Does Therapy for Low Self-Esteem Really Work?

Woman looks away from mirror, downcast, while her reflection smilesHow can being in therapy improve your self-esteem? Once we understand both the roots of self-esteem and the essence of therapy, the answer becomes clear.

Self-esteem has been described in many ways, but it can be thought of—and experienced—most simply as the absence of needless shame. In a sense, high self-esteem is the opposite of chronic shame.

This has nothing to do with thinking everything you do is great or even okay; it’s not an evaluation of your behavior or how “great” you are. People with high self-esteem may criticize their own behavior at times. They can afford to be realistic about how they’re doing because their basic worth as human beings isn’t in question. People with low self-esteem (i.e., those who experience chronic, needless shame), on the other hand, may display a need to be right all the time, or may tend to see themselves as “better” than others. Such tendencies may help compensate for a fragile sense of worth.

How Low Self-Esteem Typically Develops

Most of us learn in childhood we’re far from perfect, and that our words and actions sometimes make other people unhappy. Since kids typically have a hard time mentally separating themselves from their behavior, hundreds of behavior corrections over the course of childhood can lead to shame about the self: If Johnny does something wrong, Johnny feels he IS wrong—as a person.

One of the psychological products of childhood, then, is some level of subconscious shame. Many adults still tell themselves silently all the time, “There’s something wrong with me.” This is low self-esteem.

How Therapy Improves Self-Esteem

Once in therapy, people begin (usually cautiously) to share their inner thoughts and feelings with the therapist. If the therapist responds with acceptance and compassion rather than judgment or correction, the person in therapy generally relaxes into what can be an extremely productive therapeutic relationship.

With consistent acceptance, compassion, and understanding from the therapist, the person in therapy risks sharing even more “shameful” parts of themselves during sessions. When the therapist continues to respond with 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 basically acceptable instead of basically wrong, and this naturally improves self-esteem. By treating you as acceptable, the therapist models a different way for you to relate to yourself.

Just as needless shame is the product of a lack of acceptance through necessary social corrections (“Don’t pick your nose in public,” for example), its opposite, high self-esteem, blooms in an atmosphere of acceptance.

Your attitude toward yourself (“I’m okay” as opposed to “I’m not okay”) is not a fact, but a belief. Whatever you believe about yourself is based on experience. For example, if you received a lot of corrections in childhood, as most of us did, you may believe you’re essentially bad and need to be corrected.

To change unwanted beliefs about yourself, you need a different experience on which to base a new belief. This is what psychotherapy offers.

Therapy creates an experience of being basically acceptable instead of basically wrong, and this naturally improves self-esteem. By treating you as acceptable, the therapist models a different way for you to relate to yourself. Using that model, you can continue to improve your self-esteem between therapy sessions and long after therapy has ended.

It doesn’t matter what type or school of therapy you do—as long as you experience your therapist as accepting and affirming rather than judgmental or critical. If you feel as though you’re being judged or criticized, the first thing to do is talk with your therapist about it. If your therapist responds in any way other than with kindness, openness, and humility, it’s time to seek a different therapist. Your self-esteem is too important to place in the wrong hands.

© Copyright 2016 GoodTherapy.org. All rights reserved. Permission to publish granted by Tina Gilbertson, MA, LPC, therapist in Denver, Colorado

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Marleen

    Marleen

    May 20th, 2016 at 9:17 AM

    Do the people who have low self esteem actually realize it and seek out treatment for it?

  • Scott

    Scott

    September 28th, 2016 at 6:42 PM

    I’m actually looking for therapy for social anxiety. It’s plagued me for years and it doesn’t help that I have other disorders like ADHD, clinical depression,anxiety and bipolar. My life has been a night nightmare.

  • Geoffrey F

    Geoffrey F

    September 29th, 2016 at 2:58 AM

    I see things in a more mehhanical way. We develop habits of becoming depressed because we got attention when we were in a specific mode. A simple example is:
    A person crys and gets the simpathy of another and a hug and the learns, by habit,
    to take on the same, “Posture”, wheather they know it or not, when they meet a similar situation.
    Only a new habit can break an old habit.

  • Joe

    Joe

    May 20th, 2016 at 2:11 PM

    Well it might not help all that much but it can’t really hurt you either. And who knows? You might in the end wind up getting something really positive out of the whole experience.

  • Geoffrey

    Geoffrey

    October 21st, 2016 at 11:31 AM

    Thanks for the positive support. Just to say: Many people fall into a habit of getting depressed mainly because of the cloer people come to them. Many people “Suffer” from what works and “Forget” the source. The source is the mind of a child who forgets the origin when they grow-up but, maintain the symptoms. Look for a book from the 60s, “Man the Manipulator”. It is all there. Read about “Cry-babies”.

  • Tina Gilbertson

    Tina Gilbertson

    May 20th, 2016 at 4:28 PM

    Marleen, I don’t think I’ve ever had a new client tell me they were seeking therapy specifically for low self-esteem. But when asked about it, at least half of the people I work with identify as dealing with this issue, either now or in the past.
    In my experience, there’s usually another presenting problem that brings people into therapy. Interestingly, low self-esteem is often a contributing factor.
    Thanks for the excellent question.

  • Scott

    Scott

    September 28th, 2016 at 6:45 PM

    Hi I’m always the exception I’m actually looking for therapy for social anxiety. But yes you’re right there are a lot of contributing factors to that. Thanks for your answer also.

  • eliza

    eliza

    May 21st, 2016 at 8:58 AM

    The only person in the world who can make you happy is yourself.
    But with that being said, someone you need that person with you who can help to rebuild you when you have been so brutally torn down and that to me is a therapist will be for.
    I am not relying on this person to tell me that I am a good person and then believe it. I want this to be someone who can help me rediscover that I actually am a good person and that I don’t then mind sharing that with other people.
    They are helping to build me back up and helping me believe in myself again, and yes, I think that that is definitely do-able.

  • Geoffrey F.

    Geoffrey F.

    May 28th, 2016 at 3:22 AM

    “Happy” is for children under 7 and idiots… Try helping people to be satisfied with what they are and what they have. I major reason they suffer is because they compare themselves to people that are “fantasies” try comparing your self to a failure in your neighborhood or a friend who died or a person who is out of work and has no real skills. Life stinks, too bad, you are an idiot if you think you can be happy these days. Try this: You think life is unfair to you? Are you still alive?
    Then life is very fair.

  • Mike

    Mike

    May 21st, 2016 at 2:05 PM

    Tina, you mention that a person needs an experience of themselves as a fundamentally acceptable person (rather than a fundamentally shameful person) in order to change their self-esteem. I agree, and I’ve had a wonderful therapist who gave me that experience by projecting unconditional positive regard. But a part of my personality is to wish for self-reliance, and so it can be scary to admit I needed him—for many years I wanted to change myself with no more input than maybe reading a book. I’m not the only one—it seems that many people in our culture would rather do self-help, or talk to family/friends, or do a seminar (in which they don’t get any personal feedback). (Sometimes for financial reasons–sadly long-term therapy can be out of reach for many.) But as I’ve accepted I needed a new kind of relationship in my life, and grown to trust that my therapist was able to provide it consistently, I’ve realized that he’s not the only external source of help in my life. As a matter of fact, I wrote down a list of all the help I’ve gotten from outside myself, and I was astonished, simply astonished, to realize how long it is. A short time later I was meditating and I began to experience myself as taking in the energy of the universe, and that energy was love and compassion… just flowing freely from the universe into me.

  • Tina Gilbertson

    Tina Gilbertson

    May 22nd, 2016 at 4:32 PM

    Mike, I’m happy to hear you’ve had a good experience with your therapist.

    You may be right that many people prefer not to rely on others for support. Interestingly, research seems to indicate that learning how to depend on someone else is exactly what allows us to become more independent.

    The “okay-ness” that lucky people carry around inside themselves generally has roots in previous relationships with reliable others (external sources, as you say).

    That’s why the outcome of a course of good therapy is greater, not less, independence. And as your comment illustrates, true independence is more like inter-dependence, where you’re open to receiving the good that comes at you from all sources.

    Thank you for your thoughts, and all the best on your continuing journey.

  • brayleigh

    brayleigh

    May 23rd, 2016 at 7:10 AM

    There are many people though who are simply so down on themselves that they are never able to see anything as being positive or that they are getting anything positive from any experience.

  • Geoffrey F.

    Geoffrey F.

    May 28th, 2016 at 3:25 AM

    Try this: Everything we learn is for the benefit of others. For society for getting a job to work for the rest of our lives to what? You are feeling what you should feel. Anyone who feels good these days is a bit crazy. A famous line: “If what goes on in this world doesn’t cause you to loose your mind, you have no mind to loose.” from early 19th Century.

  • Tina Gilbertson

    Tina Gilbertson

    May 23rd, 2016 at 8:14 AM

    Thanks for bringing that topic to the discussion, Brayleigh. Do you have any tips to help people who may have a negative bias savor the good that comes to them?

    I agree with your observation, and it’s not clear to me that low self-esteem is the only culprit in those cases. People with depression, for example, often have a hard time seeing the positive side of anything. Also, it’s possible to pick up a negative mindset from others, especially if you’re exposed to chronic negativity early in life.

    I think in these cases, it may help people to experience receiving positive attention and compassion, AND at the same time, have a discussion about how hard it might be to accept those.

  • brayleigh

    brayleigh

    May 24th, 2016 at 7:49 AM

    thanks tina!

  • Paige

    Paige

    May 27th, 2016 at 9:53 AM

    There are so many ways that one can rebuild their self esteem, and I think that therapy is but one of many options for you.

  • Rahat S.

    Rahat S.

    May 27th, 2016 at 8:42 PM

    What about people with narcissistic personality. They also seem to have a low self esteem as well right?

  • Geoffrey

    Geoffrey

    October 21st, 2016 at 11:39 AM

    I suggest you read about the roots of Narcistic Disorders. We are all insecue and we need, what I call, An Esteem Engine”. To focus on what we think is important and avoid people who use terms like. Not Bad, OK, when searching for a way to withhold a compliment a phrare or action. They give themselves away and should be avaiod, after you tell them what they are doing/what they say and see what they do or if they change for the “Better” after that.

  • Gordon

    Gordon

    May 28th, 2016 at 10:16 AM

    Rahat- in my personal experience I have come to believe that those who are narcissistic are the ones who have the lowest self esteem of all. If you really cared about more than just yourself then you would want other people to feel better about themselves. The people who are so self centered are usually that way just because they are looking for ways to make them feel better than other people, and they will try to do that by being all about themselves.

  • Geoffrey F.

    Geoffrey F.

    May 28th, 2016 at 12:41 PM

    From what I have read and can see… The main reason people have a personality disorder is usually stemming from not getting enough attention from their mother, (Real or imagined) so they change their way and then they still don’t get the attention they need/want so they change and… They don’t develop a “Personality”. The give away is: The have a dream goal that they can’t do alone so they have to find people to work for them. They usually have to accept these people, they call the “Team” (this is why I hate the word, “Team”.) Also, they tolerate no critique and no real compassion.. Only the position and the goal count… Usually something to do with, “Serving, Selling, Networking… The Whole World” or going to the moon or Mars or…

    Look at: Bill Gates, Steve Jobs, Elon Musk, Mark Zuckerberg, Jack Welsh, Richard Branson, Donald Trump… and many others. The lack of self esteem comes in because they have show that they have to be known by their wealth and position not by what/who they “Really are”, whatever that is. A person with a good sense of self-esteem is satisfied with who/what he is. It also has a lot to do with getting laid in your teens and/or getting attention from the girls. It is all as simple as that.

  • Trish T.

    Trish T.

    May 29th, 2016 at 3:30 AM

    This was a great article; I have experienced that unconditional positive regard from my therapist, and it changed the way I see myself. I also aim to provide this experience for my own clients. An observation – I think modern parenting has generally moved away from criticising and correcting children, to the other extreme of telling kids they are great and wonderful and brilliant, and yet still kids suffer from low self esteem. The thinking about this that makes sense to me is that we need to encourage resillience in kids – help them accept and cope with life’s challenges and develop a belief in themselves about their ability to tackle the hard bits. If they are told they are ‘great’ and yet they find themselves struggling with stuff without a sense of what to do about it, they will become anxious, and pessimistic and full of self doubt

  • Geoffrey F.

    Geoffrey F.

    May 29th, 2016 at 4:36 AM

    To help someone to change how they feel they have to know how it happens, not just the actions/symptoms but the cause. As I said before, when some can see it is all a “Childhood Reaction” from when we are too young to understand and too young to do anything. The reason it happens is based on the fact that we don’t have morals. What works, works, period. So the only answer is to show a person that they are do/being based on the thought and needs of a 3 year old.
    The simple answer is: Grow-up. People think they cannot change or it takes too long. How can someone expect to stop smoking in a few weeks when they have smoked for years. Or, how can someone stop thinking about someone they lost in a few months or years, when they knew them for much longer. Expectations are a big part of the problem. Even self-esteem is a mater of, “Who do you think you are?” Why call it self-esteem, when it is based so much on how others see us. We do not come from the monkeys, we are the monkeys. The people who you write about think that a higher position of more control of others will cahnge the others opinion of them and therefore make them feel better. It may work, but then thy get a bit carried away with position and see others in a higher position. And, if they judge their position by a title they can loose or by how big their house or how many children they have… It is still “The Position” not the person and they know that. A General in the army knows he get respect for his rank. It is all an internal game of what works for you/them. Another point that fits in here. It is mostly the need to control. To control others, control ones image and one’s self. First, control does not really mean power. It means to control within the persons limits. The problem is the question of: What are their limits? King of the house, control my car, control my workers… So, the only reward is to get satisfaction from not having the need to do these things. It is a very hard task. The line, “Be yourself, See yourself, Free yourself” is a good beginning. People cannot see that what they think and do is based on a religious principle drilled into them and our laws: If you do something “wrong” you are “bad” and have to be punished. WRONG. One must did connect these things. They maybe necessary for society but not for the individual. First, learn to see what you have done, with responsibility and to see how and why, then find a way to forgive your self and not punish yourself. That is the hard part. The main thing is to learn how to avoid doing the same things in the future and let the “wrong deed” fade into the past. If it is something you can do for another to “Make it good” then do it but, first learn to forgive yourself and others. It does not mean go back to an old situation but, to first forgive in your mind and then forgive by an action… Another answer is to move. Go to another city and another way of living and another way of seeing, as an adult. Leave the child and take the adult with you and start over, very carefully. Then your last 10-20 years will more important than your first 10-20 years.

  • Trevor

    Trevor

    May 30th, 2016 at 9:52 AM

    It hasn’t worked for my wife and I am starting to believe that it might not ever work for her. No matter what I say to her or she and her counselor work on together there is something that always weighs her down and I don’t know, I thought that I could handle it but it is a challenge to always be with someone constantly feeling bad about herself. It honestly drains any fun out of our relationship.

  • Geoffrey F

    Geoffrey F

    May 31st, 2016 at 12:16 AM

    Dear Trevor,
    I think you and your wife have fallen into a, “It works” trap. She cannot see that this is all a behavorial habbit. She gets all of your attention and all the attention of the therapist also. She has to want to feel better and you/the therapist have to break the conection. It is like telling a person you will not respond to a baby crying. It is hard, but you have to give her rewards when she shows any imporvment and ignore the “Problem”. Try this, “Honey, I really don’t care that you have low self-esteem. I love you as you are. You are only hurting us/yourself. You are alive and we are together so… It is all not so bad. Tell here she is more than good enough for you. Huh?

    Tell the therapist to stop the therapy for a few eeks and tell your wife that it is over and accept what she says and does. Why do you want her to be what she is not, like your idea of self-esteem.

    Do you want someone to be able to run as fast as you or as smart as you. Expectations can kill.

    Stop.

  • Geoffrey F.

    Geoffrey F.

    October 21st, 2016 at 11:47 AM

    Dear Geoffrey F.,
    You are really great. Whenever I look back over your words I feel really good about who you are. Well done, considering you were close to a HS drop-out, in the Bronx.
    Important factors: Sense of Self with Sense of Humor.
    Geoffrey F.

    Geoffrey F.

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