What We Know Now About Low Self-Esteem That We Didn’t Know 5 Years Ago. And What It Means for Therapists.

By Patrick McGhee

This post is an excerpt from a forthcoming online training webinar Treating Low Self Esteem.

Jenny works in a financial services analytics department. Her advice is valued and up until recently she liked crunching numbers and then making the results meaningful to those who would no more be able to crunch numbers than juggle jelly.

But now she’s working until 11pm most nights and exhausted most mornings. She has an awful drop in the middle of her stomach every time she thinks about the weekly report to her boss. He’s going to find fault. She is sure of it. She checks and rechecks it and searches for additional information to insert. That’s what kept the reports credible so far. She fears she is going to be found out one day. And how will she cope with the new AI computer modelling system being installed? Her partner Tom seems unresponsive when she talks about work. Jenny wants to be liked by everyone — she feels that the safest tactic to avoid anyone looking to see if she is actually any good at financial analytics. Now she’s getting increasingly self-critical and becoming hypersensitive to criticism. She is starting to feel bad if she doesn’t get the approval of her co-workers and her boss. Why haven’t they fired me yet? And dreads what her partner will think of her if they do. She’s starting to wonder if she is worth anything to anyone. She agrees to extra work then hates herself for being such a pushover. She’s stressed, depressed and can’t sleep. Jenny’s therapist is listening to how she sees the world and where the stress is coming from as far as Jenny is concerned.

What to do?

Jenny is not unusual. Low self-esteem is a common feature of every day life for many people. Clinically, we talk about an individual’s subjective evaluation of his or her worth as a person being so low as to filter everything coming in and everything going out. It creates a vicious circle of self-judgment feeding on itself and perpetuating misery and anxiety. Low self-esteem is a common feature of many mental health issues including depression, anxiety, trauma, eating disorders, relationship conflict and anger. 

For some time now, fortunately, psychotherapists have been able to draw on a range of effective, evidence-based practical techniques which can break the vicious circles and help clients, adult and young people, strengthen their sense of self and, crucially, build up unconditional self acceptance. Jenny might be wrong to think that her co-workers don’t value here work – but even if they did, that should not impact on her sense of her underlying true human value and uniqueness.

For many psychologists and therapists it felt like there was little more to know about low self-esteem — what causes it, what maintains it and what kind of therapeutic interventions can alleviate it. Over the last five years or so however some interesting studies have thrown new light onto existing ideas and opened up new questions that had been given little attention at all. So here are five studies from the last five years which are making psychologists think again about some key issues. Would Jenny recognise anything of her own situation in any of them? Would her therapist? Let’s hear the evidence, then let’s see.

  1. Low Self-Esteem has a moderate genetic component. Huajian Cai and Yu Luo at the Institute of Psychology, Beijing in 2017 examined 232 twins aged 18–22 and found the identifical twins had significantly more similar levels of self-esteem than the non-identical twins. For identical twins, approximately, 28% of self-esteem could be predicted from knowing the self-esteem in the other, but this fell to 13% with non-identical twins. What does this tell us? Our genes have an influence on our adult self-esteem — but most of our adult self-esteem is not determined by our DNA. Whatever we think about our genes they do not imprison us in low self- esteem, guilt or shame.
  2. Men have higher self-esteem than women in almost every culture around the globe. For years many studies have indicated that one way or another men have higher self-esteem than women. The patriarchal organisation of society, the contradictory expectations on women as both nurturers and individuals and the socialisation of girls into that culture, confirmed that women suffer from lower self-esteem and are more likely to struggle to recover. For some time however this was thought to be a feature of ‘WEIRD’ cultures — Western, Educated, Industrialised, Rich and Democratic. But a comprehensive study in 2016 of almost 1 million people from 48 different nations led by Wiebke Bleidor and an international team from the universities of California, Tilburg, Manheim and Cambridge, indicated that the higher self-esteem of males is not just a western phenomenon. However, the size of this self-esteem gender effect varied across cultures dependent on cultural differences in socioeconomic, sociodemographic, gender-equality, and cultural values. We do need to recognise they pressures that weigh on the dynamics women’s self evaluations and that these not a western phenomenon. As unique as she is, every country has a Jenny.
  3. Self-esteem increases with age almost entirely irrespective of gender or culture. The same Bleidor study also found that on average self-esteem rises between the ages of 16 to 45 in almost every country around the world. So at least Jenny can see that in some respects at least, things have tendency to improve over time — though nothing is a given. 
  4. Robots can lower our self-esteem even when we don’t change our views of robots. With the advent of the ‘4th Industrial Revolution’ there is growing interest in the psychological experience of artificial intelligence and robots. For years we have assumed that self-esteem was really impacted only by the actions of other people. Recently however a study by Kyle Nash and his team at the University of Canterbury, New Zealand in 2018 suggests our self evaluations could be vulnerable to the actions of robots. After playing a game of Connect-4 with a human-sized robot, participants were informed by the robot that it would like to see them again (acceptance), would not like to see them again (rejection), or told nothing regarding a future interaction (control). The researchers found that that social rejection from a robot significantly reduced subsequent self-esteem relative to receiving no-feedback and social acceptance. Fascinatingly the robot rejection had no impact on attitudes to the use of robots in everyday life — suggesting that the person was, in part, attributing the rejection to something they had done. Just how we factor the possibility of android apathy into the design of the future AI technology remains to be seen. Jenny’s boss and her company need to recognise much more than they have been, perhaps, that rejection is powerful whoever — or whatever — serves it up.
  5. The partners of people with low self-esteem really are less responsive, they are not just imagining it. We know that when our self-esteem is low we tend to see the world through a pessimistic lens. Ambiguous situations seem threatening and people around us seem indifferent if not actually hostile. There is no doubt that the low mood of people with low self- esteem really does impact their perceptions of the world around them, but in one area at least they might actually be seeing the harsh reality of one part of their world: their partners. For years psychologists noted that people with low self-esteem claimed their partners were less responsive than they wanted them to be, than they thought they could be, than they used to be. Psychotherapists and others quite understandably took this to be just a particular instance of the general orientation to discounting the positive and filtering in the negative both in perception and memory. However, research by Kassandra Cortes and Joanne V. Wood in 2018 at the University of Waterloo, Canada found that the low self-esteem sufferers might actually have had a point all this time. In their laboratory study, partners were video taped listening to rejection stories. Where the speaker had low self-esteem the partner was observed to be less responsive in terms of understanding, caring and validation than when the speaker had high self-esteem. It seems that while we still know to help clients with low self-esteem recognise that they will typically see the world more negatively than is justified when they are not at their best, we need to rethink the idea that all their perceptions are coming from a biased cognitive mindset. Jenny’s therapist could do worse that reassure her that her sense of dislocation in her job and her relationship is not ‘all in her head’ as important as reflecting on those mental biases will be to her recovery.

It seems that while we still know to help clients with low self-esteem recognise that they will typically see the world more negatively than is justified when they are not at their best, we need to rethink the idea that all their perceptions are coming from a biased cognitive mindset.

So what to do? More scientific intelligence on genetics, robotics, sex differences and the perception of reality will always help the therapists that help people like Jenny find a new way. And yet, despite the new light thrown on some longstanding issues in the treatment of low self-esteem the fundamental principles derived from thousands of research studies remain the same: 

(1) identify the negative core self beliefs that we have picked up over the years from our educational experience, family, failed past relationships and workplace mistreatment. “I’m unloveable”. “I’m worthless”, “I’m not good enough”.

(2) draw out the unwritten rules and assumptions we have built up for ourselves over the years to help us cope with a world that has treated us so roughly “I must never make any mistakes”, “I can’t afford to be picky with partners”, “If I trust someone they will hurt me”. Alongside this to start to develop self acceptance of ourselves as unique individuals.

(3) identify how useful or damaging these rules really are and explore more balanced and effective ones “It’s OK if not everyone likes me”, “I don’t anyone’s respect expect my own..” and then crucially …

(4) walk the talk — put those ideas for new rules into practice. And they will be easier to follow and more effective than you imagined. Trust me, they always are. 

So Jenny, despite the fact the new robotics in the workplace might reject her, and despite the fact that her partner might really be just as unresponsive as she tells her therapist she is, and despite the fact that her self-esteem might always be more vulnerable than her male counterpart, has every reason to feel optimistic about her future. If she can get retool those rules and assumptions and build on her unique characteristics that transcend her DNA, a better future awaits. A future all the brighter and stronger because she will have built it herself. 

This is an excerpt from our real time online training webinar Treating Low Self Esteem.

Professor Patrick McGhee is a CBT therapist, psychologist and UK National Teaching Fellow. Educated at the universities of Glasgow and Oxford, he has completed CPD programmes at Harvard Business School and Ashridge. In 2017 he was a Visiting Fellow/Scholar at the universities of Cornell, Yale and MIT in the USA. He has taught, researched or practised in psychology and therapy for 30 years. His first post was a Research Fellow in Psychiatry and Psychology at St George’s Hospital Medical School, University of London. He is the author of Thinking Psychologically (Palgrave) and co-editor of Accounting for Relationships (Methuen). He has been an occasional columnist for the Guardian, the BBC and the Times Higher. He has full accreditation from the British Association for Behavioural and Cognitive Psychotherapists. He runs CBT training events for therapists across the UK and internationally. 


Cortes, K., & Wood, J. V. (2018). Is it really “all in their heads”? how self‐esteem predicts partner responsiveness. Journal of Personality, 86(6), 990–1002. doi:10.1111/jopy.12370

Nash, K., Lea, J. M., Davies, T., & Yogeeswaran, K. (2018). The bionic blues: Robot rejection lowers self-esteem. Computers in Human Behavior, 78, 59–63. doi:10.1016/j.chb.2017.09.018

Cai, H. & Luo, Y.L.L. (2017), “The heritability of implicit self-esteem: A twin study”, Personality and Individual Differences, vol. 119, pp. 249–251.

Bleidorn, W., Arslan, R. C., Denissen, J. J. A., Rentfrow, P. J., Gebauer, J. E., Potter, J., & Gosling, S. D. (2016). Age and gender differences in self-esteem: A cross-cultural window. Journal of Personality and Social Psychology, 111(3), 396–410. doi:10.1037/pspp0000078

‘Jenny’ is a fictional character.  (c) Practical CBT & P McGhee, 2020

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