London Therapy Hub
Understanding Self-Esteem
When You Struggle to Feel “Good Enough”
Having a low opinion of ourselves is a common difficulty, and yet it is often something we are not fully conscious of. When this is the case, it tends to go unexplored — and therefore unchallenged.
Low self-esteem can take the form of a loud, undermining inner critic, accompanied by a persistent sense of not being “good enough.” For others, it is quieter: a nagging self-doubt or an ongoing feeling of falling short in comparison to others.
Low self-esteem may show up as:
- Saying yes to others at the expense of your own needs
- Dismissing compliments or praise
- Overworking or striving for perfection
- Persistent self-doubt
- Avoiding opportunities for fear of failure or rejection
- Self-destructive behaviour
Low self-esteem is often a source of anxiety and can affect how safe and secure we feel in the world
Where Does Low Self-Esteem Come From?
Difficulties with self-esteem are often rooted in earlier life experiences that shaped how we learned to view ourselves and our place in relationships.
This might include growing up in an environment where approval felt conditional, where high expectations were placed on you, or where there was criticism or a sense of being unseen, unheard, or emotionally neglected.
From a psychotherapeutic perspective, these beliefs about the self are understood as adaptations — ways of coping with relational environments that felt difficult or unsafe at the time.
Why Positive Thinking Doesn’t work
If we could simply think ourselves into healthier ways of being, many of us would have done so already
A quick search online shows that much of the guidance available — from therapists, AI, and the NHS — focuses on behavioural strategies, exercise, and positive thinking. These approaches are well intentioned and can reflect a desire to take care of ourselves.
However, they often don’t lead to lasting change. This is because they attempt to address an emotional and relational difficulty using cognitive or behavioural strategies alone.
If we could simply think ourselves into healthier ways of being, many of us would have done so already.
Does Anyone Know What Helps With Self- Esteem?
After working with hundreds of clients over many years — and seeing that their self-esteem clearly improved through the work — I realised something surprising: I didn’t actually know how their sense of self-worth had changed.
I had no clear method for directly targeting self-esteem, and this wasn’t something that had been explicitly taught in my training either. So how, exactly, had therapy helped?
If we look at the origins of self-esteem, they begin very early in life — in the minds of our parents or caregivers. The way we are valued shows up in how we are held and touched, how we are spoken to, how we are looked at, and how we are prioritised.
A child feels esteemed when a caregiver is able to care for them in a consistent and emotionally available way. This may not be possible — or may feel conditional — if a parent is depressed, absent, emotionally unwell, or overwhelmed.
The key is this: when we are valued inherently — simply for being who we are, without conditions — we grow up with an internal sense of being “good enough.”
How Does Psychotherapy Help With Self- Esteem
We need to have a close and trusting relationship with someone who is valuing us and even when we aren’t
So, what helps someone who has have a firm (or unconscious) conviction that they are less valuable than others.
The fact is that what helped my clients was what was happening in the background while we were busy working on other issues
In psychotherapy, there are always two strands operating together. One is the therapeutic relationship. The other is a particular way of thinking and reflecting together.
You will often hear that therapy involves “identifying and challenging beliefs about yourself.” And yes, therapy does involve being with someone who notices how you relate to yourself and helps you reflect on this in a curious, supportive way.
You will often hear that therapy involves “identifying and challenging beliefs about yourself.” And yes, therapy does involve being with someone who notices how you relate to yourself and helps you reflect on this in a curious, supportive way.
And, together, you might explore how these beliefs developed and what they may once have been protecting. Much more importantly though, is that this thinking happens within a relationship.
And it this experience of being in close and trusting relationship with someone who is valuing and holding you in high-esteem even when you are not that is key. Your therapist is holding onto the truth that you are inherently valuable, just as you are, and no more or less valuable than anyone else.
The goal isn't idealising yourself or ignoring our imperfections (which make us human). It is about having a healthy, balanced view of ourself"
Therapy offers an experience of being genuinely seen and accepted. Over time, many people begin to internalise a sense of worth that is not dependent on achievement, approval, or being perfect.
As this develops, the inner critic often softens, making room for a kinder and more supportive relationship with the self.
If you would like to talk to me or discuss whether therapy might be right for you, please feel free to get in touch.
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