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Being Well · December 8, 2025 · 1h 12m

Borderline Personality: DBT and Working with Self-Hatred with Dr. Blaise Aguirre

Dr. Blaise Aguirre, Forrest Hanson

Dr. Blaise Aguirre, medical director of 3East at McLean Hospital, joins Forrest to discuss borderline personality disorder and dialectical behavior therapy. They explore how extreme emotional sensitivity can lead to despair, self-hatred, and fear of abandonment, and how DBT provides skills for emotion regulation. The conversation covers the importance of skill-building before narrative therapy, practical DBT techniques like mindfulness and opposite action, and strategies for shifting self-hatred.

This summary was generated from show notes and public descriptions, not from a full transcript review. Details may contain inaccuracies.

Canon

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Core DBT Skills: Mindfulness, Dialectic Thinking, and Opposite Action00:27:02
DBT emphasizes skills like mindfulness (present-moment awareness), dialectic thinking (balancing opposites), and opposite action (acting opposite to an emotion-driven urge).
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Highlights

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Common Features of Borderline Personality Disorder00:04:05
Dr. Aguirre outlined how extreme emotional sensitivity in BPD can lead to despair, self-hatred, suicidality, and an intense fear of abandonment.
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Skill-Building Before Narrative Work in Therapy00:15:16
For DBT to be effective, clients must first learn concrete emotion regulation and distress tolerance skills before exploring deeper personal narratives.
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How to Shift Self-Hatred00:33:43
Aguirre addressed the pervasive self-hatred many with BPD experience and how DBT techniques can restructure negative self-stories.
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Stigmatization of BPD00:49:22
People with borderline personality disorder face heavy stigma, even from healthcare providers, which can block them from receiving compassionate care.
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BPD vs. CPTSD00:53:25
Dr. Aguirre distinguished borderline personality disorder from complex PTSD, noting symptom overlap but distinct diagnostic frameworks.
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References

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DBT for Dummies — Gillian Galen and Blaise Aguirre — co-authored
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I Hate Myself: Overcome Self-Loathing and Realize Why You're Wrong About You — Blaise Aguirre — guest's book

Misc

✧Aguirre finds working with people with BPD especially rewarding because of their insight and empathy.
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