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A healthy sense of self can make a profound difference in how we feel and function. Self-esteem is our basic sense of worth or value. It is the degree to which we find we respect and like ourselves. Good self-esteem means self-respect, a sense of self-worth, a feeling of basic goodness about oneself. Low self-esteem can mean constant self-doubt and self-criticism, social anxiety and isolation, suppressed anger, loneliness, and even shame. Our self-esteem develops during childhood, and certain experiences may interfere with its development, for example: being subject to criticism or abuse from parents and caretakers; having early conflicts with peers; being stigmatized for unusual appearance or behaviors, or for one’s race, class, or social identity; missing out on experiences that would foster a sense of confidence and purpose, or not receiving positive reinforcement for our accomplishments; a learning disability or physical impairment.

Challenges to Self-Esteem

Even a well-developed self-esteem can be challenged by sudden life changes or perceived failures, such as losing a job, ending a marriage, having legal or financial troubles, struggling with addiction or mental illness, having children with emotional troubles, medical ailments, and a host of other events that might cause us to question our worth or value. Therapy can help put such events in perspective and support our strengths to increase resilience, social support, and hope.

How Psychotherapy Can Help Self-Esteem

When someone has low self-esteem, it could be as a result of many things, abuse, neglect or co-dependency. But over-achievers can also feel a sense of low self-worth. Those who constantly compare themselves to others, or are highly competitive and set unrealistic, perfectionistic goals, may always feel less than adequate. Additionally, some people who have suffered a significant loss, from divorce, job loss, or even loss of health or youth, may have self-esteem issues. Low self-esteem comes from having a sense of no control over a situation. 


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Therapists work with people to identify the cause of the emotional turmoil and set goals that will enable them to feel empowered and help them regain control. If the source of the problem is job related, then a therapist may focus on setting career related goals. If the lack of self-esteem comes from a divorce, a therapist may recommend that the client begin setting goals to discover who they are as an individual, apart from their spouse.  


Goal-directed therapy is one of the most common forms of therapy for people struggling with self-esteem issues. This type of therapy can be delivered individually, through a cognitive behavioral approach, in group settings, through brief strategic therapy or even using animals.People who have suffered loss of health, disfigurement or debilitation may benefit from animal assisted therapy. This form of treatment is very helpful for people who are struggling with self-esteem as a result of physical impairment. Animals that provide unconditional love, with no regard to physical appearance or limitation, can help strengthen a client’s sense of self.

Medical Disorders Associated with Low Self-Esteem

Diminished self-esteem may be linked to anxiety disorders or depression. Low self-esteem can contribute to anxiety and depression; anxiety and depression can also, like all diagnoses, contribute to lowered self-esteem, due to social stigma about mental illness.

Low Self-Esteem in Middle Age - Case Example

Roger, 42, is having difficulty in many areas of life: work, marriage, and socially. He is irritable and his friends and family are complaining about it. He is sleeping poorly. He recently found his first bald spot. He isn’t making enough money to pay for his younger son’s college tuition. Roger begins to reveal a damaged sense of self-esteem. Through individual and family therapy, Roger regains a sense of his core values--family, honesty, humor, education--and restores a sense of who he is--a competent, honest, loving person.

Young Adult Low Self-Esteem from Poor Parental Relationship - Case Example

Jodi, 22, is extremely depressed. She has a sense of herself as worthless. Therapy reveals a tremendous longing for male approval, stemming from a stormy relationship with her father, a loving but irresponsible figure. Jodi’s work in therapy helps her understand her emotions not as a product of her own intrinsic “badness,” but a natural response to a chaotic childhood. She is then able to begin rationally evaluating her own strengths and weaknesses, and to clarify her own values and needs, upon which she constructs a positive, adult sense of self.

Share Your Story About Self-Esteem

What does healthy self-esteem mean to you? Do you have a personal story about overcoming low self-esteem or maintaining strong self-esteem? If so, you are invited to submit unpublished written personal stories about mental health topics, including self-esteem, to GoodTherapy.org's Share Your Story. Stories that are chosen to be featured will be published on The Good Therapy Blog.


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Last updated: 04-01-2014


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Low Self-Esteem: Signs, Symptoms, and Solutions
Presented by Tina Gilbertson, MA


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