Self-Esteem Therapy: 5 Tips for Psychotherapists

This article is an excerpt from the Shortform book guide to "The Six Pillars of Self-Esteem" by Nathaniel Branden. Shortform has the world's best summaries and analyses of books you should be reading.

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Can psychotherapy address low self-esteem? What role does self-esteem play in mental health?

According to psychotherapist and self-esteem expert Nathaniel Branden, self-esteem should be the main goal of psychotherapy. In his book The Six Pillars of Self-Esteem, he asserts that low self-esteem is the underlying cause of many psychological issues and explains how psychotherapists could modify their practices so that they can improve their clients’ self-esteem.

Here’s how self-esteem therapy can be an untapped solution to many mental health problems, according to Branden.

How Psychotherapists Can Help Improve Self-Esteem

Branden argues that psychotherapists should make building self-esteem one of their main goals for two main reasons. First, he says that many psychological issues stem from unhealthy self-esteem. For example, he writes that shyness comes from a lack of self-assertion—or a lack of self-esteem—while aggression occurs when people try to pretend that they have self-esteem when they don’t. So building confidence with self-esteem therapy would help repair these psychological issues. Second, Branden argues that psychotherapy has two main goals: reduce suffering and uncover strengths. Building self-esteem accomplishes both of these goals.

How Modern Psychologists Think Self-Esteem Affects Shyness and Aggression

Generally speaking, psychologists agree that low self-esteem contributes to shyness, but they’re divided on how aggression relates to self-esteem levels. Some contend that low self-esteem contributes to aggression, while others contend that high self-esteem does so.

One study revealed that this difference stems from a lack of consensus on how to define self-esteem. Psychologists who link aggression to low self-esteem equate self-esteem with your general self-opinion. In contrast, psychologists who attribute aggression to high self-esteem define self-esteem as the level of confidence you have in a particular skill set (for example, if you think you’re socially skilled). They contend that this type of high self-esteem may spark aggression if others don’t agree with your self-evaluation, leading you to act out.

(Shortform note: One study suggests that framing the treatment goals as an attempt to live a life that’s more closely aligned with their values may increase how engaged the clients are—even if the psychotherapist doesn’t change the content of her treatment.)

So how, exactly, can psychotherapists help their clients improve their self-esteem? Branden makes several recommendations that we’ve listed below.

1. Respect the client, no matter how poorly the client acts. By respecting the client, psychotherapists treat the client as somebody who is fundamentally worthy as a human being. This can encourage the client to believe they are fundamentally worthy—and, as we’ve seen, such a belief is essential to self-esteem.

(Shortform note: Therapists can show respect to their patients by using appropriate language (for example, not cursing), accepting their clients’ beliefs and values without judgment, not rushing clients to say more than they feel comfortable revealing, and not allowing the relationship to move beyond a professional context.)

2. Help your clients figure out what they need to learn, instead of telling them what they need to learn. For example, don’t tell them that nobody’s coming to save them—lead them to that realization. Telling your client what to do may teach the client what they need to learn, which builds self-esteem—but it robs them of the opportunity to reach that insight themselves, which improves self-efficacy and thus self-esteem. Moreover, when telling the client what to do, you risk letting your personal desire for adulation bleed into your profession and subtly judging the client. If you judge the client, you undermine the environment of respect you are trying to create.

(Shortform note: Other professionals add that telling your clients what they need to learn or do ultimately harms your client because it doesn’t empower them to make their own decisions. As a therapist, your job is to help your clients understand why they act the way they do so that they can make better decisions in the future—even if you’re not there.)

3. Focus on discovering the client’s strengths. To encourage self-esteem, Branden recommends that you help clients discover their untapped potential so that they can do better in life. This potential may be hidden simply because it has not yet been uncovered or because the client is repressing it for whatever reason. If it’s the latter, psychotherapists can help clients work through this repression by giving them sentence stems like the following.

The bad thing about admitting my strengths is…
If I were to bring my strengths to bear on my problems…

(Shortform note: Today, therapy that helps clients discover their strengths is known as strengths-based therapy, which research shows improves self-esteem. While some of these therapists may use sentence-completion work, strengths journaling is more common: The client writes about how their strengths have improved their lives, which leads them to grow more aware of how these qualities are helping them now.)

4. Teach your clients that they perform negative behaviors because those behaviors provided some immediate benefit when they were first developed—even though they may cause long-term harm. For example, a child whose parent yells at him for expressing emotion learns to stop expressing emotion. This benefits him in the short term because he avoids parental rejection, but it may cause long-term harm if he grows into an adult who can’t express emotion. A client who understands why he behaves in some unhealthy way is far less likely to berate himself for that behavior—a self-rejecting act that makes it even harder to improve these behaviors. He’s also finally able to see why this unhealthy behavior no longer benefits him—and grows more open to considering alternatives.

(Shortform note: The mere fact that you engage in self-destructive behaviors—which provide immediate benefit but cause long-term harm—may be evidence of a simultaneously negative and positive quality. Research suggests that people who engage in self-destructive behaviors feel emotions more powerfully than others, but feeling emotions powerfully is also associated with positive qualities like greater empathy and creativity. Understanding these positive effects may reduce how likely you are to berate yourself for self-destructive behavior.)

5. Teach your clients how to recognize and unite subselves. Branden contends that everybody has subselves, which are like mini-personalities that we’ve internalized, and that often kick in when we face particular situations. Imagine yourself as a group of friends on a road trip: Your conscious self is the main driver, but each of your subselves occasionally takes over the driving.

Each of these personalities is specific to you. For example, Branden discusses the mother-self, which is an internalized version of your mother—not a generic mother figure. When you hear your mother’s voice in your head telling you not to do something, that’s your mother-self talking to you. In addition to a mother-self and father-self, you have subselves that represent internalized versions of you as a child, a teenager, and the opposite gender (your feminine side if you’re a man, or your masculine side if you’re a woman).

Branden argues that we can only accept ourselves—and thus gain self-esteem—if we become aware of and accept all our subselves and learn to unify them with our conscious self. This can be a difficult task because we may want to reject our subselves. For example, if you hated your mother, you probably dislike the idea that you have a mother-self. Even if you accept that your subself exists, you may hear your mother’s voice in your head and yell at it. But since your mother-self is part of you, rejecting that self or behaving in ways that demean it means that you are rejecting yourself, which damages your self-esteem.

Psychotherapists must help clients face each subself, accept it, and discover what it needs so that their conscious self can meet its needs in their relationship. In this way, you learn to treat each subself with kindness.

How Other Psychologists Talk About Subselves

Other psychologists have also suggested that we have subselves that we must identify and accept in order to improve our lives, but their explanations of subselves differ from Branden’s in a few ways.

For example, in The Anxiety and Phobia Workbook, Edmund Bourne proposes that there are four subpersonalities that may induce anxiety: the worrier, the critic, the victim, and the perfectionist. While Branden asserts that subselves are unique to each person, Bourne posits that these four subpersonalities represent archetypes that work the same way in everybody. For example, if Lisa and Tina have different mothers, Branden’s theory dictates that they have different mother-selves. But Lisa and Tina both have the critic, which treats both the same way: It lowers their self-opinion by judging them harshly.

Additionally, while Bourne recommends identifying and accepting our subselves, he doesn’t argue that you must learn to unify them with your conscious self. Rather, he focuses on ways to overcome these subselves so that they stop distorting your thoughts and inducing unnecessary anxiety. To do so, Bourne recommends that you stop overanalyzing and just do whatever you want. You may also consider growing mindful of harmful thoughts so that you can objectively analyze and interrupt them if necessary.

Self-Esteem Therapy: 5 Tips for Psychotherapists