Early childhood deprivation, attachment chaos, repeated medical traumata, and abuse set up neural networks of dread, shame, worthlessness, and hopelessness: the phenomenology of abject experience that resides in implicit memory. Abject interactions with others condense yearning and despair into complex enactments of abject suffering. Working in abject subgroups dilutes the intensity of abject material as ownership of toxic affects is broadened. Affective engagement and a relational perspective facilitate the management and transformation of self-abjection into more optimal relatedness in combined group and individual treatment.