Therapy for Low Self Esteem: Does it Work?

The term “self esteem” gets used fairly frequently, especially in regards to the growing pains of teenage years. For that reason, many people don’t think about low self esteem as being a serious problem, let alone a pervasive issue that extends well into adulthood.

Though low self esteem problems can start in childhood or adolescence, without any intervention, it can lead to more serious problems later in life. Likewise, trouble with low self esteem can absolutely begin as an adult. No matter the origins, low self esteem can cause pain, anxiety, emotional distress, and difficulty in relationships. Because of this, questions about how to overcome low self esteem begin to arise as well.

While there are many treatments and approaches, therapy for low self esteem is one of the most effective ways to alleviate symptoms. Depending on the severity and duration a person has been suffering, self-help, self esteem therapy activities, and lifestyle changes might not be enough to address the root of the issues causing the symptoms. For cases where it’s noticeably impacting multiple areas of daily life, therapy for low self esteem is the most recommended course of action.

But, does therapy for low self esteem work, and what causes low self esteem? First, let’s establish what low esteem means.

What is self esteem?

Before we address the treatment, let’s explore the problem. Self esteem is defined as the degree to which one feels confident, valuable, and worthy of respect. It exists on a continuum from high to low. Where a person’s self-esteem falls on this spectrum can influence overall well-being. When self confidence declines, negative thinking, and social anxiety in social situations can make these low confidence issues even harder to handle.

Self esteem reflects what we think about ourselves and has a significant prospective impact on our life experiences, but not the reverse. In other words, high and low self-esteem isn’t dependent on our success or failure.

Those with high self esteem often feel good about themselves and their progress through life, while those with low self-esteem tend to feel higher levels of shame and self-doubt. People suffering from low self esteem usually spend an unhealthy amount of time criticizing themselves and their interpersonal relationships. 

It’s important to note that low self-esteem is not represented as its own diagnosis in the APA’s Diagnostic and Statistical Manual (DSM-V), but it is considered a symptom of several mental health conditions, such as anxiety and depression. Yet, its behaviors and effects are very real. 

How does low self esteem develop?

Negative early experiences account for a majority of low self esteem issues. Factors that make it more likely that a person will develop low self-esteem include:

  • Early experiences of violent punishment, neglect, bullying, or abuse. Children who suffer these kinds of experiences at a young age often form the belief that they are inherently bad and deserve punishment due to the constant negative messages directed at them
  • Failing to meet other people’s unrealistic expectations in the past, fair or not.
  • Inability to meet the standards of a peer group. Being different or the ‘odd one out’ during adolescence when your identity is forming can powerfully impact self-esteem.
  • Lack of warmth, affection, praise, love, or encouragement. Without adequate reinforcement, children can form the impression that they are not good enough.

While there usually isn’t just one cause of low self esteem, it’s also possible to fluctuate throughout a person’s lifetime. When we’re ill or suffer a loss, such as unemployment or a divorce, we can feel down about ourselves. While people with healthy self-esteem are generally more resilient and rebound to think positively about themselves and their future more easily, they are always at risk for developing low self esteem. No one is immune to experiences that could cause problems with low self esteem.  

What are the symptoms of low self esteem?

Self-esteem draws on beliefs about oneself. Thus, people with low self-esteem are likely to have a low opinion of self, comparing themselves to others and making an inferiority judgement due to their inner critic. People may cope with low self-esteem in different ways, both internal and external. According to the Counseling and Mental Health Center at The University of Texas at Austin, low self-esteem often presents in one of three external patterns:

  1. Imposter Syndrome: A fear of failure causes a person to hide behind accomplishments or false confidence to mask their insecurities. It can also present itself in perfectionism or procrastination.
  2. Rebellion: Feelings of inferiority may manifest as anger or blame that are shown by acting out, defying authority, breaking the law, and even pretending not to care what other people think, though the opposite is true.
  3. Victimhood: Lacking the tools to face challenges and feeling helpless can create self-pitying behavior, relying on others to save or guide them

Internally, low self esteem can be a driver in self-criticism. Common examples of negative self-talk include:

  • There’s nothing I like about myself.
  • I’ll never be successful.
  • I’m not worthy of making space for things that interest me.
  • Other people are more deserving of happiness than I am.
  • No one cares about my life or problems.
  • It’s all my fault that I attract people who aren’t good for me.

Over time, the repetition of negative thoughts can become so frequent the person sees them as fact. When left on a loop, this type of thought process can be very damaging. 

Does therapy work for low self esteem?

Therapy can work for low self esteem if the patient is open and willing to do the work, and if the therapist responds with acceptance and compassion rather than judgment or correction. This will create a relaxing environment conducive to vulnerability, and ultimately,  an extremely productive therapeutic relationship. However, this requires the relationship to be a good match from the start. Using a therapy matching service like Advekit can help ensure that therapy work for low self esteem has a much higher chance of efficacy.

With consistent acceptance, compassion, and understanding from a therapist, the person in therapy can feel comfortable sharing even more “shameful” parts of themselves during sessions. When the therapist continues to reinforce acceptance, a brand-new idea is born inside the person, “Maybe there’s nothing wrong with me after all.” This is how low self-esteem is often healed.

Therapy creates an experience of being acceptable instead of feeling rejected, which inherently improves self-esteem. Being consistently treated as important, valuable, and accepted by a therapist on a regular basis can challenge the negative thoughts a patient has developed about themself. Through therapeutic work, the therapist models a different way for a person to relate to their identity. Using that model even just once a week, a patient can start to see improvements between therapy sessions and long after treatment has ended.

It doesn’t matter what type of school of therapy is chosen as long as you find the right therapist that is accepting and affirming rather than judgmental or critical. If you feel as though you’re being judged or criticized, the first thing to confront your therapist about it. If your therapist responds in any way other than with kindness, openness, and humility, it’s time to get matched with a new therapist. 

What is the goal of therapy for low self esteem?

For the treatment of chronic low self esteem issues, conventional psychotherapy works best, although treatment usually has to extend over a longer period of time. The first task of low self esteem treatment is for the patient to come to understand the particular distortions of his or her perspective. For instance, if that person thinks that people do not like him or her in general, a therapist needs to help the patient recognize this point of view as a prejudice.

Similar to vision through a colored lens, the perception of a person with low self esteem cannot be trusted as truth. Though a patient may still view circumstances pessimistically, therapy can help build tools to compensate for those distortions.

Ultimately, the main goal of therapy for self esteem is to facilitate a shift in judgment. Each of the patient’s mistaken assumptions has to be challenged individually. The second goal of self esteem therapy is to encourage the patient, despite their doubts, to behave in ways that are likely to lead to successful outcomes.

In therapy for low self esteem, patients have to be encouraged to do the right thing. Sometimes they have to smile when they do not feel like smiling, or pretend to be friendly when they do not feel that way. Similar to the saying “dress for the job you want,” it is possible to become the person we pretend to be. Eventually, it’s no longer an act.

Easier said than done, of course. Unfortunately, patients tend to resist—for two reasons: they do not feel they are capable of feeling any different, and doing the right things almost always means doing something that will make them uncomfortable. Getting out of your comfort zone is tough for anyone, but especially difficult for someone suffering from low self esteem.

Luckily, even small changes can have big effects. Being taken seriously by others helps the chronically discouraged person to feel better about him or herself, and sessions with a trusted therapist who takes their patients seriously is a great place to start. 

How to find therapy for low self esteem?

Finding a therapist can be tough. There are so many to choose from, and it’s often difficult to know if a mental health professional is the right fit just from initial communications. The best way to find a therapist is to either use a referral from someone like your general practitioner or even your personal network. Being specific about looking for someone who can help with confidence and issues related to low self esteem is also critical in finding a therapist.

The next best thing to a personal recommendation is using a trusted, secure matching service like Advekit. You can easily get matched with a qualified therapist who matches your criteria and easily schedules the first call to make sure it’s a good fit.

Feeling better about yourself is within reach. Deciding to pursue therapy for low self esteem will be one of the most important and life changing decisions you can make. The tools you learn can help you improve your self esteem for years to come.


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