Harvard Mental Health Letter (June 2000) includes: “The use and misuse of self-esteem; How important is it, and should psychotherapy promote it?”

Here’s the article:

Self-esteem is one of the subjects personality researchers and mental
health professionals most like to study. Thousands of journal articles
have been devoted to it, along with dozens of books telling adults how
to raise their own self-esteem or their children’s. In the 1980s, the
California State Legislature funded a task force to investigate the
possibility of raising the self-esteem of Californians, in the hope of a
huge return by way of reduced welfare dependency, unwanted pregnancy,
drug addiction, and crime. The results were disappointing, and since
then doubts have set in. Many still regard heightened self-esteem as a
worthy aim of social policy and psychotherapy, but others fiercely
dispute its significance and value.

It’s difficult not to feel that self-esteem is important. We all want to
like ourselves, prove ourselves, and have reasons to believe that our
virtues and talents are recognized. We want others to see us as likable,
competent, and trustworthy. But pride is one of the seven deadly sins,
and narcissism, which can be interpreted as exaggerated self-esteem, is
widely regarded as an undesirable personality trait.

To what extent do your beliefs about your own worth matter regardless of
the underlying reality? When is self-esteem justified, and when is it
wiser to criticize yourself? Even if high self-esteem is generally
desirable, might it be best earned as a byproduct of other achievements
and personal qualities — not worth chasing or even attainable by direct

Before trying to answer those questions, it’s necessary to define and
measure self-esteem in a way that is useful for research. Psychologists
have developed several rating scales for that purpose. The most popular
questionnaire for rating overall or “global” self-esteem is the
Rosenberg Self-Esteem Scale. It asks responders to say how much they
agree or disagree with statements like “I feel that I have a lot of good
qualities” and “I certainly feel useless at times.”

A good thing?

Whether judged by this questionnaire or others, there is evidence that
high self-esteem can be advantageous for mental health and personal
relationships. New Zealand researchers found, after correcting for
social class, IQ, depression, and height-weight ratio, that young
adolescents with low self-esteem were at increased risk for poor mental
and physical health, poverty, and criminal activity by their mid-20s. In
a group of 9- to 11-year-old Florida boys, those with low self-esteem
had a 60% higher rate of drug dependence 10 years later. Other studies
have found that girls with high self-esteem are less likely to develop

There is convincing evidence that people with high self-esteem are
happier as well as more likely to undertake difficult tasks and persist
in the face of failure. They recover more quickly from disasters and may
be quicker to recognize and abandon hopeless enterprises. They may have
a decreased risk for heart disease and a more competent immune system.
Some studies have found that their stress hormone levels are lower and
return to normal more quickly after a spike.

Not so good?

Other studies have failed to confirm the virtues of high self-esteem.
Child abusers and criminals, in general, do not suffer from low self-
esteem. In experimental situations, high self-esteem does not lower the
risk of aggression. Children’s belief in their own academic ability is
only modestly correlated with success in school. And many studies
suggest that your opinion of yourself is not closely correlated with
what others think of you. Sometimes the superior success and social
skills of people with high self-esteem exist mainly in their own minds.
They may make a good impression at first but later come to be regarded
as arrogant. Psychopaths, tyrants, and school bullies have a high
opinion of themselves and believe others admire them. One study found
that popularity among ninth graders was not correlated with self-esteem.
Children with low self-esteem were liked less than others only if they
were male, depressed, and prone to seeking reassurance.

It’s possible that high self-esteem merely boosts the effect of other
personal qualities. In one experiment, both the children least likely to
cheat and those most likely to cheat had higher than average self-
esteem. Critics who doubt the value of self-esteem say that some of its
advocates suffer from what they call a clinician’s illusion. Therapists
rarely see people with high self-esteem who behave badly or lead
undesirable lives, because they rarely seek help.

Kinds of self-esteem

One way to resolve the dispute is to distinguish various kinds,
components, or aspects of self-esteem. The English language has many
words for distorted or unjustified self-love and related qualities. We
refer to boastfulness, egotism, conceit, self-satisfaction, vanity, and,
especially in the mental health professions, to narcissism. The
Narcissistic Personality Inventory is a rating scale that demands
agreement or disagreement with such statements as, “I am more capable
than other people” and “If I ruled the world, it would be a better
place.” In a study of 3,000 American undergraduates, scores derived from
this questionnaire and scores derived from the Rosenberg Self-Esteem
Scale were only slightly correlated. Violent criminals in prisons turn
out to be extraordinarily high in narcissism but only average in self-esteem.

The problem of narcissism may be related to another complication in
judging the value of self-esteem. The standard way to discover which
people feel good about themselves is simply to ask them, in the form of
a questionnaire. But it’s likely that some of us become defensive when
faced with such questions and respond deceptively or self-deceptively.
So researchers are beginning to examine differences between explicit
self-esteem, as judged by what we say about ourselves, and implicit self-
esteem, as measured by automatic responses — how quickly we associate
words that have favorable or unfavorable connotations with our names or
other references to ourselves. According to some studies, there is only
a moderate correlation between explicit and implicit self-esteem.

The combination of high explicit and low implicit self-esteem is
sometimes a sign of defensive denial resulting from insecurity. That
kind of self-love is, if not inauthentic, at least fragile and unstable,
fluctuating as a person anxiously or irritably monitors the reactions of
others. It may be characteristic of narcissistic personalities, who tend
to lash out when their pretensions to superiority are threatened.

Psychologists have developed other variations on the theme of self-
esteem. The psychologist and philosopher William James defined it as the
ratio of genuine accomplishment to pretension or exaggerated self-
promotion. In this sense, it involves mainly self-confidence or a
feeling of competence. But James also mentioned “a tone of self-feeling
that is independent of objective causes for satisfaction” — self-liking
as self-acceptance. Failure can cripple the sense of competence; the
disapproval of others diminishes self-liking.

Especially where the ratio of pretension to accomplishment is concerned,
overall or global self-esteem, measured by the standard questionnaires,
may be less practically important than self-esteem in specific areas.
It’s possible to have a high opinion of yourself in general while
acknowledging limitations in many spheres — and vice versa. A person who
regards herself highly as a student but not as an athlete will be
disappointed by failing an exam but not by losing an athletic
competition. There’s evidence that even young children are suspicious of
vague and generalized praise, corresponding to global self-esteem. They
think it implies that you need encouragement because you are not very capable.

Worth pursuing?

Considering the hazards of indiscriminate praise raises the question of
whether and when it is sensible to treat self-esteem as a goal. Do we
want to expend effort to help troubled or troublesome people develop a
better opinion of themselves? Critics suggest that even when self-esteem
is associated with something desirable — apparent happiness, persistence
in the face of setbacks, taking initiative — there is no proof that it
is the cause. A genetic predisposition to feeling good — an inborn “tone
of self-feeling independent of objective causes for satisfaction” might
be the source of both happiness and high self-esteem. Good health and
social success may promote self-esteem, rather than the reverse. A body
size or image that a girl regards as unacceptable may be at the root of
both her low self-esteem and her bulimia.

If self-esteem is merely a byproduct, trying to promote it will be a
mistake — helping people to feel self-satisfied in a vacuum. That could
remove an incentive to genuine self-improvement and encourage self-
centeredness at the expense of interest in others. The resulting self-
esteem would be insecure because it is based on an unrealistic appraisal
of one’s personal qualities or accomplishments.

For example, spouse abusers who participated in a program aimed at
raising their self-esteem reported that they were less abusive afterward
— but their partners did not agree. Critics also report that efforts to
boost self-esteem are not necessarily the key to improving school
performance, as can be seen in a study of fifth graders.

In this study, the students were given a puzzle to solve. Some were
praised for their intelligence, others for their effort. Then they were
asked to choose between two new puzzles, one more difficult and one
easier. Only those who were praised for their effort chose the more
difficult puzzle.

Later the children were given another puzzle that was difficult for all
of them. Those who had been praised for their effort enjoyed the new
test and worked hard at it. Those who had been praised for their
intelligence gave up more easily, fearing that they were not “smart”
after all.

Finally, when both groups were given another relatively easy puzzle, the
first group’s scores declined and the second group’s scores improved.
The moral is that children who are overpraised for intrinsic personal
qualities in an attempt to increase their self-esteem may become less
likely to undertake any task unless they are sure of success.

Clinicians who believe in promoting self-esteem have answers to these
criticisms. They say that long-term studies provide sufficient evidence
that self-esteem is a source of good things and not just a byproduct.
They say there is good evidence that increasing self-esteem can raise
test scores, improve school discipline, and reduce the use of drugs and
alcohol, and the risk of eating disorders and depression in children and

Problem-solving and assertiveness training, advocates say, can be shaped
to serve heightened self-esteem. Cognitive therapy confronts low self-
esteem by clarifying the implicit underlying thoughts and restating them
as hypotheses to be tested. Discouraging generalizations and errors that
result from selective attention to failure are brought to light,
discussed, and refuted. Behavior therapists may ask patients to keep a
diary recording events that threaten self-esteem; they follow up by
suggesting ways to cope with the resulting feelings and change the
patients’ responses.

Proponents of these therapeutic techniques insist that they do not
produce the kind of empty self-satisfaction disparaged by critics of the
pursuit of self-esteem. The programs are designed to change the behavior
and circumstances of patients and clients, not just the way they feel
about themselves. Critics argue that the programs advertised as raising
self-esteem incorporate so many other components that they prove nothing
about the value of self-esteem itself. Advocates reply that
complications are inevitable because there are cycles of deteriorating
or improving mental health in which self-esteem is both cause and
effect. The responses of others to behavior and attitudes that result
from low self-esteem confirm and reinforce expectations of misery and failure.

The verdict on self-esteem as a goal of self-help or psychotherapy has
to be mixed. It can hardly be harmful for therapists to encourage their
patients and clients to take credit for their accomplishments, avoid
people who are hypercritical, and tell themselves that they do many
things well. Unconditional positive regard is the basic theme of one
kind of psychotherapy, Carl Rogers’ client-centered therapy. According
to his point of view, improving self-esteem (of the right kinds) can
reduce anxiety and defensiveness that degrade the quality of life.

But constant attention to self-validation is not a royal road to mental
health. It’s more likely that self-esteem will come through accurate
self-understanding, an appreciation of one’s genuine skills, and the
satisfaction of helping others. The advice inscribed on the Temple of
Apollo at Delphi was “Know yourself,” not “Approve of yourself.” Freud
might have echoed the sentiment. Both of these aims are worthwhile, but
only to the extent that approval is compatible with honest and realistic


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