How Should Therapists Treat Patients who are so Altruistic They Regularly Harm Themselves for the Sake of Others?

Mental health providers sometimes encounter patients who are exceptionally altruistic toward others and, at the same time, are willing to ignore their own needs and even significantly harm themselves to best achieve these ends for others. Traditionally, therapists have seen it to be their role to discern patients’ negative symptoms, then seek to reduce them. This article reviews gains based on positive psychology that highlight the importance of therapists giving priority to supporting patients’ strengths, particularly the sources of meaning they have in their lives. As is consistent with this view, it is suggested that therapists working with this group of self-harming, altruistic patients not only support their altruism, but particularly consider and remain cautious as to whether or not they should explore unconscious factors with the patient that might fuel their altruism. It is suggested that the discovery of such factors might be harmful because it could risk decreasing the degree to which these patients continue to show and personally value their altruism, thus potentially decreasing the meaning they derive from their altruism.