Therapy for Confidence and Self-Esteem: How Counselling Helps You Value Yourself

A client once told me: "I know, logically, that I'm competent. I've got qualifications, a good job, friends who seem to like me. But I don't feel it. Inside, I still feel like I'm faking it, like everyone's going to find out I'm not good enough."

She paused, then added quietly: "I'm exhausted from pretending."

This is low self-esteem. Not just occasional self-doubt (we all have that), but a persistent, bone-deep belief that you're fundamentally not enough—not smart enough, attractive enough, interesting enough, lovable enough.

And it's exhausting.

Therapy doesn't fix low self-esteem with affirmations or pep talks. It helps you understand where these beliefs came from, what keeps them alive, and how to build a genuinely different relationship with yourself.

This article explores what low self-esteem actually is, how therapy addresses it, and what you can expect from the process.

What Is Low Self-Esteem?

Self-esteem is how you value yourself—not just intellectually, but in the quiet, unguarded moments when no one's watching.

Signs of Low Self-Esteem

Internal experience:

• Persistent self-criticism ("I'm stupid" "I always mess things up")
• Difficulty accepting compliments ("They're just being nice")
• Constant comparison to others ("Everyone else has it together")
• Feeling like an impostor or fraud
• Harsh inner voice that never seems satisfied
• Belief that you don't deserve good things

Behavioural patterns:

• People-pleasing (saying yes when you mean no)
• Over-apologising ("Sorry for existing")
• Avoiding challenges (in case you fail)
• Seeking constant reassurance
• Staying in unhealthy relationships (believing you don't deserve better)
• Self-sabotage when things go well

Physical symptoms:

• Tension in shoulders and jaw (bracing against criticism)
• Difficulty making eye contact
• Hunched posture
• Speaking quietly or hesitantly
• Chronic stress or anxiety

What Low Self-Esteem Isn't

It's not:

• Humility or modesty
• Realistic self-assessment
• Temporary self-doubt after setbacks
• Specific lack of confidence in one area (e.g., public speaking)

It is:

• A pervasive feeling of unworthiness
• A fundamental belief that you're flawed
• Something that affects multiple areas of life
• Often formed early and reinforced over time

Where Low Self-Esteem Comes From

Understanding origins doesn't fix the problem, but it helps you see that your low self-esteem isn't truth—it's a learned response.

Childhood Messages

Direct messages: "You're so lazy." "You'll never amount to anything." "Why can't you be more like your sister?" "Stop crying—you're being ridiculous."

Children absorb these messages and internalise them as facts about who they are.

Indirect messages:

• Parents too busy, stressed, or absent to provide attention
• Affection only given when you achieved or behaved perfectly
• Emotions dismissed or minimised
• High expectations with little warmth

Even loving parents can inadvertently communicate: "You're only valuable when you perform."

Comparison and Criticism

• Being compared unfavourably to siblings, peers, or idealised standards
• Bullying at school
• Feeling different (neurodivergent, LGBTQ+, cultural minority)
• Critical teachers or coaches

Trauma and Abuse

Abuse—physical, emotional, sexual—often leaves deep beliefs of unworthiness:

• "It was my fault"
• "I deserved it"
• "I'm damaged"

Cultural and Social Messages

Society bombards us with messages about who's valuable:

• Appearance standards
• Success metrics
• Gender expectations
• Social status markers

If you don't fit these moulds, you may internalise: "I'm not enough."

Adult Experiences

Low self-esteem can also develop or worsen in adulthood:

• Abusive relationship
• Workplace bullying
• Redundancy or career setback
• Chronic illness or disability
• Significant failure or loss

Why Self-Help Doesn't Always Work

"Just think positive!" "Make a list of your strengths!" "Fake it till you make it!"

If you've tried self-help approaches and felt frustrated that they don't stick, you're not alone.

The Problem with Affirmations

When your core belief is "I'm worthless," repeating "I am valuable" in the mirror often triggers an immediate internal rebuttal:

"That's not true." "I'm just lying to myself." "Who am I kidding?"

Affirmations can work for mild self-doubt, but for deep-rooted low self-esteem, they're like putting a plaster on a broken bone.

The Problem with "Just Be Confident"

Confidence isn't something you can manufacture through willpower. It emerges from genuine self-acceptance and evidence (internal and external) that you're OK.

Telling someone with low self-esteem to "just be confident" is like telling someone with depression to "just cheer up." If they could, they would.

How Therapy Helps Build Confidence and Self-Esteem

Therapy approaches low self-esteem differently than self-help. Here's how.

1. Creating a Different Relational Experience

The therapeutic relationship itself is healing.

Unconditional acceptance: Your therapist accepts you exactly as you are—not as who you should be, could be, or might become. This experience of being met without judgment begins to challenge the belief that you're only acceptable when you're perfect.

Being truly heard: Perhaps for the first time, someone listens deeply to your experience without dismissing it, fixing it, or turning the conversation to themselves.

Consistency: Your therapist shows up reliably, holds boundaries gently, and remains present even when you share difficult feelings. This consistency helps you trust that you're worth someone's sustained attention.

Over time, experiencing this consistently can shift something fundamental: "Maybe I'm not as unworthy as I thought."

2. Exploring Origins Without Blame

Therapy helps you understand where your beliefs about yourself came from—not to excuse others or wallow in the past, but to see clearly: these beliefs were formed in specific contexts. They made sense then. They might not be true now.

Example: If you grew up with a critical parent, you learned that love was conditional on performance. Your child self concluded: "I must be perfect to be loved." That was survival.

But you're not that child anymore. You can question whether perfectionism still serves you.

3. Challenging the Inner Critic

Low self-esteem is often maintained by a harsh inner voice—what some call the "inner critic."

Therapy helps you:

• Notice the critic: Recognise when it's speaking ("There I go again, telling myself I'm stupid")
• Examine its messages: Are they actually true? Where did they come from?
• Develop compassion: What would you say to a friend in this situation? Can you offer yourself the same kindness?

This isn't about eliminating self-reflection or accountability. It's about replacing cruelty with clarity.

4. Processing Difficult Emotions

Low self-esteem is often tangled up with unexpressed emotions:

• Anger (at those who hurt you)
• Grief (for what you didn't receive)
• Shame (deep, toxic shame)

Therapy provides a safe space to feel and process these emotions rather than turning them inward against yourself.

5. Experimenting with New Behaviours

As you feel safer, therapy invites small experiments:

• Setting a boundary
• Accepting a compliment
• Trying something you've avoided
• Saying no without over-explaining

These experiments build evidence that contradicts old beliefs. Each small success creates a tiny crack in the "I'm not good enough" narrative.

6. Building Self-Compassion

Self-compassion isn't self-indulgence or letting yourself off the hook. It's treating yourself with the same kindness you'd offer someone you care about.

Therapy helps you:

• Notice when you're suffering
• Recognise that struggle is part of being human
• Respond to yourself with gentleness rather than harshness

Research shows self-compassion is more effective than self-esteem boosting because it doesn't depend on external validation or achievement.

What to Expect in Therapy for Confidence and Self-Esteem

Early Sessions: Safety and Exploration

Your therapist will:

• Create a safe, non-judgmental space
• Ask about what brings you to therapy
• Explore patterns in how you relate to yourself
• Begin noticing your self-critical thoughts together

Middle Sessions: Deeper Work

As trust builds, you'll likely:

• Explore where beliefs about yourself originated
• Process difficult emotions (shame, anger, grief)
• Examine relationship patterns (people-pleasing, boundaries, etc.)
• Experiment with responding to yourself differently
• Notice changes—subtle at first, then more significant

How Long It Takes

This varies enormously:

• Short-term (8-12 sessions): Noticeable improvement in specific areas
• Medium-term (3-6 months): Deeper shifts in how you relate to yourself
• Long-term (6-12+ months): Fundamental transformation of self-concept

Low self-esteem built over decades doesn't shift overnight. But you'll likely notice changes within weeks—moments where the critical voice softens, or you catch yourself thinking: "Actually, I handled that well."

Approaches That Help with Low Self-Esteem

Person-Centred Therapy

Creates a relationship where you experience unconditional acceptance and empathy, helping you accept yourself more fully.

Best for:

• Healing through relationship
• Developing self-compassion
• Finding your authentic voice

Cognitive Behavioural Therapy (CBT)

Identifies negative thought patterns ("I always fail") and helps you challenge and replace them with more balanced thinking.

Best for:

• Identifying specific thought patterns
• Practical tools and homework
• Shorter-term targeted work

Psychodynamic Therapy

Explores how early relationships shaped your sense of self and helps you work through unresolved feelings.

Best for:

• Understanding deep patterns
• Processing complex feelings
• Longer-term exploratory work

Compassion-Focused Therapy (CFT)

Specifically targets shame and self-criticism by developing self-compassion.

Best for:

• High shame
• Harsh self-criticism
• Trauma backgrounds

Gestalt Therapy

Uses present-moment awareness and experiments to help you reconnect with disowned parts of yourself.

Best for:

• Experiential learning
• Reconnecting with emotions
• Challenging old patterns

Integrative approach: Many therapists (including myself) combine elements from multiple approaches, tailoring therapy to what you need.

Signs Therapy Is Working

Confidence doesn't suddenly appear fully formed. Change is gradual and often subtle at first.

Early signs (weeks 2-8):

• You notice your critical thoughts more
• Moments where you speak up for yourself
• Slightly less anxiety in social situations
• One or two instances of setting boundaries

Medium-term signs (months 3-6):

• Self-critical voice less frequent or intense
• Making decisions with less agonising
• Accepting compliments without immediate dismissal
• Trying new things despite fear
• Relationships feel more balanced
• Physical symptoms (tension, anxiety) reducing

Longer-term signs (6+ months):

• Fundamental shift in how you see yourself
• Self-compassion feels natural, not forced
• Choosing yourself even when it disappoints others
• Comfort with imperfection
• Genuine belief that you're OK as you are
• Relationships based on mutual respect, not need for approval

Practical Exercises Therapists Might Suggest

These aren't magic fixes, but they support the relational work of therapy:

Noticing and Naming

When you catch yourself in self-criticism, notice and name it: "There's my critical voice again."

This creates distance—you're not your thoughts; you're the one noticing them.

The Friend Test

Ask: "Would I say this to a friend in this situation?" If not, why are you saying it to yourself?

Self-Compassion Break

When struggling:

1. Acknowledge: "This is really hard right now"
2. Normalise: "Struggle is part of life"
3. Offer kindness: "What do I need in this moment?"

Values Clarification

Identify what matters to you (not what you think should matter). Make choices aligned with your values rather than others' approval.

Boundary Practice

Start small: "I can't this time" instead of elaborate excuses. Notice what happens (usually: people are fine with it).

When to Seek Therapy for Low Self-Esteem

Consider therapy if:

• Self-doubt affects daily functioning
• You're stuck in unhealthy relationships
• Success feels hollow (you can't enjoy achievements)
• You're avoiding opportunities due to fear of failure
• Self-criticism is constant and exhausting
• You've tried self-help and it hasn't helped
• You recognise patterns but can't shift them alone

You don't need to wait until things are unbearable. Therapy isn't just for crisis—it's for wanting to live more fully.

Final Thoughts: The Slow Unfolding

Building confidence and self-esteem through therapy isn't a linear process. It's messy, slow, two-steps-forward-one-step-back work.

But it's also profoundly worthwhile.

I think of Laura (not her real name), who started therapy barely able to make eye contact. She described herself as "basically worthless" and couldn't name a single thing she liked about herself.

Eighteen months later, she sat in my office and said: "I've realised something. I'm actually quite kind. Not in a people-pleasing way—genuinely kind. And I think I'm OK with who I am."

She paused, smiled slightly, and added: "That's wild to say out loud."

That's the work. Not becoming someone different, but uncovering who you actually are beneath the layers of criticism, shame, and survival strategies.

You are not your critical thoughts. You are not your worst moments. You are not the harsh assessments others made of you.

You are a whole, complex, imperfect human being worthy of kindness—including your own.

Therapy helps you remember that.

If you're in London and struggling with confidence or self-esteem, I offer a free initial consultation to discuss whether therapy might help. I work with an integrative humanistic approach that emphasises self-acceptance, compassion, and gradual, sustainable change.

You can reach me at 07887 376 839 or through the contact form on this website.