Self-esteem is a person's opinion of his worth and value as a human being. People with low self-esteem tend to use "all or nothing" thinking such as "I'm the most stupid man I know." The focus of counselling efforts to improve self-esteem is to help the client recognise and confront cognitive distortions. Once thoughts become more positive, a person becomes more open to trying new experiences that lead to increased self-esteem.
Recognise Distorted Thoughts
Suggest clients keep a journal. People with low self-esteem often do not recognise negative false thought patterns. The client begins the healing process by keeping a journal of thought patterns, labelling each as positive or negative. These are reviewed with the therapist for a week or two to ensure the client recognises the difference between positive and negative thought patterns.
Confront Negative Thoughts
Help the client recognise that negative thoughts are false, and give examples where appropriate. If the client has the thought, "I am the most inept woman I know," for example, the therapist uses the technique of reflective listening to help the client break this distortion. The counsellor simply repeats what the client is saying in a gentle way. If the therapist says, "You are the most inept woman [pause] you know, [pause] really?" The patient explains her thinking by saying something like "Yes, I cannot do anything right." The therapist then repeats something like "Nothing?" and so on until the client is gently guided toward confronting her own false beliefs. This method is more effective than simply telling the client the truth behind her false beliefs.
Support the Client
Support the client to replace negative and false self-thoughts with positive logical thoughts. As the therapy advances, the sophistication of the journal advances with the client writing out the negative, false belief and the positive counter belief, as well as how both beliefs felt for him.
Build confidence by encouraging the client to try new activities, interpreting these through the lens of her new positive thought patterns. New actions interpreted positively lead to positive feelings, which lead to increased goal setting and achievement. This is known as a positive thought spiral.