love<br >and self-loathing. It is as true today of the sophisticated， suc-<br >cessful people I have treated in Hollywood as it was then of<br >the young， more naive patients at the university clinic.<br > As a therapist， I became involved in the attempt to ex-<br >tricate them from their unproductive struggles， and would<br >tailor their treatment according to whether the individual<br >maladjustment leaned toward self-esteem or self-denigration.<br > Working to assist these patients， I encountered a strong<br >resistance to making a change for the better. This frustrating<br >and paradoxical reaction motivated me to search for the<br >causes of such baffling behavior.<br ><br >