Dr. Blaise Aguirre
Appearances
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah. You know, the way I think about it, and a lot of my patients have really liked this, I think of a dartboard. And I think about there's that inner circle, the bullseye, and then that one around. The people... on that inner circle where there's the most intensity are going to both experience the best of who the person is, but also like the most difficult part.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And as you go out in the spectrum, trivial relationships, acquaintances aren't going to be able to experience it. So if we were to think about the earlier example of somebody who is, say, drunk, it wouldn't matter where you are on the dartboard. You'd see the person as drunk. But then often if people are more acquaintance level relationships, they're not going to see the that behavior.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's not going to activate or trigger those strong emotions, but the closer you are to the person, the more you're going to see it and the more it's going to be triggered. If you think about the brain of somebody with BPD as being a supercharged Porsche versus somebody who's driving a golf cart, person who drives a golf cart, maybe that's their emotional range up to 20 miles an hour.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
The person with BPD drives up to 200 miles an hour. It's okay to be emotionally intense and have that fast car, but you have to know how to drive it. And so for people with BPD, they've got this emotionally intense brain, but they just don't know how to manage it. They don't have the skill set to do it. I'm a very emotionally intense person, but for me, it brings me joy.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
But that's because I know how to drive this brain. Even still, every now and then I go a little too fast.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
The historical narrative was that this was kind of untreatable and that what would happen is that the lives would ultimately be lives of despair, of incompleteness. And I just refused to accept that that was true. I said, I'm going to teach you how to drive your car at 200 miles an hour. because you don't have that skill set. And when you're able to do that, then you're able to function.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And so many of the people that I've worked with using treatments like dialectical behavior therapy.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. You have to be able to monitor those high states, but I think it's also monitoring the low states. And the best way to do that is through the practice of mindful awareness of that moment. If I'm in a low state right now, it's like, I don't like the questions you're asking me. Why are you so annoying? Just leave me alone. I just want to go back to Boston and... Lie in bed.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah, I'm like, wow, you think I'm the best interview that you've ever had. Can we be here for three hours and we can hang out? So when I'm filtering that and then my mind runs away one way or another, it does a lot of damage. So it is paying attention to that and saying, okay, I'm heading that direction. I'm here. And you know what? I'm just going to do the very best that I can.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I'm going to pay attention to that. I'm going to catch my mind going to, I'm going to be the most celebrated interviewee ever. Or like, they think I'm an idiot. They keep looking at their watches. It's catching that. That's the part that is the mindfulness piece. And then it's saying, what am I lacking in order to be able to manage it? And that's more of the CBT part, the skills piece.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's the same thing as the topic of self-hatred. I've not made a person that wasn't highly sensitive that developed borderline personality disorder. So first of all, the biological DNA condition is that the person with BPD tends to be a highly sensitive person.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's a really good question. And I think actually a lot of highly sensitive people do also have sensory issues, but it's more of an emotional highly sensitive. So what do they do? They feel things quicker than other people to seemingly smaller provocation. When they have reactions, they're bigger than their peer group. And then when they're feeling something...
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
it takes longer for them to get down to baseline. Strong emotions are the super glue for labels. Let's just say that you call somebody, hey, you're kind of fat. Now, if they're not highly sensitive, they're going to brush it off. If they're highly sensitive and that was a label that was used in childhood, that label is going to stick forever. powerfully to the person's experience.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's super glue. It's like those fly traps to those kinds of labels. And so you have this highly sensitive child who then experiences what DVT calls invalidation, saying what you're saying doesn't matter so much. You're making a big deal of a thing. You're overreacting.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And imagine somebody has a peanut allergy and I give you some peanuts and then you have a big reaction and saying, Dex, you're overreacting.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. And here you are. That's the reaction that I get when I'm exposed to the prompt that I'm getting. And in this situation, that peanut is an expression of some sort of dissatisfaction. By the way, it doesn't have to be done with malice. It could just be, why aren't you like your older brother? Your older brother doesn't complain about things, gets up and goes to school.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
He doesn't care about those bullies in school. Like, come on, get up. It's okay.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
you're going to be okay and you are okay if you are okay it's not like you say today i'm going to be impacted by the cruel words that people say and you are it's because they don't have the ability to manage those things it's a skills deficit problem so when you map invalidation onto a highly sensitive person they're very much at risk of developing borderline personality and the highly sensitive person is a physiological biochemical baseline you're born with yes
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
That's what the research shows. We wanted to see this kind of response that people were having. And so we created this experiment where we compared typical teens with BPD teens. What we did is we had a cursor on a screen and then you had the mouse. And if the cursor moved one way, you had to just move the mouse to map it.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Halfway through the experiment, we switch it so that if you move the mouse to the right, the opposite thing happens. And so what happens for typically developing teens, they get a bit annoyed, but then that's it. With people with BPD, it is really, really upsetting. You can see massive amygdala reactivity. I had a kid who was extremely bright and I said, how was the test?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And she says, oh, it was okay. I said, wait, what? Did it upset you that the cursor went the other way? She said, no, I turned the mouse around. Oh.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. If we think about the amygdala and you think about the hippocampal system and then you think about the prefrontal cortex as the brake. You know, again, if you're driving that fast car, having golf cart brakes for the fast car isn't going to help you. So you either have to strengthen those brakes or learn how to drive that fast car a little bit slower.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Totally. And at least 50% of the kids who come to our unit have had trauma with a capital T. But only about a third actually develop PTSD. And most people... can have a traumatic event, including things like rape, and not develop PTSD. Interesting. Which is really interesting. Actually, the majority, about 70% of people who've had those kinds of experiences don't go on to develop PTSD.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And that's probably because either they had a lot of other protective factors, or maybe they weren't that emotionally reactive. So the case would be that you're probably a highly sensitive person, Doug.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And then impact of those peanuts on you is going to be much, much more than for your peers.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Here's what I think the key thing to do is, I think that there's integrity in letting the person know. And that is to say... When we get into the Porsche and you're driving at 200 miles an hour down Santa Monica Boulevard, I get scared. It's just too fast for me. And that when I'm with you, the kinds of emotional reactions and responses that you have are more than I can handle.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And maybe I need to develop my own skill set, but it's too much for me. It's causing me a lot of pain. And what it does is it pushes me away from you. And I don't, want to spend time with you. And I think that that's really hurtful. So I really hope that you can get some help or whatever it is.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I mean, ideally, if they were really in a much, much better state, whatever drew you to them in the first place, those qualities are still there. Right. It's just that there's a lot of other qualities that are alienating. So maybe if you can get help, we could get back together. But this is too much for me to handle. I can't eat peanuts.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
We treat people as fragile and it's the worst thing that we can do. If you just told me I've had trauma and then I might have a reaction and I now have to filter everything I say through the idea that might be triggering you. And then I say, you know what, I'm sorry about the interview. I was walking on eggshells and I treated you as fragile.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I'd rather just be able to have a conversation with you. And I would hate it. You would hate it to be treated as fragile. There's nothing I hate worse than being pitied. And by the way, I'm robbing you of an opportunity to tell me You know what, Blaze? That was kind of hurtful. And I'm saying, okay, well, now I know. But like, I'm thinking, should I say peanut one more time? Well, yeah.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So there's two things about that. One thing is right now we don't have good treatments for peanut allergies and you just know nothing that we do at this point in time because we don't have a treatment for it. Let's just say that you know that there are things that are part of ordinary life that might be triggering.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Then the responsibilities for the other person to say, do I need to exposure therapy? Basil and I often talk about psychodrama sort of stuff, body keeps the score, that kind of work. that it doesn't actually serve you to not have dealt with that. Because in this context, you could say, well, we know each other very well, and I'm not going to say things that are going to be activating.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
But, you know, you walk onto the street and somebody is going to say something. And I would rather know that there's something wrong and that I make a choice about I'm going to deal with it or I'm not going to deal with it. You don't intentionally want to be upsetting someone. At the same time, you're not the world. The world is going to do upsetting things.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It came from an old psychoanalytic concept. So more like Freudian kind of ideas. And I was trained in Freudian psychoanalysis. I then moved to behavioral therapy, dialectical behavioral therapy. So. The idea is that I, as an individual, feel very flawed. But that's unbearable for me to experience.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So I project my lack of value onto you, and then I devalue you when you're doing behaviors that I don't like. Devaluing is like you're the worst person ever.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah, I think that we see both of those sorts of things. But I think there's often an emotion that shows up before that. And that is sadness, maybe jealousy. But staying in that emotional state is very, very painful. It moves from that primary emotion, which is generally 10 to 30 seconds, to a secondary emotion, which includes a lot of cognitions and thoughts about what the other person is.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Blaise, patron saint of throats. So I grew up Catholic. Are you Irish? Half Irish, half Iberian. Aguirre is actually Basque from northern Spain. My mother is actually Spanish. So Blaise is the patron saint of throats. And it's interesting, her name is Isabel. And Blaise and Isabel are anagrams.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I've been trained in different modalities. And as with everything, in the same way that no one antibiotic treats every infection and no one exercise is the exercise to make you fit. No one treatment is the treatment. There's MBT, mentalizing-based therapy. There's schema therapy. There's all sorts of therapies.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
What I like about dialectical behavior therapy, especially in the people that come to see me, is that DBT says, until we've addressed suicide and suicidal thinking, none of the rest of therapy makes any sense.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I often say, listen, I'm one of the best DVT therapists in the world. I haven't been able to treat a dead person. So I have to keep you alive. There's a lot of irreverence in DVT. You've got to be a little bit careful.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So I don't want to talk about your difficult relationships or your struggles with your sense of self until we have an idea that when suicidal thoughts show up, which they're going to, that you're not then going to act on them.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And I was like this with my mom. Oh, that's so sweet. And where did you grow up? I grew up in South Africa. Oh, you did. Okay, that's why I came out. You've got a lot going on. Yeah, you're high in 57, my friend.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Often what happens, and this is where I think other therapies get this wrong, they start exploring what caused the pain without having the skill set to manage the strong emotions and suicidal thoughts that come up. We say, until you know how to drive that Porsche, we're not going to talk about going on a racetrack or anything else.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So when you don't have the skill set to be able to manage those things leading to those suicidal thoughts and behaviors and self-destructiveness, toxic relationships, devaluing relationships... We're not going to do that.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And actually, for a lot of the young people who come to see me, if they're not in relationship, I say you can't be in relationship until we're done with treatment because you're bringing the worst version of yourself into relationship. And what you're going to attract because of your low energy state is people at the same low energy state.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And it's going to be negativity that drags you down rather than the higher version of who you could be. You have to regulate before you can reflect. And the problem is that a lot of people with BPD are in a heightened state of dysregulation a lot of the time.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yes. So in 2011, some Spanish people found me and they said, oh, would you teach dialectical behavior therapy in Spain? And I said, yeah, of course I will. But I spoke like an eight-year-old because I left Spain when I was eight. And then I said, okay, I'm committed to learning fluent Spanish. So every year I go to Bilbao.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I've got four kids and my second has become a social worker. My third is in law school and the other one's doing AI. And so very, very different kids. I recently went to Vegas with my son because we wanted to walk in the desert and hike and meditate. And I said, what is some of the most brilliant advice I ever gave you? He says, I don't remember at all. Not one single thing.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Like a lot of it was actual bullshit. But... I remember how you made me feel. And it was very, very moving. Because when we settled and we were connected, he felt safe. He doesn't remember what I said.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Not for core borderline personality disorder. And I think people have tried to use contemporary drugs and been part of doing some studies with experimental drugs that seem to tampen down amygdala response. Because it's It has to do with a perception of self in the context of relationship. And there's no medication that can do that.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Now, parents have said, well, isn't there something that can calm my child down? I said, yes, it's called anesthesia. I promise you, your niece that has the child, they are not going to misbehave at all. Like you can dampen down the brain so much that a person cannot think, can't stay awake.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Now, having said that, BPD has a lot of comorbidity. So say a person has bipolar disorder who has obsessive compulsive disorder or severe major depression. The biological intervention through medication is to treat the comorbidity, but not core BPD.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
What I was told when we opened the unit in 2007 is that for hospitalized people, the research showed 10% would die by suicide.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Right. So we've had 5,000 as far as we know, because people respond fewer than 30. And by the way, every single one of those is tragic. So we've reduced the number, any number. And this is where the thought of the book then starts to show up.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
When I thought about the people who'd taken their lives and whose parents I was really close to, and I looked back on the records, the one thing that came up in the people who had tragically lost their lives to suicide was statements of self-hatred. Now, if you've had therapy, so you go in for an initial psychiatric evaluation. What's your name? How old are you? What do you do professionally?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I've been there. You've been there.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
How do you sleep? Do you have any nightmares? How's your eating? Energy level, obsessions, compulsions. Do you hear voices, suicidal thoughts, homicidal thoughts? Are you anxious? Anything else you want to talk about? How's your attention and concentration? Ruminations, compulsions, whatever it is. No one ever asks about self-hatred.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
You've not been asked that in any psychiatric evaluation. So here was the numbers in terms of the people who tragically took their life. They were expressing self-hatred. And when I started to speak to people who had persistent suicidal ideation and behaviors, I started to say, wait a second, if those former patients of mine
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
acted on suicide and discussed self-hatred let me ask these people about self-hatred and I would say what do you think about yourself and said no I don't like myself very much well how much do you not like yourself not very much at all is it ever self-hatred and it would surprise them because that would be the first time in tons and tons of therapy that somebody had actually asked do you not like yourself to the point of self-hatred and it'd be like yeah I do hate myself
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Okay, so you grew up till eight in Spain. I was born in Columbus, Indiana. I left when I was one. We moved to London. My brother was born there. And then from there, we moved to Spain. I had four siblings born there. And then we moved to South Africa and two siblings were born there. So I'm the eldest of eight, born in four countries on three continents.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I tell patients, I said, if I've gotten it wrong, you've got to just tell me I've gotten it wrong because otherwise I'm going to continue down this path believing what I believe to be true.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So let's just imagine a binary world. Do you identify as male?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Okay, what if I told you that you were wrong? What if I told you that, you know what, I actually quickly snuck a DNA test and you're actually XY and you're actually XX. How easy would it be for me to convince you that you're female? It'd be impossible. Impossible. Male?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Okay, no, but not only that.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Even if I had like, okay, here's your DNA. Yeah, that's what I'm saying. You'd go, that's fucked up. Exactly. So even if I said, okay, here's some proof. Now you need to be convinced.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I'm showing you this. Right. But here's what I want you to do. You're actually wrong about yourself. You are actually female. What would the relationship between me and you be if I kept insisting that you had to see yourself as female?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. Because there's nothing that I could do that would convince you that's the level of belief.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Right. It doesn't matter. There is no separation from the isness of self-hatred.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Biological identity. And then if I say, okay, you know what? I want to start talking about self-hatred. It's as alienating as if it would be, I want you to start thinking of yourself as this other gender. So like, I know I've got kids. I know who I am. Like, you're not going to convince me out of this. We're wasting time in therapy because I don't want to talk about this.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Well, that was the problem is that I thought, okay, so now what I need to do is tackle self-hatred. Why aren't any therapies tackling self-hatred? So I did what academics do, which is to go to the literature and say, find me the 10,000 papers on self-hatred and three show up. That's all I could find.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah, self-hatred is very, very hard to tackle.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly, because I can't convince you that you're female.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's this construct that gets internalized as truth. And if ever there is greater fake news, it is that. because a child is not born hating itself. It has to learn to hate. And if it can learn to hate itself, it can learn to love itself.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
My grandfather, Antonio Garrigues, was the Spanish ambassador in the Kennedy White House. Oh, wow. And they actually grew very close to the Kennedys. So my mother had been the daughter of a diplomat. Her mom had died and she was the eldest girl. So she sort of took over hostess.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Does that align nicely? So much, you know, I was thinking, okay, who am I going to get to write the foreword? I was thinking all these famous people, sort of psychiatrists and other things like that. And when I met Jewel in 2019, I found a kindred spirit. I loved how she paid attention. to who she was, to the impact of things, how she practiced meditation and skills building.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's almost as if she developed dialectical behavior therapy on her own because of the way that she paid attention. And so I found a kindredness in this. And I thought, because she's so kindred, I want her to write. And ironically, my publisher had already decided that the cover was going to be orange. So they'd already determined. And you see the appealing piece.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And she writes this independent of knowing the covers.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Because if you were to come into therapy and say like, I'm so dissatisfied, I'm really upset about something. I said, what's going on? And you said, I did this interview or I met this person or I tried to do something, just didn't work out the way I wanted it to.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
so what are you saying about yourself you know that I'm not very good under certain circumstances so okay let's just talk about that and then how can we work on that so that kind of stuff is typically dealt with in cognitive and dialectical behavioral therapy CBT DBT it's when I say okay let's just address the ways in which you're dissatisfied with yourself and that's when you get the patient saying you're not listening to me
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
This is not a flaw that can be fixed.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. And then my dad was in the U.S. Navy at the time. He was in the Pentagon. And then they met at some official function. And then he started an important export business.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I am an entity that is not only toxic. Repellent. It could be repellent to people, but there's something called the interpersonal theory of suicide. What are the elements that lead people to make a determination that suicide is the answer? One of them is loneliness, non-connectedness. It has a certain weight to acting and completing suicide.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
But another element to this, which is much more powerful, is burdensomeness. I am a burden to those around me and to the world and I have nothing to contribute.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
The world would be better off without me. I wouldn't be a burden to my family.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And by the way, and here's the other thing is I don't try to reassure people that they're not a burden. Some of that behavior is burdensome. It's not like they're going to say, okay, that isn't a burden. Maybe they'll try to reassure you, but that's disingenuous. That's not honest.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And so I'm saying some of that behavior is burdensome, but much of your behavior is you washing all the dishes before your mom comes home at night. Is that burdensome? No, that's actually kind of helpful. What about taking your little sister to school? Is that burdensome? Well, no. There's all these things that they do that aren't burdensome, but that's not how they're filtering their experience.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I started to think about conditions that had been highly stigmatized, whether it was HIV AIDS, and I was in South Africa at the time, and no one would talk about it, cancer and things like that. And the first thing you have to do is talk about it.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
We are going to bring it up because it is actually impacting your life in terms of your relationship choices, your academic choices, your employment choices, your friendship choices.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
A hundred percent. The second thing is I needed to drive a wedge between who you are and self-hatred. Now, are your parents English speakers? Yes. Yeah. Okay. Why don't either of you speak, I don't know, Greek?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
From very early on, you weren't taught. If I had plucked you from your crib and put you into a Greek speaking family, that's what you would have learned. So the idea is that you aren't born speaking English or Greek or anything. You're born blank slate in terms of language and you learn something because you're exposed to that thing. That you weren't born hating yourself.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
You learned how to hate yourself.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
That was the only way in which I was able to break through.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
They could hear that they learned. And so I would say, who were your teachers? So the other part of it is I wanted them to start writing. You weren't born hating yourself. When do you have a recollection of you starting to hate yourself? I want you to write that down. I want to know who your teachers of self-hatred were.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
the bully in school, the parent who expected perfectionism, the comparison with a more achieving sibling, the teacher who abused you. All of these teachers said that you were not enough.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yes and no. I had this mom who was such a profound, loving mainstay. My dad was very conservative and I identified much more strongly with my mom.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. So there's all this faulty conclusion. And the more you're exposed... to you being the fault of something, the more every single time something goes wrong.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. It's like, that must be the reason because I am this broken individual. And so that's what happens. And the other thing is we often determine the righteousness or the wrongness of something we do based on the outcomes. If you are really hungry and I give you $10, that's all you have. And you go and you buy a sandwich, well, that wouldn't make sense.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
But let's just say you go and buy a lottery ticket. And I say, what are you doing? Like you're hungry and you buy a lottery ticket, but then you win $100 million. You say, you see, it was still the wrong decision to make. I mean, you got lucky, but we determined that it was the right decision just because you won $100 million.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
If you were exhausted...
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
right now because you hadn't had a good night's sleep this interview might go differently and you might be critical about that and say okay next time i want to get better sleep but it would make sense that it would be different if you were exhausted and my nature would be to confirm a shortcoming i have and ignore the sleep exactly you would say i'm not going to pay attention to any vulnerability factors that may have shown up i have to be fully responsible this is a failing exactly
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's ego, really. So when the Dalai Lama was asked about self-hatred, he said it's a form of self-indulgence and self-absorption that is actually toxic. You know, I am the best, worst person on the planet. Yeah, yeah, yeah. There's certainly this faulty self-evaluation that's taking place
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. And she was so grounded in her own sense of self. But I mean, I definitely have seen, even living in the United States, if I'm in little towns where people haven't moved out of those little towns, their identity is that. So having traveled, it's really been interesting.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
At all, at all, at all. As I say, our common destiny is just stardust. In any case, we aren't that important. And then I think that when you tell somebody who doesn't feel that good about themselves, hey, look, you're not that important.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. You think that you're so impactful when you actually aren't. And it's liberating that the one thing that you have is to... recognize that you're having an experience and then make a decision about what you're going to do. One interesting thing that patients say, well, I have this tendency or I have this habit. I say, okay, you can no longer say that.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Once you recognize a tendency or a habit, it's now a choice.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
The thing is, is the glory that I have is when a patient leaves therapy. I don't want to keep them in therapy. That shouldn't be your primary relationship. You should be able to function on your own. It's always interesting to me when people have been in therapy for 10 or 15 years with the same therapist. If you think of therapy as getting to a place of autonomy, dominion over self-agency.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
What's that about? I speak very bluntly. I challenge colleagues to really examine that. Now, if somebody, say, has bipolar disorder and they need medication to be able to manage manic depressive episodes, that person is probably going to need somebody to continue to prescribe and to check in.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
We've pathologized so many typical human experiences that all of a sudden you can't walk without being a pathological specimen.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So the other thing that I've done with many of my patients, maybe they're in their late teens, early 20s, is I want them to bring me photos of their birthday, age one, age two, age three, age four, age five, until now. And I say, okay, do you hate that one-year-old? Do you hate that two-year-old? When does it start, you know? And even if you say it starts when I'm six or seven in kindergarten.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So do you really hate that little girl, that little boy? Do you hate that person? They say no, because they were abused. They were hurt. And just what would you do if that little girl came into your life? You would hate her because she learned.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Absolutely. And that what the messaging was... She was a highly sensitive kid for whom rejection and criticism stuck so powerfully and started to believe that about herself. She carried that burden until now. Now, let me ask you this. Does future you want to hate herself? They say no.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So say, okay, but if your goal is to climb to the top of the mountain, sitting around playing video games isn't going to get you anywhere. You have to start doing squats, running, you've got to start doing some hiking so that eventually future you will be grateful for present you if you start taking the steps necessary to hike to the top of the mountain. That's your goal.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
If future you doesn't want to hate herself, then you have to start taking the steps right now to recognize that that it was learned to start recognizing any kind of life-affirming behaviors as acts of self-compassion and then not give the power to your toxic teachers to continue to define who you are as a human being. The narrative has to be no. No longer...
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Do I accept that I was broken, that I was flawed, that I was stupid? Okay, I recognize I'm sensitive and I recognize that there's labels stuck.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
You cannot give that which is not within you to give. You cannot experience that which is not with you to experience. If we go back to this idea.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. It has to be within you. What's it like to have your menstrual period every month, Dax?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It doesn't matter. There's no way that you can experience that because you don't have that experience. When you experience love, when you experience kindness, it's happening inside of you. You are the source of it. There might be things in the environment that allow it to manifest more. But if it's not within you already, it doesn't matter who shows up or what shows up.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I wanted to be a philosopher. But you know what they say, how do you get a philosopher off your front porch? Pay for the goddamn pizza.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And if it's within you and if it's within you to give, it's within you to give to yourself as well.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
There's a concept in DBT is going where angels fear to tread. I have to enter the experience of ultimate darkness with a patient and risk that what I'm saying could potentially be very destabilizing. Yes.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
That's exactly right. I have to know that the relationship is strong enough to be able to withstand.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So what was happening is that she was one of these people who is uber talented and lots of things. Sadly, I think that this happens more with women who are ultra intelligent, very talented. They're objectified in a certain kind of way that they're only seen through this one lens of maybe attractiveness or whatever it is. Any of those sorts of things.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And yet there's a multidimensionality capacity, whether it's artistic, linguistic, cognitive and other things that don't actually often get seen. And her experience of being hurt for such a long time led to this change. experience of self-hatred. And she was also very self-destructive in terms of a lot of self injury and a lot of suicide attempts.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And we had really reduced all of that to the point that her relationships with her family were better and everything. So she was grateful for that. But this core self-hatred still remained. And I was floundering at that time because I didn't know what to do. That was in the early days of my program. And I just decided to go for it.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I realized that there was a lot of risk, but I also had seen that she had been able to tolerate some very, very difficult moments. The one thing that I hadn't seen is whether she could tolerate a difficult moment with me. And I said, I have so much compassion for you. And her argument was, that's because you don't see me completely. You see some of the things that I do.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
If you did, then you would also have the hatred for me. She actually once showed up a few minutes late and people for many reasons show up late. And she said, I think you should punch me in the face. as punishment for this incredible transgression when I had so much love and compassion for somebody who made an effort, showed up, really worked hard.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Not a highly employable skill set. It did get me curious about the mind. And then that led me to psychology, which led me to psychiatry. So I went to medical school in South Africa. And then I became an expert in dialectical behavior therapy. So all I do is treat suicidal kids. And I've been doing that since 2007.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And it was inconsistent with the way that she saw herself that was early on. And later on, we were able to do this. And subsequently, she began to see, in fact, there was a lot of worthiness. And when she started to do that, she started to exercise more. It becomes a virtuous cycle. It does. It went the other way.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
We market to self-hatred. You're not tall enough. You're not skinny enough. Your boobs aren't big enough. You're not light-skinned enough. You're not intelligent enough. You don't have six packs enough. But by the way, if you buy my product, you'll be fabulous and everybody's going to love you.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
We market to self-hatred. So the thing is that people who are at risk are going to be dissatisfied with whatever that is within them. And we sell an idea of what virtue, perfection is going to be if only you do this one thing. And so for those who are vulnerable, they chase that.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
100%. I think that in an already very, very vulnerable person that then spends a lot of time on social media, TikTok, Instagram, watching these videos over and over, it reinforces the idea of that. So I think that for the vast majority of us, you go by that billboard. Now, what I do with the kids on my unit, I say, okay, show me what your social media apps are.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
What I want you to do is I want you to open TikTok, Instagram, Snapchat, whatever it is. Tell me how you feel when you consume that social media. If you feel good about yourself, if you feel neutral, carry on. It's not a problem. If you're feeling terrible about yourself, it's like me eating gluten. You're allergic to it.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
But in the nanny state, we take away not only personal responsibility, but we say dominion over self is not important. I want the person to make that determination that for you, TikTok's okay, but for this other person, it isn't. They are the ones who determine that. I don't want to be the one who says, I'm going to take away all social media.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
A hundred percent. Isn't it better that either you've learned how to deal with it or that you've decided, yeah, I hate seeing my friends at parties all the time where I'm not invited. Okay, well then you don't have to continue to consume that media if it's making you sick, if you're allergic to it. Yeah.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
But then teaching in Jerusalem was different from teaching in Riyadh, was different than teaching in the UAE, different than teaching in South Africa, teaching in Spain. And looking at identity and pathology through this cultural lens is just really interesting.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Okay, so there's a couple of things. First of all, let me just say that I used to say that all the time. When people died, they died by cancer, by pneumonia, by whatever it is. The problem was that it assigned a certain degree of blame when you used that rather than saying they died by suicide. They died by cancer. They died by pneumonia. They died by whatever it is.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Rather than committed, like I committed a crime. I walked into your house and I stole your money.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I suppose you could in a certain way. But you wouldn't say that. But you wouldn't. And the other thing is, I have this concept of, do I want to be right or do I want to be effective? And there's some times when maybe I know what I'm saying, but I don't want that to be the disagreement. And what's it cause our relationships?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
If what anybody's going to remember about this show was that you said committed suicide, then people are going to say, what a jerk, like he didn't understand. And then you may have had 99% really great points. That's not what they're going to remember.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Here's the dialectic. Both of you are right. There is so much ignorance in the world. And then what happens is we bite into our ignorance and then we spout our ignorance. Then you're just going to continue down that ignorant path. Now, I would be with you if I heard people talking about drunks and junkies.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And I just said, OK, I know one of those guys who's turned his life around and done an incredible service to the world. And that when you devalue and diminish somebody into a state that through your ignorance means that they're going to be on skid row for the rest of their life, you're doing a disservice.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
If I can have a discussion that's going to open somebody's eyes to another possibility, that's fine. But I think that what happens with a lot of ignorance is that people just have a degree of certainty about a perspective and then they're not willing to change it. They open their mouths before they open their hearts and their minds.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah, I'm actually going to India in two weeks and introducing DBT. We're seeing increasing rates of suicide in Indian youth and whatever we're doing isn't helping. So I'll be there in two weeks and I'll be in Spain in four weeks.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
if we go back in time during the COVID pandemic, I wrote the book with a colleague, DBT for Dummies, and it hit number one on Amazon, not number one in psychology or in therapy, number one on Amazon for three days in a row. It was the number one. And, you know, we were on a lot of shows and stuff like that. And I thought it was a very, very important book.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And so when I proposed this book, because I'd written other books, they were willing to take a chance. But they said, there's no comparison. No one's ever written about this sort of topic. And then they asked me the question, what do you hope from it? And I really wanted to speak to people with lived experience to say, you've learned this false truth.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And by the way, there's a lot of fake news in the world today, a lot of false narrative that many of us believe. But this one is going to destroy your life and is very, very toxic. So I said to the publisher originally, you know, I want it to be for everybody, for therapists, for parents. He said, no, it can't be that. You have to pick one lane. That's just the way it works.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
First of all, there's no other book on this. Secondly, pick a lane.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly right. So I said, okay, so we're going to do it for people with lived experience because they're often at the bottom of the pecking order in terms of like who gets help. But what happened is that as I started to talk about it, therapists started to say, would this be helpful to us? And I said, yeah, because A, you'll understand the condition a lot more.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Secondly, what I want you to start doing is I want you to start asking the question. In your inventory of questions, include a question about self. If I say, do you have nightmares? And you say, no, I don't have nightmares. Are you addicted to drugs? No, I'm not addicted to drugs. I'm not going to continue down like, okay, we have to work on your nightmares and your
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Drug use, I don't have a problem with those things. If there is no core self-hatred, then great, let's just move on. But there's kindred ideas like perfectionism, people-pleasing behavior, self-criticism, self-judgment that are on the way to self-hatred.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
A hundred percent. And then I have a questionnaire that I ask all my patients. And I think the therapist could also take that questionnaire. When did it start? How old are you when you first remembered? Who were the teachers? What were the circumstances in which you started to believe this about yourself?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I don't have access to someone like me sometimes. Again, I don't want something that could potentially be helpful to a lot of people to remain the exclusive domain of anyone who can just like afford best care. You can work on some of these ideas yourself, understand it a little bit better. And then when you go to therapy, maybe say, I do want to explore this.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah. And not only me, but the world. I just want to say, on the other hand, is I think it takes courage also for you and other people who are interested in having this discussion to have me on because it can also seem like this is so way out there that we can talk about OCD, even if you get it wrong. Yeah.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
about depression and alcoholism, but there's this sort of degree of novelty that hasn't been well researched, hasn't been well examined. What happens if it turns out that this whole construct is wrong? But you know what?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Even if the book prompts more research, more thinking about it, but more than anything else, to think that somebody who is struggling with this feels that they're so burdensome that the only way is out. You know, if one person can read the book and say, I can see myself differently, then we've done something important. And I appreciate you guys being part of this journey and helping.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Thank you so much for having me.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
I think we've had about 5,000 patients come through our programs since we opened them in 2007. And I'd say about 70% have had borderline personality disorders.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah, very, very high. For the people who come to my unit, I don't remember one that hasn't had suicidal ideation. So I say of all those 5,000, they've all had suicidal ideation. A very large percentage have made attempts. Now, it's possible that the people who come to my unit are people with very severe forms of BPD. You know, it's like not everybody with asthma ends up in an intensive care unit.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. And I think that there's mild to very severe forms. But I think that when you get to the severe forms, almost everybody has suicidal ideation and self-destructive behaviors.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So mood disorder, as we think a little bit about it, is you have discrete episodes of mood states, typically either depressed or manic, that last for a certain period of time, 10 days, two weeks, and respond typically to treatment such as medication and cognitive behavioral therapy. When you're in that situation, There's very little reactivity to that state.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So when somebody is depressed, they stay in that state for some period of time. With personality disorders, there are traits about who you are, the way that you experience yourself in relationship to other people. Maybe you're emotionally very intense. Maybe you tend to be reactive to what people say and do. That those personality traits, when activated, interfere with your ability to function.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So what's confusing is that say somebody has borderline personality disorder and everything's going fine. To the outside observer, they're just like doing fine. But they're on Instagram and they didn't get invited to a party and they see all their friends at a party and now there's incredible rage, incredible anger, incredible jealousy, envy, and it spikes their emotional state.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And in that state, they cannot function. Their relationships begin to be impacted. Maybe their work does.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And this is what's interesting. Let's just say that somebody was drunk and they walked into the studio and we all walk in independently. We could see that the person is drunk. That state is permanent in that moment. But let's just say it's somebody with borderline personality disorder and you guys have a good relationship with that person, but I've really pissed them off.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So then you come and you're chit-chatting and everything and I walk in and suddenly you see this spike of rage. From your perspective, that person seems to be doing fine. But from my perspective, all of a sudden this person's angry and maybe they're devaluing me or very, very upset and you guys are saying, what's going on? That
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
That state only manifests when there's something either interpersonal or intrapersonal inside their own head that gets triggered.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's interesting that I don't know narcissism as well. And the reason why is because people with narcissism don't tend to come in for therapy.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Maybe I could teach you a thing or two.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
What I'm saying is that's what the narcissist will say. But the most common comorbidity with a personality disorder is another personality disorder. So you can have borderline personality disorder with some narcissistic traits.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And one of the ways in which I have been able to work with a few cases of people with a narcissistic personality disorder is to say, here's the thing, no one actually likes you. And you also have to just call it out as the truth. Like I know that you feel that people adore you and you're surrounded by people who you believe love. are supportive. They don't actually.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And the thing about it is you can't even see it. So I'm going to teach you how to see the world differently, even if you don't feel that what I'm telling you is true, because what's happening is that you're kind of lonely for a narcissist, like what's going on. Is it actually about everybody else or maybe it's about you?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
So mostly it's hard for me to answer that question only because I see so few people with NPD.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Yeah, and I talk a lot about it in the book because that's the group that I found with most self-hatred and self-loathing was the group of people with borderline personality disorder. Okay, so if we go through the criteria, the first criteria is frantic efforts to avoid real or imagined abandonment. So what do I mean by that?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Nobody wants to be abandoned, you know, and say like, okay, I'm going to go home. My kids and wife have disappeared. Yeah.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
What's so beautiful about this is we're all on the spectrum. Yeah. Who wants to be abandoned? Go home. The people who love you aren't going to be there because they don't want to be there with you anymore. Well, that would be terrifying. But the person with borderline personality disorder fears it. Whether it's real or whether it's not real.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And sometimes it's like, boy, this relationship is so painful for me that I can't be with you anymore. And so then that's real abandonment. But then the other one is no one's ever liked me. No one's ever cared about me. I just worry that people are going to abandon me. And so then what they start to do, this is the first part of the criteria, frantic efforts to avoid the abandonment.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It's constant texts, constant phone calls, constant seeking of reassurance. Then to the other person, it's like, how many more times do I need to tell you?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Okay, so you've actually touched on two of the other criteria. So the second criterion is intense interpersonal relationships. So they're very rapid, very intense, characterized by extremes of idealization and devaluation. So in one moment, I just met you, Dax, you're like the best person ever. I'm going to marry you tomorrow. Yeah. And there's this glow.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And then all of a sudden, hey, listen, I'm not making it for dinner tonight. You're the worst person ever. What did I ever see in you? And then the ninth criteria, which you find, especially if there's been trauma, is paranoia. Clearly, you're plotting against me. Clearly, you must be seeing somebody else. Clearly, you never cared about me. And I'm very suspicious of that.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Now, just imagine living that way. Oh, so awful. And the thing is, people don't choose it. It's not a choice to live that way.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Exactly. It's heartbreaking. And the compassionate thing is just to remind yourself of it.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
They idealize me. And then when I, hey, by the way, I need to cancel this session because I'm going to go to LA to hang out with the movie stars and everything. It's like, if you, where'd you get your degree? You know, you're terrible. You're abandoning me and all of that. And the thing about it is it's such a horrible way to live because that's how you're experiencing the world.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
It feels so interpersonal. It is interpersonal, but it's a manifestation of pathology. It's not like I'm waking up in the morning and thinking, how am I going to mess up somebody else's life today? Right. It's not malicious. But what happens is that when somebody gets really activated, the most difficult of their pathology begins to show up. But that happens to all of us.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And I've never met a person for whom this wouldn't be true. I could put you under so much stress, threaten the person you love most, that the worst of who you are, worst in quotation marks, whatever it is that you have to do to get through that moment. Exactly. And that when you're dysregulated, you can't think.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
If you hear that your house is on fire right now, we're not continuing this interview. Wait a second, don't you want to hear about borderline personality?
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
Where it gets tricky is that, I mean, what a wonderful thing to feel loved. And you can't make anyone love you. When you feel it, there is no word for it. Words do such a violence to our experience because we try to capture this concept in words. But I mean, what does a three-month-old say to its parent? I love you. No, it's not in the words. You sort of feel something.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And if you felt threatened for such a long time, and then you're in the context of somebody who elicits a warmth and expansiveness in who you are, it's such a beautiful feeling. And then you want more of that. But who wouldn't want more of that? And when you've been deprived for most of your life, you want to cling to it. The problem is that that clinging can have its own consequences.
Armchair Expert with Dax Shepard
Blaise Aguirre (on overcoming self-hatred)
And that's where you start to see the fifth criteria, which is like suicidal behavior, the sense of emptiness, and then the reactivity of mood. You know, it's like, why are you looking at me that way?