Interview with Dr. Blaise Aguirre: Confronting the Shadows of Self-Hatred

Episode Transcript
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Jacqueline Trumbull (00:00):
Hey guys, welcome to A Little Help for Our
Friends, the podcast for peoplewith loved ones struggling with
mental health.
Hey Little Helpers, welcomeback.
Today we have a really cooltopic.
It's one I always love doingthese episodes where it's a
concept that can apply reallybroadly, but we do see it in
certain diagnoses more thanothers.

(00:21):
The concept is self-hatred,self-loathing, something that a
lot of people unfortunatelystruggle with at different parts
in our lives.
But to help us with this topicis how do you pronounce your
last name?
Blaise Aguirre.

Dr. Blaise Aguirre (00:34):
Like a car gear.
Like a car gear, dr AguirreBlaise.
Aguirre Aguirre is French, soOkay, which is also cool.

Helping us with this topic is Dr Blaise
Aguirre.
He is a child and adolescentpsychiatrist.
He's a trainer in andspecializes in, dialectical
behavior therapy, which shouldbe familiar to many of our
listeners, as well as othertreatments such as
mentalization-based treatmentfor borderline personality
disorder and associatedconditions.
He is the founding medicaldirector of Three East Continuum

(01:07):
of Care, which is an array ofprograms for teens that uses DBT
to target self-endangeringbehaviors and BPD symptoms.
He's been a staff psychiatristat McLean Hospital at Harvard
since 2000 and is nationally andinternationally recognized for
his extensive work in thetreatment of mood and
personality disorders.
He's the author and co-authorof many books, including

(01:29):
Borderline Personality Disordersin Adolescence, Mindfulness for
Borderline Personality Disorder, Coping with BPD and Fighting
Back.
Blaze, welcome to our show andthank you so much for offering
us your expertise and now thisbook.

Dr. Kibby McMahon (01:43):
Subtle, subtle plug.

For those of you with YouTube, you will
have just seen Blaze raise abook called I Hate Myself and we
just saw the message I hatemyself come completely over the
screen, so that is why we'retalking.

Let me jump in, but.

Blaze welcome.

Oh, thank you so much for having me on and
I just I really appreciate thewillingness of thinking people
to have a discussion about thisreally complicated topic.
So thanks tremendously forhaving me on.

Awesome and Kibby.
I'm going to jump over to youto tell KulaMind about on
Awesome and Kibby.

I'm going to jump over to you to KulaMind us
about yeah, just jumping inwith all different kinds of
plugs for things.
But I'm really, really excitedfor this conversation with Dr
Aguirre and we'll definitelylink where they can find your
book and other resources afterthis.
But I also mentioned that foranyone who wants hands-on help

(02:45):
with navigating theiremotionally challenging
relationships with loved ones,with mental health issues like
borderline personality disorder,which we'll talk about, anger
issues, narcissism and otherthings like that, check out
KulaMind K-U-L-A-M-I-N-D.
com.
Or you could check out our shownotes and you find a link and
you could talk to us.
You know you could book a freeconsultation call to learn a

(03:07):
little bit more about how we canhelp you with with navigating a
relationship like that.
So, done with all that, let'sjump into self-hatred.
Tell us a little bit about you.

No, it's just.
It's such an aggressivesounding title, but I think it's
something that so many of ushave struggled with at different
parts of our lives.
That was me as a teen.
But you, I know, have studiedthis mostly in the context of
BPD.
Can you?
Tell us how you came to thistopic, what interested you about
it?

Yeah, but I was struck by your comment about
how aggressive it sounded, thiswhole concept of self-hatred.
And I remember that when I wasspeaking to a lot of my patients
who've got borderlinepersonality disorder, eating
disorders, severe eatingdisorders and other conditions,
and I said, you know, I'm really, I'm working on this project,

(03:59):
what should we call it?
And then you know, should wecall I loathe myself, or you
know like learn to love yourself, or something like that, and
they all, to a person, said thatthey would never buy such a
book.
I said, why not?
Because it doesn't capture theexperience.
I said, well, what is that?
What is the experience?
And they said, like you don'tunderstand, I hate myself.

(04:20):
And so it wasn't a.
You know, they didn't want somesort of euphemistic, watered
down version of what theexperience was.
And so and the reason it cameabout, was that for people who
know conditions like borderlinepersonality disorder, we know

(04:41):
that suicidal thinking andsuicide attempts is very, very
high and unfortunately, inpeople who are hospitalized with
borderline personality disorder, the suicide rate is about 10%,
which is a tragic number.
Any number, any loss is atragedy, but certainly 10% is a

(05:03):
very high number.
And, using dialectical behaviortherapy in our adolescent
residential treatment center, webrought the suicide rate way,
way down.
Nevertheless, we did lose somekids and when I was sort of
reviewing what we'd missed inthose kids, I realized that

(05:28):
throughout their record theywould talk about the self-hatred
.
And when I started to work withpatients and I asked them about
their self-hatred, they youknow many patients said no, I
don't hate myself.
You know, I don't like some ofthe things I do.

(05:49):
I'm dissatisfied with certainthings.
I'd like some things to change.
But a few of them talked aboutthis core self-hatred that they
had hated themselves ever sincethe beginning and that even if
depression, anxiety, substanceuse had improved, that
self-hatred persisted.

(06:10):
And when I asked them what theproblem with that was, you know,
they would talk about the wayit would impact their
relationships with others, theirlove choices, their friendship
choices, their academic choices,their employment choices.
They would always putthemselves down, believing that
they didn't deserve more andfundamentally they felt that

(06:34):
they were a burden to themselvesand to the people that loved
them and to the rest of theworld and that the world would
be better off without them.
And that, independent of allother behavioral improvement,
the self-hatred persisted and itwas really linked to suicidal

(06:55):
thoughts, actions and behaviorsand I thought, okay, well, if we
understand that this is avulnerability factor, we have to
begin to target it some way.
So you know, as a DBT therapist, I tried to use DBT techniques
and they just didn't work.

Can you give us a picture of what self-hatred
looks like?
How does it show up in peoplewho aren't as familiar with?
Oh, I hate myself.
Like I don't deserve this.
What are the thoughts orbehaviors that people tend to do
when they hate themselves?

Yeah.
So there's certainly a lot ofself-criticism, a lot of
self-judgment, there's a lot ofself-blame, so everything that
goes wrong is their fault.
Every time something goes badly, it's because there's something
flawed with them.
Every time they mess up in lifethat we all do I think I did in

(07:54):
my last session person sothere's a lot of self-judgment.
Anytime things work out well,it was luck.
There's a lot of people-pleasingbehavior.
There's a lot of perfectionism.
There's creating a standardthat is just very, very hard to

(08:17):
meet, and you know that when Iwould talk with my patients, you
know they would say things thatweren't very kind towards
themselves and I would say like,wow, it doesn't sound like you
like yourself very much.
And they'd say, actually Idon't.
I said, well, how badly, howbad is it?
And they said, to be honest, Ihate myself.

(08:38):
And so those are the behaviors alot of self-judgment,
self-criticism and, by the way,most, almost all of the people
that I met with self-hatred werehighly sensitive people, and I
mean I'm a highly sensitiveperson and so if you look at my
name, b-l-a-i-s-e and my motherwas Isabel, i-s-a-b-e-l and same

(09:00):
letters and she was my I don'tknow my angel, you know like she
was somebody who could validatea highly sensitive person.
So I mean, I'm sure, had I hadvery toxic and invalidating
environments, I probably alsowould have hated myself for
being so sensitive, and I thinkthat highly sensitive people are

(09:22):
at greater risk for self-hatred.

And I think that highly sensitive people
are at greater risk forself-hatred.
My thesis and dissertationresearch is on BPD, shame and
mentalization, so you're a bitof a goldmine for me.
But the kind of shame theoriststhat I was following were kind
of telling the story of, I mean,the biosocial model effectively

(09:44):
, but that when a child comesinto the world and starts
emoting and those are the onlytools it has is to cry right and
then eventually to smile, andit gets met with totally
opposite information, thatthere's kind of an incapability
of forming a solid sense of selfbecause the very tools that
they begin life with don't work,and that creates such a sense
of confusion and it's reallyimpossible to build on that.
And then there's the shameproneness that comes in.

(10:06):
Is that kind of a formulationof how this happens, or would
you add to it.

Yeah, no, I think that that's beautifully,
theoretically and real lifeexperience stated.
I mean, it's you know.
I think that that's all truebecause you know, I mean, a fish
doesn't know what it's like tobe out of water.
It just like you know, itdoesn't understand water is
separate from itself.
It's sort of like you know, andit's just like that's the

(10:33):
environment in which it lives.
And you know, it's only whenyou take it out that it says, OK
, maybe I do need to be in water.
So it's not a perfect analogy,but I'm just saying it's like
that's the uh, emotionalenvironment, emotional ocean in
which that young child is living.
Uh, and and and and.
So I haven't felt I haven't mettoo many adults, although I met

(10:57):
one recently who developedself-hatred when not having it
in childhood.
Um, and that's because I thinkthat when bad things happen to
adults, they can contextualizeit and there's often people in
their environment that they canturn to good friends, maybe

(11:18):
relatives and other people.
They say, hey, this thinghappened and they'll say, wow,
that sounds terrible.
But a child doesn't have thecontext and the words to be able
to, to, to say something.

Interesting .
It strikes me that you'reworking with like two
populations that would both haveself-hatred, but for different
reasons, like BPD and alsoadolescence.

Like.

I hated myself in adolescence for a
period, and I think it wasbecause I was developing a new
identity and I didn't have anyskills yet to be successful at
it, and so all I was seeing wasmyself messing up all the time,
like me being bad at socializingbad at getting guys to like me
bad at having friends, but thatthat's like not contextualized
yet like you're talking about inadulthood, but it also doesn't

(12:03):
stem from childhoodcontextualized yet like you're
talking about in adulthood.
but it also doesn't stem fromchildhood and it's not based on
this kind of undergirding of notbeing validated or listened to
or understood in any way.
So it's just, I don't know whatmy question is here, but it
seems like you've got two majorforces colliding at the same
time no, I, I think you'reabsolutely right.

But then, but by you know, just by
extrapolation, you would havehave been a highly sensitive
child, a highly sensitive teen.
Because I think that kids whohave you know, you insult them.
You say you know, you're notpretty, you know whatever the

(12:39):
affirmation would be to say agirl or to a guy or whatever.
If you know, um, uh, if I sayto a guy you're not strong
enough, your muscles aren't bigenough, and and he just doesn't
care, so what?
Okay, like let's just move on,but but high sensitivity, it's,
it's like the gorilla glue forlabels.
You know, if you're a highlysensitive person, I say you're

(13:00):
not that pretty, you're not tallenough, you know you're not
curvy enough, you're not pretty,whatever.
It is like that.
It is just like that, thatthat's going to stick to you
much, much more as a highlysensitive person than someone
who's not highly sensitive doyou see common um common styles

(13:22):
of parenting or childhood?

that leads to the self-hatred.
I only ask this because we'velearned over and over that, in
an invalidating environment,critical parents, not supportive
with highly sensitive kidsleads to this kind of
self-hatred.
However now that I'm a mom and Ihave a two and a half year old
who has big feelings.
You know learning thisprofessionally.

(13:44):
Sometimes, when he yells forthe 50th time, I'm like, come on
, it's not, it's just a sock.
Okay, your feelings are notlegitimate right now, Just get
that sock on.
Am I doing it?
Or what do you see as thecommon pathway for someone to
learn to hate themselves?

Yeah, so, so , okay, so you have a.
So again, you started with thebiology, which is that of high
sensitivity, okay, and then, um,uh, I'll give you an example.
I mean and, by the way, most ofthe parents that I meet are
ultra loving parents, so I havenot met a parent who said my
goal for my child is to go toHarvard and to hate themselves.

(14:24):
You know, it's like no one wantsto have a person with who
struggles in their, in theirlife.
Okay, but but for instance, Ihad a kid.
Parents had gone to a veryprominent West Coast University.
Both parents the child, thechild's two siblings had gone to
the same university.

(14:46):
You walked in to their houseand they had cups from this
university, they had, you know,duvet covers they had, they
painted the doors in the samecolor and stuff like that and so
.
But this kid was notacademically gifted at all, but
was super artistically talented.

(15:08):
Now the child was learning thatin order to be appreciated in
this family, she had to go tothis school and no one was
saying that to her.
But there was an, there was, itwas explicit, it just in the.

(15:40):
You know the way in whicheither the school was talked
about, the signaling in thehouse was that that's what we
value.
Wow, I'm not as smart as mysiblings, I'm not as kind of
athletically talented as mysiblings, I'm not going to make
it there and started to reallydevalue.
And then, in that context,every time something would go
wrong maybe they'd get a B in atest or something like that.

(16:02):
It would reinforce this ideathat they were flawed in a way
and then, in the context of asexual assault in school, it
just pushed her over the edgeand then she just said like you
know, like I'm never going to beenough, there's this question
of not enoughness.
So, yes, of course, if you're ahighly sensitive child, there's

(16:25):
sexual, physical, emotionalabuse and you don't have
somebody who can validate andprotect you.
It's the only thing that you'regoing to learn Now, you know,
with your child.
I mean, you know, it's so funny.
I went for a hike with my sonthe social worker he's now a

(16:46):
social worker and I said we wenthiking in the desert outside of
Vegas and I said, son of mine,tell me all the brilliant things
that I told you as a child andall the things that you learned.
And he said, honestly, I can'tremember a single thing, but I

(17:08):
remember how I felt around you.
I remembered feeling safe.
I remember feeling listened to.
So I think that it's not somuch that you say you should
brush your teeth 20 times oneway and 20 times the other way,
and that way you know like noneof that, that's not the you know
, like none of that.
That's not the thing, you know.
The thing is that they feelseen, they feel heard, they feel

(17:30):
validated.
That you can say, and then alsothat I can admit my own
mistakes.
You know, like, yeah, I screwedup, I screwed up and I yelled
at you and I was just veryfrustrated and I, you know I
made a mistake and frustrated,and I, you know I made a mistake
and you know, or, yeah, maybeyou did deserve to be yelled at
because you know, I told you notto take the car and you're 14
years old and you know what wereyou doing driving the car, you

(17:54):
know.
But but so so I think you know,yes, it's not so much that
you're yelling at your kidbecause they've taken the
software the 50th time, but it'sit's.
It's about.
It's about a seeingness, abeingness.
It's about not rejecting thechild's legitimate statements of
dissatisfaction and notenoughness.
The other thing is that howoften, when somebody tells us

(18:15):
you know, nobody loves me, Idon't have any friends at school
, Do we reject that by sayingthat's just not true.
Now, it's probably not true, itprobably isn't, but no one has
been convinced that they'relovable by being told that they
were not true.
Now it's probably not true, itprobably isn't, but no one has
been convinced that they'relovable by being told that they
were lovable, you know.
And so it's not like okay, Ilove you, you know.

(18:35):
Oh, okay, that's great, Now Ilove myself.
It's sort of saying, like how,how did you get to the idea that
nobody likes you at school?
And often it has to do with,like, maybe the best friend has
another group of friends and sothis one really essential person
doesn't like them anymore.

(18:57):
And so what happens is thatbecomes a catastrophe for the
highly sensitive person and itfeels as if nobody loves them.
Catastrophe for the highlysensitive person and it feels as
if nobody loves them.
But when you're able to sitthere and listen, it actually
brings the emotions down andthey're able to reflect on the
absoluteness of their statement.

So do you see?
Okay.
So I mean, are we seeing kidsas young as like seven
experiencing the self-hatred andthen it just keeps going, or is
it more something that developsin adolescence?
Like what?
What is the development of this?

yeah.
So I think that I don't know.
You know, when I've asked mypatients like, when did you
start hating yourself?
I mean, most say sometimearound kindergarten and but.
But but if I said like, if I'dasked you, do you hate yourself,
that would not have been aconcept, Right.

(19:58):
So so it's.
There's this internaldissatisfaction that is showing
up.
It's not formulated asself-hatred, it's formulated as
being flawed, it's like I cannot, I can no longer charm my
parents, I am no longer enoughfor my parents, I am an

(20:22):
embarrassment, I'm adisappointment, I am valueless.
And this is whether I mean it'spossible that a parent is
saying you know, you're not asgood as your siblings, but also
but more often than not it's notexplicitly stated it's just how
they're internalizing thoseexperiences, those experiences.

(20:49):
And then, as they get older andthey begin to formulate a kind
of a more complex sense of whothey are.
You know, in early adolescencethey start to make a lot of
comparisons and when they makethose comparisons they see that
they don't have what otherpeople seem to have, and then

(21:16):
they feel that they're very,very flawed around in those five
to 10, in the ooze of the fiveto 10 year old brain, the
formulation, the determinationof self-hatred seems to show up
in, you know, early, in theearly teenage years.

Yeah, this is a totally self-serving
question because I'm basicallyasking you the answer of my
dissertation.
But since you do mentalizationwork, what I'm interested in is
I've seen a lot of thementalization work with BPD has
mixed results, but in all of thequestionnaires that I see, or
the measures, it asks them tomentalize about two other people
and they are not included inthe equation.
So I basically switched themeasures to include them in the
equation so that they'rementalizing about themselves and
someone else.
And the reason I'm doing thatis because it seems like if you
hate yourself and you seeyourself as essentially flawed,

(22:14):
then that would affect how youthink that others view you.
So, maybe if somebody slightsyou in some way, or doesn't even
, then you might think that'sbecause they hate me or that's
because they see what'sessentially worthless in me.
Do you find those kinds oferrors?

Yeah, 100%.
And this is why trying todisprove it through any kind of
affectionate statement orstatement of compassion just
doesn't work.
Because if I say to that personwho sees themselves in that way
, I actually don't see you thatway.
I you know, I see you withkindness, I see you with

(22:50):
compassion, and said you know,well, you have to do.
You have to say that becauseyou're my parent, you have to
say that because you're mytherapist.
You know it's like, or you'reso deluded that you cannot see
the rottenness within, within me, and so they truly cannot
conceptualize that they can beseen in that way, because that's

(23:13):
not how they experiencethemselves.

I mean, this might be taking a peek into
what's in your book, but what doyou do then?
I really resonate with what youyou do then, like I, I, I
really, um, resonate with whatyou're saying as a therapist,
that when you deal with that,the self-hatred, that really
hard core belief of I'munlovable, I'm, I'm terrible,
You're just saying nice thingsbecause you're paid to do it.
There's my therapist blah, blahblah.

Um then, what do you do Like?
How do you what?

is the most effective way of helping people
through their self-hatred.

Mm, hmm.

OK, let me, let me ask you this I mean, and
I and again, and if you, if itfeels like an impertinent
question, just tell me it is.
But I mean, would you bothidentify as women?

Yes.

A hundred percent yes.

I mean, it depends on how we define gender
identity, but yeah, yeah, prettymuch Okay.

Now what if I said to you listen, we were
hanging out in Iceland and Itook a why not?
Iceland seems like a cool place, I've been there, great and I
took some DNA from the cup thatyou were drinking from and it
turns out that you're both XY.
Now how?

(24:37):
And I said you know what?
You're actually genetically aman.
How Could I convince you thatyou're not a woman by showing
you the test results?
And not only that, not onlythat could I convince you that

(24:58):
you have to change whateverfeminine stereotype you're
presenting with and the way thatyou're acting and do things
differently.
So you have to, like I don'tknow, sit around on a Sunday you
know, belching beer whileyou're watching.

I mean, I'd have to believe there's a
really good incentive, Like ismy life going to just radically
become a lot better if I cut offmy boobs and sit around
drinking beer?

But I mean, could you internalize, could you
internally identify in that way?

I think that would be very difficult
very difficult.

and what if I told you and like you were
coming into therapy and I saidto you okay, listen, we have to
speak, we have to talk about whyyou're avoiding being a man?
What would eventually happen toour relationship?

Yeah, when he trusts you yeah.

I mean like listen, we've talked about this.
This is nonsense, you know,like I know.
I mean you know you have toexplain why.
I've had a baby who's two and ahalf and running around with a
sock, and you know, and nomatter what.
So the thing about it is that inthe early stages, like telling
somebody that they're lovablethat's how fused it is with

(26:18):
their identity.
There is no convincing themthat they're wrong about
themselves.
Okay, so now the first thing Ihave to do is I have, you know,
like nothing I did.
I said practice loving,compassion, and I'm a
mindfulness like person and youknow, do all these kinds of, and

(26:38):
they just, it was as much, itwas as as invalidating as me
telling you to start consideringyourself as being male.
And, by the way, this is justlike it.
It's a simple kind of analogy tolike thinking the world in a
very binary way.
But I'm just, you know, justfor the sake of the, of the, of
the example, and how can youbelieve something that no amount

(27:01):
of you saying can be like forthe next year, I'm going to
believe I'm a man is going toget you to really believe that
that's true, you know.
So it's like um, it's so.
So this idea of practicing,loving yourself, practicing uh,
any of these things is not goingto work unless you're willing
to accept that, that thatconcept is fundamentally wrong,

(27:27):
um, and that that concept waslearned, um.
Do you both speak English as afirst language?
Yeah ¿Y alguno de vosotroshablas español o no?

No.

No, okay, why not?
Because that's not what you werebrought up learning.
You're brought up learningEnglish, and so what I say is
like you were taught, you're ahighly sensitive person, who was
taught that you weren't enough,and who were your teachers?
Who were the teachers whotaught you that?
And why is it that you continueto listen to those teachers?

(28:01):
And why is it that you don'tlisten to the teachers who are
teaching you something much morefundamentally beautiful, much
more fundamentally true aboutyou?
So you learned how to hateyourself, but if you learn how
to hate yourself, you can learnhow to love yourself, because

(28:21):
love comes much more naturallyto the human heart than hatred
does.
But it's a learned behavior,and and but it's a learned

(28:46):
behavior.
And so what I you know, andthere's a.
There's an interesting thingthat happens.
A lot of my patients have tellme that their parents are always
ask them advice on what?
On advice on how to be happy,and I say, are your parents
happy?
And they say no, they're not.
So why are you getting advicefrom unhappy people?
They're teaching you how to beunhappy.
We get so much advice fromunhappy people as if their
advice is good advice and itisn't.
And um, and if it was goodadvice.

(29:08):
Well then, they'd be happy.
But they're not.
And I said do you want to endup being like that unhappy
person?
I said, no, I don't want to belike that.
Well then, don't stop takingadvice from them.
No, they're telling me I shoulddo this, this and this.
I say OK, well, you know whatthe outcome is going to be.
So, so what about saying,rather than learning?

(29:28):
And, by the way, those peoplethat were so hurtful to you, I'm
not hating them.
You cannot overcome hatredthrough hatred.
I'm not hating them, I'm justsaying they are a product of
their environment, of theirbiology, of their circumstances
and the behaviors that ensuedfrom who.

(29:49):
They were treated you in thisreally toxic way.
The problem is, you began tobelieve their toxic message, and
it was a.
It was fake news, it wasabsolutely fake news.
You know and um, and you go tolike you know, so we have to
start.
So you drive that wedge.
You say okay every time theybring it up.
No, you learned that wedge.
You say okay every time theybring it up.
No, you learned that.

(30:10):
That was learned.
And sometimes you don't know,but I'm saying as often, you can
see how.
Maybe there was school bullying, maybe there was a sexual,
physical, emotional abuse.
Maybe there was a lot ofinvalidation, maybe there was a

(30:30):
lot of comparison with you knowother functioning kids.

So that's how I first start, yeah,
identifying the source of whereyou learn that and try and
evaluate whether that makessense.
Moving on Exactly.
Well, speaking of fake news,it's interesting.
I'm going to bring up the waythe different reactions to your
book of I Hate, I hate myself.
Um, there's that.

(30:53):
There's one segment from msnbcand there's one from fox news
and the fox news one wassurprising or maybe not for
people listening that they saidthey were kind of like well,
maybe it makes sense that thatperson hates himself and maybe
maybe self hatred is actuallygood.
I mean, you should hateyourself if you're a person

(31:17):
which at first I was like thisis so silly, but we do.
We do talk about how sometimesself doubt or negative thoughts
could be functional, like what?
And also sometimes you havepatients who say I hate myself
and I've done horrible things,and then you listen, you're like
that wasn't great.

(31:39):
And then you have some patientswho have no self doubt maybe
should have a little bit of a,let's say, self hatred, but a
little touch.
So can you talk about that?
Can you talk about thedifferent perspectives on
self-hatred, and maybe even morethan people like we're talking
about?
Okay, yes, you should learn tolove yourself, but like yeah,

(32:00):
well, let me ask you something.

I mean how?
Many of these shows have youdone, would you say 130 or
something 130 have you have?
Has there ever been one thatyou were just like really upset
with, really dissatisfied with,like just like, wow, that didn't
you know.
Out of those 130, could youthink of like the top five and
maybe like one said, oh wow,that didn't go as well.

(32:23):
Maybe there were technologicalissues, technical issues, maybe
I don't know.

No, we've been perfect.
That's incredible.
Yes, that is fantastic.

The shoes maybe, I don't know.
No, we've been perfect.

That's just incredible.
Yes, that is fantastic.
10 out of 10 every time, andyou know what?

I think you should put your child on right
now and let me tell your childwhat a fabulous mother he has
that and that not to complainabout the socks anymore.
So so you know, if you, you, ifyou, if something were to happen
and you were to say okay, likethat didn't go the way that we
were expecting, it wouldn't bebecause I am a flawed individual

(32:58):
.
It's like maybe I didn'tprepare enough, Maybe I don't
know, the guest you know wasjust not on, Maybe they, we had
the wrong guest, we got thewrong.
You know, Brene Brown, we gotyou know.

(33:19):
So there was something wrongabout, there was something that
happened, but it's not becauseyou're flawed, it's because
something didn't work out.
So that's something that'sexternal to you and that you can
fix.
So I think that if you useself-criticism, self-judgment as
a way of correcting something,then that's OK.
I mean, I'm not saying, youknow like, have blind and bland

(33:43):
love for yourself and you know,we all screw up and we have to
correct those mistakes.
We all screw up and and we haveto correct those mistakes, so,
uh.
So in that context, a littlebit of uh, self-judgment,
self-criticism, self-blame isfine, but but when it's, when
it's, everything is because I'mso flawed, you know, um, uh,

(34:07):
then uh, um, then you're stuckin a state of like, well, then
nothing can ever go right,because if things go right it
was luck, and if things go wrong, then it was your fault.
So I drive this wedge and thenI start to kind of examine,

(34:28):
moment by moment, whenself-hatred is getting stronger,
when it goes down.
And typically self-hatred getsstronger in the context of
people that they're not veryhappy with and self-hatred goes
down when they're in connectionwith people that they love.
So if we get back to youroriginal question, which was
MSNBC, you know, recognizing thevalue of examining this topic,

(34:51):
and maybe Fox News saying not somuch.
Maybe you should hate yourselfor using it as a prop for
attacking people that they havepolitical differences with.
My problem with that is, youknow, I mean, look, I'm all for
a good joke and I'm good for,I'm all for a good joke and I'm
good for, I'm all for a goodpolitical joke, but when you

(35:15):
take a vulnerability factor thata human being experiences that
might lead them to take theirlife, I just think that you've
done a disservice to those whosuffer from the experience.
And you know, I actuallyemailed the host and said, look,

(35:39):
I mean, I think that's one ortwo of the things that they said
were kind of ridiculous,somewhat funny, but at the same
time, you know, can we take theother side of it so you don't
show a level of ignorance anddisdain and disregard for people
who are suffering?

Agreed.

I hear that sex is done as a disturbance.
What?

were you going to say, kadee?
I mean, it kind of touches onsomething that we're seeing
across the board in our society,where there's you know, I hate
myself, I'm worthless or theother side, which is no, like
charge ahead, let's be strong,let's dominate right.

(36:26):
There's like this conservativemovement of don't doubt yourself
, in fact, storm in with fullconfidence, and that's that's
the, that's the approach tostrength, and it, you know,
there's going to be people whostill feel that way inside and
and learn oh, I'll just have toproject the opposite.

(36:47):
So you're right, it's verydangerous to make fun of.
You know that, struggle inside.

Well, and I think I mean you know, it's not
as if self-hatred goes to thevoting booth and says are you a
Democrat or a Republican, areyou conservative, are you
liberal?
And if you're one or the other,then I'm going to latch on to
you.
I mean that's true of anycondition diabetes, asthma,
arthritis, cardiac illness andstuff like that.

(37:15):
It's not as if, you know, anyof these conditions is picking
one person or another.
And at a time when deaths ofdespair are an all time high,
when suicide rates are an alltime high, and we're talking
about closing the bordersbecause of fentanyl coming into
the country or increasingtariffs by 25% because of

(37:38):
fentanyl coming into the country, why?
Because the tragedy of thesedeaths of despair is so
heartbreaking.
Then, if we think about, whatare the vulnerability factors,
what are the conditions whenpeople die, maybe through
overdose or by suicide?

(37:59):
That is so trivialized.
I think that that was thesadness of the of that fox
segment um I'm trying to think.

I'm like I don't know that I want to go in
this direction, but I am tryingto think if I see traits along
the, the political lines thatwould lend themselves to healing
from Um, I can kind of see anargument for both.
But um, so you start by there.
Whenever I have a patient witha lot of self-loathing, I always

(38:38):
have this somewhat absurd well,it's logical, but emotionally
absurd reaction which is likethis is so pointless, like none
of this isn't doing you anyfavors.
This is just serving to preventyou from having any kind of
like reparative action in yourlife to you know, to show that
you could be happy and could belovable.
But then when I think about myown like body image issues,
since literally up until I gotliposuction, you couldn't talk

(39:02):
me out of it.
You know it was just this thing, like I just don't like my body
, so how am I supposed to startliking it?
And there also felt like therewas this point to hating it,
like if I keep hating it, thenI'll get better, which is kind
of what you're talking about,you know criticism so I know
that while it may be pointless,it doesn't just a lot.

(39:22):
You can't just logic it away.
So you're saying that first youkind of go in and create a
wedge between their trust of theself-hatred, like, oh wait,
this was taught to me by figuresthat maybe I shouldn't trust in
the same way.
What do you do next?

Okay, by the way, you know, it's interesting
how you.
I really appreciate yourvulnerability.
So let me just say, you knowthat, in terms of talking about
your own experiences and I thinkit's refreshingly honest to
have somebody say, hey, you know, I didn't like my body had
liposuction here we are, youknow, but here's the other thing

(40:02):
is is that, you know, when Iwas young, I'd get like Time
magazine or National Geographiconce a month and that would be
it.
Now we're bombarded withmarketing for self-hatred.
We market to self-hatred.
You're not tall enough, you'renot skinny enough, you don't
have six pack enough, you're notstrong enough, you're not

(40:24):
athletic enough, you're notsmart enough.
But, by the way, if you buy myproduct, you'll be fabulous,
people are going to love youbecause you'll be so fabulous.
And if you buy my book, um,which is, um, this one, people,
you know you're going to, uh,it'll make your life so, so much
better.
You know, but, but I think thatthat's it.
It's it's like we market toyour self-dissatisfaction, and

(40:47):
it doesn't even have to be verybig.
It's just like wow, you know,like I don't know, my wrinkles
could be just a tiny bit less,or you know something like that.
And if you do that, likeeverything in your life is going
to change in terms of how yousee it and, by the way, I'm not
saying that some of those thingsaren't true, like some of those

(41:08):
things could be true but it'sjust that you can never reach
that pinnacle because that'ssomething outside of you.
It's not something inside ofyou.
You can only ever get toself-acceptance through
something that's inside of you.
Okay, so you get back to thispoint.
So I drive this wedge betweenokay, this was taught.
Okay.
Then I want to be very specificabout what the lessons were.

(41:34):
The lessons were my dad callingme stupid, calling me lazy,
telling me I was never going tosucceed, and that message being
repeated over and, over and overagain.

(41:54):
Okay, so that was one of yourteachers, the bullies at school,
who called me fat or who calledme, you know, I don't know
whatever that label was thatstuck so strongly?
whatever that label was thatstuck so strongly?
The teacher who told me that Ishould leave piano because I was

(42:16):
just never going to be good atpiano.
Any teacher negation of aperson's effort or a person's
capacity, comparison withsomebody who is more talented,
without any mitigation, withoutany recognition of the value of
that human being as a humanbeing.

(42:36):
You know, I want them toactually write it down and I'm
saying, wow, look at all of this.
These are your teachers tellingyou these things.
And then it's often there'ssuch powerful voices that you
cannot hear the voices of thekind people.
And then, you know, to anearlier point, you just stop

(42:59):
believing them because you saythe toxic people must be right
and the kind people obviouslycannot see what the toxic people
see in me, you know.
So I say okay, like now.
And then I do a very interestingthing and this is something
that I worked out with a patientis I got them to bring

(43:22):
photographs of I think she was19, of every birthday from one
to 19.
And I put them down and you seethe change every year, year two
, they have a sock in theirmouth because they stole it from
Kibi and I say tell me when youstart hating her, tell me when

(43:50):
you start hating that littlegirl.
And they can't.
They want to reach back in timeand grab her in their arms and
just tell that little girl howmuch they love her.
And then they see the educationthat that child received.

(44:13):
That told her she was soworthless.

What does healing look like At that point
when they start to soften andchange around and around those,
those thoughts and beliefs?
What, what, what do you seehealing look like at that point?

I had a patient who, um, uh, who was uh
who said to me that, um, she'dalways dated these toxic men by
toxic men.
It's just like men who wouldnot, they didn't feel valued by,
but they felt that theydeserved because they were so
flawed.

(44:55):
And one day she told me, youknow, as she broke through, as
she began to see how that toxicmessaging had led her to make
toxic relationship choices, Iwas teaching the interpersonal

(45:17):
effectiveness skills of DBT andhe said, well, what's that?
And he said well, what's that?
He says, you know, like, bydoing this, I'll be she misused
the word, but she says I'll be abetter person.
And then he said, well, good,because you need to be a better
person.
And she stops and she thinksabout this and she says you know

(45:38):
what, if I'm a better person,I'll get a better boyfriend.
That was brilliant, that was sofantastic, you know.
And it was sort of like yes,you're seeing that you deserve

(45:58):
more than what you've learned tobelieve is the best that you
can get.
And again, I did not want her tohate this guy.
I mean I say I'll do all thehating for you because I didn't
like how he was treating her,but nevertheless, who knows?
I don't know how he's beenmaltreated, how he's been abused
and everything like that.
It's just that that is not herdestiny, it's not what she
deserves.
So you start to see healthierchoices, living up to their

(46:25):
potential in terms of academics,in terms of of employment,
learning how to say no.
Stop people pleasing.
Less perfectionism, I mean.
People pleasing is such a redflag for self-hatred.
Um, you know it's, uh, it's, Iwill do whatever it takes to get
you to like me.

(46:46):
You know, to the point ofdevaluing yourself, and you know
the person then gets whateverthey want and moves on and
you're left resentful becauseyou get nothing back.
Doing the right thing for youis never doing the wrong thing
for someone else, and thecorollary is like doing the
wrong thing for you is neverdoing the right thing for
someone else, and the corollaryis like doing the wrong thing

(47:07):
for you is never doing the rightthing for somebody else.

I'm rifling through patients in my head
right now of like when I couldhave used these interventions.
Is there a difference?
Do you think about that?
Wedge trust, wedge of like dowe really?
Trust these people who havegiven you these messages and I
guess I'm like okay, so what ifyou know?
You ask, like I had a patientwho was bullied in middle school

(47:37):
and so those are the people,presumably, who gave me that.
But we don't know if they'rehappy now.
We don't, because at the timeshe she probably saw them as
cool, pretty pretty like well,what happens then?

Yeah, but I mean it doesn't actually matter
Because I just want to know.
Those were the teachers at thattime.
It doesn't matter how they'veturned out and we don't actually
know what their lives are likeand that shouldn't be our focus.
In any case, they may turn outfabulous, posting pictures of
themselves in bikinis on yachtsin the Mediterranean, you know,
or I don't know, sitting in thetoilet with dysentery after a

(48:12):
trip to down the Okabanga swamps.
I mean, who knows, you know,who knows who knows what?
But it doesn't matter becauseyou may, it's not about, it's
not about this, it's just thatthose were the teachers.
Who knows how they turned out?
And it doesn't actually matterhow they turned out and even if
they seem outwardly happy, wedon't know the lives of others.
So it's like saying, okay,those were the lessons.

(48:32):
It doesn't matter where theyare now and what they're doing
now.
It matters how you're doing now.
It matters that you've carriedthe weight of uh, of those
lessons, the, and that weighthas been such a burden.
I do this exercise with uh, withsome of my patients.

(48:53):
I I get them to hold out a twopound weight and can be you.
How heavy is your kid?
very heavy, more, okay, morethan two pounds 40 pounds, there
we go and you can hold him.
But if you think about, okay,so you could hold out a two
pound weight, you know, giventhat you can do 40.
But if you hold it out likethat, you're holding it out,

(49:13):
holding it out, eventuallyyou're saying, wow, this is
getting really heavy, and I say,okay, well, let's put it down
and weigh it, and it would stillbe two pounds.
But the longer you hold on tosomething, the heavier it feels.
The longer you hold on to thosemessages of toxicity, the
heavier they feel, the more theyweigh on you, especially if

(49:33):
you're an emotionally sensitiveperson although to Jacqueline's
point, what's interesting aboutsometimes, when, when patient,
when people re-evaluate whotaught them to hate themselves?

like these messages of being successful,
being beautiful, being like yourbrother is?
the way for me to love you.
I see sometimes that they canget to the point where they
recognize who the teachers are.
I then having to doubt that orquestion that could dismantle a

(50:08):
lot of their lives, right?
Oh, if my, if my dad, my dad'smessages of what's right and
wrong, um, and to hate myself orlove myself are incorrect, well
then he, he's wrong, and then I, and then this might threaten
my whole, then maybe he's a badperson, and then maybe this
ruptures my whole relationshipwith it.
Right, there's kind of like aholding on of these beliefs

(50:31):
sometimes when you trust thathe's taught you versus.

Yeah, that's fair, but this is where wise
mind comes in.
I mean, like that, here's thething is like when you feel shut
down, when your body contracts,it's a bad lesson, you know.
When your body shut down, youget.
When you're sick, your bodyshuts down and you contract.
What happens when you likeexperience love and experience

(50:54):
joy?
It's like expansion, you knowso.
So your body is actuallytelling you whether something's
toxic or not, and I think youknow, from a DBT point of view,
with dialectics, it's.
It's, you know, not everymessage is a toxic message and
not every positive message isuseful.
You know, telling me that I candunk a basketball.
You know, I'm old and decrepitand you know, I mean I can

(51:18):
barely, you know, put my armsaround the rim of the, I mean
touch the bottom of the net.
So I mean, some things are justtrue, you know, but it's really
examining, okay.
So you say okay, like that wasthe student.
Now, by the way, often what wefind is that a parent uses the

(51:40):
same technique with all of theirchildren.
You know, I said I, you know I.
I yelled at the oldest, heturned out okay.
I yelled at the middle one andshe turned out okay.
But this one, you know, I tellher get up and, you know, do
whatever it is starts crying.
That's because they're highlysensitive people, and so the
well-intentioned techniques thata parent uses with one child

(52:03):
and with two children, you know,if your child's allergic to
peanuts and your other one isn't, one's going to have a reaction
that the other one isn't goingto have.
And so now it may not beintentional that they're getting
these messages, that the parentis delivering those messages.
It just might mean that, look,okay, we're not going to sit

(52:24):
here and say that because yourdad taught you these messages,
that he's a fundamentallyterrible human being.
I don't want to get into that.
And in any case, hatingsomebody to stop hating yourself
just doesn't work.
Hatred does not cure hatred.
So it's sort of saying, ok, Ilearned these lessons, but maybe

(52:45):
they were just, like they were,teachers who'd been taught that
way themselves.
I learned that the word conchais a Spanish word for a shell.
I used that word in Ecuadorwhen I was teaching and it is

(53:06):
the word for intimate femaleanatomy, and I was there, you
know, lecturing away, talkingabout like this wonderful shell
that I had found on the beach,and it was nice and smooth on
the inside and I could put it tomy ear, hear the ocean and it

(53:26):
smelled a little bit like fish.
And you know, it was like, andI could see the students like
mortified, because I had beentaught so the word is correctly.
That in Spanish is how Iunderstood the word, but I was,
you know, like in the differentcontext did not come out so well

(53:49):
, you know.
So the point is OK, that was amistake.
Now people could go home and say, oh, my God, like this American
professor came and gave us themost disgusting teaching ever
about female vaginas, teachingever about female vaginas, and,

(54:10):
um, and and.
But there was somebody couldsay, oh, you know what, like,
okay, he, he mislearned, likethat was it?
What was the context?
And then say, okay, like thatwas bad teaching, let's correct
that.
Can you go back to a parent andsay you know what?
Those were actually hurtful,and I know that may not have
been intentional, but butnevertheless it had a certain
impact.
There was some attempts to, youknow, like, going on to going

(54:33):
down to New York and and doingsome some of the morning shows,
but you know they haven't pannedout yet because there's a lot
of political news in the in thenews cycle, and so you know that
this hasn't taken um you knowon, but um, yeah, so we'll,
we'll see but yeah, no, I'd loveto.

(54:54):
Uh, you know, uh hang out and uh, you know, happy to.
I just love teaching and um, uh, yeah.

Well is it.
Can you tell us where?
Um where?
We'll definitely put the linkto your book in the show notes,
but is any other resources orwhere that people can find you
or talk to you or anything elsethat you want to give to the
listeners?

Yeah, I mean , I think I think our website
but I mean our website is atreatment program, you know so,
it's the continuum, whether it'soutpatient, residential or a
partial hospital.
But people send me, you know so, that I, because I think that

(55:43):
the flood of emotions as theycome are are so powerful that
that, by stopping and gettingthe person to do some reflection
, you know so, I think, in thebook that there's all these
exercises, but I think thatwe're at the beginning of a
journey of of really examiningthis concept of self, you know,

(56:03):
this concept of who we are ashuman beings, and I think that
in this day and age, theself-absorption leads us to a
level of self-hatred that iskind of unprecedented, and I
think that we're going to seemore and more of it.
And I think, you know, I mean Iwrote this, it took, I've

(56:24):
written 20 books.

And and run 57 marathons.

So I mean you know, like I live a very
extreme life.
I mean I mean I very like Ilive on the intense age of life
and but but this one I can.
You know, I can really churnout a book quickly, but this one
took two years because it wasso important.
It's my, I think to me it's mymost important book, because I,

(56:55):
because I, because it is soantithetical to my experience to
see somebody who I so deeplylove to hate themselves.
You know, I just, and now theproblem is is that all my
patients who not love themselvesthey won't leave me alone.
I mean they're so frigging,annoying.
They send me pictures of theirultrasounds and of their

(57:16):
marriages and of their babies.

And.

I'm not your therapist anymore.

I said never stop loving yourself.

Exactly, leave me alone.
But you know it's justwonderful to stay connected.
I mean they often will travelonce a year to come to Boston,
to come and say hi and bringtheir families or go and grab a
coffee.
It's lovely.

I'm literally putting this in my
Amazon cart after we hang up,because I have a patient who
struggles with this and it canmake you feel so incredibly
helpless.

I think the only thing is thank you so much,
just in terms of recommendation, because of the Fox piece there
was a little bit of negativity,negativity if, if, uh, if you,
if you review it and you thinkthat it's worth anything.
Um, you know, like one thingthat can help is sort of like

(58:15):
supporting it on amazon bysaying you know five stars or
whatever it is you know justjust in terms of like, because I
I think, um, there's a, there'sa sense of like it being that,
there's a self-indulgence, and Ithink that people are mistaking
kind of superficialself-dissatisfaction with the
self-hatred that is going totake someone's life.

(58:36):
You know, guys, you arebeautiful and wonderful and,
kibi, if I come down, I'mdefinitely bringing socks for
the little guy to drive you nuts.

Well, we're in New York, so we would love to
also come and visit, if there'sany kind of mentalization-based
training.

Well, little Helpers.
Now I'm about to beg for fivestars.
So after you're done readingBlaze's book, give him five
stars.
Then come on here and give usfive stars and we'll all be so
happy and we'll love ourselves.
For now, see you later andyou'll hear from us next week.
By accessing this podcast, Iacknowledge that the hosts of
this podcast make no warranty,guarantee or representation as

(59:21):
to the accuracy or sufficiencyof the information featured in
this podcast.
Representation as to theaccuracy or sufficiency of the
information featured in thispodcast.
The information, opinions andrecommendations presented in
this podcast are for generalinformation only and any
reliance on the informationprovided in this podcast is done
at your own risk.
This podcast and any and allcontent or services available on
or through this podcast areprovided for general,
non-commercial informationalpurposes only and do not

(59:43):
constitute the practice ofmedical or any other
professional judgment, advice,diagnosis or treatment, and
should not be considered or usedas a substitute for the
independent professionaljudgment, advice, diagnosis or
treatment of a duly licensed andqualified health care provider.
In case of a medical emergency,you should immediately call
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The hosts do not endorse,approve, recommend or certify

(01:00:04):
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