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What Keeps Low Self-Esteem Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their disorders persist, and how they might be interrupted. What Keeps Low Self-Esteem Going? is designed to help clients with low self-esteem understand more about their condition.

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A PDF of the resource, theoretical background, suggested therapist questions and prompts.

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Languages this resource is available in

  • Arabic
  • Chinese (Simplified)
  • English (GB)
  • English (US)
  • Greek
  • Italian
  • Polish
  • Spanish (International)

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Introduction & Theoretical Background

Low self-esteem means not holding yourself in high regard. If you have low self-esteem you might feel shy or anxious around other people, think of yourself as incapable or criticize yourself harshly, by telling yourself things like “You’re stupid”, “You’ll never manage this”, or “You don’t amount to anything”. When you have low self-esteem, you tend to see yourself, the world, and your future more negatively and critically. You might feel anxious, sad, low, or unmotivated. When you encounter challenges, you doubt whether you will be able to rise to them. 

Research studies have shown that Cognitive Behavioral Therapy (CBT) is one of the most effective treatments for low self-esteem (Kolubinski et al, 2018). CBT therapists work a bit like firefighters: while the fire is burning they aren’t very interested in what caused it, but are more focused on what is keeping it going. This is because if they can work out what keeps a problem going, they can treat the problem by ‘removing the fuel’ and interrupting this maintaining cycle. 

In 1997, psychologist Melanie Fennell identified key components that are thought to explain why some people keep suffering from low self-esteem. The What Keeps Low Self-Esteem Going? information handout describes some of these key factors which maintain low self-esteem. It illustrates these maintaining factors in a vicious flower format, in which each ‘petal’ represents a separate cycle. Helping clients to understand more about the cognitive model is an essential part of cognitive therapy for low self-esteem. Therapists can use this handout as a focus for discussion, or as a template from which to formulate an idiosyncratic model of a client’s experiences.

Therapist Guidance

“One interesting way of thinking about low self-esteem is to look at why, for some people, it does not get better by itself. This handout shows some of the most common reasons why some people’s self-esteem remains low. I wonder if we could look at it together and think about whether it describes what is happening for you?”

References And Further Reading

  • Fennell, M. J. (1997). Low self-esteem: A cognitive perspective. Behavioural and Cognitive Psychotherapy, 25(1), 1-26.
  • Kolubinski, D. C., Frings, D., Nikčević, A. V., Lawrence, J. A., & Spada, M. M. (2018). A systematic review and meta-analysis of CBT interventions based on the Fennell model of low self-esteem. Psychiatry Research, 267, 296-305.