Therapy for Low Self-Esteem: How It Works, When To Seek It & Treatment Options

Pervasively poor self-esteem can lead to depression and anxiety, and have other psychological or emotional implications. Your self-esteem likely varies: somedays, you feel confident and capable; other days, you're flat-out miserable, and self-doubt clouds your every action. Perhaps you lean more towards one or the other, but want to reach a steady balance in your life.

Therapy can help! Here are four ways you'll benefit from therapy that's specially designed to help you with low self-esteem:

1. Identify and understand the source(s) of low self-esteem

Low self-esteem has roots in things like events, relationships, or behaviors, both past and present. Working with a therapist, you can start to understand the source of these insecurities, and how that original cause is still affecting you today. Your therapist might encourage you to reflect on the settings and situations in which you feel your best — and your worst. Sharing these thoughts with your therapist may help you recognize any patterns that need attention.

2. Process past negative experiences in a safe, nurturing space

In therapy, you have a chance to talk through/process some of these experiences (e.g. being bullied, experiencing trauma, physical, verbal, or emotional abuse). Your therapist will remain non judgemental and constantly compassionate — you can do no wrong in your therapist’s eyes (a little magic called Unconditional Positive Regard!).

Oftentimes, people who experience maltreatment don’t believe they deserve to be treated better; therapy shows you otherwise. During your therapy journey, you’ll feel empowered to express your true feelings about those experiences — that you didn’t deserve them.

3. Learn to recognize critical voices that are not your own

As a therapist, I often hear clients speaking critically of themselves. They’re speaking from a place of insecurity, low self-esteem, or negative judgment, which leads me to ask “whose voice is that?”

Often, people can identify a parent’s, peer’s, or partner’s critical voice. They’ll then recognize that those critical voices may not be their own (or may not have started as their own). A therapist can also help you identify cognitive distortions, or warped thoughts not based in reality.

Learning to recognize these patterns helps you separate yourself from these criticisms and replace them with kinder, more self-compassionate voices.

4. Notice “all or nothing” thinking patterns

Fearing or envisioning extreme outcomes can prevent people from setting boundaries, speaking up for themselves, and protecting their own wants and needs.

When you start to notice triggers for your own black and white thinking, you can mindfully manage them as they arise, and honor your own desires. Hint: this is another example of a cognitive distortion!

When to seek therapy for low self-esteem

Low self-esteem is easy to brush off, since it can seem more like a character trait than a mental health condition. But there are times when it's advisable to seek treatment. Here are a few examples of indications you might benefit from working with a therapist on self-esteem:

Low self-esteem is preventing you from healthily developing in your everyday life

If low self-esteem is having a negative impact on the following everyday situations, you might want to consider seeking help.

• Your interpersonal relationships: You don't feel like you're "worth" better treatment. This might lead to unhealthy relationships that are codependent, abusive, or boundary-crossing.
• Your school or work responsibilities: You set yourself up to, or assume that you will, fail. This could then become overwhelming work stress.
• Socializing and interacting with others: You have extreme social anxiety at the thought of having to open up to others because you think you aren't "good" enough.
• Setting boundaries with others: You don't feel like your needs are important, so you let others cross healthy boundaries and take advantage.

Signs that it’s time to seek therapy for low self-esteem

In addition to the above external situations, here are some personal "warning signs" that may indicate the need for help:

• You are feeling overwhelmed, angry, ignored and/or taken advantage of in relationships
• You are experiencing mood swings
• You are having difficulty beginning, completing and/or accomplishing tasks (at work, school, personal or otherwise)
• You feel alone and at a loss as to how to help yourself
• Constantly trying to “fix,” “do” or “say” the right thing to get people to like you, or agree with you

Treatment options for low self-esteem

When it comes to treating low self-esteem, you have options! Two of the major approaches are psychodynamic and cognitive behavioral therapy (CBT). Here's what they each looks like in terms of developing healthier self-regard:

Psychodynamic therapy: Provides insight into the origins of your insecurities

Psychodynamic therapy can help people identify and recognize the underlying causes or reasons for having low self-esteem. It can also help people connect past experiences to present ones that may be influencing their self-esteem.

This type of relational therapy also encourages people to use their voice, identify what they want and need, and practice doing this with a professional so it can come more easily in situations outside of therapy.

Psychodynamic therapy: An example of treatment for low self-esteem

A patient of mine had highly critical parents growing up – parents who constantly told her that trying her best wasn’t good enough, that she wasn’t reaching her potential and needed to try harder, now feels like nothing she does is good enough, that she isn’t good enough.

This has led her to repeatedly enter romantic relationships with partners who are emotionally abusive and manipulative and to feel this is all she deserves. She is familiar with being criticized and made to feel small and so doesn’t know how to ask for more for herself.

We have been using psychodynamic therapy to understand the root of her self-esteem, to explore what she thinks "good enough means," what she wants out of her relationships. We're using psychodynamic therapy to practice saying these things aloud, without fear of criticism or devaluation.

Cognitive behavioral therapy (CBT): Helps you identify and tackle self-defeating patterns

In cognitive behavioral therapy – often shortened to CBT – clients learn to identify thought patterns that are influencing their low self-esteem thoughts, behaviors, and actions.

This skills-based approach, in other words, helps clients tackle their self-defeating thoughts and ineffective behavior to turn out more confident.

CBT: An example of treatment for low self-esteem

I have a patient who constantly has the narrative, “I am too much for people” in her mind, so everything and anything that happens in her life gets filtered through this narrative.

It has affected a lot of her interpersonal relationships, and comes up the most often in moments where she could/would benefit from asking for help. Her fear is that asking for help with anything will be too much for anyone and inevitably they will leave or abandon her.

By recognizing this narrative, or unhelpful thought pattern, she is slowly starting to realize how much this negatively impacts her at work and in her relationships. She is completely overwhelmed by daily tasks because she is so afraid of asking for help.

She is changing the thought “I am too much for people” to “If I don’t start asking for help, my needs could become too much for me to handle and I will explode,” which is helping her to make small changes in her day to day life and get support from people who would be happy to help her.

Some therapists use a combination of CBT and psychodynamic therapy

You may prefer to work with a therapist who incorporates elements of both into their work, depending on your needs. The best way to figure out what type of therapy you need is by talking with therapists. You can schedule calls with as many therapists as you would like through Zencare’s therapist directory. On these calls, you can determine if this therapist’s style and approach are in line with what you’re looking for. To find a therapist who specializes in helping clients with their self-esteem, filter by Specialities.