Self-Esteem Issues

WHAT IS SELF-ESTEEM?

Self-esteem is the amount of respect or self-worth that a person has for himself or herself. People are often described as having either high self-esteem, meaning they think very well of themselves and their abilities, or low self-esteem, meaning they are filled with doubts and criticisms about themselves and their abilities. People with low self-esteem may experience many problems in their lives. However, the term “low self-esteem” is only a popular description of the way a person thinks or feels about himself or herself; it isn’t an official diagnosis of a mental health problem. Nevertheless, many mental health care professionals agree that healthy self-esteem is important to many aspects of a person’s life.¹

People with low self-esteem often think of themselves in very critical ways, such as “I’m not good enough,” “I’m a failure,” or “I’ll never amount to anything.” And with these thoughts come painful feelings, such as sadness, anger, anxiety, fear, and worthlessness. People with low self-esteem may find it harder to make decisions, because they doubt that they’ll be successful. They also find it harder to make friends, because they’re shy or they don’t think other people will like them. In addition, people with low self-esteem frequently stay away from situations in which they might be judged, so they avoid taking chances or trying new things, especially when other people are around.

In comparison, people with higher self-esteem often report having happier and more satisfying lives.^2-4 They’re more confident about their abilities to cope with problems and take on new challenges, and also more likely to approach new people to make friends. In some studies, high self-esteem often acts as a protective factor for many people, helping them deal more effectively with common stressors in life.⁵

But despite these potential benefits, many mental health care professionals still disagree about the costs and benefits of helping people increase their level of self-esteem. Some researchers claim that encouraging people to raise their self-esteem does more harm than good or that it encourages people to become more narcissistic or impulsive.6 However, for people who recognize that their lives are suffering because of their critical, judgmental thoughts about themselves, increasing self-esteem, even just a little, can have many lasting benefits.⁷

ARE THERE OTHER PROBLEMS RELATED TO SELF-ESTEEM?

As previously stated, low self-esteem is not an official mental health diagnosis. But because of the fact that it results in judgmental thoughts and distressing feelings about oneself, it’s easy to understand how low self-esteem can lead to more serious problems. For example, research has found that it is often a factor in the development of problems like bulimia⁸ and depression.^{9, 10}

Low self-esteem can be particularly damaging during adolescence. One study found that it was associated with aggression, antisocial behavior, and delinquency.¹¹ Another study found that low-self esteem during adolescence was related to an increased likelihood of later problems in adulthood, including depression, anxiety, poorer physical health, increased tobacco use, increased criminal behavior, and greater employment difficulties.¹²

Because of the possibility of low self-esteem leading to bigger and more serious problems, it’s important for people who do struggle with this problem to get help as soon as possible, before the issue develops into a bigger, more serious disorder.

WHAT CAUSES SELF-ESTEEM PROBLEMS?

There are many issues that contribute to how people think of themselves and their abilities, including social, economic, cultural, and biological factors. For example, one large study found that children in families who communicated in positive ways had higher levels of self-esteem.¹³ That same study found that African-American and Latina girls had higher self-esteem than their peers, as did boys who were involved with their religious organizations. However, the same study also found that boys were more likely to report higher levels of self-esteem than girls. As you can see from this one study, there are many factors that can influence a person’s self-esteem.

But from the perspective of cognitive behavioral therapy, judgmental and self-critical thoughts often cause the problems associated with low self-esteem.⁷ For example, people with low self-esteem often think of themselves as being unworthy of happiness, unable to cope with problems, and unlikable. Such thoughts cause these people to feel sad, anxious, and generally unhappy. And then the combination of these thoughts and feelings causes them to avoid opportunities like social events, friendships, challenges, and certain kinds of jobs, which all tend to make them feel worse and judge themselves even more.

WHAT TREATMENTS ARE EFFECTIVE FOR SELF-ESTEEM PROBLEMS?

Obviously, increasing a person’s self-esteem is not as easy as repeating positive statements over and over again, such as “I’m a good person.” Real improvements in self-esteem come from challenging the self-critical thoughts that caused the problem in the first place and engaging in behaviors that have been avoided. These “lifestyle tests” are the prime focus of cognitive behavioral therapy.

COGNITIVE BEHAVIORAL THERAPY FOR SELF-ESTEEM

Cognitive behavioral therapy (CBT) is a form of treatment that combines elements of both cognitive therapy and behavior therapy. Cognitive therapy examines the way people’s thoughts about themselves, others, and the world affect their mental health. Behavior therapy investigates the way people’s actions influence their own lives and their interactions with others. By combining the two, CBT examines the way people can change their thoughts and behaviors in order to improve their lives.

The CBT treatment for self-esteem focuses on addressing the causes of the problem. In general, this treatment can be divided into ten steps:⁷

Conduct an assessment and provide education
Refute the self-critic
Challenge cognitive distortions
Develop compassion for self and others
Combat the “shoulds”
Learn to handle mistakes
Learn to respond to criticism
Use visualization and self-hypnosis techniques
Challenge core beliefs
Prevent relapse

1. Conduct an Assessment and Provide Education

The first step in the CBT treatment of self-esteem problems is to conduct an assessment. This will help determine both the cause of the problem and the ways in which a person can respond to the problem. For some people, their self-esteem levels might vary according to the situation they’re in. For example, they might feel confident about their abilities at work but have low self-esteem when they come home to their families. For other people, their self-esteem might be generally low in all aspects of their lives. Treatments for these two groups of people often incorporate different strategies, so a thorough assessment can improve the chances that the treatment will work. Self-assessment tools, such as a self-concept inventory, can also be helpful. It’s also important for the person to understand that CBT is an active form of treatment that requires him or her to do work outside of the therapy session. (Click here for information about assessing self-esteem problems.)

2. Refute the Self-Critic

The self-critic is the judgmental inner voice that tells people they’re incompetent or valueless. The self-critical voice often replays messages such as “You’ll always be alone,” “You always screw up,” and “You’ll never be happy.” Messages like these are the driving force of low self-esteem. One of the first steps of the CBT treatment is to identify these pathological, self-critical messages and confront them. It’s very important to understand where these messages come from, how they affect the person’s life, how they are strengthened over time. Based on this information, the person can begin confronting these messages with a number of different techniques, such as talking back to the self-critic. (Click here for techniques to refute the self-critic.)

3. Challenge Cognitive Distortions

Cognitive distortions are unhelpful thinking styles that often cause people to make automatic judgments about themselves, others, and the world. For example, overgeneralizing involves making broad negative conclusions about life based on limited situations, and minimizing and maximizing involve discounting the positive and enlarging the negative aspects of life. Another cognitive distortion is mind reading, where people assume they know what others are thinking about them. All of these cognitive distortions need to be successfully challenged in order to remove the power of the self-critic.

Challenging these distortions begins with identifying when they are used and then making a strong rebuttal statement every time they are noticed. For example, a person who uses mind reading might challenge that distortion by thinking, “Stop it; it’s impossible for me to know what anyone else is really thinking.” (Click here for information on identifying and challenging cognitive distortions.)

4. Develop Compassion for Self and Others

Compassion for oneself and others is an essential part of healthy self-esteem. People struggling with low self-esteem often think very poorly of who they are and what they do, even though no one is perfect and everyone struggles with self-doubts at times. What differentiates people with low self-esteem from others is that they criticize themselves more frequently than do people with healthy self-esteem.

The most important step in developing compassion is to cultivate a sense of acceptance. Simply put, acceptance is the ability to stop fighting things that cannot be changed. For example, many people would like to look different, be smarter, have a different family, or find a different job, but these things aren’t always possible. People who struggle against things that can’t be changed get very angry and frustrated. Acceptance acknowledges the facts of what can and can’t be changed, while the final step, forgiveness, releases oneself and others from judgments and criticisms.

There are many techniques people can use to develop compassion for themselves and others, such as cultivating a peaceful state of mind, understanding true self-worth, and learning to communicate without making judgments. (Click here for information on developing compassion for self and others.)

5. Combat the “Shoulds”

The “shoulds” are powerful rules that many people live by that often cause great frustration and low self-esteem. Examples of powerful “should” statements include “I should do everything perfectly,” “I should always be helping others,” and “I should be completely competent.” The truth is, no one is right all the time or perfect in everything he or she does. We all make mistakes.

The key to combating the “shoulds” is to develop healthy values that are flexible and realistic and allow for mistakes. A person with low self-esteem might need to reassess his or her values to determine their true worth, and possibly redefine those values in order to make them healthier and more compassionate. (Click here for information on combating the “shoulds.”)

6. Learn to Handle Mistakes

People with healthy self-esteem are often more compassionate toward themselves when they make mistakes and don’t continue to blame themselves for mistakes after they’ve occurred. It’s far healthier to learn from one’s mistakes than to endlessly blame oneself for them. Mistakes can be reframed as events from which a person can learn, or they can be viewed as warnings that something needs to change. In addition, mistakes can sometimes be avoided by developing a greater awareness of the benefits and disadvantages of ones actions. (Click here for information on learning to handle mistakes.)

7. Learn to Respond to Criticism

Learning to respond to criticism from others is a very important step in the cognitive behavioral treatment of low self-esteem. It begins by recognizing that other people can be critical for many reasons, many of which don’t reflect directly on the person being criticized. For example, a person might be in a bad mood and take out his or her frustration on others. Sometimes it helps to probe the other person’s criticism to determine what he or she really wants. Then it often helps to respond with assertive communication skills. Learning to be assertive can help people ask for what they want, learn to say no, and respond to criticism in a healthy way. (Click here for information on learning to respond to criticism.)

8. Use Visualization and Self-Hypnosis Techniques

Visualization skills use the power of the imagination to help people achieve their goals. These skills often begin with relaxation techniques and then proceed to imagining doing a difficult task successfully, interacting with others in effective ways, or successfully achieving a goal. These are the same techniques that many musicians, actors, and athletes use to prepare themselves for successful performances. Visualization skills prepare people for successful action by imagining that success happening.

Similarly, self-hypnosis techniques can be equally powerful. In many ways, people with low self-esteem have been brainwashed into believing that they are failures. Many of their beliefs in this regard are very old and resistant to change, but this is where self-hypnosis can be a powerful tool. Self-hypnosis techniques can help people reprogram themselves with positive, empowering messages to overcome old habits and develop self-acceptance. (Click here for information on using visualization and self-hypnosis.)

9. Challenge Core Beliefs

As the work on challenging cognitive distortions continues, people usually begin to notice common themes among their thoughts. These themes often point to deeper, more firmly entrenched core beliefs about one’s self that make a person more vulnerable to low self-esteem. These core beliefs, often called schemas, include thoughts like “I’m a failure,” “I’m worthless,” and “I’m unlovable.” When these core beliefs are encountered, they too need to be challenged and modified using an evidence log and tests of those beliefs. (Click here for instructions on challenging core beliefs.)

10. Prevent Relapse

Challenging one’s beliefs and improving self-esteem can be difficult. There are likely to be successes and difficulties during the process. The key to developing long-term, healthy self-esteem is to continue using the skills described in this section and to seek professional help when needed. (Click here for information on preventing relapse.)

REFERENCES FOR SELF-ESTEEM

1. Swann, W. B., Jr., C. Chang-Schneider, and K. Larsen McClarty. 2007. Do people’s self-views matter? Self-concept and self-esteem in everyday life. American Psychologist 62: 84-94.

2. Campbell, A. 1981. The Sense of Well-Being in America: Recent Patterns and Trends. New York: McGraw-Hill.

3. Diener, E., and M. Diener. 1995. Cross-cultural correlates of life satisfaction and self-esteem. Journal of Personality and Social Psychology 68: 653-663.

4. Lyubomirsky, S., C. Tkach, and M. R. Dimatteo. 2006. What are the differences between happiness and self-esteem? Social Indicators Research 78: 363-404.

5. Dumont, M., and M. A. Provost. 1999. Resilience in adolescents: Protective role of social support, coping strategies, self-esteem, and social activities on experience of stress and depression. Journal of Youth and Adolescence 28: 343-363.

6. Baumeister, R. F., J. D. Campbell, J. Krueger, and K. D. Vohs. Does high self-esteem cause better performance, interpersonal success, happiness, or healthier lifestyles? Psychological Science in the Public Interest 4: 1-44.

7. McKay, M., and P. Fanning. 1992. Self-Esteem: A Proven Program of Cognitive Techniques for Assessing, Improving, and Maintaining Your Self-Esteem. Oakland, CA: New Harbinger Publications.

8. Vohs, K. D., A. M. Bardone, T. E. Joiner Jr., and L. Y. Abramson. 1999. Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: A model of bulimic symptom development. Journal of Abnormal Psychology 108: 695-700.

9. Pelkonen, M., M. Marttunen, J. Kaprio, T. Huurre, and H. Aro. 2008. Adolescent 7risk factors for episodic and persistent depression in adulthood. A 16-year prospective follow-up study of adolescents. Journal of Affective Disorders 106: 123-131.

10. Roberts, J. E., I. H. Gotlib, and J. D. Kassel. 1996. Adult attachment security and symptoms of depression: The mediating roles of dysfunctional attitudes and low self-esteem. Journal of Personality and Social Psychology 70: 310-320.

11. Donnellan, B., K. Trzesniewski, R. Robins, T. Moffitt, and A. Caspi. 2005. Low self-esteem is related to aggression, antisocial behavior, and delinquency. Psychological Science 16: 328-335.

12. Trzesniewski, K., B. Donnellan, T. Moffitt, R. Robins, R. Poulton, and A. Caspi. 2006. Low self-esteem during adolescence predicts poor health, criminal behavior, and limited economic prospects during adulthood. Developmental Psychology 42: 381-390.

13. Birndorf, S., S. Ryan, P. Auinger, and M. Aten. 2005. High self-esteem among adolescents: Longitudinal trends, sex differences, and protective factors. Journal of Adolescent Health 37: 194-201.