What Is Self-Hatred?

It’s not unusual for children, especially teenagers, to say they hate themselves. They say it when they’ve failed at something — botched a test or missed a goal — or said something painfully awkward in some social situation. They’re upset with themselves. And in that moment they dislike themselves.

But for some kids, disliking themselves — a sense of being flawed, inadequate, or even toxic — becomes a core part of their identity. That’s what psychiatrist Blaise Aguirre, MD, calls self-hatred or self-loathing. He sees it in many of the children he treats at McLean Hospital near Boston, where they are often admitted after making a suicide attempt. And it’s the subject of a book by Dr. Aguirre called I Hate Myself.

Self-hatred, Dr. Aguirre explains, is a persistent, intense dislike of oneself that comes with feelings of self-blame and low self-worth. This goes beyond kids and teens lacking confidence or getting down on themselves. “It’s practically a rite of passage for teens to have self-doubt,” Dr. Aguirre notes. But for some, a high level of negative thinking becomes embedded, making it hard to distinguish it from themselves. They come to loathe who they are.

Self-hatred isn’t an official mental health diagnosis like depression or anxiety, but it does occur in teens or young adults who have diagnoses, most often borderline personality disorder.

Often, self-hatred isn’t recognized by mental health professionals, Dr. Aguirre says, because it isn’t included in any of the questionnaires used to gauge how patients are feeling. And patients, especially young ones, don’t bring it up, he says, because they are ashamed of it. They see not being worthy of love as a part of themselves they can’t change. And if you tell them it’s not true — that they are lovable and worthy — they often feel that you’re lying to them. This makes the condition particularly challenging to treat.

Self-hatred is such a painful feeling that it can lead to self-injury or dangerous behaviors — reckless driving or risky sex — that the person feeling it uses to numb the pain.

At worst, self-loathing can lead to suicidality. “People with self-hatred at times see themselves as a burden that needs to be removed from the world,” Dr. Aguirre says. “There is an enduring sense that ‘I will never be good enough.’”

“No one is born hating themselves,” Dr. Aguirre observes. Children learn to hate themselves when they receive messages from the adults around them that they are bad, lacking, or not worthy of love.

Those messages can come from harsh, abusive, or negligent parents and other adults. But self-hatred can also develop when a child who is highly sensitive reacts very emotionally to things that don’t seem that important to other people, and well-meaning parents dismiss or reject their feelings. Constantly being told “You are overreacting” or “Don’t be so sensitive” can make kids conclude that there is something wrong with them.

Self-hatred can also develop, Dr. Aguirre argues, when kids are told they are lazy, stupid, or bad. For highly sensitive children, the labels stick. Praise for other kids in the family can also be experienced as evidence that they don’t measure up.  

Self-loathing can then take root and become “a hurtful core self-belief,” Dr. Aguirre notes, further reinforced by an inner monologue that filters out or discounts all positive experiences. “Given this continuous negative dialogue, it is completely understandable that you come to the conclusion of self-hatred,” he says.

Children also get invalidating messages from the culture, including advertising and curated social media feeds, Dr. Aguirre argues. “I think that we market to self-hatred,” he explains. “You’re not tall enough, strong enough, pretty enough, thin enough, intelligent enough, a good-enough cook, friendly enough, put-together enough. You’re just not enough of a person. But if you buy this product…”

Highly sensitive children are more reactive emotionally than most children, explains Dr. Aguirre. “They have more intense reactions to seemingly smaller prompts. And then, once the reaction happens, it takes them longer to reach their emotional baseline.”

This reactivity makes them particularly sensitive to criticism. And as children, they don’t have the ability to put criticism in context, so a minor complaint can feel defining.

How do you know if your child is highly sensitive? A child’s emotional reactivity often shows up very early, Dr. Aguirre says. “Parents often tell me that their children were sensitive straight out of the womb.”

Parents may recognize that a child is more reactive than their siblings, or other children they are around — something that one child takes in stride can feel crushing to another.

Dr. Aguirre, who has four children, uses his own family as an example. When he took his two young sons to judo practice, he recalls, he would yell encouragement from the sidelines. “If they were on the mat, I would yell, ‘Get up! Turn the guy over,’” he says. One son found the yelling motivating, rose to the challenge, and felt proud of himself. The other experienced it as criticism and eventually left the practice crying. “I said exactly the same words to both boys,” he recalls, “but they heard completely different things.”

Dr. Aguirre highlights some of the behaviors in people that are symptomatic of self-hatred:

• All-or-nothing thinking: Forexample, they make a minor mistake and then feel that their life is ruined or that they are a failure.

• Seeking approval and constant reassurance: They need others to tell them that they are worthy — you don’t believe it on your own.

• Doing all they can to fit in: They worry excessively that if they don’t do certain things, people won’t like them and won’t want to spend time with them — which reinforces the idea that they are worthless.

• Taking any feedback as criticism or a personal attack: They take even friendly recommendations or suggestions as hostile.

• Bringing others down: They intentionally make others feel bad in order to feel better about themselves.

• Fearing healthy connections: They push away friends, lovers, or healthy people in their life because they fear that if they get too close to them, they will discover what an awful person they are and leave them.

• Being afraid of having, or refusing to have, big dreams and goals: They don’t believe that anything will ever work out, or that if they go for something big, they will inevitably fail.

• Being overly self-critical: If they make a mistake, they have a very hard time being kind to themselves and instead, tend to take full blame for what happened.

Therapy can help kids become recognize these patterns in their behavior. “Awareness is the first step toward breaking the cycle of self-hate and beginning to think and behave in ways that are more consistent with self-care and eventually self-compassion,” says Dr. Aguirre.

While there isn’t any form of therapy specifically devised to treat self-hatred, Dr. Aguirre notes that several forms of therapy have been used with some success. All of them work with kids to reframe their self-image. It’s a painful process, he says, as it’s very difficult to dissuade someone from a core belief that began developing in early childhood.

Dr. Aguirre tells patients: “While your younger self had limited agency in this process, you now have the power to erode, and eventually dismantle, the toxic building blocks that led to such a hurtful core self-belief.”

Therapies that involve this kind of rethinking include:

• Acceptance and commitment therapy (ACT)
• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Mentalization-based therapy (MBT)
• Schema therapy

If as a parent you are worried about your child, you should begin by listening, Dr. Aguirre advises.

“I think that if parents pay a lot of careful attention, they’re going to see the ways in which children talk about themselves, devalue themselves,” he says. “They say, ‘I’m a loser,’ ‘I’m not clever enough,’ ‘I’m not strong enough,’ ‘No one likes me,’ and those kinds of things. The child might not identify that as self-hatred and nor might the parent. But I think if you’re hearing that on a persistent basis, you have to wonder about what that’s doing to the child’s core sense of self.”

The goal is not to try to talk them out of it. “It doesn’t work for a parent to just reassure them — ‘Oh, you’re so wonderful, you’re so intelligent’ — because that’s not how the child is feeling,” he says. “You have to explore it, and you have to sit with the discomfort of the child’s experience.”

That means asking questions about how they have come to think that way about themselves. He suggests saying something like: “Wow, you say some pretty mean things about yourself and you know, it doesn’t sound like you like yourself very much. What makes you say that?”

He also recommends that parents avoid using judgmental labels (like you’re a “good student” or a “bad student”).  Instead, try to assess what is going on and how you can help. “Like, ‘OK, you didn’t do very well on the test. How can you do this differently next time?’”

Starting in May, Dr. Aguirre will be offering a Continuing Education course for mental health professionals called Targeting Self-Hatred in Psychotherapy through Praxis Continuing Education and Training.