Well my therapist told me that all the pain I fear has already happened and that my real fear is remembering it. He said the fear of death is the fear of not having lived. And despite whatever within me might wish for the welfare of others, he said that until I understood my self loathing a part of me would sabotage those wishes and that I would hate him for bringing that news.
There are many different models of the mind. The more I look at them, the more they tend to lead me to the same place, though I am just a novice in the psychoanalytic world. Perhaps surprisingly, significant psychic pain is one of the most important characteristics for doing well with psychodynamic psychotherapy. One way of looking at the goal of therapy is bringing someone's ego function and ego ideal closer together, and that psychic pain is indicative of how far apart they are. Better ego function involves helping someone utilize mature defenses over immature defenses. The process of exploration involves regression, whereby someone enacts in therapy the roles that they experienced earlier in life including more and more immature defenses.
I'm sure it would not surprise you to find that repression, projection, and related defenses -- which involve disavowing distress and either inventing a reality in which it does not exist or assigning ownership of it to someone else -- are those defenses which children access first, when we are truly confronted with our most basic and disastrous conflicts.
And it would not surprise you to find that altruism, for example, is a defense mechanism in which one's own earlier suffering is turned into acts to protect others from the same suffering you have experienced. And that altruism is one of those mature defenses.
Of course, it is still a defense mechanism. And it is used, in this instance, to face that pain you reference, and since it is not a defense that involves disavowal, it requires that you understand your self-loathing in order to utilize it without sabotaging yourself.
For those that find me critical here, perhaps you may attend to some other idea. Those who have not experienced much pain tend to be relatively unconflicted in life, happy, and successful people. And they are always quite dull and could never utilize altruism to contribute to the public good nor sublimation to create beautiful works of art. If I am critical of you here, know that it represents a recognition that you have potential. And know that, by definition, I could never be more critical of you than I am of myself.