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Dr. David Burns on treatment for low self esteem, The Self Esteem Ladder

Dr. David Burns

Tip#2: The ladder of self esteem from self defense to acceptance to death of the ego.

So how can we develop greater “self-esteem”? I think of the development of self-esteem as a ladder you can climb:

Step 1 on the ladder is conditional self-esteem. You decide you are worthwhile because of this or that skill, talent, feature or accomplishment. For example, you may tell a depressed child that she is worthwhile or special because she has pretty eyes, or a nice voice for singing, or an athletic skill, or good grades, or whatever. This is a step up from self-hatred and depression, and is sometimes promoted by parents and teachers.

But even as an adult, we may tell ourselves that we are worthwhile because, for example, we have a PhD, or good therapy skills, or a good income, etc. Often, therapists make the same mistake of trying to cheer up a depressed patient by pointing out their good qualities. I have never seen this help anyone, and have often seen this irritate patients who are depressed. I’ve seen it in group therapy groups, and in my workshops, too, when I do live demonstrations.

Or, in another version of conditional self-esteem, we can decide we are “lovable” and “worthwhile” because others have loved us. In this case, self-esteem depends on love as opposed to achievement, but both are contingent versions of self-esteem.

Or, you can decide, as many religious people do, that you are “worthwhile” because of your faith in God, or in your religion. Well, what happens when you suddenly doubt your faith? Are you now “less worthwhile”? And, do you believe you are “more worthwhile” than others who do not share your faith, or who have no religious faith at all?

Anytime you say, “I need substance X” to be worthwhile, you are potentially in trouble.

Step 2 is unconditional self-esteem. You decide you are worthwhile and lovable just because you are human. Ii is simply a decision you have made to love and accept yourself, just as you might decide to love your child–as a gift, or because your child is hurting and needs your love and comforting, and not because your child has “earned” your love through some accomplishment, like getting A’s in school.

And by the same token, you can declare that all human beings are worthwhile, and equally worthwhile. You can decide that we all have one unit of “worth” just because we exist as human beings.

As an aside, would this mean that we are now “more worthwhile” than animals? Lots of people think this way, including, perhaps, people who hunt for sport. Many humans treat animals shabbily, even horribly, just as Hitler decided that some humans are more or “less worthwhile” and chose to exterminate them, thinking he had a justification.

Step 3: Once you have achieved unconditional self-esteem, you can decide to throw it away, to get rid of it as fast as possible. You suddenly see “self-esteem” as just another perfectionistic (and meaningless) verbal trap, a waste of time. You discover that “self-esteem” and “worthwhileness” are something you never needed in the first place. Just another burden, like the equally meaningless concept of a “self.”

When you make the decision to get rid of your self-esteem, you can decide to get rid of your belief that you “have” or “are” a “self” as well. You may discover that you don’t need or want or have a “self.”

These are just some rambling thoughts. This is on a philosophical level–ultimately, in clinical settings, we have to do agenda setting. What is it the person wants help with?

If someone feels successful, and therefore worthwhile, and wants to preserve this system of thinking, he or she definitely has the right to do that. Perhaps, like an addiction, you may have to hit a low point to feel motivated to challenge the habit. And certainly, the idea that we are “special” or “superior” or “worthwhile” can be a heady one, something like getting high, perhaps. But the goal of Cognitive Behavior Therapy, to my way of thinking, is not to develop self-esteem, but to throw the concept away and to recognize it as meaningless.

It is my belief that this is part of what the Buddha promoted as “enlightenment,” but there are many forms of enlightenment. Letting go of the idea that you have a “self” is only one of them, and the “Great Death” can take many forms, I think.

Finally, I want to emphasize that for many negative thoughts that cause anxiety or depression, the combination of self-defense plus the acceptance paradox will be, by far, the most effective, or only effective, approach. For other negative thoughts, the self-defense paradigm will be, by far, the most effective, or only effective, approach. There is never any one single “best” approach to the relief of suffering, but many approaches.

To learn more about Dr. Burns’ approach to healing depression, anxiety and low self esteem with his cutting edge CBT methods, come to his intensive workshop for therapists. Click here to learn more.

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