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Treatment of a Low Self-esteem

by Jurriaan Plesman BA(Psych), Post Grad Dip Clin Nutrr

The best way of overcoming a low self-esteem is to treat both a possible biological angle and psychological angle. A low self-esteem seldom exists by itself. If you have a biological disorder, of which you may not be aware and which could date back to your childhood, this will affect your self-image, because you may have been bombarded with stress hormones over which you have no conscious control. By far the most common biological disorder is hypoglycemia. This can be treated by going on a hypoglycemic diet as a first step.  A low self-esteem comes in all forms and shapes, from feeling sorry about the self, to being overly sensitive or feeling insecure and being aggressive in personal relationships. Most of these feelings are usually interpreted to be of “psychological” origin.

When the body suffers from a biological disorder such as hypoglycemia (pre-diabetic insulin resistance), it is flooded with stress hormones such as adrenaline (the fight/flight hormone). This will inevitably affect one’s self-image in a negative way. See Notes.

Obesity and Depression 

It is interesting to note that there is an association between being overweight (obese) affecting our self-image and being depressed. This is not necessarily because being “fat” alone, causes you to have a negative self-image, but being overweight and depression have a common biological factor, that causes you to be both overweight AND depressed. The common factor is insulin resistance which interferes with the absorption and metabolism of carbohydrates (sugars) in the diet into biological energy called ATP. This energy is essential in the production of feel good neurotransmitters such as serotonin. Hence without that energy we tend to become depressed and cannot feel good about oneself. Furthermore, without serotonin we cannot produce melatonin the sleeping hormone, and causing one to suffer from insomnia.  For a discussion as to what came first; insulin resistance (hypoglycemic syndrome) or obesity, see here.

The unabsorbed sugars are stored in the body as fat cells causing obesity. This can also be due to hypothyroidism which slows down the rate of metabolism. This condition can be detected by Dr George Samra’s medical test for hypoglycemia as explained here. See Type 4 Hypoglycemia as to how you can test yourself at home.
A topic related to this is when we believe that a physical handicap or some other perceived unattractive physical feature causes us to have a low self-esteem: This is called The Wooden Leg Argument discussed in my book Getting off the Hook.

You can test yourself for hypoglycemia at home by completing the Nutrition Behavior Inventory Test (NBI) or The Hypo Quiz. If you score high you are likely to have a metabolic disorder that may have affected your self-image. This can be treated nutritionally under the supervision of a Nutritional Doctor or a Clinical Nutritionist. Apart from that, I know from clinical experience that a low self-esteem cannot be got rid of with “rational” arguments alone, and well-meaning motherhood statement like “love yourself”.

In terms of Transactional Analysis (TA) a negative self-image is derived from a judgmental PARENT EGO STATE, over which we have no conscious control. The PARENT ego contains “habits of thought”, mostly irrational on a “good” “bad” spectrum, that can be retrained by means of “behaviouristic techniques”. Part of our mind does not respond to rational debates, but are simply TRAINED to think in a particular way.The PARENT ego is more like an animal thinking like your pet dog. You cannot rationalize with your dog to behave in a certain way. YOU HAVE TO TRAIN IT. The Positive Ego Training Program is really a RCBT program that retrains the mind to think the way you want it to think. I have set out this program in my book”Getting off the Hook” here. (Go to page 36).

A shortened version of our self-help psychotherapy can be found at our web site here, which needs to be studied in its entirety from beginning to end. It includes a program showing you how to overcome a negative self-image, and assertiveness training program, communication course and values clarification course. See also: Nine weeks Psychotherapy Course:

You may require the help of a CBT counsellor to successfully complete this program, although most people can help themselves by reading the articles over and over again.Thus there is a systematic approach in treating a “low self-esteem” taking into account both the biological and psychological factors. Training is mostly in the hands of the client’s work with himself, once he knows and understand the technique. Ignoring biological factors is responsible for most of the failures in “psychological” counselling.

What is hypoglycemia
The Serotonin Connection
Depression is a Nutritional Disease
Depression: Disease of Energy Production
The Positive Ego Traning Program
Alcoholism and Addiction is a Treatable Disease
Self-Help Personal Growth Psychotherapy

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