Self-esteem is essential for psychological survival. It is an emotional sine qua non—without some measure of self-worth, life can be enormously painful, with many basic needs going unmet.
One of the main factors differentiating humans from other animals is the awareness of self: the ability to form an identity and then attach a value to it. In other words, you have the capacity to define who you are and then decide whether you like that identity or not. The problem of self-esteem is this human capacity for judgment. It’s one thing to dislike certain colors, noises, shapes, or sensations. But when you reject parts of yourself, you greatly damage the psychological structures that literally keep you alive.
Judging and rejecting yourself cause enormous pain. And in the same way that you would favor and protect a physical wound, you find yourself avoiding anything that might aggravate the pain of self-rejection in any way. You take fewer social, academic, or career risks. You make it more difficult to meet people, interview for a job, or push hard for something where you might not succeed. You limit your ability to open yourself with others, express your sexuality, be the center of attention, hear criticism, ask for help, or solve problems.
To avoid more judgments and self-rejection, you erect barriers of defense. Perhaps you blame and get angry, or bury yourself in perfectionistic work. Or you brag. Or you make excuses. Sometimes you turn to alcohol or drugs.
This book is about stopping the judgments. It’s about healing the old wounds of hurt and self-rejection. How you perceive and feel about yourself can change. And when those perceptions and feelings change, the ripple effect will touch every part of your life with a gradually expanding sense of freedom.
Hundreds of researchers have quizzed thousands of people of various ages and situations, trying to see what causes self-esteem, who has the most of it, how important it is, how it can be increased, and so on.
Studies of young children show clearly that parents’ style of child-rearing during the first three or four years determines the amount of self-esteem a child starts with. After that, most studies of older children, adolescents, and adults share a common confusion: What is cause, and what is effect?
Does academic success foster self-esteem, or does self-esteem foster academic success? Does high social status cause high self-esteem, or does high self-esteem help you gain high social status? Do alcoholics drink because they hate themselves, or do they hate themselves because they drink? Do people like themselves because they do well in job interviews, or do they do better in interviews because they like themselves?
These are classic chicken-and-egg questions. Just as eggs come from chickens and chickens come from eggs, it seems that self-esteem grows out of your circumstances in life, and your circumstances in life are influenced strongly by your self-esteem. Which came first? The question has serious implications for your success at raising your self-esteem.
If external circumstances determine self-esteem, then all you have to do to improve your self-esteem is to improve your circumstances. Let’s say you have low self-esteem because you never graduated from high school, you’re short, your mom hated herself, you live in the slums, and you’re 100 pounds overweight. All you have to do is go to night school and get your degree, grow about six inches, have been raised by a different mother, move to Beverly Hills, and lose 100 pounds. It’s a cinch, right?
But you know you’ll never make it. There’s nothing you can do about your parents or your height. Your only hope is that things are the other way around: that self-esteem determines circumstances. This means that if you improve your self-esteem, your circumstances will improve. So just stop hating yourself, and you’ll get taller, your mom will become somebody different, and those 100 pounds will evaporate like the morning dew.
If you feel that this second scenario is also a little unlikely, you can be congratulated on a keen appreciation of the real world.
The fact is that self-esteem and your circumstances are only indirectly related. There is another intervening factor that determines self-esteem 100 percent of the time: your thoughts.
For example, you look in the mirror and think, Boy, am I fat. What a slob. This thought clobbers your self-esteem. If you looked in the mirror and thought, Well, all right, it looks good to wear my hair like this, the effect on your self-esteem would be the opposite. The image in the mirror remains the same. Only the thoughts change.
Or let’s say that you’re discussing the news, and when you make a remark about the right-wing rebels, your nitpicking friend corrects you: “No, you mean the left-wing rebels.” If you tell yourself, I really sound stupid, your self-esteem will take a nose dive. If you say to yourself, Oh yeah, I’ve got to keep that straight next time, your self-esteem will not suffer so much. In either case, you don’t change the circumstances, only how you interpret them.
Does this mean that circumstances have nothing to do with self-esteem? No. Obviously, in the area of social status, bank vice presidents have more opportunity to feel better about their careers than cab drivers. This is why a study of 100 vice presidents and 100 cab drivers will “prove” that the higher status job leads to higher self-esteem. What is overlooked among the statistics is that there are some vice presidents who slaughter their self-esteem by telling themselves, I should have been president of my own bank by now; I’m a failure, just as there are some cab drivers who feel good about themselves because they think, So I’m just a cab driver—I’m putting bread on the table; the kids are doing good in school; things are going just fine.
This book uses proven methods of cognitive behavioral therapy to raise your self-esteem by changing the way you interpret your life. It will show you how to uncover and analyze the negative self-statements you habitually make. You will learn how to create new, objective, positive self-statements that will foster your self-esteem instead of undermining it.
This book is organized logically, with the most important and universally applicable material at the beginning.
Chapter 2 introduces the pathological critic, the voice inside you that criticizes and keeps your self-esteem low. The next chapter deals with disarming the critic so that you can be free to begin raising your self-esteem without interference.
Chapter 4 shows you how to make an accurate self-assessment of your strengths and weaknesses, an important first step in changing your self-esteem.
Chapter 5 explains cognitive distortions, irrational ways of thinking that contribute to low self-esteem. Chapter 6 presents the process of defusion, a strategy for letting go of self-judgments and ruminative attacking thoughts.
Chapter 7 introduces the concept of compassion. Self-esteem is closely tied to compassion for others and compassion for yourself.
Chapter 8 is about your shoulds, all the rules you have made for yourself about how you should act, feel, and be. Revising your shoulds is one of the most powerful ways to undo old negative programming.
Chapter 9 focuses uncovering and acting on your values, the realistic standards that give your life meaning and direction.
Chapter 10 shows how to handle mistakes by changing how you relate to error and by letting go of mistakes in the past.
Chapter 11 teaches you how to react to criticism without losing your self-esteem or having to attack others.
Chapter 12 covers asking for what you want, one of the most difficult tasks for people with low self-esteem.
Chapter 13 shows how to set practical goals and make detailed plans for achieving them.
Chapter 14 teaches powerful techniques of visualization, a way of setting and achieving self-esteem goals.
Chapter 15 is called “I’m Still Not Okay” and is designed to help you stop running away from pain while you develop an attitude of nonjudgment.
Chapter 16, “Core Beliefs,” will help you explore, challenge, and change deeply held convictions about your worth.
Chapter 17 is for you if you have children. It explains what you can do to give your kids the priceless legacy of high self-esteem.
Using this book is simple. Keep reading until you reach the end of chapter 3, “Disarming the Critic.” At that point, there is a chart for you to consult. That chart will direct you to the appropriate chapter to deal with specific problems you may have. If you want to learn about and improve your self-esteem in general, just read the book in sequence from start to finish.
Benefiting from this book is not as simple as just reading it. You have to do some work. Many chapters have exercises to do and skills to learn. When the text tells you to “close your eyes and imagine a scene from your past,” you should actually close your eyes and do it. When the book says, “On a separate piece of paper, list three situations in which you have felt inadequate,” you really need to go find some paper and a pen and sit down and list your three situations.
There is no substitute for doing the exercises. Imagining yourself doing the exercises is not enough. Skimming through the exercises with the vague intention of coming back to them sometime and trying them is not enough. Doing only the exercises that seem easy or interesting is not enough. If there were a way to improve your self-esteem that was easier than doing exercises, it would be in this book. The exercises that are in this book are here because they are the best, easiest, and only way the authors know to raise self-esteem.
You should take your time reading this book. It is densely packed with ideas and things to do. Read it at a pace that will let you absorb the contents fully. Self-esteem takes a long time to develop in the first place. You’ve spent your whole life developing the level of self-esteem you have now. It takes time to tear self-esteem down, and it takes time to build it up. Make a commitment right now to take the time you need.
In his book, The Shrinking of America, Bernie Zilbergeld concludes that psychotherapy has only limited effectiveness for many of the problems that it purports to help. But a review of outcome studies led him to find that psychotherapy does positively affect self-esteem and that improved self-esteem “may be counseling’s most important outcome” (Zilbergeld 1983, 147).
Clients come to therapy wanting help with anxiety, depression, eating disorders, sexual problems, relationship difficulties, and a host of other symptoms. Sometimes the symptoms improve; sometimes they persist despite years of intensive work. But most clients do get a sense of greater personal worth from therapy. While specific symptoms may or may not change, clients at least begin to see themselves as more okay, more deserving, more capable.
The problem with therapy is time. Over the course of months, and often years, a client’s self-perception changes in response to consistent positive regard from the therapist. The sense of approval from an authority figure, particularly one who substitutes for the critical parent, has the potential to be enormously healing. Yet this vital process of raising self-esteem, one that can change many aspects of a client’s experience, is inefficiently and haphazardly implemented. Often the process takes far longer than it should. And often it is done without a plan and without the specific interventions that could hasten its success.
This book is about hastening the process. You can increase a client’s self-esteem more rapidly and more effectively using the cognitive restructuring techniques presented here. Through an exploration of chronic negative self-talk, a systematic confrontation of cognitive distortions, and the development of a more accurate and compassionate self-evaluation, you can intervene directly to raise a client’s sense of worth.
There are basically two kinds of self-esteem problems: situational and characterological. Low self-esteem that is situational tends to show up only in specific areas. For example, a person might have confidence in himself as a parent, a conversationalist, and a sexual partner, but expect to fail in work situations. Someone else might feel socially inept, but see herself as a strong and capable professional. Low self-esteem that is characterological usually had roots in early experiences of abuse or abandonment. The sense of “wrongness” in this case is more global and tends to affect many areas of life.
Situational low self-esteem is a problem ideally suited for cognitive re-structuring techniques. The focus is on confronting cognitive distortions, emphasizing strengths over weaknesses, and developing specific skills for handling mistakes and criticism. Since the client is not rejecting himself or herself globally, you will find that changing maladaptive thinking patterns will significantly increase a sense of confidence and worth.
Since characterological low self-esteem derives from a basic identity statement, a feeling of being bad, changing a client’s thoughts is not enough. Identifying and beginning to control the internal critical voice will help, but will not entirely undo the feeling of wrongness. Your main therapeutic emphasis must therefore be on the negative identity that gives rise to negative thoughts. The focus should be on developing self-compassion and a commitment to nonjudgment (see chapter 7). These positions can be reinforced through defusion and visualization techniques.
The best place to begin is with the client’s thoughts. Ask what he or she was thinking during a recent episode of self-reproach. Get as much detail as you can about the critical self-talk and then introduce the concept of the pathological critic (see chapters 2 and 3, “The Pathological Critic” and “Disarming the Critic”). Encourage the client to develop his or her unique name for the critic as a way to begin to take ownership of the concept. Typical names are “the bully,” “the shark,” “my kicker,” “Mr. Perfect,” “Marsha (the client’s mother),” and so on.
Personifying the critic helps the client begin to externalize the self-accusing voice. You want him or her to experience the voice as something coming from outside, rather than as a part of the normal flow of thought. It’s easier to fight something that is perceived as external. It’s also easier to make the critical voice ego dystonic, something the client eventually rejects as “not me.”
At the same time that you are identifying and naming the pathological critic, you can also introduce the client to his or her “healthy voice.” The healthy voice is the client’s ability to think realistically. By emphasizing and strengthening this ability, you are positioning the client to begin talking back to the critic. Names that are typically used for the healthy voice include “my rational part,” “my accepting part,” “my compassionate part,” “my healthy coach,” and so on. Choose a name that fits the client’s self-concept (such as rational, compassionate, caring, or objective).
By creating this dichotomy between the critical voice and the healthy voice, you can encourage the client to confront his or her critic. The following dialogues exemplify this process.
Therapist: So what did the critic say when you waited and didn’t hear from your new friend?
Client: That I’m not interesting, that I bored him, and that he was tired of me.
Therapist: What does the healthy coach say back to that?
Client: That our conversation was lively and fun. That there was nice energy between us. I could feel it.
Therapist: What else? Does the coach think you should stew about it, or is there some action you can take?
Client: I could call him and try to get a sense of how he feels.
Here’s another example:
Client I didn’t get an assignment at work in on time.
Therapist: What did the bully say about that?
Client: That I’m lazy. Over and over: “You’re lazy, you screw up, you’ll never get anywhere.”
Therapist: Can you mobilize the healthy voice to say anything back?
Client: All I hear is the bully.
Therapist: Right now see if you can find your healthy voice so you can talk back to the bully. Are you really lazy and a screw-up?
Client: Well, my healthy voice says, “You did drag your feet, but still you finished it; you turned it in. No one really cared that it was late but you.”
Therapist: So the bully exaggerated about screwing up?
The next step in cognitive restructuring is to identify the main function of a client’s critic (see “How the Critic Gets Reinforced” in chapter 2). In every case, the critical voice is being reinforced because it serves some positive function—to promote desired behavior, paradoxically to protect self-worth, or to control painful feelings.
A client must understand the reason why he uses the critical voice and how it helps to protect him. Here’s an example of how this issue can be discussed.
Therapist: When you were feeling nervous during dinner, what was the critic saying?
Client: She won’t like you. You don’t know anything and haven’t much money. And you’re not very funny.
Therapist: Remember we said that the critic always tries to meet some need. What was he trying to protect you from this time?
Client: From being blown off.
Therapist: He was trying to protect you from the fear of rejection?
Client: Right.
Therapist: How?
Client: By expecting it and then not getting so hurt.
Therapist: So the critic was sort of desensitizing you, preparing you. You wouldn’t feel quite so bad if she didn’t like you because you expect her not to. That’s something we’ve seen a lot before. It’s one of the main functions of your critic—protecting you from the fear of rejection.
Learning the critic’s function sometimes requires an exhaustive inquiry. You have to explain that every thought, no matter how painful, exists because it is rewarded in some way. Critical self-attacks must therefore serve an important function. Ask the client: “What would you be forced to feel or be aware of if the critic weren’t attacking you in this situation? How does the critic help you in this situation? What are you afraid you might do or fail to do without the critic in this situation?” Some of the main functions of the critic are listed in chapter 3, “Disarming the Critic.” Using that chapter as a resource, you may want to suggest the major functions you see the critic serving for your client.
Once the function of the critical voice has been unmasked, this information can be used again and again during confrontations. “Once again you are using the critic to push you toward impossible levels of achievement.” “Again you deal with the fear of failure by letting the critic tell you that you can’t do it so why try.” “You are letting the critic punish you again so you won’t have to feel so much guilt.”
Identifying what reinforces the critic is half the battle. In addition, the client must learn that the important needs his critic helps him meet can be satisfied in healthier ways (see “Making your Critic Useless” in chapter 3). The critic is not the only way to deal with the fear of failure, fear of rejection, guilt, and so on. New, nontoxic strategies must be devised.
Therapist: Is there another way of lowering your anxiety about rejection? A way that doesn’t use the critic?
Client: I guess so. I could remind myself that we’re both probably nervous. And that we’re just there to have a pleasant evening, and it doesn’t have to be anything beyond that.
Therapist: In other words, tell yourself that it’s just a date, and you don’t necessarily expect her to like you so much that she’ll spend the rest of her life with you.
Client: Right.
Therapist: Does reframing it like that lower your anxiety?
Client: I think so.
While you may invent your own terms, it’s important to define the particular distortion as clearly and with as many examples as possible.
Therapist: I’m saying that words like “stupid,” “fraud,” and “idiot” are toxic labels because they’re total indictments of you as a person. They’re global put-downs. You’re not saying that you’re ignorant about taxes; you’re saying, “I’m a stupid person.” You’re not saying that you feel insecure about certain tasks at work; you’re saying, “I’m a fraud.” These terms are a total dismissal of all your strengths and assets. They’re pejorative and brutal because they generalize the negative and forget the positive. They are plain wrong, inaccurate. Part of our work is to find ways to get away from these labels and become more accurate.
The therapist has defined the distortion and is also defining the task. Now she starts teaching the client how to substitute accurate language for the toxic labels.
Therapist: Okay, you’re calling yourself a fraud. This is pejorative, a generality. What’s the accurate statement?
Client: That I try to look more confident than I am.
Therapist: Continuously, or just in certain things?
Client: Well, mostly in terms of the gas chromatograph. I look like I know more than I really do.
Therapist: So is the accurate statement that you know less than people expect about the gas chromatograph?
Client: Yes.
Therapist: That’s very different from being a fraud.
Client: That’s true. Fraud is a big exaggeration.
During your first few sessions, ask many specific questions about the content of any self-critical thoughts. “What did the critic say to you when you visited home? When you finished the term paper? When your son got angry? At the end of our last hour?” The more you learn about the content of the critical voice, the better prepared you will be to confront specific distortions.
When introducing the concept of cognitive distortions, focus only on the most significant ones. Don’t overload the client. Most people can’t remember to fight more than one or two negative thought patterns at any given time.
When you are first looking at distortions, it’s helpful to review three or four self-critical cognitions and show what they all have in in common.
Therapist: Last week you talked about being late and called yourself “a screw-up.” Then you were struggling with your tax forms and said that you were stupid. Today you described yourself as a “fraud” and an “idiot” at work. “Screw-up,” “stupid, “fraud,” “idiot”—these are toxic labels that really undermine your self-esteem. They are part of the problem we are working on. Every time you use one of these labels, you wound yourself a little bit more; you cut a little deeper into yourself. Have you noticed how much your critic uses toxic labels to put you down?
The therapist in this example has done her homework. She can point to specific examples of toxic labeling so that the confrontation has more impact. She has chosen the term “toxic labeling” (officially known as “global labeling”) because her client is an organic chemist and the word toxic has more meaning for him.
Your best technique for helping the client arrive at a more accurate statement is Socratic questioning. This is a method that Socrates used to expose logical inconsistencies in the arguments of his students. There are three main lines of questioning that you can use.
Here’s how it might work during a session.
Therapist: So lately the kicker’s been telling you that you’re ugly.
Client: He’s been on me with that a lot.
Therapist: Is every part of your face and body ugly, or just some parts? (This is an example of exposing overgeneralization.)
Client: Mostly my nose, and I think my chin is weak. And my stomach is spongy and out of shape after the baby.
Therapist: Are there any parts of your body that you like?
Client: My legs, I guess. My hair and my eyes.
Therapist: So you’re generalizing three features among many and labeling yourself completely ugly.
Client: Yeah, it’s kind of crazy.
Therapist: Is it true that your chin and nose are totally ugly and repulsive? (This is an example of exposing faulty labeling.)
Client: Well, they’re not real attractive.
Therapist: But are they really ugly?
Client: No. Not really.
Therapist: So what’s the accurate statement; what would the healthy voice say?
Client: That my legs, hair, and eyes are nice, and I don’t like my nose, chin, or stomach.
Therapist: All right, the critic’s telling you that you’re ruining your relationship with your son. That’s the self-blame again. What can the healthy voice say back to that?
From the strengths list, you should select two to four qualities that you genuinely appreciate in the client. At least one of these should be worked into every session. This means finding a creative way to bring up a particular strength so that it fits into the context of the hour.
The repetition of the strengths is a must. Remember that your client’s self-esteem was damaged originally when an authority figure (parent) repeatedly attacked his or her worth. It takes a great deal of positive repetition by another authority figure (therapist) to begin to undo this early programming. Saying it once, saying it five times, will probably have no effect. You’ll have to remind a client ten, fifteen, twenty times before your praise has much impact. That’s why you should only choose two to four positive qualities to focus on. Attempting to praise too many of the client’s strengths dilutes the attention given to any one of them.
There are several specific interventions you can use to reinforce the healthy voice.