By Leslie Becker-Phelps, PhD
Clients who feel worthless are chronically unhappy. They might find some solace by throwing themselves into work or by being an incredibly kind and caring friend. But underneath it all, they have a nagging sense that they don’t matter. In therapy, they might express their emotions and dutifully complete their homework assignments, but it is all just to be cooperative and avoid rejection. So, the therapy remains stuck.
For these clients, developing a warm, trusting connection with a therapist can be particularly effective in helping them progress in treatment. They make gains when they are able to experience you as a caring figure who is empathic, compassionate, and affected by your interactions together. However, their self-concepts resist this. So, therapy progresses with repeated moments of connecting—even if just brief ones. These moments work by loosening clients’ rigid self-perceptions, opening them to the experience of feeling that they have value.
It is important that these clients make the connection that they, like all people, have inherent value—based on who they are, not what they do. For instance, you might note that people generally have a sense that all infants are precious, despite the fact that they do nothing of value—and they need to be fed, changed, and comforted to stop crying. Such examples won’t cause sudden and lasting epiphanies, but they might cause these clients to briefly doubt the “hard truth” of their self-perceptions. This is progress, especially when the experience is repeated and clients feel safe enough to explore these doubts (either verbally or in allowing themselves to feel they sometimes have worth).
Whatever other approach you use in therapy, clients who are convinced they have no worth can blossom if they feel safe and valued enough to explore the possibility that they do matter.
Leslie Becker-Phelps, PhD, is a licensed psychologist, author, and speaker. She writes The Art of Relationships blog for WebMD and is the relationship expert for WebMD’s relationships and coping community. She also writes the blog Making Change for Psychology Today. Becker-Phelps previously served at Somerset Medical Center in Somerville, NJ, as director of women's psychological services and chief of psychology in the department of psychiatry. She lives with her husband and two sons in Basking Ridge, NJ. Find out more about her at www.drbecker-phelps.com.