Healing from self-hatred

Many of us have felt self loathing at some point in our lives — maybe when you've failed at an important task at work, or lost an important relationship. But some people hate themselves all the time — their inner monologue is a constant drumbeat of self-criticism and self-loathing. Where does this kind of all-encompassing self-hate come from? And is there a way to unlearn it? We speak to psychiatrist Dr Blaise Aguirre, author of I Hate Myself: Overcome Self-Loathing and Realize Why You're Wrong About You. This episode discusses the topic of suicide - please take care while listening. This episode first aired in February 2025. Guest: Dr Blaise AguirreChild and adolescent psychiatristAssistant Professor of Psychiatry, Harvard Medical SchoolAuthor, I Hate Myself: Overcome Self-Loathing and Realize Why You're Wrong About You Credits: Presenter/producer: Sana QadarSenior producer: James BullenProducer: Rose KerrSound engineer: Isabella TropianoThanks to Freesound.org https://freesound.org/ users 7by7 https://freesound.org/people/7by7/, qubodup https://freesound.org/people/qubodup/, laft2k https://freesound.org/people/laft2k/, andre.nascimento https://freesound.org/people/andre.nascimento/ To find the transcript for this episode, head to it's original webpage https://www.abc.net.au/listen/programs/allinthemind/do-you-hate-yourself-self-hatred/104892058. Resources: Lifeline Australia https://www.lifeline.org.au/1800RESPECT https://1800respect.org.au/You can catch up on more episodes of the All in the Mind podcast with journalist and presenter Sana Qadar, exploring the psychology of topics like stress, memory, communication and relationships on the ABC Listen app (Australia) or wherever you get your podcasts.

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  OK, here is the scenario. You are at a dinner party. You're having a good time, you're chatting to people, you're feeling chill. And then you drop a glass of wine all over the cream coloured carpet.

• 0:52Speaker 01

  Oh, no.

• 0:53Speaker 02

  And no, this isn't white or even rosé. This is a full bodied red.

• 0:57Speaker 01

  That's definitely going to stain.

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  What goes through your mind in this moment? If you're like me, you feel awful and embarrassed and you're apologising profusely and promising to never drink red wine again.

• 1:09Speaker 03

  You say, look, I'll pay to get it cleaned up. I'm a klutz. And then generally it gets taken care of. And then the next day, you're at a different dinner party, you're spilling wine on somebody else's carpet, you know? Or you decide you're not going to go to dinner parties where carpets exist and you're going to only drink white wine or something.

• 1:27Speaker 02

  You are human and you made a mistake.

• 1:32Speaker 02

  But then there are people who feel like the wine spilling makes them a bad person to the core or proves they're a bad person to the core.

• 1:42Speaker 03

  For the person with core self hatred, it is a manifestation of their badness. Of course this happened to me. I not only deserve this to happen to me and pay the consequences, I deserve the shame and the ridicule.

• 1:58Speaker 02

  This is a hideous headspace to be trapped in. But Dr Blaise Aguirre reckons not enough people talk openly about this kind of experience of self loathing. He's a child and adolescent psychiatrist with the Harvard Medical School and he's the author of the book, I Hate Myself: Overcome Self Loathing and Realise Why You're Wrong About You.

• 2:21Speaker 02

  This is All in the Mind from ABC Radio National. I'm Sana Qadar. Today, we revisit one of our most popular episodes from 2025 about self-hatred. We'll cover what it is.

• 2:35Speaker 03

  It starts off with the idea that they are deeply flawed.

• 2:40Speaker 02

  Where it comes from.

• 2:41Speaker 03

  I have not met a person that isn't highly sensitive that hates themselves.

• 2:45Speaker 02

  And how to manage it.

• 2:47Speaker 03

  You have to create this wedge from the idea that self-hatred is a core part of your identity and you.

• 2:56Speaker 02

  And a heads up, this episode touches on the topic of suicide, so take care while listening.

• 3:12Speaker 02

  I don't know about you, but I have definitely felt self-hatred at various points in time, and not when I've spilt wine at a party, which I am prone to doing because I am klutzy, but more so when more major things are not going right in my life, like in my relationships or my work, for example. But the kind of self-hatred that Dr. Blaise Aguirre is talking about is a different beast altogether, and one that is foreign to me. So I asked Dr. Aguirre to tell me in more detail about what goes on in the head of a person who struggles with this kind of deeper self-loathing.

• 3:48Speaker 03

  So take yourself back into the headspace of those moments when you've been dissatisfied. And maybe it's been in the context of a relationship, maybe it's been in the context of a job, maybe a project that you were doing, and it just didn't go as well as you wanted. And then you, you know, you're self-critical, you know, you sort of, I shouldn't have dated that person, you know, I should have asked these questions in the interview, et cetera. But you don't then take that dissatisfaction, but then you go to, you know, yell at your parents and tell them that they're awful and stuff like that because it's circumscribed to that event.

• 4:24Speaker 02

  But for people with a pervasive sense of self-loathing.

• 4:27Speaker 03

  First of all, it starts off with the idea that I'm a deeply flawed person. So that's built into this sense of self. And then all the things that happen to me are a manifestation of my flawedness. It's almost karmic. And then when occasionally good things happen, those are discounted as, you know, luck or just some other happenstance. Or that, sure, that good thing happened, but something really bad is going to continue.

• 5:02Speaker 02

  Let me give you an example of just how toxic and sometimes irrational this kind of thinking can be. Blaze had this one patient he'd been working with, who one day turned up about 10 minutes late to an appointment. And she was so horrified with herself, so ashamed for her tardiness, that she told Blaze she thought he would be justified in slapping her.

• 5:25Speaker 03

  You know, this was a child who, she was adopted. And the people who had adopted her felt that she was at risk for not getting into a good college and not having a successful life. And so they were ultra, ultra critical of her, you know, insisting that she be perfect, that she get perfect grades, that she be in better than average athletic shape, better dressed than the average kid, and all of that sort of stuff. So, so the message is that you cannot fail, because if you fail, what's going to happen is you'll be rejected by colleges. And then, you know, when you don't get into a good college, you're not going to meet the right caliber partner. And when you don't meet the right caliber partner, you're going to get into a poorer

• 6:10Speaker 03

  relationship. So even though these adoptive parents were very well-meaning, the messaging is that you're not good enough. And so what would, what would happen is if she was late. If she didn't get an A, if she didn't hand in her homework on time, she was severely punished. So she started to pair the idea that when you don't satisfy or perform up to the standard, that people that care about you expect that you deserve punishment. So by showing up late, and you know, she respected our therapy and she always was prompt. She thought that, oh, here's somebody who seems to care about me

• 6:53Speaker 03

  and really wants me to, you know, have better mental health. But I'm disrespecting him by showing up late. And I think in that situation, I don't know, it was traffic or a bus or something happened, you know, was out of her control. But even if it had been within her control, the idea was that that kind of negligence deserved punishment.

• 7:18Speaker 02

  How did you respond when she said that to you?

• 7:21Speaker 03

  Well, you know, I mean, I said like, I don't even know how you got there. She, she still felt that I should be more upset. And I said, you know, that's not how my wiring works.

• 7:34Speaker 02

  You might be wondering how common this kind of feeling is. And the trouble is, we don't really know. Blaze says research on self-loathing isn't well-developed. And he's hoping his book can help inspire more of it. But one thing he has noticed in his clinical experience is that women tend to be more inclined to feel self-hate. The reasons for this would be many and varied. And honestly, it could probably take a whole separate episode to explore. But let's focus on how self-hatred can develop, what causes it in general.

• 8:10Speaker 02

  I want to talk about what leads a person to develop this kind of core pervasive self-loathing. Because you write that we're not born hating ourselves. So can we safely blame, you know, our parents? Like, is it the result of high-pressure parenting or abusive parenting? Like, how much does the parenting a person receives, you know, result in self-loathing?

• 8:31Speaker 03

  Not at all. I don't want to blame the parents. If the message is that parents are to blame, then I've done an awful job. So, so if you think about this, the child is not born hating itself. It has to learn to hate itself. And the teachers, whether intentional or not, are the people in the environment. It can be the parents, it can be relatives, it can be neighbors, it can be bullies in school. Now, the one thing that all of these kids had in common, every one of them, was that they were highly sensitive people. So I have not met a person that isn't highly sensitive, that hates themselves. Now, why is this?

• 9:11Speaker 03

  Well, because high sensitivity and high emotionality is like the super glue for labels. So that if I say, "Oh, you're so stupid," to a kid who's not sensitive and who could just brush it off, they just move on. To the highly sensitive child, that sensitivity glues that concept into their self-concept.

• 9:35Speaker 02

  A quick word on highly sensitive people. Research on the idea that there are highly sensitive people began to emerge in the 90s, led by psychologists Elaine and Arthur Aaron. And studies suggest that highly sensitive people, sometimes termed HSPs, tend to be, well, more sensitive. They feel emotions more deeply, they are more aware of the feelings of others, and they react more strongly to stimuli like pain, noise, or temperature. Research around HSPs is still also developing, but as Blais says, in his practice, it's these people who are at higher risk of self-hatred.

• 10:14Speaker 03

  And it happens when it's very, very young. So you've got this highly sensitive child who's being criticized. Maybe it's like the, you know, the people I just described who, through well-intention, insisted that their child get straight A's, show up on time, be well-dressed and well-combed, et cetera. And the message that they're getting is that you're not enough. And so they're beginning to turn around. Sometimes it is physical, sexual, emotional abuse. Sometimes it's bullying. But remember that these are, yeah, these are, these are really highly sensitive children who are going to take... Those criticisms as a manifestation of their flawedness. I have four of my own children. My two youngest have the emotional sensitivity of a oak tree.

• 10:59Speaker 03

  My two oldest are ultra sensitive. So the two youngest, they were playing soccer or something and said, get up, run, go kick the ball. And they get up and go kick the ball. The other two like, ah, they start crying. Why are you bothered? You know? And so, so the thing is, is that, you know, you have different children and your different children have different levels of sensitivity. And what's fine to say to one kid sticks painfully in the minds of another kid.

• 11:29Speaker 02

  How much does also trauma and a traumatic childhood play into, you know, how likely people are to develop self loathing?

• 11:37Speaker 03

  So three of my patients with the most severe self hatred were extremely suicidal, had early childhood sexual trauma. And not only that, they all had siblings and they were the only ones who were singled out for this, for the sexual abuse. And so this idea of, especially as they started to get older and realize that what was happening to them was, was abusive and was, you know, very hurtful. And then especially when it wasn't happening to their siblings. And that they felt that, you know, that they couldn't tell anyone, they kept it within them. And they started to feel this is happening to me because there's something wrong with me.

• 12:16Speaker 02

  The other thing I'm wondering is, how often is self hatred a thing that kind of exists on its own or is it usually tied up in a larger mental health issue like borderline personality disorder or depression or whatever else in the way that, you know, perfectionism often turns up in anorexia, for example?

• 12:35Speaker 03

  Yeah, that's, that's a really, really good question. And actually, what's interesting to me is that I thought, you know, well, mainly I work with people with borderline personality disorder. So I thought it was just in people with borderline personality disorder. But then I started to work with, in an eating disorder program with people with anorexia and believing in neurosis, et cetera. And Then I saw a lot of self-loathing there. And then I had a colleague who was referring me patients with severe OCD. And I saw some of them had self-loathing. And then there was even people without mental illness who were, say, you know, amidst some trans people who had internalized transphobia.

• 13:18Speaker 03

  And we needed themselves and they didn't have any like formal psychiatric diagnosis. So, so one of the questions is, you know, should it be a standalone diagnosis in the DSM with certain modifiers? And again, you know, there's no research, there's no questions about this. So I think so much more understanding needs to take place. But I do think it can be part of certain illnesses or certain psychiatric diagnoses, but it also could stand alone.

• 13:54Speaker 02

  You're listening to All in the Mind on ABC Radio National. I'm Sana Qadar.

• 14:01Speaker 02

  Dr. Blazegire is a child and adolescent psychiatrist and he's the author of the book, I Hate Myself. And he got interested in the topic of self-loathing back in the early 2000s when he began working at a place called McLean Hospital. It's a psychiatric hospital affiliated with the Harvard Medical School. And interestingly, it's also the hospital where Girl Interrupted is set. That's the book that later became the film starring Angelina Jolie and Winona Ryder. But here's what got him thinking about self-hatred to begin with.

• 14:37Speaker 03

  You know, I think that the worst possible consequence of any psychiatric disorder is obviously the ultimate price. It's somebody taking their life. And we know that suicidal thoughts and behaviors are common in, you know, conditions like depression, bipolar disorder and others. And when I got to McLean, one of the things that I saw was that there are many children who were sadly very, very suicidal and that the standard of care was they would come into the hospital. Maybe they would express suicidality. They'd be locked away in a padded room, you know, with constant observation. They would seem to settle and then they'd go back into the environment where suicidal thinking had sort of evolved.

• 15:22Speaker 03

  So, nothing was really happening in terms of treatment per se. They were just settling for a little bit. And this didn't seem right. So, in 2007, I started a treatment unit for suicidal and self-injurious kids. And we decided to turn conventional thinking on its head. We weren't going to lock people up. We weren't going to give them, you know, a lot of very powerful psychiatric medications. We weren't going to strap them down. That we were going to treat their symptoms as a manifestation of their suffering. And that by listening to them and then giving them the skills to be able to manage differently in different situations, that they would, you know, improve.

• 16:05Speaker 03

  And in fact, that that's exactly what happened, you know. I mean, if you're going to go and travel in, I don't know, Greece and you say, you know, I'm really worried about it and I don't know what to do. And I say, well, why don't I teach you some Greek? You're going to settle, you know. So, so, so, so kids settled. However, there was a group of young people who, despite knowing all these skills, tragically took their life. And even though using the, the, the therapy I used, dialectical behavior therapy, we had brought down the level of suicidality, suicidal thinking and action, self-destructive behaviors, there was still this group of people that, for whom, despite having all their skills, you know, paid the ultimate price of their mental struggle.

• 16:50Speaker 03

  And that was death by suicide. And I, and I wondered, what is it about that group that we couldn't help? And when I started reviewing the records and talking to some of my more suicidal patients, they all had this core self-hatred. So then I thought, okay, well. You know, there's many risk factors for suicidality. And you know, maybe there's substance use and you can target the substance use. Maybe there's loneliness, you can target the loneliness. So I said, let me just target the self hatred. But again, I went to the literature, there was no therapy for self hatred. No one was even talking about it. And, um, and so I thought, if this is such a core part

• 17:33Speaker 03

  of why people end up taking their lives or living with chronic suicidality, why don't we have a treatment for it? And so that's what got me going.

• 17:46Speaker 02

  All these years later, Blais says there still isn't a standardized treatment for self hate. And when he's tried dialectical behavior therapy or cognitive behavior therapy, it hasn't worked. So what he does now with patients is more dynamic.

• 18:02Speaker 03

  You have to create this wedge, this separation from the idea that you were born with self hatred, that self hatred is a core part of your identity and you. You have to create the understanding that this is a learned construct. And so the first thing I do is that when, so, so maybe I do an evaluation and there's nothing going on there, maybe there's some anxiety or depression. I treat the anxiety or depression and move on. Next patient comes in, I'm doing an evaluation and I see a lot of people pleasing. I see a lot of perfectionism. I see a lot of self criticism, self judgment, self disgust. And I say, you know, wow, it doesn't seem like you like yourself very much.

• 18:46Speaker 03

  And they say, yeah, not really. Say, well, how much do you not like yourself? And they'll say, well, not a lot. Are there times you do like yourself? Yeah, there are some times I like myself, you know, I've got these friends. I really enjoy spending time with them. That's not necessarily core self loathing, although I'm going to keep an ear out for if that worsens.

• 19:08Speaker 02

  Right.

• 19:08Speaker 03

  But it's, no, there isn't a time that I like myself. I always hate myself. Wow, so who, uh, when did you learn to hate yourself? They're like, what? What are you talking about? I was born this way. No, you weren't born that way. A child is not born hating itself. It cannot be born hating itself. It doesn't have a concept of what hatred is. So you had to learn it. Who were your teachers? And so I want you to start writing down who your teachers were of self-hatred. Who were the people who hurt you so badly that you believed that this was true? And by the way, some of these people could have been people that loved you deeply. So for instance, I had another family. So the parents had gone to Yale University.

• 19:53Speaker 03

  Two of the children had gone to Yale University. And the youngest was not scientifically or academically gifted. They were wonderful artists, but they were not, you know. And so when you went into their house, all you saw was Yale paraphernalia. And so the message was you had better go to Yale. Even though the parents never stated it, it was sort of implicit or it was explicit. Explicit. And so she always felt that she didn't live up to the standards of the parents and the standards of the older sisters. And she was highly sensitive. So she, that internal criticism was like, if I were a better person, my parents would love me more. If I were, you know, more academically talented, I'd be more like my sisters.

• 20:38Speaker 03

  And so if she internalized this message and really did not like herself very much. And, you know, that one was a little bit different to treat because what happened is when the parents realized what was going on, they really supported her going to art school. They realized just how invalidating it must have been to have had Yale, you know, cutlery, Yale plates, Yale pictures, Yale posters all over the place. To a child who isn't going to get there.

• 21:10Speaker 02

  The other thing Dr. Aguirre does is to try and help patients actively unlearn the self-hate that they've learned.

• 21:18Speaker 03

  Just telling them to love themselves or that you love them does not make a dent. Once they see there's some erosion, there's some wedge between sense of self and self hatred, they see that it was learned, then we say, what are the actions to take to unlearn those sorts of things? Okay, so let's just think about the elements that perpetuate and reinforce self hatred. Unhealthy relationships, because you think you deserve them. So what we're gonna do is we're gonna practice getting into healthier relationships. You're not going to jump into bed with the same first person you meet. You're not going to tolerate their abusive behavior towards you.

• 22:03Speaker 03

  You're going to walk away from those relationships because you've learned this behavior and we don't want these people to be your teacher. We're going to reclassify small acts of self caring behavior as small acts of self compassion. If you're going to the gym to be healthier, you're taking care of your body. If you're brushing your teeth, you're taking care of yourself. If you're getting to bed early, you're taking care of your mind. If you create a sense of future you, so if we take the analogy of future you's gonna go and live in Greece, the time to start learning Greek is not when you get to Greece, it's now.

• 22:45Speaker 03

  So if you, if you think about future you, you two years from now, are you going to be hating? Do you want to be hating yourself? Can you start to see that it was a learned behavior and that you can learn to see acts of self compassion and self care as loving actions towards yourself? So, so it has to be gradual.

• 23:09Speaker 02

  So it sounds like creating that wedge between their sense of self and like that feeling that self hatred is part of them. That's like the first and most important and most difficult step, is that correct?

• 23:21Speaker 03

  Uh huh, yeah, you are, you are a hundred percent correct. You're a hundred percent correct. I don't know how it can be done without creating that wedge.

• 23:32Speaker 02

  Do we know yet whether working on self hatred and minimizing that also minimizes suicidality?

• 23:40Speaker 03

  Yeah, well, this is the one thing that I feel pretty convinced about. So the way in which I decided to kind of research or have patient collaborators in my book was really to take the people who'd had the most psychiatric inpatient units for suicidal behavior. So I wanted people who were really, really suffering with a lot of self hatred, who'd had multiple hospitalizations, who'd made, you know, near lethal attempts on their life. So, you know, I think I've got like 10 who've journeyed with me. And subsequent to the work that we've done together, not a single one of them has been hospitalized again.

• 24:24Speaker 03

  They've all described huge reductions in their self hatred. In many cases, an improvement in how they see themselves, so not only reductions in self hatred. One of them now married her childhood sweetheart and has three children and has become a nurse. Just something that she never believed could possibly happen is taking care of people. And when people thank her for the work that she does, she accepts it. She accepts it as a true manifestation of like her ability. And they all attribute the reduction in suicidality to the improvement in their self hatred because they now don't feel that they're a burden.

• 25:03Speaker 02

  Right, right. And so is that still anecdotal or did you publish that in a paper?

• 25:08Speaker 03

  The thing is, is that this has been an evolution in my mind for a few years and pinned to paper over the last year. So really, it's an idea in its infancy. So I have an anecdotal caseload of 10 patients who didn't take their lives. But here's the thing about that, and by the way, maybe it's just because I'm fabulous. I mean, who knows? I mean, maybe it's got nothing to do with that, you know? Maybe it's because they felt that somebody believed in them. I don't know. So maybe there's all these other factors.

• 25:40Speaker 02

  Sure.

• 25:41Speaker 03

  But what I'm saying is, the fact that people who are most likely to die by suicide, even if just one didn't take their lives, that means that that person is in a relationship with somebody else, feeling better about who they are, suffering a lot less.

• 25:54Speaker 02

  Yeah.

• 25:55Speaker 03

  So in other words, I don't know. I just know that the group of people I work with were like, I suicide. And you're exactly right. What were the factors? Is it just anecdotal? We just, that's the thing is, if this can catalyze more research into this whole topic, then we'll get the researchers out there in applying for grants.

• 26:17Speaker 02

  To end on really, do you have a final bit of advice that you'd like to leave people with who struggle with self-loathing, who listened to this episode? And yeah, what's a final kind of message you'd want to leave people with?

• 26:29Speaker 03

  I love our patients who hate themselves, and which is sort of like a very bizarre thing to say. And that is because I see them. I see them. I see their inner strengths, their beauties, the wonder of who they are as human beings, of the things that they're capable of. And they don't see that within themselves. So if you're out there and you're saying, I really identify with this concept of self-hatred, is to say, that concept, something that you learned such a long, long time ago, you can erode that. It's almost like going to like one of those house of mirrors where everything is distorted. And suddenly you see clarity because, and you see a mirror that shows you who you really are.

• 27:13Speaker 03

  So you're not deserving of it. It was built on a false premise about who you are. It is understandable that as a young child, you wouldn't have known what else to think. But you don't have to believe it any longer.

• 27:26Speaker 02

  And yeah, because it was learned, it can be unlearned, I suppose.

• 27:30Speaker 03

  And you know that that love comes so much more naturally to the human heart than hatred does. And so you've got to allow it to sink in a little bit.

• 27:43Speaker 02

  That is Dr Blaze Aguirre, a child and adolescent psychiatrist working at McLean Hospital in Massachusetts. He's also on the faculty at Harvard Medical School and he's the author of the book, I Hate Myself: Overcome Self-Loathing and Realise Why You're Wrong About You. And if this episode raised any issues for you, you can call Lifeline anytime on 131114. And that is it for All in the Mind this week. Thanks to producer Rose Kerr, senior producer James Bullen, and sound engineer Isabella Tropiano. I'm Sana Qadar. Thank you so much for listening.

• 28:28Speaker 02

  I'll catch you next time.

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