Overcoming low self-esteem

Fennell, M.J.V. (1999). Overcoming low self-esteem: A self-help guide using cognitive behavioral techniques. Robinson: London

Fennell, M. J. (1998). Cognitive therapy in the treatment of low self-esteem. Advances in Psychiatric Treatment, 4(5), 296-304.

Introduction
How to tell if someone has low self-esteem: thoughts and statements about self; behavior; emotions; body state (186). Low self-esteem can impact school and work; personal relationships; leisure activities; self-care (187).

CBT is an appropriate approach b/c "a person's opinion of himself or herself lies right at the heart of low self-esteem" (313).

How Low Self-Esteem Develops

If "your experiences in life have largely been negative and undermining, then your view of yourself is likely to be negative and undermining" (383). Experiences that can lead to low self-esteem: systematic punishment, neglect or abuse; failing to meet parental standards; failing to meet peer group standards; being on the receiving end of other people's stress or distress; your family's place in society; an absence of good things; being the "odd one out" at home; being the "odd one out" at school (423-541).

"As people grow up, they take the voices of people who were important to them with them" (560). Why does this happen? B/c "our experiences have created a foundation for general conclusions about ourselves, judgments about ourselves as people. We call these conclusions 'The Bottom Line' [or Core Belief]. The Bottom Line is the view of the self that lies at the heart of low self-esteem. The Bottom Line can often be summed up in a single sentence, beginning with the words, 'I am...'" E.g., I am bad, I am stupid, I am unlovable (581).

Although my Bottom Line might seem incontrovertible to me, "it is usually biased and inaccurate, b/c it is based on a child's eye view." It's helpful to imagine another person w/ my experience and ask if I would judge them as negatively as I judge myself (611). "Once the Bottom Line is in place, it becomes increasingly difficult to detach oneself from it and question it. This is b/c it is maintained and, indeed, strengthened by systematic biases in thinking, which make it easy for you to notice and give weight to anything that is consistent with it, while encouraging you to screen out and discount anything that is not" (631).

"Two biases in thinking contribute to low self-esteem by keeping negative beliefs about the self going." First, biased perception -- you "notice anything that is consistent with the negative ideas you have about yourself," and you "screen out anything that is not consistent with your prevailing view of yourself." Second, biased interpretation -- "If something does not go well, you are likely to use this as the basis for a global, overgeneralized judgment of yourself -- typical, you always get it wrong, etc." (631); you also twist positive experiences -- "If, for example, someone compliments you on looking well, you may privately conclude that you must have been looking pretty bad up till now, or discount the compliment altogether" (650).

Rules for Living (RfL). Core Belief (CB) --

CB: I am bad. RfL: If I allow anyone close to me, they will hurt and exploit me. I must never let anyone see my true self. // CB: I am not good enough. RfL: Unless I always get it right, I will never get anywhere in life. If someone criticizes me, it means I have failed. // CB: I am fat and ugly. RfL: My worth depends on how I look and what I weigh. // CB: I am unlovable. RfL: Unless I do everything people expect of me, I will be rejected (678). If I ask for what I need, I will be disappointed

How Low Self-Esteem Is Maintained
Early Experiences (temperament, life circumstance) >>>

Bottom Line (core beliefs) >>>

Rules for Living (what I must do to avoid Bottom Line) >>>

Trigger Situation (situation in which I don't fulfill RfL) >>>

Activation of Bottom Line >>>

Predictions >>> Maladaptive Behavior >> Confirmationof Bottom Line >> Self-Criticism >> Depression

OR

Anxiety >>> Confirmation of Bottom Line >>> Self-Criticism >>> Depression

Here's how self-esteem is maintained. My self-esteem lies in my core beliefs about myself (e.g., I'm not lovable). RfL function as "escape clauses," allowing me to feel content with myself -- as long as I'm able to fulfill them. But sometimes a "critical incident" happens, causing me to believe that I might not be able to fulfill the RfL. These critical incidents "precipitate negative predictions" (article 297-298). The negative predictions in turn can lead to avoidance and unnecessary precautions; they can disrupt performance (b/c I'm so nervous), or lead to success being discounted (e.g., I got lucky that time) (810-853). Whatever the case, in the end I always feel that my core belief about myself has been confirmed.