Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!

Section 6
Characteristics of Depressed Clients

Question 6 | Test | Table of Contents

In the last section, we discussed the six common consequences of perfectionism. These common consequences were Constant Failure, Demotivation, Disillusionment, Never Beyond Reproach, and Negative Focus.

In this section, 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.

One day while driving to school for class, for example, he missed his highway turnoff. Even though the next turnoff still got him to campus and did not make him late, Steve punished himself extensively in the car, screaming obscenities at himself and pounding his fist on the dashboard repeatedly. Steve later said to me, "I was so mad at myself, I just had a fit."  Because Steve had failed to achieve the level of perfect behavior he had lined out for himself, he condemned his mistake much too harshly

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 # 1. Self-Hatred
The first characteristic of the "Hanging Judge," self-hatred, is distinguished from other forms of self-criticism because it is overly harsh, vindictive, and has a prosecutorial quality.

As you saw in Steve’s case, the qualities of hatred and rage came out in his string of screamed obscenities at himself. It was not simply a quiet quality that one can find in clients who simply draw negative comparisons between themselves and others. These obscenities served no purpose other than expressing Steve’s self-contempt. Steve stated, "I couldn’t believe how stupid I was for missing the turnoff. I just hated myself so much – I had to yell at myself."  This self-hatred can be particularly damaging to depressed or dysthymic clients as it could contribute to their feelings of worthlessness or "badness".

♦ Characteristic # 2. Injustice
The second characteristic of the "Hanging Judge" is injustice. An unbiased observer seeing a "Hanging Judge" punishing him or herself would see the self-critical attacks and punishments as seriously out of proportion to the alleged offense or crime.

Again, you can see this in Steve’s case. His abuse of himself in the car for missing a turnoff on the highway was severely out of proportion considering the size of his mistake. Taking the later turnoff did not delay Steve in reaching his destination, yet he launched an enraged and hateful tirade against himself. He stated, "It was such a stupid little thing, but I should have known better. I take that turnoff practically every day!"  In his daily life, Steve constantly uses the phrase "I should have…" creating an unrealistic standard for himself.

♦ Characteristic # 3. Lack of Compassion for Self
In addition to self-hatred and injustice, the third and final characteristic of the "Hanging Judge" is a lack of compassion for self. As you know, a lack of compassion for oneself is exhibited when the depressed or dysthymic client displays little interest in helping him or herself. Instead, his or her interest seems to be focused entirely on punishing and reviling him or her character.

Again, Steve exhibits this lack of compassion clearly; his screaming obscenities and pounding his fist on the dashboard did nothing to improve his behavior or benefit him in the future. Steven’s criticism was delivered with the desire to punish alone; he had no desire for self-improvement in the delivery of the criticism.

♦ Technique:  Critical List
One technique that that I have used with depressed or dysthymic and self-critical clients like Steve, who are also suffering from the "hanging judge" syndrome is a "Critical List."

To make a "Critical List" I asked Steve to make a list of five things for which he criticized himself.
Steve's 5-Part Critical List
-- 1. Getting lost driving
-- 2. Forgetting class work
-- 3. Not spending enough time with my girlfriend
-- 4. Doing badly on tests
-- 5. Disappointing my father, again.

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.

I then asked him to instead try to tell himself positive statements. Steve protested, saying "I can’t do that. I don’t know how to tell myself positive things. I don’t deserve to hear positive things." I told Steve that it may take a while for him to accept the new, positive messages because he was so used to being negative, but that eventually he would become accustomed to the positive messages. He agreed to do it, saying "I guess I could try."(Hay, Love Yourself Heal Yourself, p. 77)

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"?

In this section, 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.

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.

QUESTION 6
What are the three common characteristics of a depressed or dysthymic client with the hanging judge syndrome? To select and enter your answer go to Test.