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The Positive Outcomes Blog

Self Loathing: A Clinical Tool

By Laxmi Parmeswar, MA MS LPC DCC

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Most people who have been diagnosed with anything on any version of the Diagnostic and Statistic Manual (DSM) have most likely experienced either covert or overt self-hate. Sometimes it is full blown and sometimes it is masked as something else. It may present itself as acute, chronic, a fleeting, temporary phase or a deep-rooted personality trait.

Most people who suffer from depression or anxiety disorders typically report “I don’t think I like myself” in clinical interviews. Those with personality disorders usually wear it as a second skin- even those who display strong anti-social tendencies or feelings of narcissism report a feeling of self-hate. 

Self-loathing is complex and complicated and continues to remain a critical issue that needs to be addressed with care, caution and good clinical acumen. It promotes ‘clinical resistance’ especially when clients say- “I don’t deserve to feel better because I hate myself.” It can pose as an insurmountable barrier in multiple settings leading to clinical/treatment providers, teachers, bosses, parents and friends feeling stuck and ‘apathetic’!

The first step is recognizing it and the following questionnaire can be used to assess if it exists and to what extent. It can be a conversation starter and encourage reflection and understanding for all parties concerned.


We are a product of our genes, life experiences, successes, failures, traumas, privileges, circumstances, gifts, weaknesses, growth areas and so on. BUT do we suffer from self-loathing? Here’s a quick test:

Answer yes or no to each question truthfully based on your feeling at this moment in time.

1.   My past experience and my life story has forced me to work harder.

2.   I am disciplined in following through on most tasks regardless of whether it goes well or not.

3.   I have pretty high expectations and they seem to be consistently higher than what I am able to accomplish.

4.   After a period of careful self-examination, I have discovered that I can’t let go of criticisms from others. 

5.   When learning something new, I approach it slowly- taking small steps, making incremental, but steady progress, punctuated by feelings of despair and doubt.

6.   I strive for perfection in everything I do and opt out when it seems unrealistic or unlikely that I will achieve it.

7.   I feel uncomfortable when I am recognized and appreciated because I don’t always deserve it.

8.   I socialize with people when I suspect that they may not like me or approve of my choices.

9.   I am prone to experience rage towards strangers when I perceive injustice.

10.  I am able to re-examine past negative experiences and discern what I was responsible for and what was not my responsibility.

11. My perceptions of past rejections are distorted by shame and fear.

12.  My biggest worry is that people will see me the way I see myself; so I feel the need to hide the REAL me.

This questionnaire has not been researched and there is no reliability or validity data available at this time. It is recommended for use as a clinical tool in treatment settings as a starting point for reflection and understanding.

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