Low self-esteem is not simply a lack of confidence. For many people it is a deep, often unconscious conviction about who they are — a persistent sense of low self-worth formed early and reinforced over years, sometimes rooted in childhood bullying or other experiences that taught you, implicitly, that you were not acceptable as you were. You may appear capable and composed to others while privately feeling like an imposter, overly self-critical, or unable to take praise at face value.
Sometimes this shows up as perfectionism, people-pleasing, or difficulty setting limits with others. Sometimes as a harsh inner voice that comments on everything you do. This often involves a deep sense of shame — not just about specific things, but about who you fundamentally are. Sometimes low self-worth focuses on appearance or the body — a preoccupation that may be described as body dysmorphic disorder. You may have achieved a great deal and still feel it is not enough.
How therapy can help with low self-esteem and self-confidence
Approaches that focus on building confidence can help in the short term, but they do not always reach the roots of low self-esteem — the early experiences, internalised voices and unconscious beliefs about whether you are acceptable as you are.
Psychoanalytic psychotherapy is interested in how your relationship to yourself was shaped over time, and how that inner relationship plays out in work, intimacy and daily life. Understanding this does not remove self-doubt overnight, but it can gradually loosen its grip.
Online therapy for low self-esteem — who it's for
Most people I see with self-esteem difficulties are functioning well on the outside — working, maintaining relationships, getting through their days — but carrying a private sense that they are not quite enough. You do not need a diagnosis or a crisis to get in touch. Sessions are 50 minutes, held weekly online, at £75.
Read more: Why choose psychoanalysis over other types of therapy? →