Low self-esteem is rarely loud. It tends to sit in the background: an inner voice that is quick to criticise and slow to give credit, a sense that you are only as good as your last achievement, or a feeling that if people really knew you, they would think less of you. Many people who live with it are capable, conscientious and successful, and few of the people around them would guess how they feel.
Low self-esteem or low confidence?
The two are often confused, but they are different. Low confidence is usually specific. You might feel unsure about public speaking, driving, or a new role at work, while feeling fine about yourself as a person. It tends to grow with practice and experience.
Low self-esteem goes deeper. It is about how you see yourself, not how you rate a particular skill. Success doesn't seem to count, or only counts until the next challenge, while mistakes feel like proof of something you have always suspected. You can be highly skilled and widely respected, and still feel this way.
How it can show up
- A harsh inner critic, especially after a mistake
- Brushing off praise, or putting success down to luck
- Comparing yourself with others and always coming up short
- Working very hard so that you never fall short, or avoiding challenges in case you do
- Finding it hard to say no, ask for what you need, or put yourself first
- Feeling like an impostor, waiting to be found out
The pattern that keeps it going
Low self-esteem is often held in place by the very ways people learn to cope with it. To protect against feeling not good enough, it is common to live by unwritten rules: always do things perfectly, never let anyone down, never show weakness. Living by those rules can work for a long time, but it is tiring, and when a rule is threatened, the old feeling comes straight back.
Meanwhile, the effort to stay safe means the belief underneath never really gets questioned. Each success is put down to the extra effort, and each setback seems to confirm the belief, so the pattern keeps going, sometimes for decades. It often sits underneath other difficulties too, such as perfectionism, social anxiety or burnout.
How CBT helps with low self-esteem
CBT offers a structured way to work on low self-esteem directly, rather than only managing its effects. Together we build a clear picture of how it works for you: the beliefs you hold about yourself, the rules you live by, and the situations where it hurts most. Then we work through them systematically, testing old predictions, responding differently to self-criticism, and building a fairer, more balanced view of yourself.
This isn't about positive thinking or repeating affirmations you don't believe. Because low self-esteem is so personal, the work is tailored to you: your history, your goals, and what matters most in your life. I describe the CBT approach in more detail in Low self-esteem and how CBT can change it.
Online or in person
I see people online across the UK and in person on Thursdays at The Re-mind The Body Centre in Queen's Park, North West London, close to Kilburn, Maida Vale, Kensal Green and West Hampstead. This work is just as effective online as in the room.
Is this the right service for you?
I work with adults (18 and over) on a private, self-pay basis. Many people with low self-esteem wonder whether their difficulties are "serious enough" for therapy; that doubt is very common, and it isn't a reason to wait. It starts with a free 10-minute phone call, so we can talk about what's been happening and whether I can help. From there, the first session is a 50-minute assessment: you'll come away with a clearer understanding of what's going on and what treatment would involve, whether or not you decide to continue.
