Some are uncomfortable with the word love applied to themselves. It's not a romantic love, of course. Unconditional love of the self is a complete acceptance and approval of the self. Many will claim that their loved ones do or did love themselves and are offended at the suggestion that they didn't. Or did their facade fool people into thinking that they did.
People have a private, hidden part of themselves and a mask is developed to cover it.
A well developed facade will deny the presence of inner negativity. My facade fooled many people into thinking I loved myself and sometimes it fooled me. I have discovered that I had my feet planted firmly in the air for years when I thought they were firmly on the ground. Environmental factors play a part, too, in the disease that will manifest. Constant, habitual, negative thoughts about ourselves will create a disease in a person that they are genetically and environmentally prone to.