Self-Esteem & Self-Criticism Therapy

Psychological therapy for low self-worth, self-doubt and being hard on yourself

You can be successful, capable and valued by other people while still feeling that you are somehow not good enough.

Low self-esteem does not always look like a lack of confidence.

You may function well at work, maintain relationships and appear self-assured while internally questioning yourself, comparing yourself with other people or feeling that your mistakes say something important about who you are.

Perhaps you are much kinder and more understanding towards other people than you are towards yourself.

I am Dr Aaron Shaw, Chartered Clinical Psychologist, and I offer evidence-informed psychological therapy for adults experiencing difficulties with self-esteem, self-worth, confidence and persistent self-criticism.

Therapy can help us understand where these patterns may have come from, what keeps them going and how you can begin developing a more balanced relationship with yourself.

Book a Free 15-Minute Consultation

When never feeling good enough starts affecting your life

Most of us doubt ourselves sometimes.

The difficulty comes when self-doubt becomes a familiar way of relating to yourself.

You might notice that you:

frequently feel that you are not good enough
focus on your mistakes while dismissing your successes
compare yourself with other people
worry considerably about what others think of you
need reassurance that you have done the right thing
find criticism particularly difficult
hold yourself to much higher standards than you expect from other people
struggle to recognise your strengths
feel uncomfortable receiving compliments
assume other people's achievements say something negative about you
feel guilty when prioritising your own needs
find it difficult to say no
worry about disappointing people
believe you need to achieve in order to feel worthwhile
feel like an impostor despite evidence that you are capable
repeatedly think about things you said or did
judge yourself harshly for relatively small mistakes
find it difficult to treat yourself with the same understanding you would offer somebody else

Sometimes people describe living with an internal sense that:

“If people really knew me, they might think differently.”

Or:

“Whatever I achieve, it never quite feels enough.”

When these beliefs become deeply established, they can influence relationships, work, decisions and the way you respond to everyday setbacks.

What is self-esteem?

Self-esteem broadly refers to how we see and value ourselves.

Healthy self-esteem does not mean believing that you are wonderful at everything.

It does not mean never feeling insecure, never making mistakes or always feeling confident.

It means being able to recognise your strengths and limitations without allowing either to determine your entire sense of worth.

When self-esteem is low, our view can become much less balanced.

A mistake may become evidence that:

“I'm incompetent.”

Someone being disappointed with you may become:

“I've let everyone down.”

Another person's success may become:

“I'm falling behind.”

A relationship ending may become:

“There must be something wrong with me.”

The event itself becomes connected to a much broader judgement about who you are.

Psychological therapy can help us begin separating:

what happened

from

what you have learned to conclude about yourself because it happened.

Self-esteem, self-worth and confidence are not quite the same thing

These terms are often used interchangeably, but it can be useful to distinguish between them.

Confidence

Confidence tends to relate to whether you believe you can do something.

You might feel confident giving a presentation but not confident meeting new people.

Confidence can therefore change depending on the situation.

Self-esteem

Self-esteem relates more broadly to how you evaluate yourself.

Someone can be highly confident professionally while still having quite low self-esteem.

Self-worth

Self-worth goes a little deeper.

It concerns whether you believe you have value as a person, independently of what you achieve, produce or provide for other people.

This distinction can be particularly important in therapy.

Sometimes the problem is not simply:

“I don't believe I can do this.”

It is:

“If I don't do this well, what does that say about me?”

Where does low self-esteem come from?

There is rarely one simple explanation.

The way we learn to see ourselves develops over time through many experiences.

For some people, difficulties with self-worth may be connected with experiences such as:

frequent criticism
being bullied or excluded
difficult family relationships
feeling different from other people
rejection
academic or workplace experiences
difficult romantic relationships
being compared with others
experiences of failure or humiliation
having very high expectations placed upon you
receiving approval mainly when you achieved or behaved in particular ways
experiencing anxiety or depression
frightening or difficult life experiences

Sometimes there is no obvious single experience at all.

A belief such as:

“I'm not good enough”

may have developed gradually through many smaller experiences.

The purpose of therapy is not to search for somebody to blame.

Understanding where a belief came from can help explain why it made sense for you to develop it and whether it remains useful or accurate today.

When self-worth becomes conditional

One important pattern I often think about is conditional self-worth.

Instead of experiencing worth as something relatively stable, you may have learned that you feel acceptable only when certain conditions are met.

For example:

I'm okay if I achieve.

I'm okay if people like me.

I'm okay if I don't make mistakes.

I'm okay if I'm useful.

I'm okay if other people need me.

I'm okay if I look a particular way.

I'm okay if I'm coping.

The difficulty is that these conditions are difficult to satisfy permanently.

There is always another goal.

Another person whose approval matters.

Another opportunity to make a mistake.

Another comparison.

Another reason you could have done better.

This means self-esteem can become surprisingly fragile even when life appears successful from the outside.

Therapy can help us explore whether your value has gradually become too dependent upon achievement, approval or performance.

The inner critic

Many people with low self-esteem describe having an extremely powerful internal critic.

It might say:

You should have done better.

That was embarrassing.

Everyone else seems more capable.

You're lazy.

You're too sensitive.

You've let them down.

Why can't you just get on with it?

Often this voice feels so familiar that it is barely questioned.

It may simply feel like the truth.

For some people, self-criticism also serves a purpose.

Part of you may believe:

“If I'm hard enough on myself, I'll improve.”

Or:

“If I criticise myself first, I won't make mistakes.”

Or:

“If I keep pushing myself, nobody else will have a reason to criticise me.”

In this sense, self-criticism can sometimes function as an attempt to motivate, protect or prevent rejection.

The problem is that continually attacking ourselves can come at a considerable psychological cost.

Being kinder to yourself does not mean lowering your standards

People can sometimes feel uncomfortable with the idea of self-compassion.

You may worry that if you stop criticising yourself:

“I'll become lazy.”

“I'll stop pushing myself.”

“I'll just make excuses.”

“I need to be hard on myself or nothing will get done.”

But there is an important difference between accountability and self-attack.

You can recognise that you made a mistake without deciding that you are a failure.

You can want to improve without humiliating yourself.

You can maintain high standards while responding constructively when you do not meet them.

Compassion-focused work is not about convincing yourself that everything you do is brilliant.

It is about learning to respond to difficulty in a way that is more balanced, useful and sustainable.

Why reassurance often doesn't seem to stick

You may receive plenty of evidence that other people think highly of you.

People tell you that you have done well.

Your manager gives you positive feedback.

Friends value you.

Your partner reassures you.

And for a moment, perhaps you feel better.

Then the doubt returns.

You may discount the reassurance:

“They're just being nice.”

“They don't know how much I struggled.”

“Anyone could have done that.”

“I just got lucky.”

Positive information is dismissed while mistakes are treated as meaningful evidence.

This can leave other people confused.

From their perspective, the evidence that you are capable or worthwhile seems obvious.

From yours, it never quite feels convincing.

Therapy can help us understand the beliefs through which you are interpreting that evidence rather than simply trying to provide more reassurance.

Comparing yourself with other people

Comparison is part of being human.

The difficulty arises when comparison becomes almost entirely one-directional.

You notice:

their confidence

their career

their relationship

their appearance

their social life

their achievements

and compare those things with the parts of yourself you feel most uncertain about.

Meanwhile, you have very little access to their doubts, insecurities, mistakes or private struggles.

This can create the impression that everybody else is somehow moving through life more successfully than you are.

Social media can make this particularly easy because we are often comparing the full complexity of our own lives with selected moments from somebody else's.

The aim is not necessarily to stop noticing other people.

It is to become more aware of what your mind does with those comparisons.

Self-esteem and worrying what other people think

When your own evaluation of yourself feels uncertain, other people's opinions can become extremely powerful.

You may find yourself repeatedly asking:

“Did I say the wrong thing?”

“Do they like me?”

“Did I come across badly?”

“Are they annoyed with me?”

“What will they think if I say no?”

You may adapt yourself according to the people around you, avoid expressing disagreement or spend a great deal of time analysing social interactions afterwards.

Caring about other people's opinions is normal.

We are social beings and relationships matter.

The difficulty comes when other people's opinions consistently carry more weight than your own.

People-pleasing, boundaries and self-worth

Low self-worth can also make boundaries difficult.

If being liked, helpful or dependable has become important to how you feel about yourself, saying no may feel surprisingly threatening.

You might find yourself:

agreeing to things you do not want to do
taking responsibility for other people's feelings
avoiding disagreement
apologising excessively
putting other people's needs before your own
feeling guilty when you set boundaries
worrying that assertiveness is selfish
becoming resentful after repeatedly saying yes

People-pleasing is often understandable.

It may have helped you maintain relationships, avoid conflict or feel valued.

But over time, constantly prioritising everybody else can make it increasingly difficult to recognise what you actually need.

Perfectionism and self-esteem

Perfectionism and low self-esteem often become closely connected.

You may tell yourself that once you:

get the promotion

lose the weight

finish the qualification

earn more money

make fewer mistakes

become more confident

or finally get everything under control

then you will feel better about yourself.

But when that goal is reached, the relief may not last.

The standard simply moves.

Instead of:

“I did well.”

your mind says:

“That's what I should have done.”

And attention immediately moves to the next thing that needs improvement.

When achievement becomes the main way we regulate self-worth, success can become strangely unsatisfying.

Read: Why Am I Such a Perfectionist? When High Standards Become a Problem

Self-esteem can affect anxiety and depression

Difficulties with self-esteem rarely exist completely in isolation.

Persistent beliefs about not being good enough can contribute to:

anxiety about making mistakes
fear of judgement
social anxiety
perfectionism
overthinking
people-pleasing
burnout
low mood
withdrawal
guilt and shame

Equally, experiencing anxiety or depression can affect how you see yourself.

This is one reason a broader psychological assessment can be useful.

Rather than treating self-esteem as a completely separate problem, we can understand how it fits within the wider picture.

Learn more about Anxiety Therapy

Learn more about Depression Therapy

How can psychological therapy help with low self-esteem?

Therapy is not about repeatedly telling yourself:

“I'm amazing.”

If you fundamentally do not believe that, positive affirmations can feel artificial rather than helpful.

Instead, psychological therapy can help us understand how your current view of yourself developed and what continues to reinforce it.

We might explore:

the beliefs you hold about yourself
where those beliefs may have come from
the standards you expect yourself to meet
what happens when you make mistakes
how you respond to criticism
the role of achievement in your self-worth
how much importance you place on other people's approval
patterns of comparison
self-critical thinking
avoidance
reassurance-seeking
perfectionism
boundaries and assertiveness
how earlier relationships or experiences may have shaped your view of yourself

From there, we can begin testing whether some of those assumptions still hold true and developing different ways of relating to yourself.

What happens in self-esteem therapy?

First, we understand the pattern

The first stage involves exploring what difficulties you are experiencing now.

We might look at situations that particularly trigger self-doubt, criticism or feelings of inadequacy.

For example, this could happen:

at work
in relationships
following mistakes
around certain people
when receiving feedback
when comparing yourself with others
when trying something new
when setting boundaries

Understanding the situations that activate these beliefs gives us useful information about the pattern.

We develop a shared understanding

Clinical psychologists often refer to this as a psychological formulation.

A formulation brings together your experiences, beliefs, emotions and behaviours to help explain how a problem may have developed and what keeps it going.

For example:

Early experiences of criticism

may contribute to:

“I'm not good enough.”

which leads to rules such as:

“I must never make mistakes.”

This may then create:

perfectionism → anxiety → overworking → exhaustion → mistakes → stronger self-criticism.

Once we understand the cycle, we can begin identifying places where something different could happen.

We begin questioning old rules

You may have lived according to certain psychological rules for a long time:

Don't disappoint anyone.

Always cope.

Never make mistakes.

Put other people first.

Keep achieving.

Don't show weakness.

Therapy gives us an opportunity to consider where these rules came from, what they have helped you achieve and what they may now be costing you.

We practise responding differently

Change is not simply intellectual.

You may understand logically that you are too hard on yourself while continuing to feel exactly the same.

Therapy therefore often involves experimenting with different behaviours.

This might include:

expressing an opinion
tolerating an imperfect outcome
setting a boundary
accepting a compliment
reducing reassurance-seeking
doing something without excessive preparation
acknowledging an achievement
responding differently to a mistake
allowing yourself to prioritise your own needs

These experiences allow new beliefs to develop through what actually happens rather than through reassurance alone.

We develop a more balanced relationship with yourself

The aim is not to create permanently high self-esteem or eliminate every moment of self-doubt.

Everybody experiences insecurity sometimes.

Instead, therapy can help you develop a more stable sense of yourself that is less dependent upon achievement, perfection or the approval of other people.

My approach to self-esteem and self-criticism

My approach is integrative and formulation-led.

Rather than assuming everyone with low self-esteem needs the same exercises, we first try to understand what your particular difficulties look like and where they may have come from.

Depending on your needs, therapy may draw upon approaches including:

Cognitive Behavioural Therapy (CBT)
Compassion Focused Therapy (CFT)
Acceptance and Commitment Therapy (ACT)
mindfulness and acceptance-based approaches
work focused on perfectionism
assertiveness and boundary-setting
behavioural experiments
work exploring the impact of earlier experiences and relationships

For people with a particularly strong inner critic, compassion-focused approaches can be especially useful in exploring how you respond to yourself when things go wrong.

The aim is not simply to replace negative thoughts with positive ones.

It is to develop a more balanced, flexible and constructive way of understanding yourself.

Why work with a Clinical Psychologist?

Clinical Psychologists undertake extensive doctoral-level training in psychological assessment, formulation and psychological therapy.

Their training covers a range of psychological models rather than one therapeutic approach alone.

This can be useful because low self-esteem may be connected with many different experiences.

For one person, perfectionism may be central.

For another, it may be anxiety about rejection.

For somebody else, self-criticism may be connected with depression, difficult relationships or earlier experiences.

My role is therefore not simply to give you techniques for "boosting confidence".

It is to understand the wider psychological picture and work with you to develop an approach that makes sense for you.

You do not need to become a completely different person

People sometimes worry that therapy will change the qualities they value about themselves.

Perhaps your high standards have helped you achieve a great deal.

Perhaps caring about other people is important to you.

Perhaps being conscientious and dependable are qualities you genuinely value.

Therapy does not need to remove those strengths.

Instead, we can explore whether there are ways of keeping what is valuable while reducing the psychological cost.

You can be ambitious without believing your worth depends on success.

You can care about other people without being responsible for everybody.

You can make mistakes without attacking yourself.

You can have high standards without demanding perfection.

And you can value other people's opinions without allowing them to define you.

You don't need to feel terrible about yourself all the time to seek support

Low self-esteem is not always obvious.

You might have relationships, qualifications, a successful career and plenty of evidence that other people value you.

You may simply recognise that:

you are much harder on yourself than you would ever be towards somebody else
achievements rarely feel enough
mistakes feel disproportionately important
other people's opinions strongly influence how you feel
comparison frequently leaves you feeling inadequate
you struggle to set boundaries
you constantly question yourself
you are tired of feeling as though you need to prove your worth

You do not need a diagnosis before seeking psychological therapy.

An initial conversation can help us understand what you are experiencing and consider whether therapy could be useful.

Self-esteem therapy face-to-face and online

I offer individual psychological therapy for adults experiencing low self-esteem, self-criticism, difficulties with self-worth and related psychological difficulties.

Face-to-face appointments are available on weekday evenings in Bristol and on Saturdays in Cheltenham. Online appointments are also available across the UK.

Online appointments can also provide additional flexibility for people fitting therapy around work and other commitments.

If you are looking specifically for face-to-face psychological therapy, you can visit my local therapy pages for more information.

Self-Esteem Therapy Bristol

Self-Esteem Therapy Cheltenham

Self-Esteem Therapy Gloucester

Online Therapy

Using private health insurance

I am recognised by a number of private medical insurers, including AXA Health, WPA and Vitality.

Whether psychological therapy is covered will depend upon your individual policy and the difficulties for which treatment has been authorised.

If you are hoping to use private health insurance, it is therefore important to confirm your cover with your insurer before treatment begins.

I have created a separate guide explaining how private health insurance appointments work and what information you may need before booking.

Using Private Health Insurance for Psychological Therapy

Related self-esteem resources

Why Am I Such a Perfectionist?

High standards can be valuable.

But when your sense of worth becomes dependent upon meeting those standards, even success may never quite feel enough.

Read: Why Am I Such a Perfectionist?

Frequently Asked Questions

Is low self-esteem a mental health diagnosis?

Low self-esteem is not itself a mental health diagnosis.

However, difficulties with self-esteem and self-criticism can cause considerable distress and may occur alongside difficulties such as anxiety and depression.

You do not need a formal diagnosis to explore these difficulties in psychological therapy.

What is the difference between self-esteem and confidence?

Confidence often relates to a particular ability or situation.

You might feel highly confident at work while feeling very uncertain in relationships.

Self-esteem relates more broadly to how you evaluate and value yourself.

It is therefore possible to appear very confident while privately struggling with low self-worth.

Is therapy for self-esteem just about positive thinking?

No.

Therapy is not about trying to convince yourself that everything about you is wonderful.

Instead, it involves understanding the beliefs you hold about yourself, where they may have developed and the patterns that continue reinforcing them.

We can then work towards developing a more balanced and realistic relationship with yourself.

Will becoming less self-critical make me less successful?

This is a common concern, particularly for people who believe being hard on themselves has driven their achievements.

Therapy does not require you to abandon ambition or high standards.

Instead, we can explore whether you can remain motivated and conscientious without relying so heavily on fear, criticism or the belief that your worth depends upon performance.

Can therapy help if I've felt like this for most of my life?

Long-standing beliefs about ourselves can feel particularly convincing because they have been present for so long.

That does not mean they cannot change.

Therapy can help us understand how those beliefs developed, how they continue to be reinforced and what experiences might allow a different perspective to develop.

What if I know logically that I'm too hard on myself but still can't stop?

This is very common.

Intellectually understanding that a belief is unhelpful is different from emotionally experiencing things differently.

For this reason, psychological therapy usually involves more than discussing thoughts.

We can also use practical exercises and behavioural experiments that allow you to experience different ways of responding.

How many sessions will I need?

There is no fixed number that is appropriate for everybody.

For some people, difficulties are focused around a particular area such as confidence at work or perfectionism.

For others, beliefs about themselves have developed over many years and affect several different areas of life.

We can discuss this during assessment and review progress throughout therapy.

Can self-esteem therapy take place online?

Yes.

Online psychological therapy can be appropriate for difficulties with self-esteem and self-criticism and allows me to work with adults throughout the UK.

Whether online or face-to-face appointments would suit you better can be considered during an initial consultation.

Can I use private health insurance?

I am currently recognised by AXA Health, WPA and Vitality.

Whether treatment is covered will depend upon your policy and the psychological difficulty your insurer has authorised treatment for.

You should therefore confirm your individual cover before therapy begins.

Thinking about working on your self-esteem?

You do not need to become more confident before coming to therapy.

And you do not need to know exactly why you feel the way you do.

A free 15-minute consultation gives us an opportunity to briefly discuss what you have been experiencing, answer any initial questions and consider whether arranging a full psychological assessment would be a helpful next step.

Book a Free 15-Minute Consultation

Get in Touch

If you are looking for self-esteem therapy, you can view support options in your area or get in touch to arrange an initial consultation.