Foreword vii

Introduction xi

Structure of the Book xvii

Part 1 Understanding Self-hatred 1

1 What Is Self-Hatred? 3

2 Why Is Overcoming Self-Hatred So Critical? 23

3 Common Signs of Self-Hatred 33

4 The Lived Experience 51

5 What Is the Self That You Are Hating? 65

Part 2 Roots of Self-hatred 75

6 Where Does Self-Hatred Come From? 77

7 Could It Be Temperament or Biology? 99

Part 3 Self-hatred in Mental Health 105

8 Borderline Personality Disorder (BPD) and Self-Hatred 107

9 Other Psychiatric Diagnoses and Self-Hatred 117

10 Other Personality Traits and Self-Hatred 129

Part 4 Treatment and Overcoming Barriers to Treatment 137

11 Targeting Self-Hatred 139

12 Why Is Self-Hatred So Hard to Tackle? 173

13 Reflections of Therapists 187

14 Advice from Those with Lived Experience 197

15 Alternative Treatment Ideas 231

Part 5 Finding Hope and Technology’s Limits 249

16 The Dawn of Hope 251

17 AI’s Take on Self-Hatred 257

Afterword 263

References 265

I Hate Myself 273

Acknowledgments and Gratitude 275

About the Author 277

Index 279

Praise for I HATE Myself

"I hope that in exploring Dr. Aguirre's concepts in this book, you will begin to realize that destructive thoughts and opinions and certainties of self-hatred are not only not true but are distracting you from experiencing the journey of a lifetime—discovering who you actually are. And who you are, I promise, is beautiful. Scars and all."
—JEWEL, Grammy-nominated singer-songwriter, humanitarian activist, and mental health advocate

"Dr. Blaise Aguirre has led the way on many clinical issues. Here he again breaks new ground on the poorly understood and researched topic of self-loathing... This practical and ultimately hopeful book will be of use to individuals, families, and therapists alike."
—KEN DUCKWORTH, MD, Chief Medical Officer, NAMI, and author of You Are Not Alone: The NAMI Guide to Navigating Mental Health

"I thought I knew what self-hatred was, but I only knew how it manifested in other observable symptoms. As a concept of its own, defined equally by the author and by the generous people with lived experience who contributed to this book, self-hatred transcends diagnoses and can be, or rather finally will be, a core treatment target in the alleviation of human suffering."
—JON HERSHFIELD, MFT, Director of The Center for OCD and Anxiety, Sheppard Pratt Hospital

"Not only is this book beautifully and compassionately written as itself an act of love and inspiration, it shines a light on one of the most underlooked topics in mental health and the lives of suffering people who deserve better. It's not just my hope but my belief that this book can bring relief to millions."
—Dr. CHRIS WILLARD, PsyD, Harvard Medical School faculty and author of How We Grow Through What We Go Through

"In this evocative volume, Blaise Aguirre provides critical information on a deeply painful, yet under-recognized clinical problem: the persistent, unrelenting, and unyielding intense dislike of the self that is self-hatred. In his characteristic straight-talking yet compassionate style, Aguirre not only provides a rich understanding of self-hatred, but the life-saving tools to combat it. This book is essential reading for those who experience self-hatred and the clinicians who support them."
—CARLA SHARP, PhD, John and Rebecca Moores Professor, University of Houston

"A long overdue masterful deep dive into the importance of tackling self-hatred head-on, with expert viewpoints from individuals with lived experience and mental health professionals. This is a must-read for those impacted by self-hatred, with insights to overcome this distressing core belief, and for therapists and researchers to take up the challenge of addressing this condition, allowing affected individuals to reclaim their self-worth."
—LYNN COUREY, CSW, Founder and President of The Sashbear Foundation, helping families with skills and hope

"I hope that in exploring Dr. Aguirre's concepts in this book, you will begin to realize that destructive thoughts and opinions and certainties of self-hatred are not only not true but are distracting you from experiencing the journey of a lifetime—discovering who you actually are. And who you are, I promise, is beautiful. Scars and all."
—Jewel, Grammy-nominated singer-songwriter, humanitarian activist, and mental health advocate, from the foreword

"He caught us empty-handed. Blaise Aguirre genuinely captured the essence of a significant gap in the practice of psychotherapy for mental health conditions. While much has been written about distorted thinking and self-criticism in conditions such as borderline personality disorder, OCD, and depression, no one has singled out the concept of self-hatred as a tangible and coherent phenomenon that can be assessed for and treated directly. I thought I knew what self-hatred was, but I only knew how it manifested in other observable symptoms. As a concept of its own, defined equally by the author and by the generous people with lived experience who contributed to this book, self-hatred transcends diagnoses and can be, or rather finally will be, a core treatment target in the alleviation of human suffering."
—Jon Hershfield, MFT, Director of The Center for OCD and Anxiety, Sheppard Pratt Hospital

"Not only is this book beautifully and compassionately written as itself an act of love and inspiration, it shines a light one of the most underlooked topics in mental health and the lives of suffering people who deserve better. It's not just my hope but my belief that this book can bring relief to millions."
—Dr. Chris Willard PsyD, Harvard Medical School faculty and author of How We Grow Through What We Go Through

"In this evocative volume, Blaise Aguirre provides critical information on a deeply painful, yet under-recognized clinical problem: the persistent, unrelenting, and unyielding intense dislike of the self that is self-hatred. In his characteristic straight-talking yet compassionate style, Aguirre not only provides a rich understanding of self-hatred, but the life-saving tools to combat it. This book is essential reading for those who experience self-hatred and the clinicians who support them."
—Carla Sharp, Ph.D., John and Rebecca Moores Professor, University of Houston

"With a questing knight's stalwart heart, a philosopher's sweeping vision, and a poet's relentless pursuit of beauty, Dr. Aguirre approaches a dragon’s lair where many fear to tread and successfully develops an empathic descriptive phenomenology of self-hatred and a full quiver of actionable strategies for both patients and clinicians. His stirring vision of how to understand and target self-hatred got me thinking more deeply about my patients and myself, and it rattled all the chambers of my heart. For all those who suffer the sting and scrape of this particular dragon's claw, with this book Dr. Aguirre may just have landed a javelin toss that pierces the heart of suffering, lets in some light, and recovers what is irrefutably worthy of love."
—Brandon Unruh, MD, Founding Director, Mentalization-Based Treatment Clinic, McLean Hospital, Instructor in Psychiatry, Harvard Medical School

"A long overdue masterful deep dive into the importance of tackling self-hatred head-on, with expert viewpoints from individuals with lived experience and mental health professionals. This is a must-read for those impacted by self-hatred, with insights to overcome this distressing core belief, and for therapists and researchers to take up the challenge of addressing this condition, allowing affected individuals to reclaim their self-worth."
—Lynn Courey, CSW, founder and president of The Sashbear Foundation, helping families with skills and hope

"World-renowned expert on borderline personality disorder, Dr. Blaise Aguirre draws on over 24 years of experience at McLean Hospital and in private practice to delve into the roots of self-hatred. Through his insights, Dr. Aguirre offers a path toward healing for both clinicians and patients, illuminating ways to foster understanding and resilience."
—Neal Mills, MD, Inspiring Children Foundation

"The author’s unparalleled insights into navigating the immense pressures of young adulthood—particularly the college transition—is nothing short of transformative. At a time when both students and parents face overwhelming emotional and psychological challenges, this guide is an essential resource. The author's ability to address the often-overlooked psychological dynamics with parent, child in the high-school to college transition makes this work groundbreaking and truly invaluable for families seeking a path to success during this critical phase. Beyond the book, on a personal note, our foundation has worked very closely with Dr. Aguirre and we have witnessed firsthand the practical ideas outlined in the book."
—Ryan Wolfington, Co-founder of Inspiring Children Foundation; President, Jewel Inc.

"Dr. Blaise Aguirre has led the way on many clinical issues. Here he again breaks new ground on the poorly understood and researched topic of self-loathing. He starts with asking his patients what they have experienced, and confirms with his colleagues that they are not trained to help people with this issue. This practical and ultimately hopeful book will be of use to individuals, families, and therapists alike."
—Ken Duckworth, MD, Chief Medical Officer, NAMI, and author of You Are Not Alone: The NAMI Guide to Navigating Mental Health

In I Hate Myself: Overcome Self-Loathing and Realize Why You’re Wrong About You, internationally recognized Harvard academic and psychiatrist Dr. Blaise Aguirre delivers a groundbreaking and insightful discussion of one of the most important—and least discussed—experiences in the field of mental health: self-hatred.

Self-hatred is a key source of suffering as well as contributing factor in many cases of attempted and completed suicide. Yet, it is rarely discussed in therapy, and even more rarely studied by researchers. Dr. Aguirre explains how to identify, understand, and then overcome this deeply disturbing and potentially life-threatening experience. He also highlights why self-hatred is such an intractable problem and why simply applying the seemingly commonsense practices of “self-care” or “self-love” may not go far enough in addressing the issue.

I Hate Myself contains the honest, firsthand accounts of many patients who have conquered self-hatred and related constructs. It outlines the real impact of self-hatred on affected people and makes clear why they erroneously come to believe that they are irredeemably flawed and then come to see why they are worthy of compassion and love.

The author explores the origins and the signs of self-hatred, reviews its manifestation in commonly co-occurring disorders—including borderline personality disorder, eating disorders, and depression—and identifies specific strategies that those who experience self-hatred can apply to reduce their suffering.

Perfect for those with lived experience, and for those who love them, I Hate Myself will also earn a prominent place in the libraries of social workers, psychologists, counselors, psychiatrists, researchers, and other mental health practitioners and clinicians with an interest in this critically important and infrequently discussed subject.