Therapy for Low Self-Esteem: "why do I feel not good enough and how do I change it".

Self-esteem quizzes are not going to give you the answer

One of the most common questions I am asked is "why do I feel not good enough and how do I change it".

There are a lot of words and phrases in the English language that we use and don't often consider what they actually mean.

Self-esteem is one of them. I would invite you to pause for a moment and jot down your definition of self-esteem, before you read on.

Even when I am writing this, after nearly 20 years of working with people experiencing anxiety, often coming from low self-esteem, I am struggling to find a succinct way to define it myself. And that is because, it is a very complex thing. I don't think that trying to find a sentence or two to try and define self-esteem is a helpful thing to do. For me, self-esteem is the very essence of being human.

When we think of self-esteem, we tend to think of the low kind! But there is also resilience that comes from a sense of self worth. Most of my clients will talk to me about their confusion of what they often call the rollercoaster of their experience of being them. At times, feeling like they are coping well, happy enough and fairly content. At other times, wracked with worry, doubt and very stressed, not sleeping, not very productive.

I would qualify this by saying that is perfectly natural to have struggles in life. Crap happens, right? So when is it something more?

As you know, we have labels for everything in psychology (as with just about everything). Labels of Obsessive Compulsive Disorder (OCD), Social Anxiety and so on. Interestingly, in the world of psychiatry (the diagnosticians) self-esteem is not a label. Whilst we all are so familiar with the concept, it is not a 'thing' to be treated. So there is not so much research around it. And the research there is, is very mixed. To add to the confusion there are 10,000s of articles, fix it immediately social media posts, self-help books and the like, aren't there? I find it a bit crazy! I therefore, can't say to you that x = low self-esteem. Studies that have been done cannot conclusively suggest that factors in childhood that lead to low self-esteem mean that the adult self is going to be anxious or depressed either.

However, in my clinical experience, most of the clients I have seen over 18 years have low self esteem that underpins their anxiety and/or depression. But that is not to say, that everyone who has low self-esteem will go on to develop anxiety and/or depression. Again, this is a very complex and multi-faceted thing.

First of all, my personal opinion is, that low self-esteem, in essence, are the fears we have about ourselves that we think might be true. Those fears, often referred to as core beliefs in CBT, colour the way we see ourselves and our own self-worth. Those fears of not being good enough, that we are an imposter (imposter syndrome), no-one could really love or like us, as examples (there are far more). It can make us feel really low and pessimistic about life. Low self-esteem kind of skews how we evaluate ourselves in terms of achievement. We may focus only on the odd thing that might not go according to plan, and disregard and reject all the successes and compliments we receive from others about our achievements.

Low self-esteem is further fuelled by that harsh critical voice in our head that tells you that you're not good enough, not worthy of love, or not capable of achieving the things you want in life. It's the feeling that other people have something you don't or are better than you. It can lead us to making unhelpful comparisons to others, and always finding ourselves inferior.

We have often learnt this poor opinion of ourselves much earlier in our life. That critical teacher. A well meaning parent trying to motivate us. As a child we may have felt that being loved and/or accepted meant we had to perform well or perfectly. Even if that is not what parents intended. We may have been bullied. Failed relationships. We might have experienced a difficult childhood where things were uncertain. For some people, one event, can really make them question themselves. It is that horrible self-doubt that can lead my clients to have little faith in themselves.

Often my clients will say, but it was not that bad. I wasn't abused. It is not about the severity of what happened, it is about the impact it has had on us.

If that sounds familiar, you're not alone. Low self-esteem is one of the most common reasons people seek therapy, and often, my clients do not realise that is at the bottom of their anxiety. And that is anxiety by any label, worrying, OCD, social anxiety and so on.

I am often asked, how do I know if I have low self-esteem.

Common signs of low self-esteem are:

• Reassurance seeking

• Difficulty with accepting compliments

• Huge distress over 'mistakes' perceived or otherwise

• Comparing self to others unfavourably

• Feeling a failure, despite others saying how successful you are

• Pessimism

• Perfectionism

• Checking

• Avoidance

• Procrastination

• Avoidance

• Worrying

• Post-mortems (going over past conversations)

To name but a few!

I don't think that a few tips really help anyone. Those types of tips are not individualised to you.

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You might be interested to read why in another article that I wrote:

Why “2-Minute Life Hacks” Don’t Really Work—Especially When You're Anxious

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What does help is individualised therapy to help you understand where these fears come from. That will hopefully give you the answer to the 'why am I like this?' question and then we can develop strategies to help you manage all those strong emotions, anxiety and thoughts to develop more helpful coping strategies.

In these current times, you may worry about the cost of private therapy. This is totally valid. I have been working with clients, more lately, every two weeks, rather than weekly to make this easier. It does mean you have to be really committed and do some work between sessions, but outcomes are good so far.

If this article has raised some questions for you, I would be happy to try and answer them for you. I offer a no obligation, 20 minute free phone call. It really is no obligation. I will not contact you after that call.

Or you can join me over at Substack for some free resources and to get to know me a bit better, you can find me here

Or click here to get in touch now.

I look forward to hearing from you.

With all warm wishes

Jane