Does Therapy for Low Self-Esteem Really Work?

How 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.

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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.

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