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What to Do When Your Kid Says “I Hate Myself” and How to Build Self-Compassion With Renowned Harvard Psychiatrist Dr. Blaise Aguirre - Raising Good Humans | Wave AI Podcast Notes

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What to Do When Your Kid Says “I Hate Myself” and How to Build Self-Compassion With Renowned Harvard Psychiatrist Dr. Blaise Aguirre

Raising Good Humans

Fri Apr 25 2025

Summary

Raising Good Humans: What to Do When Your Kid Says “I Hate Myself” and How to Build Self-Compassion

Host: Dr. Aliza Pressman
Guest: Dr. Blaise Aguirre, Psychiatrist, Author, Harvard Medical School Professor, Medical Director at McLean Hospital
Release Date: April 25, 2025

In this compelling episode of Raising Good Humans, Dr. Aliza Pressman engages in a profound conversation with Dr. Blaise Aguirre, a leading psychiatrist specializing in child mental health. Together, they delve into the intricate subject of self-hatred in children, exploring its origins, manifestations, and effective strategies for fostering self-compassion.

1. Understanding Emotional Sensitivity: The "Emotional Peanut" Metaphor

Dr. Pressman introduces a powerful metaphor shared by Dr. Aguirre to illustrate the varying impacts of criticism on children based on their emotional sensitivity.

Dr. Blaise Aguirre [00:01]: "Saying 'you are lazy' to an emotionally sensitive child is like giving someone with a peanut allergy a peanut. It triggers a much bigger reaction than it would in a less sensitive child."

This analogy underscores the necessity of tailoring our responses to children's unique temperaments, recognizing that what might be a minor comment to one child can be profoundly hurtful to another.

2. Defining Self-Hatred vs. Transient Self-Dislike

A critical distinction is made between occasional feelings of dissatisfaction with oneself and pervasive self-hatred.

Dr. Aliza Pressman [03:21]: "We need to define self-hatred in a culture where we talk about self-hatred so much."

Dr. Aguirre elaborates on this differentiation, explaining that while everyone experiences moments of self-doubt, self-hatred involves a deep-seated belief in one's inherent flaws and unworthiness.

Dr. Blaise Aguirre [03:21]: "Self-hatred is part of the fabric of who the human being is... there's a perception of not being able to escape it because it is part of who I am."

3. Origins of Self-Hatred: Learned Behavior

Dr. Aguirre emphasizes that self-hatred is not an innate state but is learned through negative experiences and interactions during early childhood.

Dr. Blaise Aguirre [05:47]: "A child is not born hating itself. It has to learn how to hate itself... You can begin to unlearn that messaging."

He compares this learning process to a fish being confined to water, suggesting that children internalize negative beliefs about themselves from their environment.

4. Treatment Strategies for Self-Hatred

Addressing self-hatred requires innovative therapeutic approaches beyond traditional methods. Dr. Aguirre discusses his breakthrough concept that self-hatred is a learned behavior that can be unlearned.

Dr. Blaise Aguirre [14:46]: "Love comes much more naturally to the human heart than hatred does."

He advocates for helping individuals identify and unlearn the negative messages they internalized from influential figures in their lives, such as parents or teachers.

5. Supporting Emotionally Sensitive Children

Dr. Aguirre provides practical strategies for parents to support children who exhibit high emotional sensitivity and self-critical thoughts.

Dr. Blaise Aguirre [33:16]: "Listening is the most powerful problem-solving technique that we have without having to actually solve it for them."

Key approaches include:

Active Listening: Encourage children to express their feelings without immediate judgment or problem-solving.
Curiosity: Genuinely inquire about the circumstances leading to their negative self-perceptions.
Validation: Acknowledge their feelings to make them feel seen and understood.
Emotion Regulation Skills: Teach children strategies to manage and process their intense emotions effectively.

6. The Impact of Social Media on Self-Hatred

The conversation shifts to the role of social media in exacerbating self-hatred among teenagers.

Dr. Blaise Aguirre [42:31]: "Social media in at-risk individuals is just going to aggravate the self-hatred."

Dr. Aguirre explains that while social media can be benign for some, it often intensifies negative self-perceptions in sensitive children by fostering unhealthy comparisons and unrealistic standards.

7. Navigating the Adolescent Mental Health Crisis

Dr. Pressman and Dr. Aguirre address the broader context of rising mental health challenges among adolescents, attributing it to multiple factors including the COVID-19 pandemic, increased academic pressures, and pervasive social media influence.

Dr. Blaise Aguirre [48:25]: "There were thousands and thousands, thousands of micro connections that could have taken place... and those were all taken away."

They discuss how the pandemic disrupted essential social interactions, leading to increased isolation and mental health struggles that persist beyond its resolution.

8. Fostering Self-Compassion and Agency

Building self-compassion involves empowering children to feel competent and in control of their emotional experiences.

Dr. Blaise Aguirre [38:13]: "Once they start to feel that agency, they start to feel much better about themselves and they tend to be less critical about themselves."

By teaching emotion regulation and critical thinking, parents can help children develop resilience against negative self-perceptions and cultivate a healthier self-image.

9. Final Insights: The Importance of Curiosity and Validation

In concluding the discussion, Dr. Aguirre reiterates the significance of approaching children's self-critical statements with curiosity rather than immediate dismissal.

Dr. Aliza Pressman [57:31]: "If you have a younger child who says I hate myself in reaction to messing up something."

Dr. Blaise Aguirre [58:10]: "Just get curious about how they got there."

This approach allows children to explore and understand the roots of their negative self-talk, facilitating long-term emotional well-being.

Conclusion

This episode of Raising Good Humans offers invaluable insights into the complex issue of self-hatred in children. Dr. Aguirre's expertise illuminates the path from recognizing learned self-hatred to implementing compassionate strategies that foster self-compassion and emotional resilience. By emphasizing active listening, curiosity, and emotion regulation, parents and caregivers can significantly impact their children's mental health and overall happiness.

Notable Quotes:

Emotional Peanut Metaphor:

"Saying 'you are lazy' to an emotionally sensitive child is like giving someone with a peanut allergy a peanut."
– Dr. Blaise Aguirre [00:01]
Defining Self-Hatred:

"Self-hatred is part of the fabric of who the human being is."
– Dr. Blaise Aguirre [03:21]
Unlearning Self-Hatred:

"A child is not born hating itself. It has to learn how to hate itself."
– Dr. Blaise Aguirre [05:47]
Listening as a Solution:

"Listening is the most powerful problem-solving technique that we have without having to actually solve it for them."
– Dr. Blaise Aguirre [33:16]
Impact of Social Media:

"Social media in at-risk individuals is just going to aggravate the self-hatred."
– Dr. Blaise Aguirre [42:31]
Fostering Agency:

"Once they start to feel that agency, they start to feel much better about themselves and they tend to be less critical about themselves."
– Dr. Blaise Aguirre [38:13]

This episode serves as a crucial resource for parents seeking to understand and support their children through challenges related to self-esteem and emotional well-being.

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Transcript

Dr. Blaise Aguirre (0:01)

The following podcast is a Dear Media production. If, on the other hand, you don't have a sensitive child who says, you know, I'm lazy, and you say, yeah, okay, I mean with I tell them, yeah, you are lazy. Now get up and go study. Because this non sensitive child is not going to have me saying that is not an emotional peanut. To the emotionally sensitive child, me saying you're lazy if they say they're lazy is an emotional peanut and they're going to have a much bigger reaction.

Dr. Aliza Pressman (0:32)

Welcome to Raising Good humans podcast. I'm Dr. Aliza Pressman, Developmental psychologist and host, and I'm here today with Dr. Blaise Aguirre, who is a psychiatrist and author and renowned leader in the field of child psychiatry. His latest book, I hate Myself Overcoming self hatred and realize why you're wrong about you, is coming at a really important time. He's a professor of psychiatry at Harvard Medical School and he tackles really hard stuff. He's also the medical director at the McLean Hospital, which is a very important place that serves families with the continuum of care using dialectical behavioral therapy. He's just incredibly well regarded. His contributions are immeasurable. So I'm really thrilled to be able to bring this episode to you. One of the things that struck me is how he talks about peanut allergies and the metaphor of for those highly sensitive, highly attuned kids and people saying something critical, making just a quick comment can be like peanut for someone with a peanut allergy. Whereas a kid who's kind of that dandelion that just sort of moves along, you can make those kind of flippant comments too. You could tell them to stop being lazy and get going and all the things. But when you say that to someone for whom there's the equivalent of a peanut allergy, it's gonna feel different than somebody who can eat a bunch of peanuts and move along. I thought that was a very helpful way of distinguishing between why some kids are able to experience things or hear things and bounce back. And some kids just temperamentally are coming from a different place. And so we need to give those kids more tools to be able to move through the world with more ease and, and self compassion. I think we need to define self hatred in a culture where we talk about self hatred so much. And I also just to. To get the landscape correct, can you just talk about the distinction between self hatred where we're worried and just those days when you see your teenagers come home or your kids or your adult self and you just feel like, I don't I don't like this, I don't like this person that I am today.

Dr. Blaise Aguirre (3:21)

Yeah, no, I mean, it's such an important distinction. And I think that all of us have, have those days where, you know, maybe as a parent, I didn't manifest the best version of who I am. You know, I said something that was, I don't know, hurtful to my kids. Maybe as a colleague, I didn't listen. Maybe as a therapist I was short and abrupt with my patient who is, you know, I was getting frustrated and annoyed with. And you know, we all have those moments and there could be lots and lots of things. I mean, maybe something actual happening in our life, maybe it could be dehydration, we haven't eaten well, the weather's off, and just not feeling goodness about ourselves. But typically speaking, if we were to sort of zoom out and think about ourselves, you know, they wouldn't, There would be a recognition of dissatisfaction and there would also be a recognition that if certain things changed in our lives, like maybe if we had a meal or maybe if we had a bed, if we were able to call our colleague and have a discussion with him or just be able to repair with our kid or just that the sun came out or something like that, that things would be better, the sun will come out tomorrow. But, but the kind of experience that I'm talking about has to do with this idea that the things that are making life difficult don't lie without, but actually lie within. And that there's a flawedness to the self, there's a brokenness, a non deservingness to the self that is built into the fabric of who the human being is. And, and because of that, it's inescapable. So if you have a, if you've had like 10 rainy, dreary days and you're just not feeling good because you haven't been able to exercise and stuff like that, you know that that's going to end at that and that things will change. But for, but for people with the core self hatred that I was talking about, there's no, you know, there's the perception of not being able to escape it because it is part of who, who I am. It's like in the same way that I cannot escape from my heart or from my lungs or from my brain, it is, it is a core part of who I, who I am. So there's not a transientness from their point of view.

Dr. Blaise Aguirre (5:47)

So I'll just start, right? Yeah, well, so here's the thing is, you know, it struck me that many people with self hatred didn't actually recognize how much they hated themselves. And, and when I thought about this is, you know, a fish doesn't question that it's in water. I mean, it's surrounded by water all the time. And you know, maybe if it gets fished or you know, you know, taken out of the water, it says what the heck is going on here? There's this other entity called air or land or something like that. And. But as long as it's in water and surrounded by other fish, it just thinks water is the only medium. So what was interesting is that for a young child, say 4 or 5 years old, who's experiencing experiences, for lack of a better word, that somehow tell it that it is unworthy, that it is not as good as, that it is not good enough, that it is deserving of punishment, deserving of very unpleasant experiences, if that's the water that it lives in, it's the only thing it's going to know. And so what happens is, is that here's this child, you know, kind of going along, maybe they're experiencing comparisons with the older sibling at home, punishment from parents for whatever transgression they've done. And it's constant, constant belittling. Maybe they're going to kindergarten and they're being bullied at school. Maybe there's physical sexual abuse, emotional abuse. And it doesn't necessarily need to be something manifestly cruel, but it could just be, you know what, you're kind of lazy, you know, you're not, you're not as talented as your sibling. And maybe, maybe what they see is they don't even have those kinds of comparisons, but they see the parents glowing over the wonderful older child, but, and they say, wow, I don't get that kind of glow and there's something wrong with, with me and no matter how much I try and not, not that good enough. And so clearly there's something fundamentally flawed about me, but different from, you know, to the person who's always had a headache, having a headache is just the thing that they have. But if you've never had a headache and then you develop a headache, then you say, wow, I have a headache. So, so when these young people would come into our program and say, you know, that they were depressed or anxious or feeling suicidal or feeling self destructive, that, that when I would start to explore that experience and wonder about that suicidality. And I would say, you know, well, why don't you, you know, why is it that you're choosing. Why is it that you're choosing, you know, courses below the ones that you're able to study? Or why is it that you're choosing romantic partners that are, you know, kind of, you know, maybe hurtful to you? Or why is it that you aren't applying to jobs that you're better qualified for? And they said, well, I'm just not that good. I'm just like, you know, not, not a very good person. I'm not a very deserving person. And then I would say things like, well, that, you know, you're not treating yourself very well. And they said, well, of course not, because, like, I'm just not that worthy. And I said, you know, it doesn't sound like you like yourself very much and say, well, duh, you know, like, I hate myself. Like, it's so obvious. Like, that's just. Yeah, it's just obvious. And then, and then what happens is when it gets really extreme and they don't have someone who can listen to them and validate how difficult it is, they start to feel that they're a burden to, to the people that they love in the society that they live in. And unfortunately, the idea of suicide then becomes pretty entrenched. And the thing about it is that in that situation, no amount of telling that person that you love them, that they're worthy is going to make any sort of dent, because it's not what they believe, you know, it's, it's, it's. They've been taught something about themselves that's not true. And so, you know, you know, you, you, you, you identify as a mom, right? I mean, there's very much, there's no, there's no way that I could convince you that you're a father, is there?

Dr. Aliza Pressman (10:57)

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Dr. Blaise Aguirre (16:02)

So then I say, okay, well, let me just listen to how hard that is for you. You say, oh, so you're telling me that I have to accept my flaws. And just like that, that's. That you're just going to accept me because I'm such a terrible individual, you know, so. So I couldn't. I couldn't get at it using any of these approaches. And, you know, I care deeply about my patients. I certainly don't want them to kill themselves. But they, you know, I mean, and they would actually start to get really upset with me when I would say, okay, we've got to tackle this. And so the breakthrough I had was the idea that in as much as a child is born with lungs and a heart and a spleen and a liver and all of these things, the child is not born hating itself. It has to learn how to hate itself. And if it can learn to hate itself, it can learn to love itself, because love comes much more naturally to the human heart than hatred does. And so when I started to say, you learned this, you weren't born with this. This wasn't built into your DNA. This isn't the fabric of your essence or the essence of your fabric. This is something that you learned. So let's start off with finding out, when did you learn this? Who were your teachers? Now, it's such a bizarre question coming from a psychiatrist, like, who are your teachers of self? Hatred. It's normally like, uh, so when did you start having nightmares? You know, so, okay, you know, that was three years ago when I apple fell on my head or something. And you say, okay, but. But it's. It's like, wait, what? You know, I said like, you weren't born that way. You, you were not born hating yourself. You. Like, that had to develop. That had to. And that development had to be because of learning. And that learning had to be because you had teachers who were teaching you that you were not enough, that you were not worthy, and that you didn't have a protective other person who told you that those experiences were toxic to you. So now you have a. You know, it's sort of like, wait a second. These teachers of old, I've learned their lessons, but they're not the people that I aspire to be like. So, okay, how do we unlearn that messaging? And so what? I got them to do is I'd actually literally got them to start writing when they first started to notice this whole concept of self hatred and to write down all the people in their lives who had been hurtful to them, who had been, who had taught them that they weren't enough. Now there would be times when some of those people were actually people that they loved. Like say a parent who would constantly compare them to the older sibling and saying, you know, like, that wasn't nice of my, you know, like my parents, I understand that they didn't know that. They didn't know what the impact was on me. But every single day I would come home and I would just see the trophies and I would see the accolades and I would see the praise and I just realized that I was less than. And then there were the teachers in gym who told me like, I was never going to be good at something or, you know, or the uncle who maybe sexually abused me. Whatever, whatever, whatever that hurt was that said you are deserving of bad things happening to you because. And the only conclusion that a child can come up with is that it's because I am a bad child. So if we get back to this question, it's starting to show that this evolves from a place of non self hatred to self hatred because of these lessons and that you can begin to unlearn them.

Dr. Blaise Aguirre (23:02)

No, I think it's a really important question. And I think, I mean, you know, if you could imagine that, that you were born with a certain temperament and that you were irritable a lot of the time and that, I mean, and we've all experienced irritability within ourselves and it's just a very unpleasant state to be in. But what if you had to live that way the entire time? Certainly one would have to think about, are there biological interventions such as, is it representative of an underlying depression or, you know, bipolar disorder? And could in those situations, medications make sense? You know, if you've got a toothache, Like, I'm very unpleasant when I've got a bad toothache. So, you know, either when I'm given, you know, painkillers or the tooth is dealt with, then I become a much more pleasant person. But I think, you know, I'd hate to, to. I'd hate to be myself with, with a constant toothache. But there's, you know, so, so sometimes there might be some sort of biological underpinning. But what about the idea that, what if somebody were to say, you know, just, I don't know, like, people just don't like me. You know, they don't like me, they think I'm awful. And, and nothing has particularly happened. I mean, it's not, you know, that there's been no real like abuse or whatever it is. But maybe they do a lot of their own comparisons in their mind. You know, I'm not as popular as I'm not as good as I'm, you know, and, and I think that there has to be a level of acceptance. Like, I mean, there's a thousand million things that I'm really not good at. I'm a great psychiatrist. I, I started to accept that and it's just okay because thank God I'm good at something because, like, don't make me cook. You know, my kids used to say that me cooking was like intermittent fasting. You know, it was, it was just so terrible. But, you know, there's lots of things I can't do, but I'm good at some things. And it's. And again, not, not that that replaces how I feel necessarily about myself. But you also have to be accepting, like, okay, like, you might not be the smartest, the tallest. Parenthetically, it's interesting how contemporary society, social media, markets to self hatred. You know, you're not thin enough, you're not tall enough, you're not pretty enough. You're not, you're not a good enough parent. You're not a good enough parent. But if you buy my book, you know.

Dr. Blaise Aguirre (25:43)

Exactly. Yeah, absolutely. And not everybody's going to either like this or resonate with it or. And they're also going to have ideas that, you know, that some of these ideas are wrong. And I have to validate that, you know, just, you know, because that's whatever their experience is. But, but it's interesting, you know, you just get on anything and it's, it's, it's, you know, if you worked harder, you'd be able to buy yourself a yacht or, or whatever it is. And, and there's a, a less than this not enoughness that is being, you know, kind of propagated out there. And I think it's much more difficult now if you have some core difficult experiences and you're constantly in this comparative state. Like, I'm going to compare myself to something else. I'm not as much as I really don't like myself. Typically speaking, you know, that degree of self dissatisfaction doesn't lead to the level of self hatred that I'm talking about, to the point where the person doesn't feel that they're a burden to others and that they need to take themselves. But the one thing I would say about this is telling the child, like, if somebody says, you know, like, oh, nobody likes me at school, to say, that's ridiculous. Of course people like you at school. You know, just last week you were at 63 parties. I mean, you know, what are you talking about? Everybody likes you. You're constantly being invited. So rather than challenging the idea, it's actually to get curious about how the child got there. It's like, what? Okay, like I'm, you know, I have to say, like, I'm confused by that. And that's what you're feeling. So tell me how you got there. You know, what you want to do is you want to start initiating a process of critical thinking that gets them to evaluate the circumstance in a much clearer way. Because what happens if you tell them that's ridiculous, People love you, move on. It immediately shuts down an experience that the child is having without allowing them to sort of see how they got there. And then they come to the conclusion, well, mom just doesn't know who I am. Like, she just doesn't get it. Or.

Dr. Aliza Pressman (27:56)

Now for a quick break so I can tell you about my sponsors. We talk about all the different ways to parent, but a topic that comes up consistently and rightfully so are teens and their relationship to social media. And regardless of whether you loathe social media, have mixed feelings about social media. Think social media is awesome. Whatever your feelings, teens need support from adults to responsibly manage their social media. So I'm excited that Instagram created teen accounts because they are built to give parents more peace of mind that the right protections are in place. Know that now there is sleep mode that automatically mutes notifications overnight between teens 10 and 7am Again, I think you should just grab those phones and take them out of the room. But how great to know that if you forget, at least it's in sleep mode. There's also importantly all profiles are automated into privacy by default, so they're only allowed to be public if you actually make them public. The content restrictions and automatic filters for offensive comments are automated. You don't have to sign them up for it. All of these things are set to automatic so there is no extra work on parents. Instagram is automatically placing teens into teen accounts and teens under 16 will need a parent's permission to change any of the settings to be less strict. So Instagram teen accounts will limit who can contact teens and the content they see help ensure teens time on the app is better spent and that I can get behind. I want to tell you about my sponsor Vionic, which has the best essential styles for everyday wear that helps your feet feel good and healthy. Because if you're walking around a lot, which hopefully we are, you want comfort and support and that is where Vyonx comes in. Vyonx exclusive Viomotion technology is what sets them apart. They basically began revolutionizing medical orthotics and now they're committed to harnessing that medical foundation in the advancement of biomechanics to engineer significantly better performance shoes that strengthen your natural movement while aligning and balancing you feet first. Every shoe in Bionic is powered by their VIO motion technology. So they look good, but there's also well being in every pair. Bionic is about the science that sets you in motion. So when I'm walking around the city, the Uptown Willa is awesome. It's a new everyday essential, but Bionic's most coveted style. This Uptown loafer has a new friend. It's part sneaker, part moccasin. It's a streamlined design that delivers wearable wellbeing for your feet. So you can walk around, chase toddlers, get your steps in and your back won't feel terrible. Use the Code Humans at checkout for 15% off your entire order at www.vionics s h o e s.com www.vionicsshoes.com when you log into your account, it's one time use only Vionix shoes, wearable well being for your feet. Okay, I want to tell you about Molly Suds because I happen to love this brand. Molly Suds is a brand that's really helpful when you want to create a safe environment at home and just makes it really easy for you. So I don't know if you all know this, but a lot of laundry detergents contain terrible additives that can do harm, especially when you have sensitive skin. And so you can ditch those nasty chemicals and switch to Molly Suds. And I love it because Molly Suds laundry detergent is free from formaldehyde and synthetic dyes and artificial fragrances and all the harmful chemicals that frankly bother me because I just have sensitive skin but also make me feel just not good about putting it in my household. And Molly Suds is cruelty free vegan and leaping bunny certified and it's made in the usa. So now you can just get Molly Suds. They've launched at Target so you can grab it on your next shopping trip or, or you can order it now with my exclusive URL to get 20% off all Molly Suds products. So for this fantastic deal, go to mollysuds.com humans and use the code humans at checkout. Again, for 20% off, go to M O L L Y s s u d s.com humans and use the code Humans at checkout. So I, I think that's worth spending a little bit of time on just some compassionate, loving ways to support kids when they make statements that feel incredibly hard to hear for. Like we don't want to hear them criticizing themselves or saying something that we, we know can't be true in the, you know, objectively, from when, from our view at least. What are some ways to support authentically, of course. But like, what are some ways to support kids in those moments when they do report these terrible things that they're feeling?

Dr. Blaise Aguirre (33:16)

You know, so the first thing is they, they aren't going to spontaneously arise. They're not like sitting there eating, you know, their scrambled eggs for breakfast and all of a sudden the thought will pop into their mind, you know, nobody loves me. That, that's just a, that would be a very, very unusual experience. What'll happen is, I don't know, they'll go to school and the teacher will tell them to, you know, split up into groups and their best friend will go and sit with somebody else. And that will then, then lead to, you know, well, and I need to say this before I finish this statement. And that is all the kids that I, that I worked with that had core self hatred are all ultra sensitive people. So there are children who not sensitive, which is like, ah, you know, good, like I'm gonna whatever, like just move on. But for the ultra sensitive child who in that, in the, in the situation I just described, says, my best friend chose to be with somebody else, like clearly there's something wrong with me or like maybe they don't like me or maybe they're going to abandon me. And so by the time they, they come home because they're so sensitive, they've been playing this over and over and over in their head. And now what was just like an incident and who knows why that incident occurred, it then has taken on a magnitude of its own that is just much, much bigger than what the original incident was. And they've come to all sorts of conclusions. And so rather than saying like that's not true, it's like, really, it's to sort of get curious about, wow, what happened today. Can you just tell me what happened today? And do it with just radical curiosity because you don't know what happened today. But don't be like, huh, like, of course that's not true. It's sort of like what happened? What happened that you got there, what happened that. That showed up? And you know, maybe they start to tell you about, about, oh, you know, we had to pick groups and my friend went with this other group. You say, okay, yeah, that sounds like kind of painful. Like you wanted to be with your friend. But, but how did you, why did you get to like that you hate yourself? I still, I don't see the connection between those two things. So then it forces them like to say, well, okay, I don't really hate myself. I just didn't like that my friend was, was doing that. But it'll get them to more critical thinking. But if you shut that down, then they're going to say like, okay, you don't understand, you're not even curious. And then they'll go back to school the next day, they don't want to speak to their friend because, and find out what happened because they're so sensitive and might possibly get rejected or ridiculed for having those Kinds of thoughts. So it's sort of, it's standing back and just being curious about, about whatever the experience is, you know. I'm so stupid. Saying what? Oh, like what happened? Oh, man, I, I, you know, I got, I got a B on a test or something and. Yeah, okay, so, but what do you mean you're so stupid? Like, I should have gotten an A. So what happened? You know, maybe they didn't study. My, I went to Notre Dame. My dad found my report card for my first year in Notre Dame and I was put on academic probation. And why? Because I got a D. In what course? In psychology. What kind of psychology? Psychology of personality. So it was, it was like, you know, okay, that wouldn't have predicted that I would be at Harvard today teaching psychiatry like one.

Dr. Blaise Aguirre (38:13)

Yeah. Imagine that there were five kids and they're all Learning how to ride bicycles. And say three of them were like, very athletic and got it right away. And one was sort of maybe less so and less coordinated. And then the other one was just like really uncoordinated whatsoever. That in that particular context, if that fifth child was very, very sensitive, they might then conclude that they're terrible at bike riding, that people aren't going to like them, that they're never going to be able to have fun with their friends. And so if you knew that about that child, the thing to do would be to help that child out with the deficits that they have, which might be coordination, might be bike riding, they might need some extra help. So, so there are very sensitive people who have the skill set to manage sensitivity. It just comes to them intuitively. And maybe they had very supportive parents who just taught them what to do with strong emotions. But when the child doesn't know what to do, the kind thing to remember is that they don't have the skills to be able to manage their sensitivity or that the conditions are so powerful that no amount of regulation is going to allow them to manage their emotions. So if you think about somebody who's a very good swimmer in a, you know, in an oceanic storm, it wouldn't matter how good a swimmer is, they're going to drown just like everybody else because the conditions are, are too big. So when that child who doesn't know how to manage their strong emotions. And what do I mean by this emotionally sensitive child? It's a child who feel things quicker than other people to seemingly smaller provocation. The amplitude of that emotion is much higher, and it takes them longer to get to their emotional baseline. When that child cannot manage their, their emotions, you know, they might hear critical statements like, you know, oh, you're so emotional, you're so sensitive, you're being such a baby, and those kinds of things. But when, when, when they learn how to manage those emotions, they then have agency over their own experience. They have competence over their own experience. And once they start to feel that agency, they start to feel much better about themselves and they tend to be less, less critical about themselves. So, so, so the tools, you know, that certainly the ones that I teach are, are the tools of a treatment such as mine known as dialectical behavior therapy, which teaches emotion regulation, so skills and meditation. But there are cognitive behavioral therapy skills, there's social emotional learning in schools. You know, can, can teach some of these skills. But rather than, than, than, than thinking of these skills, these kids as willful is to think of them as lacking the skill set to be able to manage emotions effectively and that the kind thing to do is to teach them. So it's just to know that about your kid, you know, and not like wow, if you were more like Johnny, Johnny's always in control of himself. Well, you know, Johnny might not be emotionally sensitive and just might be temperamentally different and just calmer. Just the things that bother one person don't bother another person. Imagine telling the child that is allergic to peanuts to stop being allergic to peanuts, right? It's just like, you know, something that you can tell someone to do if that, if that one child is and one child isn't, you have to manage the condition that is, which is the sensitivity to peanuts.

Dr. Aliza Pressman (44:23)

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Dr. Blaise Aguirre (48:25)

So, okay, I think that the point that you've made is a beautiful point and it shows wonderful critical thinking because I think that manipulators of data can, can make anything seem worse or better than it is. I, you know, I've been fortunate enough to now start teaching all over the world and recently I was invited to India because the absolute numbers of adolescent suicide were going up. Now, is it that they are going up in an absolute way? Is it that reporting has gotten better? I was once teaching in the Middle east and the Middle Eastern country where I was teaching. I said, you know, what is your rate of adolescent suicide? And they said, we don't have adolescent suicide in our country, which is just unthinkable because it's increasing all over the world. So there must be, say there's not a single case. Okay, so it gets back to your question about is it that there is more depression, more anxiety, you know, and certainly some of the indicators might be that you know, the emergency rooms have more. Are seeing more people with depression and anxiety. So you could say, you know, that that's true, that there's more deaths of despair. And by that, not just suicide, but, you know, drug overdose, fentanyl, substance use, that there's more of that. So that, you know, that there's certainly a level of despair and dissatisfaction that seems to be increasing, that all my colleagues are full in their private practices and can't take any more patients despite the demand. So those would be indicators that in fact, it is going up in adolescence. But I think, you know, one of the things I worry about tremendously is that, is that, I mean, as a child, I remember telling my mother I was bored, and she said, only boring people get bored. And I was so affronted that she said that I said, okay, well, I'm going to find out something to do that. That I had to find a way to kind of use my mind to entertain myself. And. And, you know, I was the oldest of eight kids. And we had to find a way, you know, that we entertain ourselves. And it led to a level of creativity. And not to say that, you know, we weren't upset when there were breakups and all those things like that, but we were constantly, like, figuring something out. And I just. I find that many of the young people I see now, I also want to. There's a bit of a caveat here, and that's that I work is who I'm seeing, but there's a certain fear of. Of. Of. Of newness. I mean, and I mean, you certainly. I see recklessness as well, but just, you know, kind of a worry that. That somehow that the world, if they do certain things, that the world is going to not allow them to succeed. And so they. They seem more hesitant. I think that Covid had a very, very big impact. A lot of micro connections that should have happened in school, playgrounds were. Were stolen from children. And you know, you need. You know, there were thousands and thousands, thousands of micro connections that could have taken place. Place where kids could have figured something out. Like they'd have to deal with different kinds of friendships and. And different kinds of playground activities and school activities, and those were all taken away. And it's very, very hard to get those back. So I think, you know, there was Covid. I mean, it. So it's multifactorial. I think that. I think that the world as it is is a more anxious place. We. We. The news spreads very quickly, fake news even quicker. There's social media, there Was, you know, pandemic. There is unrelenting pressure to try to get into good colleges and I don't know when the teen learns how to breathe, you know, and just like, and just like be at peace, you know. And I think that all of these things contribute and I, so I, so, you know, I mean, I really think that more than taking an antidepressant, you have to live an antidepressant life by doing some of the things that bring you joy outside of the instant demands of getting into college and stuff, like reading a book, you know, watching your favorite Netflix series and, and whatever it is, hanging out with friends, you know, I don't know, like those things are better than, like, than, than getting straight A's and then getting into a college where you're going to be miserable.

Dr. Blaise Aguirre (53:47)

Yeah, I think I would just go and listen, you know. And by the way, I think one of, one of my kids did have a major depressive episode in college and did need therapy and did need medication. So it's not again, like, I'm not going to dismiss that. I mean if there are true symptoms where a person's like staying in bed extra late, not eating, not bathing, you know, just like very self critical thoughts, unable to do something clearly you need to have some sort of intervention when this has been going on for a period of time. But you know, when the child comes in and they're just like kind of, you know, they have an off day and they don't want to hug and they typically do, or, you know, it's, it's, it's. Is there a way to lighten the moment? But often it's just, it's just like, hey, what's going on? I'm just like noticing that there's, I'm just noticing that you're off a little bit. And if they, even if they tell you to like, mind your own business and, and to leave them alone, what you've done is you've established a method of communication, an openness to communicate that says I'm here, you know, But I think that sometimes what'll happen is like the kid will come home and they're a little bit off and now the parents get really worried and they're following the child all around and you know, like, tell me what's going on. You got to tell me right now. And they're saying like, what's going on? It's like, I wasn't really happy, but now you've made me even more unhappy, you know, because leave me alone. And it's just like, I'm here, you know, I'm here. You don't have to solve that child's problem. It's like, we've got to. Listening is the most powerful problem solving technique that we have without having to actually solve it for them. So I just, I think that my kids would say that I listened and that that was the most helpful thing. And then, and then if they needed my help, to ask for help. I mean, I used to jump in and try to solve problems as a parent. It just wasn't that helpful. And listening and offering to help was much more powerful.