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Low Self-Esteem Formulation

Worksheet

Fennell’s cognitive behavioral model of low self-esteem proposes that negative beliefs about the self are maintained by biased information processing, including perceptual and interpretation bias. This worksheet describes the sequence by which negative self-beliefs in low self-esteem are maintained. It can be used to help clients to explore their negative beliefs and predictions, rules for living, how they interpret what happens to them, and the consequences of those interpretations.

Low Self-Esteem Formulation Low Self-Esteem Formulation Low Self-Esteem Formulation Low Self-Esteem Formulation

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Description

At the core of low self-esteem are negative beliefs or judgements about the self, which persist despite seemingly contradictory evidence. Melanie Fennell draws upon Christine Padesky’s metaphor to describe negative beliefs in low self-esteem as being analogous to prejudices: unfair and ill-informed. Fennell argues that information relating to the negative beliefs may be subject to perceptual and interpretation biases:

  • Perceptual bias: Information that is consistent with one’s beliefs is readily accessible and easily processed, whereas data inconsistent with the negative belief is ‘screened out’.
  • Interpretation bias: Information that is perceived is biased towards the negative belief. Ambiguous data is interpreted negatively, and positive or neutral data is distorted to fit. Negative data is “attributed to enduring flaws or weaknesses”.

Fennell proposes that negative beliefs in low self-esteem are perpetuated by a sequence in which:

  1. Negative beliefs are activated by situations in which rules and standards are threatened.
  2. Once they are ‘on line’ they result in biased predictions and expectations.
  3. These predictions lead to anxiety, which promotes avoidance or the use of safety-seeking behaviors.

Information processing biases place the individual with low self-esteem in a ‘no win’ situation:

  • If their negative predictions turn out to be accurate, the negative beliefs are reinforced (“I knew it”).
  • If the predictions turn out to be inaccurate, the contradictory evidence is usually ignored, discounted (“I only succeeded because…”) or distorted (“They said they liked it, but I could see in their eyes that they didn’t”).

The Low Self-Esteem Formulation worksheet displays the sequence underlying schemas maintenance in low self-esteem. It can be used with clients to explore specific situations that activated their negative schema and led to negative predictions, and the ways in which they interpreted the outcome of events.

Instructions

“Surprisingly, people with low self-esteem often continue to think badly of themselves despite having achievements and successes. Would you be willing to help me to understand more about what happens when you have successes and setbacks?”

 

    1. Situations in which our rules or personal standards might be broken are often the most triggering. For example, if someone has the rule “I’m OK as long as I’m not criticized”, situations where they might get feedback from other people can be particularly stressful for them.
      • Can you think of a recent situation that made you feel particularly anxious?
      • Can you think about a recent situation when you gave yourself a hard time?
    2. Beliefs & rules. Our positive and negative beliefs about ourselves are based on the things that have happened to us. These beliefs are often expressed in the form “I am …”, as if it is a fact about yourself.
      • Write your negative belief here.
      • What belief about yourself could have been activated in this situation?

      We all have rules that we live by and which guide our behavior. In low self-esteem these rules often try to compensate for your underlying negative belief. For example, if you believe “I’m unlovable” you might compensate by always putting other people’s needs first, in order to receive love. When these rules *might be* or *are* broken, we feel very anxious.

      • Which of your rules might be broken here?
      • What rule or standard is in danger of being broken in this situation?
    3. Negative predictions. Some people are optimistic and expect or predict that positive things will happen. People with low self-esteem often make negative predictions about particular situations, especially when their rules are being threatened.
      • In that situation, what were you predicting or expecting?
      • What were you worried might happen?
      • How strongly were you expecting that to happen?What you think affects the way that you feel.
      • How did that prediction or expectation make you feel?
      • What did you feel when you were predicting that would happen?
    4. Safety behaviors. When we predict something bad will happen, we are often tempted to avoid it. If we can’t avoid it, we might use our ‘safety behaviors’ to prevent the worst from happening. For example, if someone is very worried about being criticized, they might try very hard to please other people, or they might be very conscientious at work.
      • How did you respond when you couldn’t avoid that situation?
      • What did you do to that helped you to cope?
      • What safety behaviors did you use?
      • Did you do anything to make sure that the worst didn’t happen?
    5. Interpretations of what happened. When things go badly, the negative belief is confirmed and strengthened. Even when things go well, they can be discounted or distorted, so that the negative belief goes unchallenged.
      • What sense did you make of what happened?
      • What did you say to yourself when it happened?

      If there was a positive outcome:

      • What did you do to discount or distort what happened to make it fit with your negative belief?
      • What did you say to yourself when that happened?
      • If your friend did this, what would you say to them?

      If there was a negative outcome:

      • What did you say to yourself?
      • How did it affect your negative belief?
    6. Reflection. Reflect on what you have learned, and identify what might need to change.
      • (Encourage reflection on the other pathway of the diagram) If things had gone the other way, what sense would you have made of that outcome? What does this tell you?
      • Can you think of other situations that were similar? Do you notice this pattern in other situations?
      • Can you imagine a friend or someone you know (someone with a positive self-belief) confronting the same situation? What might they have thought & felt? What does this tell us about what needs to change? How might we get there?
      • What would you say to a friend who did a lot of self-criticism? What would you say to friend who did lots of minimizing or distorting?

References

  • Fennell, M. J. (1997). Low self-esteem: A cognitive perspective. Behavioural and Cognitive Psychotherapy, 25(1), 1-26.
  • Padesky, C. A. (1990). Schema as self-prejudice. International Cognitive Therapy Newsletter, 6(1), 6-7.