Strengthen your self-esteem

A self-esteem problem is a persistent negative perception and assessment of yourself. It affects how you think about, feel about and act in relation to yourself and the world around you. It can show in many ways, but what is common is a deep-seated insecurity and doubt about yourself and your worth as a person.

Self-esteem problems often arise in childhood. Were you met with constant criticism? Did you only feel loved when you were praised for impressive achievements or did what mum and dad thought was right? Did you feel rejected and wrong because you had different interests from the others in your class, or did you compare yourself with others and never feel good enough? Such experiences shape your self-image. But later events such as break-ups, job loss, divorce or trauma can also contribute to low self-esteem.

The signs are constant self-criticism and focus on your own mistakes, excessive worry about what others think, fear of rejection that makes you avoid others, a feeling of inadequacy and inferiority, a tendency to exaggerate mistakes and play down successes, perfectionism and constant fear of failing, and physical discomfort from the constant stress and unease. It can affect everything from relationships and working life to your physical health. Fortunately it can be treated, through therapy, your own strategies and support from those you love.

Anyone, regardless of age, gender, background, culture and education. Self-esteem problems do not discriminate. Life events such as divorce, unemployment, trauma or even "minor" disappointments can create or worsen them. Children who grow up with a lot of criticism, bullying, physical or emotional abuse, or who feel overlooked and not accepted as who they are, can develop persistent self-esteem problems. In a world of social media, where everyone shows their best sides, constant comparison can give a feeling of never measuring up, and society’s expectations of appearance, behaviour and performance create a pressure that is not always possible to live up to.

Your innate temperament also plays a part, because it shapes how you handle what is hard: do you fight, or do you give up? If you are a fighter, you can develop a great need for control and perfectionist traits, and then you become very self-critical, because it is never good enough. If you give up, you never get to experience that you actually can cope with yourself and your challenges, and so you maintain the belief that you are not good enough. Hormonal changes in puberty, during pregnancy or in the menopause can affect mood and self-esteem, and so can chronic illness, disability and other health conditions.

The important thing is that self-esteem problems can arise for many reasons and affect anyone. Acknowledging the problem and seeking help are the first steps towards stronger self-esteem and more balance in your life.

Self-esteem problems can be classified by where they come from, how they show, and how they affect your everyday life. Most people recognise themselves in several of the forms at once, and all of them very probably have roots in childhood.

Understanding which form or forms you struggle with helps us target the treatment.

Low self-esteem shows in your feelings, your thoughts, your actions and your body. Here are the reactions I see most often:

Self-esteem problems are often linked to anxiety, depression, eating disorders and addiction. Seek professional help if you have persistent or serious symptoms.

Life with low self-esteem is challenging and often painful, because self-esteem governs how you see yourself, your relationships and your place in the world. Your perception of yourself is negative and marked by self-reproach and self-criticism, and you often doubt your abilities, your worth and your importance.

That makes it hard to form and keep close relationships. You are afraid of rejection and criticism, hold back in social situations, avoid closeness or shy away from conflict. It becomes a vicious circle: you withdraw because you do not feel worth anything, so you get no close relationships, and that seems to confirm that you are worth nothing. Decisions become a struggle, because you are constantly afraid of failing or being judged, and so you become passive or far too dependent on other people’s opinions. Perhaps you set no goals for yourself at all or avoid anything where you can be judged, and that limits your opportunities. Or you become a perfectionist and chase unattainable standards to compensate for the insecurity inside.

The body pays too. Some neglect hygiene, food and exercise, and in some cases it leads to self-harm or substance abuse. Others do the opposite and become obsessed with appearance, over-train and eat extremely healthily to make up for the negative core belief about themselves. Chronic low self-esteem can precede or follow depression, anxiety, substance abuse and eating disorders, and even small everyday events, a minor mistake, can trigger overwhelming shame.

Life with low self-esteem is like carrying a heavy burden, where your own thoughts constantly undermine your wellbeing and joy in life. But it is possible, with the right support and therapy, to build healthier self-esteem and gain a completely different quality of life. I see it happen in my practice.

Low self-esteem develops over time in an interplay between internal and external factors. Self-esteem begins to take shape in the early childhood years, and negative experiences such as constant criticism, neglect, bullying or overprotection can plant the seeds. The child begins to believe that they are not valued, loved or capable. In the school years, self-esteem is affected by achievements, or the lack of them, in academic, sporting and social life, while comparison with peers and being left out or bullied lower the sense of worth further.

In adolescence, identity formation is central. Friends become more important than parents, the brain becomes more attuned to comparing oneself with others, and belonging to the group matters. Comparison (especially in the age of social media), body image, peer pressure and first relationships can complicate self-esteem, especially if you experience rejection, failure or criticism. As an adult, job loss, divorce or other personal setbacks can hit self-esteem hard.

Over time, individual negative experiences are reinforced through repeated patterns and self-fulfilling prophecies. If you believe you are unlovable, you may unconsciously sabotage your relationships, and then your perception is confirmed. To protect yourself from more pain you avoid challenging situations, but then you never get to experience that you can actually cope with them, and you do not develop the skills it takes. That undermines self-esteem even more. Low self-esteem can be both a cause and a result of depression, anxiety and eating disorders. But whenever it took root, cognitive therapy has good methods for strengthening it, so it becomes healthy and realistic.

Working on your self-esteem takes time, patience and sustained effort. Self-esteem is not built overnight. But there are steps you can take right now:

• See your strengths. Set aside time to reflect on your strengths, successes and good qualities, and write them down in a notebook.
• Challenge the negative thoughts. When you notice a self-deprecating thought, stop and ask whether it is really true. Look at the situation more objectively, and replace the thought with a more balanced one.
• Aim for "good enough". Instead of perfection. And celebrate the small victories along the way.
• Set boundaries. Learn to say no. It gives a sense of control and strengthens self-esteem.
• Look after yourself. Prioritise what makes you feel good: exercise, meditation, reading, hobbies or time with those you love. Try learning something new, it gives self-esteem a lift.
• Drop the comparison. Comparison is the thief of joy. Focus on your own journey.
• Talk to someone. Share your thoughts with friends or family. They often see you more clearly than you see yourself. And consider therapy, where cognitive behavioural therapy is particularly effective, because it works with both thoughts and behaviour.
• Practise gratitude. Focusing on what you are grateful for can shift your perspective and strengthen the sense of worth.

Change takes time. But with sustained effort you begin to see changes in how you see and value yourself.

Your support can make a considerable difference. Sometimes the person you care about just needs someone to talk to, and listening without judging is one of the most supportive things you can do. Be careful with criticism, because even well-meant criticism can be misunderstood and reinforce the self-criticism. Instead give honest and specific compliments that help the person see their own strengths. And never compare the person with others, certainly not disparagingly.

Encourage professional help, because a therapist can provide techniques and insight that are crucial. Be patient, because change takes time, and even when the self-perception begins to change, there will be setbacks. Be a stable support through the ups and downs, and encourage social contact, even in small ways, a walk or a hobby. Learn about self-esteem problems yourself, through books or courses, so you understand what your loved one is going through.

And set boundaries for how much you can give, so you protect your own wellbeing. Supporting someone can be draining, so consider a support group or sessions yourself. Remember that your love and support mean a lot, but that the change ultimately lies in the person’s own hands. Be there as a resource, not as the one who has to carry it all.