Low self-esteem is characterized as a negative sense of the self and co-occurs with many other mental health problems. Although not formally represented in the diagnostic manuals it is nevertheless a distinct and treatable psychological difficulty.
People are not born with low self-esteem. Instead, we develop ideas about ourselves and our place in the world as a result of our life experiences. People who experience enough positive reinforcement, praise, love, and acceptance are more likely to develop positive self-beliefs. Those who suffer experiences of adversity, trauma, criticism, bullying, and neglect are more likely to experience low self-esteem. Known predictors of low self-esteem include peer victimization (van Geel et al, 2018), childhood trauma (Weindl et al, 2018), maltreatment (Bolger, 1998), and chronic illness (Pinquart, 2013).
The cognitive behavioral theory of low self-esteem proposes that negative self-beliefs are self-reinforcing: once activated, they can bias the way that an individual perceives, remembers, thinks, and feels (Fennell, 1997). Treatment of low self-esteem involves understanding one’s negative self-beliefs and their origin; becoming aware of the processes that maintain one’s negative self-belief (including cognitive biases, safety seeking and avoidance behaviors); testing whether such globally negative summaries (and the predictions made in their wake) are fair and accurate; and developing healthier beliefs and assumptions.
What Do People Think About Themselves? is a ‘conversation starter’ exercise designed for children and young people to explore how self-beliefs are developed. Clinically, the purpose of the exercise is to help young people to make links between experiences and self-beliefs in a de-centered (and potentially less threatening) way.
“Would you be willing to look at these people’s stories with me? Imagine how each person feels, and what they might think of themselves.”
Helpful questions to explore ideas about self-esteem may include:
- What might <the children mentioned in the vignette> think about themselves?
- What words would they use to describe themselves?
- Why do these children use different words to describe themselves? Where have those words come from?
- What words do you use to describe yourself? What things have happened to you that make you see yourself in this way? Where have those words come from?
- Sometimes people describe themselves using only a few short words like ‘not good enough’, ‘unlovable’, or ‘defective’. Is that fair? Can you really ‘sum up’ a whole person using so few words?
- Were any of these children born thinking this way about themselves?
- If <a child mentioned in the vignette> was your friend, what would you want to do for them?
- Bolger, K. E., Patterson, C. J., & Kupersmidt, J. B. (1998). Peer relationships and self‐esteem among children who have been maltreated. Child Development, 69(4), 1171-1197.
- Fennell, M. J. (1997). Low self-esteem: A cognitive perspective. Behavioural and Cognitive Psychotherapy, 25(1), 1-26.
- van Geel, M., Goemans, A., Zwaanswijk, W., Gini, G., & Vedder, P. (2018). Does peer victimization predict low self-esteem, or does low self-esteem predict peer victimization? Meta-analyses on longitudinal studies. Developmental Review, 49, 31-40.
- Pinquart, M. (2013). Self‐esteem of children and adolescents with chronic illness: a meta‐analysis. Child: Care, Health and Development, 39(2), 153-161.
- Weindl, D., Knefel, M., Glück, T. M., Tran, U. S., & Lueger-Schuster, B. (2018). Motivational capacities after prolonged interpersonal childhood trauma in institutional settings in a sample of Austrian adult survivors. Child Abuse & Neglect, 76, 194-203.