You mention neglect and abuse. Perhaps this combination does "better" because being neglected gives some space from abuse so there is a warped sense of recovery, time to adjust to something different, breaking the constant in the situation, to some degree. Being either abused or neglected, singularly, gives no break in the character of mistreatment, so the stress stays the same. Another thought. Speaking from my own experience, kids want to please and will try to adjust to whatever living conditions they are in. My mom was unpredictable, could be mean, could be OK. I learned to be on guard with her but also tried my best to be accepted by her. I never figured out her ground rules. So I grew up knowing something was wrong with me when in actuality, something was wrong with her. That meant I instantly rejected other's complimentary views of me as rubbish. They didn't see what I saw and knew because I adopted mom's view and role that I was defective. But, as I have gotten older, I have come to accept how others see me (sometimes). They see me more as I really am. They see me as the world sees me. They are not seeing me filtered through my mom's eyes or mine. They are the ones with the more correct view of my character and personality than me. They are seeing the positives in me while I see only the negatives and self-protection efforts. I still struggle like you all that I am damaged, ugly, fat, pretty much stupid, out of place and not about to trust anyone with me etc. Our therapists react to us because they, too, see the good in us and are trying to help us crawl out of our holes of warped thinking and self-views. It is scary entering into a world we do not fully trust, because like our abuser or person of neglect, we think the world sees us like they did/do. It is hard to let go of my warped self-view but in therapy, it is beginning to be exposed and challenged with a more balanced view of who I am. I tell myself that I need to choose to change and it is scary and hurts to do so. And to trust my therapist with my hidden self can be terribly difficult. It is hard to give up something that has been "me" since toddlerhood. But, for me, I have to force myself to talk, even if it seems a sock has been stuffed in my mouth, 'cause in order to get better, the junk inside has to be expressed. Not easy but necessary. Please repeat this all back to me after me next rant.