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The general conclusions of the field do not allow for a step\u2010by\u2010step granularity of relevant emotional experiences in clients. This is particularly important for personality disorders, especially borderline personality disorder (BPD). Using a controlled out\u2010of\u2010therapy assessment, we assume that the lessening of expressed self\u2010contempt by clients gives way to proportionally more expressions of self\u2010compassion and assertive anger after a brief psychiatric intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The present secondary analysis of a randomized controlled trial includes\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200979 participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927 clients with BPD in the active treatment following the principles of good psychiatric management [GPM];\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923 clients with BPD in the treatment as usual [TAU];\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929 healthy controls). Both treatments\u2014GPM and TAU\u2014lasted 4\u2009months. All participants underwent out\u2010of\u2010therapy experiential two\u2010chair dialogues focusing on self\u2010criticism at two time points. The participants' emotional expressions were assessed using the video\u2010rated Classification of Affective Meaning States and the Self\u2010Contempt Rating Scale.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results indicated that the intensity of out\u2010of\u2010session observed self\u2010contempt as part of a person\u2010relevant self\u2010criticism decreased in clients with BPD undergoing GPM, with a large effect, similar to healthy controls. A medium\u2010sized effect was found for reduction in self\u2010contempt in clients undergoing TAU. The results also indicated that the proportion of individuals with BPD undergoing GPM accessing self\u2010compassion and assertive anger increased, which was not the case for healthy controls nor clients in TAU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Undoing self\u2010contempt may be an elusive, yet central task in psychotherapy for clients with BPD. The present study explored the client process of change of undoing self\u2010contempt and moving towards self\u2010compassion and assertive anger. These conclusions bear important clinical and research implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cpp.70335","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:24:16Z","timestamp":1789737856000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Undoing Self\u2010Contempt in Borderline Personality Disorder: A Controlled Test of Change in Emotion Processing in Psychotherapy"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5603-0394","authenticated-orcid":false,"given":"Ueli","family":"Kramer","sequence":"first","affiliation":[{"name":"University Institute of Psychotherapy, Department of Psychiatry Lausanne University Clinic and University of Lausanne  Lausanne Switzerland"},{"name":"Department of Psychology University of Windsor  Windsor Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7684-2501","authenticated-orcid":false,"given":"Loris","family":"Grandjean","sequence":"additional","affiliation":[{"name":"University Institute of Psychotherapy, Department of Psychiatry Lausanne University Clinic and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0068-656X","authenticated-orcid":false,"given":"H\u00e9l\u00e8ne","family":"Beuchat","sequence":"additional","affiliation":[{"name":"General Psychiatry Service, Department of Psychiatry Lausanne University Clinic and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9128-2821","authenticated-orcid":false,"given":"St\u00e9phane","family":"Kolly","sequence":"additional","affiliation":[{"name":"General Psychiatry Service, Department of Psychiatry Lausanne University Clinic and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"I Hate Myself. 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