Caring about the self involves making efforts to do the things which enhance and value the self both in the present and where the effects of these efforts extend into the future. Efforts in the here and now are more easily taken up then efforts organized around a future self. There are many ways to not care about the self, especially the self extended into the future. In most of these non caring instances the person does not even think about the self extended into the future. He/she does not have an image, a story of "I", "me" and what these choices will help create and/or wreck for some future me.
Why does this lack of caring happen. I think there are many forces at play, one of them involves "a lack", and "absence" in the persons growing up years; for example, think about whether the child was required to take care of his/her teeth growing up, and what kind of effort was put into it. Another factor involves the aging process, wherein opportunities for the creation of possible parts of a self have waned. Part of the task of therapy is to help the person see this lack of caring about the self and find ways to challenge the person to take up the effort. Belief in the patient's potential is very important here.
