Ep. 131 - Interview with Dr. Blaise Aguirre: Confronting the Shadows of Self-Hatred

Do you hate yourself or know someone who does? We delve into the painful reality of people who loathe themselves with Dr. Blaise Aguirre, a distinguished expert in child and adolescent psychiatry at McLean Hospital. We navigate the often-overlooked dimensions of self-loathing, delving into how it manifests in various mental health conditions, particularly borderline personality disorder and suicidality. 

Dr. Aguirre sheds light on the origins of self-hatred, tracing it back to formative childhood experiences, critical family environments, and societal expectations that can shape a person's self-image. Throughout our discussion, he emphasizes the profound impact of high sensitivity on emotional resilience, illustrating how those with heightened sensitivity often internalize negative messages, leading them to struggle with self-worth. 

The episode also provides practical insights into healing from self-hatred. We discuss various therapeutic approaches aimed at reframing harmful narratives and fostering self-compassion. Dr. Aguirre’s compassionate insights encourage listeners to shift their perspectives on self-worth and understand the vital role of emotional connections in cultivating a positive self-image. 

Whether you’re on your own journey toward self-love or seeking to support a loved one grappling with self-hatred, this episode offers both understanding and hope.

• Transcript

  Jacqueline Trumbull (00:01.042)

  Hey, little helpers. Welcome back. Today we have a really cool topic. It's one, I always love doing these episodes where it's a concept that it can apply really broadly. But we do see it in certain diagnoses more than others. The concept is self-hatred, self-loathing, something that a lot of people unfortunately struggle with at different parts in our lives. But to help us with this topic is, how do you pronounce your last name, Blaze? Aguirre?

  Blaise Aguirre, MD (00:25.686)

  Like a Cargir, like a Cargir, Dr. Aguirre, Blaise Aguirre. Aguirre is French, so, which is also cool.

  Jacqueline Trumbull (00:28.08)

  A gear blazing or it okay? Okay? Helping us with this topic is dr. Blaise Aguirre. He is a child and adolescent psychiatrist. He's a trainer in and specializes in dialectical behavior therapy, which should be familiar to many of our listeners as well as other treatments such as mentalization based treatment for borderline personality disorder and associated conditions.

  He is the founding medical director of Three East Continuum of Care, which is an array of programs for teens that uses DBT to target self-endangering behaviors and BPD symptoms. He's been a staff psychiatrist at McLean Hospital at Harvard since 2000 and is nationally and internationally recognized for his extensive work in the treatment of mood and personality disorders. He's the author and co-author of many books, including Borderline Personality Disorders in Adolescents, Mindfulness for Borderline Personality Disorder,

  Coping with BPD and fighting back. Blaze, welcome to our show and thank you so much for offering us your expertise. For those of you with YouTube, you will have just seen Blaze raise a book called I Hate Myself. And we just saw the message I hate myself come completely over the screen. So that is why we were giggling. But Blaze, welcome.

  Blaise Aguirre, MD (01:32.469)

  And now, let's vote.

  Dr. Kibby McMahon (01:35.713)

  Subtle, subtle plug.

  Dr. Kibby McMahon (01:43.572)

  You

  Dr. Kibby McMahon (01:50.497)

  and I'll just, let me jump in.

  Blaise Aguirre, MD (01:50.658)

  Okay.

  thank you so much for having me on and I just really appreciate the willingness of thinking people to have a discussion about this really complicated topic. So thanks tremendously for having me on.

  Jacqueline Trumbull (02:12.476)

  Awesome and Kibbe, I'm gonna jump over to you to tell us about Cooler Mind.

  Dr. Kibby McMahon (02:16.212)

  Yeah, just jumping in with all different kinds of plugs for things, but I'm really, really excited for this conversation with Dr. Aguirre. We'll definitely link where they can find your book and other resources after this. But I also mentioned that for anyone who wants hands-on help with navigating their emotionally challenging relationships with loved ones with mental health issues, like borderline personality disorder, which we'll talk about,

  anger issues, narcissism and other things like that, check out KULAMIND.com or you could check out our show notes and you find a link and you could talk to us. You know, you could book a free consultation call to learn a little bit more about how we can help you with navigating a relationship like that. done with all that. Let's jump into self-hatred. Tell us a little bit about...

  Jacqueline Trumbull (03:07.986)

  Such an ad.

  No, it's just it's such an aggressive sounding title, but I think it's something that so many of us have struggled with at different parts of our lives. That was me as a teen. But you, I know, have studied this mostly in the context of BPD. Can you tell us how you came to this topic? What interested you about it?

  Blaise Aguirre, MD (03:14.414)

  Mm-hmm.

  Blaise Aguirre, MD (03:27.422)

  Yeah, but I was struck by by your comment about how aggressive it sounded this whole concept of self-hatred and I remember that when I was speaking to a lot of my patients who've got borderline personality disorder, eating disorders, eating disorders and other conditions and I said, know, I'm really working on this project. What should we call it? And then, you know, should you call it I loathe myself or you know like

  learn to love yourself or something like that. And they all, to a person, said that they would never buy such a book. I said, why not? Because it doesn't capture the experience. I said, well, what is the experience? And they said, like, you don't understand. I hate myself. And so it wasn't a, you know, they didn't want some sort of euphemistic, watered down version of what the experience was. And, and

  Jacqueline Trumbull (04:20.424)

  Mm-hmm.

  Blaise Aguirre, MD (04:25.582)

  So, and the reason it came about was that for people who know conditions like Borland Personality Disorder, we know that suicidal thinking and suicide attempts is very, very high. And unfortunately, in people who are hospitalized with Borland Personality Disorder, the suicide rate is about 10%, which is a tragic number. Any number, any loss is a tragedy, but certainly 10 % is a

  high number.

  using dialectical behavior therapy in our adolescent residential treatment center, we brought the suicide rate way, way down. Nevertheless, we did lose some kids. And when I was sort of reviewing what we'd missed in those kids, I realized that throughout their record, they would talk about the self-hatred. And when...

  I started to work with patients and I asked them about their self-hatred. you know, many patients said, no, I don't hate myself.

  I don't like some of the things I do. I'm dissatisfied with certain things. I'd like some things to change. But a few of them talked about this core self-hatred that they had hated themselves ever since the beginning and that even if depression, anxiety, substance use had improved, that self-hatred persisted. And when I asked them what the problem with that was, they would talk about the way it would impact

  Blaise Aguirre, MD (06:09.624)

  their relationships with others, their love choices, their friendship choices, their academic choices, their employment choices. They would always put themselves down believing that they didn't deserve more. And fundamentally they felt that they were a burden to themselves and to the people that...

  love them and to the rest of the world and that the world would be better off without them. And that independent of all other behavioral improvement, the self-hatred persisted and it was really linked to suicidal thoughts, actions and behaviors. And I thought, okay, well, if we understand that this is a vulnerability factor, we have to begin to target it some way. you know, as a DBT therapist, I tried to use DBT techniques and

  They just didn't work.

  Dr. Kibby McMahon (07:06.688)

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

  Blaise Aguirre, MD (07:17.069)

  Mm-hmm.

  Blaise Aguirre, MD (07:23.886)

  Yeah, so there's a there's a certainly a lot of self-criticism a lot of self-judgment There's a lot of self 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 life that we all do. I think I did in my last session. I'm a terrible person, so there's a lot of self judgment. Anytime things work out well, it was luck. There's a lot of people pleasing behavior. There's a lot of perfectionism. There's creating a standard that is just very, very hard to meet.

  Blaise Aguirre, MD (08:10.91)

  And you know that when I would talk with my patients, they would say things that weren'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, I don't. I said, well, how badly, how bad is it? And they said, to be honest, I hate myself. And so those are the behaviors. A lot of self-judgment, self-criticism.

  And by the way, most, almost all of the people that I met with self-hatred were highly sensitive people. And I mean, I'm a highly sensitive person. And so if you look at my name, B-L-A-I-S-E, and my mother was Isabelle, I-S-A-B-E-L, and same letters. And she was my...

  I don't know, my angel, know, like she was somebody who could validate a highly sensitive person. So, I mean, I'm sure had I had very toxic and invalidating environments, I probably also would have hated myself for being so sensitive. And I think that highly sensitive people are at greater risk for self-hatred.

  Jacqueline Trumbull (09:17.371)

  I might.

  thesis and dissertation researches on BPD shame and mentalization. So you're a bit of a gold mine for me. What the kind of shame theorists that I was following were kind of telling the story of, I mean, the biosocial model effectively, but that when a child comes into the world and starts emoting, and those are the only tools it has is to cry, right? And then eventually to smile. And it gets met with totally opposite information that there's kind of an incapability of forming a solid sense of self because the very tool

  Blaise Aguirre, MD (09:24.654)

  Mm.

  Jacqueline Trumbull (09:48.63)

  that they begin life with don't work and that creates such a sense of confusion and it's really impossible to build on that. And then there's the shame proneness that comes in. Is that kind of a formulation of how this happens or what would you add to it? Okay.

  Blaise Aguirre, MD (10:01.698)

  Yeah, yeah, I know, think that that's

  that beautifully theoretically and real life experience stated. mean it's you know I think that that's that's that's all true because I you know I mean a fish doesn't know what it's like to be out of water. It just like you know it doesn't understand water is separate from itself. It's sort of like you know and it's just like that's the environment in which it it lives. And you know it's only when you 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 that's

  emotional environment, emotional ocean in which that young child is living. And so I haven't felt, I haven't met too many adults, although I met one recently who developed self-hatred when not having it in childhood. that's because I think that when bad things happen to adults, they can contextualize it and there's often...

  people in their environment that they can turn to good friends, know, maybe relatives and other people, say, hey, this thing happened, and they'll say, wow, that sounds terrible, but a child doesn't have the context and the words to be able to say something.

  Dr. Kibby McMahon (11:22.208)

  Interesting.

  Jacqueline Trumbull (11:22.96)

  It strikes me that you're working with like two populations that would both have self hatred, but for different reasons, like BPD and also adolescence. Like I hated myself in adolescence for a period. I think it was because I was developing a new identity and I didn't have any skills yet to be successful at it. And so all I was seeing was myself messing up all the time, like me being bad at socializing, bad at getting guys to like me, bad at having friends. Like, but that, that's like not contextualized yet.

  like you're talking about in adulthood, but it also doesn't stem from childhood. And it's not based on this kind of undergirding of not being validated or listened to or understood in any way. So it's just, I don't know what my question is here, but it seems like you've got two major forces colliding at the same time.

  Blaise Aguirre, MD (12:09.516)

  No, I think you're absolutely right. But just by extrapolation, you would have been a highly sensitive child, a highly sensitive teen. Because I think that kids who have, you insult them, say, you're not pretty. Whatever the...

  Affirmation would be to say a girl or to a guy or whatever, you know If I say to a guy you're not strong enough your muscles aren't big enough and he doesn't care So what okay, like let's just move on but but high sensitivity It's it's like the gorilla glue for labels, you know, if you're a highly sensitive person I say you're not that pretty you're not tall enough, you know, you're not curvy enough, you're not Pretty whatever it is like that. There's just like

  that that's going to stick to you much much more as a highly sensitive person than someone who's not highly sensitive.

  Dr. Kibby McMahon (13:04.798)

  Mm.

  Dr. Kibby McMahon (13:09.56)

  Do you see common common styles of parenting or childhood that leads to the self-hatred? I only ask this because we've learned over and over that in an invalidating environment critical parents not supportive with highly sensitive kids leads to this kind of self-hatred. However, now that I'm a mom and I have a two and half year old who has big feelings, know, learning this professionally.

  Blaise Aguirre, MD (13:33.646)

  You

  Dr. Kibby McMahon (13:37.192)

  Sometimes when he yells for the 50th time, like, come on, it's not, it's just a sock, okay? Your feelings are not legitimate right now, just get that sock on. So am I doing it or what do you see as the common pathway for someone to learn to hate themselves?

  Blaise Aguirre, MD (13:43.274)

  Exactly.

  Blaise Aguirre, MD (13:55.202)

  Yeah, so, okay, so you have a, so again, you started with the biology, which is that of high sensitivity. Okay, and then...

  I'll give you an example. mean, and by the way, most of the parents that I meet are ultra loving parents. So I have not met a parent who said, my goal for my child is to go to Harvard and to hate themselves. You know, it's like no one wants to have a person with who struggles in their life. Okay, but for instance, had a kid, parents had gone to...

  very prominent West Coast University, both parents. The child's two siblings had gone to the same university. You walked in to their house and they had cups from this university. had duvet covers. They painted the doors in the same color and stuff like that.

  So, but this kid was not academically gifted at all, but was super artistically talented. Now, the child was learning that in order to be appreciated in this family, she had to go to this school. And no one was saying that to her. but there was an there was it was explicit. just in in in the in the, you know, the way in which

  either the school was talked about, the signaling in the house, was that that's what we value. And so the child thought like, wow, I'm not as smart as my siblings. I'm not as kind of athletically talented as my siblings. I'm not going to make it there. And started to really devalue. And then in that context, every time something would go wrong,

  Blaise Aguirre, MD (15:51.534)

  Maybe they'd get a B in a test or something like that. It was a it would reinforce this idea that they were flawed in a way and and then in the context of a sexual assault in school, it just pushed her over the age and then she just said like, you know, like I'm never going to be enough. There's this question of not enoughness. So yes, of course, if you're a highly sensitive child, there's sexual, physical, emotional abuse and you

  don't have somebody who can validate and protect you.

  It's the only thing that you're going to learn. Now, you know, with your child, I mean, you know, it's so funny. I went for a hike with my son, the social worker. He's now a social worker. And I said, we went to, we went hiking 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 and all the things that you learned. And he said, honestly, I can't remember a single thing.

  But I remember how I felt around you. I remembered feeling safe. I remember feeling listened to. So I think that it's not so much that you say, you should brush your teeth 20 times one way and 20 times the other way and that way, know, like none of that.

  That's not the thing. The thing is that they feel seen, they feel heard, they feel validated, that you can say, and then also that I can admit my own mistakes. Like, yeah, I screwed up. I screwed up and I yelled at you and I was just very frustrated and I made a mistake. Or yeah, maybe you did deserve to be yelled at because I told you not to take the car and you're 14 years old and what were you doing driving the car? So I think, yes, it's not so much that you're yelling at your kid because they've

  Blaise Aguirre, MD (17:47.712)

  taken the sock for the 50th time, but it's about a seeingness, a beingness. It's about not rejecting the child's legitimate statements of dissatisfaction and not enoughness. The other thing is that how often when somebody tells us, you know, nobody loves me, I don't have any friends at school, do we reject that by saying that's just not true? Now,

  It's probably not true. It probably isn't. But no one has been convinced that they're lovable by being told that they're lovable. You know, and so it's not like, OK, I love you, you know. OK, that's great. Now I love 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 so this one really essential person doesn't like them anymore. And so what happens is that becomes a catastrophe for the highly sensitive person and it feels as if nobody loves them. But when you're able to sit there and listen, it actually brings the emotions down and they're able to reflect on the absoluteness of their statement.

  Jacqueline Trumbull (19:15.784)

  So do you see, okay, so I mean, are we seeing kids as young as like seven experiencing this self-hatred and then it just keeps going or is it more something that develops in adolescence? Like what is the development of this?

  Blaise Aguirre, MD (19:27.81)

  Yeah, so I think that I don't know, you when I asked my patients like, when did you start hating yourself? mean, most say sometime around kindergarten. And, but, but, if I said, like, if I'd asked you, do you hate yourself? That would not have been a concept. So, so it's, there's this internal dissatisfaction.

  Jacqueline Trumbull (19:49.233)

  Right.

  Blaise Aguirre, MD (19:55.372)

  that is showing up. It's not formulated as self-hatred. It's formulated as being flawed. It's like, cannot, I can no longer charm my parents. I am no longer enough for my parents. I am an embarrassment, I'm a disappointment. am valueless. And this is whether, I mean, it's possible that a parent is saying, you you're not as good as your siblings.

  But also, but more more often than not, it's not explicitly stated, it's just how they're internalizing those experiences. And then as they get older, and they begin to formulate kind of a more complex sense of who they are, you know, in, in early adolescence, they start to do make a lot of comparisons. And

  when they make those comparisons, they see that they don't have what other people seem to have. And then they feel that they're very, very flawed. So even though a lot of those early primordial ideas are floating around in those five to 10, the ooze of the five to 10 year old brain,

  the formulation, the determination of self-hatred seems to show up in the early teenage years.

  Dr. Kibby McMahon (21:31.136)

  Hmm.

  Jacqueline Trumbull (21:32.572)

  This is a totally self-serving question because I'm basically asking you the answer of my dissertation. But since you do mentalization work, what I'm interested in is I've seen a lot of the mentalization work with BPD has mixed results. But in all of the questionnaires that I see or the measures, it asks them to mentalize about two other people, and they are not included in the equation. So I basically switched the measures to include them in the equation so that they're mentalizing about themselves and someone else. And the reason I'm doing that is because it seems like if you hate

  Blaise Aguirre, MD (21:40.014)

  Mm-hmm.

  Jacqueline Trumbull (22:02.506)

  yourself and you see yourself as essentially flawed, then that would affect how you think that others view you. So maybe if somebody, you know, slights you in some way or doesn't even then you might think that's because they hate me or that's because they see what's essentially worthless in me. Do you find those kinds of errors? Okay.

  Blaise Aguirre, MD (22:19.17)

  Yeah, yeah, 100%. But it's, and this is why trying to disprove it through any kind of affectionate statement or statement of compassion just doesn't work. Because if I say to that person who sees themselves in that way, I actually don't see you that way.

  I see you with kindness, I see you with compassion. You have to say that because you're my parent, you have to say that because you're my therapist. Or you're so deluded that you cannot see the rottenness within me. They truly cannot conceptualize that they can be seen in that way because that's not how they experience themselves.

  Dr. Kibby McMahon (23:09.504)

  What, I mean, this might be taking a peek into what's in your book, but what do you do then? Like, I really resonate with what you're saying as a therapist, that when you deal with that, self-hatred, that really hard core belief of I'm unlovable, I'm terrible, you're just saying nice things because you're paid to do it, there's my therapist, blah, blah. Then what? Like, what?

  Blaise Aguirre, MD (23:31.084)

  Right, yeah, yeah, Not enough, you don't pay me enough to say those nice things. Yeah, yeah.

  Dr. Kibby McMahon (23:37.866)

  What do you do? What is the most effective way of helping people through their self-hatred?

  Blaise Aguirre, MD (23:44.91)

  Okay, let me let me ask you this. mean, and I would and again, and if you if it feels like an impertinent question, just tell me it is. But I mean, would you both identify as women?

  100%.

  Jacqueline Trumbull (24:02.832)

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

  Blaise Aguirre, MD (24:06.03)

  Pretty much. Okay. Now, what if I said to you, listen, I, we were hanging out in Iceland and I took a, why not? Iceland seems like a cool place. I would have been there, but so, and I took some DNA from the cup that you were drinking from and it turns out that you're both XY. Now how, and I said, you know what? You're genetically a man.

  How could I convince you that you're not a woman?

  by showing you the test results. And not only that, not only that, could I convince you that you have to change whatever feminine stereotype you're presenting with and the way that you're acting and do things differently. So you have to like, I don't know, sit around on a Sunday belching beer while you're watching.

  Jacqueline Trumbull (25:06.758)

  I mean, I'd have to believe there's a really good incentive. Like, is my life gonna just radically become a lot better if I cut off my boobs and sit around drinking beer and burping?

  Blaise Aguirre, MD (25:17.966)

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

  Dr. Kibby McMahon (25:19.082)

  bully.

  Jacqueline Trumbull (25:24.316)

  I think that would be very difficult.

  Blaise Aguirre, MD (25:25.794)

  Very difficult. And what if I told you and like you were coming into therapy and I said to you, OK, listen, we have to speak. We have to talk about why you're avoiding being a man. What would eventually happen to our relationship?

  Jacqueline Trumbull (25:42.108)

  you

  Dr. Kibby McMahon (25:46.484)

  Yeah, wouldn't trust you. Yeah.

  Jacqueline Trumbull (25:46.738)

  wouldn't go well.

  Blaise Aguirre, MD (25:48.034)

  Yeah, mean, like, listen, we've talked about this, this is nonsense, you know, like, I know, I mean...

  You know, you have to explain why I've had a baby who's two and a half and running around with a sock and you know, and no matter what. So the thing about it is that in the early stages, like telling somebody that they're lovable, that's how fused it is with their identity. There is no convincing them that they're wrong about themselves. so now, so the first thing I have to do is I have, you know, like nothing I

  Jacqueline Trumbull (26:00.2)

  You

  Dr. Kibby McMahon (26:11.626)

  Mm.

  Jacqueline Trumbull (26:11.656)

  Hmm.

  Blaise Aguirre, MD (26:23.344)

  I said, practice loving compassion and I'm a mindfulness like person and you know, do all these kinds of, and they just, was as much, was as invalidating as me telling you to start considering yourself as being male. And by the way, this is just like, it's a simple kind of analogy to like thinking of the world in a very binary way. But I'm just, you know, just for the sake of the example. And.

  Jacqueline Trumbull (26:44.636)

  Yeah.

  Yeah.

  Blaise Aguirre, MD (26:51.096)

  How can you believe something that no amount of you saying, Kibbe, like for the next year, I'm going to believe I'm a man is going to get you to really believe that that's true. You know, so it's like it's so this idea of practicing loving yourself, practicing any of these things is not going to work unless you're willing to accept that that that concept is fundamentally wrong.

  and that that concept was learned. Do you both speak English as a first language? No. Okay, why not? Because that's not what you brought up learning. You're brought up learning English. so what I say is like, you were taught, you're a highly sensitive person who was taught that you weren't enough. And who were your teachers?

  Dr. Kibby McMahon (27:24.904)

  Mm-hmm. Yes.

  Jacqueline Trumbull (27:26.034)

  Yeah.

  Jacqueline Trumbull (27:29.521)

  No.

  Dr. Kibby McMahon (27:31.466)

  I'm fucking dead.

  Blaise Aguirre, MD (27:47.758)

  Who were the teachers who taught you that? And why is it that you continue to listen to those teachers? And why is it that you don't listen to the teachers who are teaching you something much more fundamentally beautiful, much more fundamentally true about you? So you learned how to hate yourself.

  But if you learn how to hate yourself, you can learn how to love yourself because love comes much more naturally to the human heart than hatred does. But it's a learned behavior. There's an interesting thing that happens. A lot of my patients have tell me that their parents are always giving them advice.

  And I often ask them advice on what? 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 advice from unhappy people? They're teaching you how to be unhappy. We get so much advice from unhappy people as if their advice is good advice. And it isn't. if it was good advice, well, then they'd be happy. But they're not. And I said, do you want to end up being?

  like that unhappy person. They said, no, I don't want to be like that. Well, then don't stop taking advice from them. No, they're telling me I should do this, this and this. say, OK, well, you know what the outcome is going to be. what about saying rather than learning? And by the way, those people that were so hurtful to you, I'm not hating them. You cannot overcome hatred through hatred.

  I'm not hating them, I'm just saying they are a product of their environment, of their biology, of their circumstances and the behaviors that ensued from who they were.

  Blaise Aguirre, MD (29:42.83)

  treated you in this really toxic way. The problem is you began to believe their toxic message and it was a it was fake news. It was absolutely fake news, you know, and and you got it like, you know, so we have to start so you drive that wedge you say, okay, every time they bring it up, no, you learned that that was learned. And sometimes you don't know.

  Dr. Kibby McMahon (30:03.104)

  Hmm.

  Blaise Aguirre, MD (30:06.274)

  But I'm saying as often you can see how maybe there was school bullying, maybe there was sexual, physical, emotional abuse, maybe there was a lot of invalidation, maybe there was a lot of comparison with other functioning kids. So that's how I first start.

  Dr. Kibby McMahon (30:21.12)

  Hmm. Yeah, so really, identifying the source of where you learn that and try and evaluate whether that makes sense moving on. Well, speaking of fake news, it's interesting. I'm going to bring up the way the different reactions to your book of I Hate Myself. There's that there's a one segment from MSNBC and there's one from Fox News and

  Blaise Aguirre, MD (30:29.42)

  Yeah, exactly.

  Dr. Kibby McMahon (30:51.648)

  the Fox News one was surprising, or maybe not for people listening, that they said they were kind of like, well, maybe it makes sense that that person hates himself and maybe self-hatred is actually good. I mean, you should hate yourself if you're a bad person, which at first I was like, this is so silly. we do talk about how sometimes self-doubt or negative thoughts could be functional.

  Blaise Aguirre, MD (31:19.128)

  Mm-hmm.

  Dr. Kibby McMahon (31:19.444)

  Like what, and also sometimes you have patients who say, I hate myself and I've done horrible things. And then you listen, you're like, well, that wasn't great. And then you have some patients who have no self doubt and maybe should have a little bit of a, I to say self-hatred, but a little touch. So can you talk about that? Can you talk about the different perspectives on self-hatred and maybe even more than people, like we're talking about, okay, yes.

  Blaise Aguirre, MD (31:29.91)

  Mm-hmm, mm-hmm, mm-hmm. Yeah.

  Mm-hmm. Mm-hmm. Mm-hmm.

  Dr. Kibby McMahon (31:49.096)

  You should learn to love yourself, but like.

  Blaise Aguirre, MD (31:51.95)

  Yeah. Well, let me ask you something. I mean, how many of these shows have you done? What do you say? 130. Have you have has there ever been one that you were just like really upset with, really dissatisfied with, like just like, wow, that didn't you know, out of those 130, can you think of like the top five and maybe like once that wow, that didn't go as well. Maybe there were technological issues, technical issues, maybe. I don't know.

  Jacqueline Trumbull (31:56.568)

  or something.

  Dr. Kibby McMahon (31:58.507)

  Mm-hmm.

  Dr. Kibby McMahon (32:20.062)

  No, we've been perfect. It's just, it's just, yes. Just like 10 out of 10 every time. Yeah.

  Jacqueline Trumbull (32:20.232)

  What an amazing...

  Blaise Aguirre, MD (32:21.9)

  That's incredible. is fantastic. And you know what? I think you should put your child on right now and let me tell your child what a fabulous mother he has and not to complain about the socks anymore. if something were to happen and you were to say, OK, like that didn't go the way that we were expecting, it wouldn't be because I am a flawed individual.

  Jacqueline Trumbull (32:29.799)

  you

  Dr. Kibby McMahon (32:33.748)

  Perfect.

  Jacqueline Trumbull (32:44.412)

  Mm-hmm.

  Blaise Aguirre, MD (32:51.586)

  Maybe I didn't prepare enough. Maybe, I don't know, the guest was just not on. Maybe we had the wrong guest. We got the wrong Brene Brown. So there was something wrong about, there was something that happened. But it's not because you're flawed.

  it's because something didn't work out. So that's something that's external to you and that you can fix. So I think that if you use self-criticism, self-judgment as a way of correcting something.

  then that's OK. I mean, I'm not saying, you know, have blind and bland love for yourself. And, know, we all screw up and and we have to correct those mistakes. So so in that context, a little bit of self-judgment, self-criticism, self-blame is fine. But but when it's when it's everything is because I'm so flawed, you know.

  then you're stuck in 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, okay, so I drive this wedge and then I start to.

  kind of examine moment by moment when self-hatred is getting stronger, when it goes down. And typically self-hatred gets stronger in the context of people that they're not very happy with and self-hatred goes down when they're in connection with people that they love. So if we get back to your original question, which was MSNBC.

  Blaise Aguirre, MD (34:38.978)

  you know, recognizing the value of examining this topic. And maybe Fox News saying, not so much, maybe you should hate yourself or using it as a prop for attacking people that they have political differences with. My problem with that is, you know, I mean, look, I'm all for a good joke and I'm good for a more for a good political joke, but.

  When you take a vulnerability factor that a human being experiences that might lead them to take their life, I just think that you've done a disservice to those who suffer from the experience.

  And you know, I actually emailed the host and said, look, I mean, I think that's one or two of the things that they said were kind of ridiculous, somewhat funny. But at the same time, can we take the other side of it so you don't show a level of ignorance and disdain and disregard for people who are suffering?

  Jacqueline Trumbull (35:52.744)

  Yeah.

  Dr. Kibby McMahon (35:53.033)

  Agreed.

  Jacqueline Trumbull (35:56.168)

  Who's shocked here that Fox has done us a disservice? What were you going say, Kibbe?

  Dr. Kibby McMahon (35:56.544)

  Bye.

  Dr. Kibby McMahon (36:00.287)

  I mean, it kind of touches on something that we're seeing across the board in our society where there's, you know, I hate myself, I'm worthless, or the other side, which is, no, like charge ahead, let's be strong, let's dominate, right? There's like this.

  conservative movement of don't doubt yourself, in fact, storm in with full confidence. And that's the approach to strength. there's going to be people who still feel that way inside and learn, I'll just have to project the opposite. So you're right. It's very dangerous to make fun of that struggle inside.

  Blaise Aguirre, MD (36:45.954)

  Well, and I think, mean, you it's not as if self-hatred goes to the voting booth and says, are you a Democrat or a Republican? Are you 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 any condition, diabetes, asthma, arthritis, cardiac illness, and stuff like that. It's not as if, you know, any of these conditions is picking one person or another. And at a time when deaths of despair are an

  time high, when suicide rates are an all time high. And we're talking about closing the borders because of fentanyl coming into the country, or increasing tariffs by 25 % because of fentanyl coming into the country. Why? Because the tragedy of these deaths of despair is so heartbreaking. Then if we think about

  what are the vulnerability factors, what are the conditions when people die maybe through overdose or by suicide that is so trivialized. I think that that was the sadness of that Fox segment.

  Jacqueline Trumbull (38:08.464)

  I'm trying to think, I'm like, I don't know that I want to go in this direction, but I am trying to think if I see traits along the political lines that would lend themselves to healing from this, I can kind of see argument for both. But,

  So you start by, whenever I have a patient with a lot of self-loathing, I always have this somewhat absurd, well it's logical, but emotionally absurd reaction, which is like, this is so pointless. Like, none of this isn't doing you any favors, this is just serving to prevent you from having any kind of like, reparative action in your life to show that you could be happy and could be lovable. But then when I think about my own like, body image issues, since literally up until I got liposuction, you couldn't talk 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 start liking it and there also felt like there was this point to hating it like if I keep hating it then I'll get better which is kind what you're talking about it about judgment, you know criticism So I know that while it may be pointless. It doesn't just a lot You can't just logic in a way. So you're saying that first you kind of go in and create a wedge between

  Blaise Aguirre, MD (39:06.922)

  Exactly.

  Jacqueline Trumbull (39:21.224)

  their trust of the health self-hatred like, wait, this was taught to me by figures that maybe I shouldn't trust in the same way. What do you do next?

  Blaise Aguirre, MD (39:32.16)

  Okay, by the way, you know, it's interesting how you I really appreciate your vulnerability. So let me just say, you know, that in terms of talking about your own experiences, and I think it's refreshingly honest to have somebody say, Hey, you know, I didn't like my body had liposuction. Here we are, you know. But but here's the other thing is, is that, you know, when I was young, I'd get like,

  Time magazine or National Geographic once a month and that would be it. Now we're bombarded with marketing for self-hatred. We market to self-hatred.

  tall enough, know, skinny enough, you don't have a six pack enough, you're not strong enough, you're not athletic enough, you're not smart enough. But by the way, if you buy my product, you'll be fabulous. People are going to love you because you'd be so fabulous. And if you buy my book, which is this one, you know, you're going to it'll make your life so so much better, you know, but I think that that's it's that we market to your self dissatisfaction. And if it doesn't even have to be

  very big. It's just like, wow, you know, like, I don't know my

  my wrinkles could be just a tiny bit less or you know, like that. And so like, and if you do that, like everything in your life is going to change in terms of how you see it. And by the way, I'm not saying that some of those things aren't true. some of those things could be true, but it's just that you can never reach that pinnacle because that's something outside of you. It's not something inside of you can only ever get to self-acceptance or something that's inside of you. Okay, so you could get back to this point. So I drive this wedge between, okay, this was taught.

  Blaise Aguirre, MD (41:17.712)

  Okay, then I want to be very specific about what the lessons were. The lessons were my dad calling me stupid, calling me lazy, calling me, telling me I was never gonna succeed.

  Jacqueline Trumbull (41:39.336)

  you

  Blaise Aguirre, MD (41:40.942)

  And that message being repeated over and over and over again. Okay, so that was one of your teachers. The bullies at school who called me fat or who called me, I don't know, whatever that label was that stuck so strongly. The teacher who told me that I should leave.

  piano because I was just never going to be good at piano. Any negation of a person's effort or a person's capacity, comparison with somebody who is more talented without

  any mitigation without any recognition of the value of that human being as a human being. I want them to actually write it down. And I'm saying, wow, look at all of this. These are your teachers telling you these things. then it's often there's such powerful voices that you cannot hear the voices of the kind people. And then to an earlier point, you just stop believing them because you say,

  the toxic people must be right and the kind people obviously cannot see what the toxic people see in me. So I say, now, and then I do a very interesting thing and this is something that I worked out with a patient is I got them to bring photographs of, I think she was 19, of every birthday from one to 19.

  and I put them down and you see the change every year. Year two they have a sock in their mouth because they stole it from Kiwi. And I say, me when you start hating her.

  Blaise Aguirre, MD (43:42.19)

  Tell me when you start hating that little girl.

  Blaise Aguirre, MD (43:47.49)

  And they can't. They want to reach back in time and grab her in their arms and just tell that little girl how much they love her. And then they see the education that that child received that told her she was so worthless.

  Dr. Kibby McMahon (44:11.584)

  What does healing look like at that point when they start to soften and change around those thoughts and beliefs? What do you see healing look like at that point?

  Blaise Aguirre, MD (44:16.46)

  Yeah.

  Blaise Aguirre, MD (44:26.722)

  I had a patient who said to me that she'd always dated these toxic men. By toxic men, it's just like men who would not, they didn't feel valued by, but they felt that they deserved because they were so flawed. And one day she told me,

  you know, as she broke through, as she began to see how that toxic messaging had led her to make toxic relationship choices. She was teaching the interpersonal effectiveness skills of DBT. he said, Well, what's that? He says, you know, like, by doing this, I'll be

  She misused the word but she says I'll be a better person and then he said well good because you need to be a better person and She stops and she thinks about this and she says you know what if I'm a better person. I'll get a better boyfriend That was brilliant That was so fantastic. You know and it was it was sort of like yes, you're seeing that you deserve more than what you've learned to believe

  Jacqueline Trumbull (45:38.311)

  Yeah.

  Blaise Aguirre, MD (45:48.534)

  is the best that you can get. And again, I did not want her to hate this guy. I I say I'll do all the hating for you because I didn't like how he was treating her. But nevertheless, who knows? I don't know how he's been maltreated, how he's been abused and everything like that. It's just that that is not her destiny. It's not what she deserves. So you start to see healthier choices living up to their potential.

  in terms of academics, terms of employment. Learning how to say no, stop people pleasing, less perfectionism. mean, put people pleasing is such a red flag for self-hatred. It's, I will do whatever it takes to get you to like me.

  you know, to the point of devaluing yourself. And you know, the person then gets whatever they want and moves on and you're left resentful. Because you get nothing back. Doing the right thing for you is never doing the wrong thing for someone else. And the corollary is like doing the wrong thing for you is never doing the right thing for somebody else.

  Jacqueline Trumbull (47:06.862)

  I have, I'm rifling through patients in my head right now of like when I could have used these interventions. Is there a difference do you think? I'm thinking about that wedge, the trust wedge of like do we really trust these people who have given you these messages and I guess I'm like, okay, so what if, you you ask, like I had a patient who was bullied in middle school.

  And so those were the people, presumably, who gave her that message. But we don't know if they're happy now. Because at the time, she probably saw them as cool, pretty, likeable. What happens then?

  Blaise Aguirre, MD (47:37.644)

  Right. But I mean it doesn't actually matter because I just want to know that those were the teachers at that time. It doesn't matter how they've turned out. You know and we don't actually know what their lives are like and that shouldn't be our focus. In any case they may turn out fabulous posting pictures of themselves in bikinis on yachts in the Mediterranean.

  Jacqueline Trumbull (47:47.197)

  Yeah.

  Blaise Aguirre, MD (47:59.278)

  you know, or I don't know, sitting in the toilet with dysentery after a trip to down the Okabanga Swamps. I mean, who knows? You know, who knows, who knows what they're, but it doesn't matter because you're maybe, it's not about, it's not about this. It's just that those were the teachers. Who knows how they turned out? And it doesn't actually matter how they turned out. And even if they seem outwardly happy, we don't know the lives of others. So it's like saying, okay, those were the lessons. It doesn't matter how, you know, where they are.

  Jacqueline Trumbull (48:22.088)

  Mm.

  Blaise Aguirre, MD (48:28.75)

  they're doing now. It matters how you're doing now. It matters that you've carried the weight of those lessons. And that weight has been such a burden. I do this exercise with some of my patients. I get them to hold out a two pound weight. And heavy is your kid?

  Dr. Kibby McMahon (48:50.885)

  Very heavy, more than two pounds. It's like 40 pounds, yeah.

  Blaise Aguirre, MD (48:51.814)

  Okay, there we go, more than two pounds. And you, there we go. And you can hold it. But if you think about, okay, so you could hold out a two pound weight, you know, given that you can do 40. And now, but if you hold it out, like that, you're holding it out, holding it out, eventually, you're saying, wow, this is getting really heavy. And I'd say, okay, well, let's put it down and weigh it. And it would still be two pounds. But the longer you hold on to something, the heavier it feels. The longer you hold on to those messages of

  toxicity, the heavier they feel, the more they weigh on you, especially if you're an emotionally sensitive person.

  Dr. Kibby McMahon (49:29.6)

  Although to Jaclyn's point, what's interesting about sometimes when people reevaluate who taught them to hate themselves, like these messages of being successful, being beautiful, being like your brother is the way for me to love you. I see sometimes that they can get to the point where they recognize who the teachers are, but then having to doubt that or question that could dismantle

  Blaise Aguirre, MD (49:44.856)

  Yeah.

  Dr. Kibby McMahon (49:59.965)

  a lot of their lives, right? if my dad's messages of what's right and wrong and to hate myself or love myself are incorrect, well then he's wrong and then this might threaten my whole, then maybe he's a bad person and then maybe this ruptures my whole relationship or that, right? There's kind of like a holding on of these beliefs sometimes.

  Blaise Aguirre, MD (50:02.659)

  Yeah.

  Jacqueline Trumbull (50:12.945)

  this.

  Blaise Aguirre, MD (50:20.277)

  Mm-hmm. Yeah.

  Jacqueline Trumbull (50:22.768)

  Or what can you trust that he has taught you versus what can't?

  Blaise Aguirre, MD (50:25.656)

  Yeah, that's fair. But this is where wise mind comes in. mean, like, here's the thing is like, when you feel shut down, when your body contracts, it's a bad lesson. You know, when your body shut down, you get when you're sick, your body shuts down and you contract. What happens when you like experience love and experience joy?

  expansion. So your body is actually telling you whether something's toxic or not. And I think from a DBT point of view with dialectics, it's not every message is a toxic message and not every positive message is useful. Telling me that I can dunk a basketball, I'm old and decrepit and I can barely put my arms around the rim of the, mean touch the bottom of the net. So some things are just true.

  But it's really examining, okay, so you say, okay, that was the student. Now, by the way, often what we find is that a parent uses the same technique with all of their children.

  You know, I yelled at my the oldest, he turned out okay. I yelled at the middle one and she turned out okay. But this one, you know, I tell her get up and you know, do whatever it is, start crying. That's because they're highly sensitive people. And so the the well intentioned techniques that a parent uses with one child 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 going to have. so, now it may not be intentional that they're getting these messages, that the parent is delivering those messages. It just might mean that, look, we're not going to sit here and say that because your dad taught you these messages, that he's a fundamentally terrible human being.

  Blaise Aguirre, MD (52:24.942)

  I don't want to get into that and in any case hating somebody to stop hating yourself just doesn't work. Hatred does not cure hatred. So it's sort of saying, okay, I learned these lessons but maybe they were just like they were teachers who'd been taught that way themselves. I learned that the word concha is a Spanish word for a shell. I used that word in Ecuador when I was teaching.

  and it is the word for intimate female anatomy. And I was there lecturing away, talking about this wonderful...

  Dr. Kibby McMahon (53:08.862)

  Vaginas.

  Blaise Aguirre, MD (53:09.012)

  shell, the wonderful shell that I had found on the beach and it was nice and smooth on the inside and I could put it to my ear, hear the ocean and it smelt a little bit like fish and you know it was going and I could see the students like mortified because I had been taught. The word is correctly that in

  Jacqueline Trumbull (53:16.583)

  You

  Blaise Aguirre, MD (53:31.626)

  In Spanish, it's how I understood the word. But I was, you know, like in the different context, did not come out so well. You know, so the point is, okay, that was a mistake. Now, people could go home and say, my God, like this American professor came and gave us the most disgusting.

  Dr. Kibby McMahon (53:52.704)

  You

  Blaise Aguirre, MD (53:53.198)

  teaching ever about female vaginas. But there was somebody who could say, know what, like, okay, he mislearned, like that was it, what was the context? And then say, okay, like, that was bad teaching, let's correct that. Can you go back to a parent and say, you know what, those were actually hurtful. And I know that may not have been intentional, but nevertheless, it had a certain impact.

  Dr. Kibby McMahon (54:20.352)

  want to be mindful of your time. know that this is where we have to jump off. well, is there anything else you want us to touch on? This is like a planning thing will be cut out, but is there anything else you want us to say before? Okay.

  Blaise Aguirre, MD (54:30.018)

  Sure, No, I wanna hang out with you guys.

  Jacqueline Trumbull (54:34.888)

  Please do.

  Dr. Kibby McMahon (54:34.976)

  Definitely will.

  Blaise Aguirre, MD (54:37.23)

  Yeah, no, I there's a there was some attempts to I was you know, like going on to going down to New York and and doing some some of the morning shows but you know, they haven't panned out yet because there's a lot of political news in the in the news cycle and so you know that this hasn't taken you know, but

  Yeah, so we'll see. But yeah, I know I'd love to, you know, hang out and, you know, happy to just love teaching and yeah.

  Dr. Kibby McMahon (55:05.984)

  Take care, home.

  Dr. Kibby McMahon (55:16.16)

  Well, can you tell us where, we'll definitely put the link to your book in the show notes, but is there any other resources or where people can find you or talk to you or anything else that you want to give to the listeners?

  Blaise Aguirre, MD (55:27.714)

  Mm-hmm.

  Yeah, I mean, think our website, but I mean, our website is a treatment program, you know, so it's the continuum, whether it's outpatient, residential or...

  partial hospital. But people send me, know, kind of emails. And I think, you know, in the book, I've added a lot of like, mini little worksheets, you know, so that I, because I think that the flood of emotions as they come are, are so powerful that, that by stopping and getting the person to do some reflection, you know, so I think in the book that there's all these excesses. But I think that we're at the beginning of a journey of,

  really examining this concept of self, you know, this concept of who we are as human beings. And I think that in this day and age,

  the self-absorption leads us to a level of self-hatred that is kind of unprecedented. And I think that we're going to see more and more of it. I think, I mean, I wrote this, took, I've written 20 books and run 57 marathons. So I live a very extreme life. I mean, very, like I live.

  Dr. Kibby McMahon (56:29.408)

  Mm.

  Jacqueline Trumbull (56:42.342)

  I'd like to make just one.

  Blaise Aguirre, MD (56:52.686)

  on the intense age of life. But this one, can really churn out a book quickly, but this one took two years because it was so important. I think to me it's my most important book because it is so...

  antithetical to my experience to see somebody who I so deeply love to hate themselves. You know, I just and now the problem is, is that all my patients who now love themselves, they won't leave me alone. I mean, they're so frigging annoying. They send me pictures of their ultrasounds and of their marriages and of their babies. I'm not your therapist anymore. I frig off. You know, said never. Exactly, exactly. Leave me alone. But, you know.

  Dr. Kibby McMahon (57:34.016)

  Stop loving yourself. I'm too busy.

  Blaise Aguirre, MD (57:41.902)

  I just, it's just wonderful to stay connected. I mean, they often will travel once a year to come to Boston to come and say hi and bring their families or go and grab a coffee and yeah.

  Jacqueline Trumbull (57:42.076)

  you

  Jacqueline Trumbull (57:56.328)

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

  Blaise Aguirre, MD (58:04.14)

  Yeah, yeah. No, I think the only thing is, thank you so much, just in terms of recommendation, because of the...

  the Fox piece, there was a little bit of like negativity. you review it and you think that it's worth anything, know, like one thing that can help is sort of like supporting it on Amazon by saying, you know, five stars or whatever it is, you know, just in terms of like, because I think there's a sense of like it being that there's a self-indulgence and I think that people are mistaking

  kind of superficial self dissatisfaction with the self-hatred that is going to take someone's life. Guys, you are beautiful and wonderful and Kibby if I come down, I'm definitely bringing socks for the little guy to drive you nuts. Yeah. Yeah.

  Jacqueline Trumbull (58:51.816)

  without.

  Jacqueline Trumbull (59:00.008)

  You

  Dr. Kibby McMahon (59:00.832)

  Well, we're in New York, so please, and we would love to also come and visit, know, if there's any kind of mentalization-based training. Anyway, let's close out the, let's, we'll close out the episode and then.

  Blaise Aguirre, MD (59:10.574)

  There is, there is, yeah, yeah. Oh yeah, you can cut all this out. But there's, okay, yeah, yeah, so, all right.

  Jacqueline Trumbull (59:16.584)

  Well, little helpers, now I'm about to beg for five stars. So after you're done reading Blaze's book, give him five stars, then come on here and give us five stars and we'll all be so happy and we'll love ourselves. For now, see you later and you'll hear from us next week. Okay.