Hate in the rehabilitation setting.

Hate has been overlooked as a clinical issue in the rehabilitation setting. Factors are discussed which make hate an intrinsic part of the rehabilitation process. Four common situations that involve hate are described. Dealing with hate is difficult because the natural responses, retaliation or aversion, are harmful. New ways of understanding hate that enable therapeutic responses are provided. These include viewing hate as: 1) an expression of powerlessness, not strength, which frequently results from the clinical state of regression; 2) a maladaptive way to maintain, not end a relationship; and 3) a result of staff-patient interaction, not a purely objective phenomenon. An understanding of these concepts leads to the proper use of the two major therapeutic responses to hate: empathy and nonpunitive limit setting.