For GPs

Dr Cate Howell, GPMHSC accredited FPS ST activity provider, on self-belief in patients

A common question that arises during case presentations on FPS ST courses is how to help patients increase their ‘self-esteem’.

To work with our patients in relation to this, it is important to be aware of some definitions:

• Self-esteem refers to how you see and judge yourself, often in comparison to others. It describes your opinion of yourself and sense of self-worth
• It includes self-confidence or how confident you feel about your abilities (Howell, 2023, p. 63)
• Underlying beliefs about yourself, when constructive, are referred to as self-belief, and these drive your thinking about yourself and how confident you feel
• A more recent term is self-compassion, which means that you are kind and understanding towards yourself when faced by your personal failings, instead of criticising and judging yourself harshly (Neff, 2021, p.4).

From the moment we are born, there are a range of influences on our self-belief. These include:

1. Our early life experiences – have we received affirmations from others or criticism?
2. The society in which we live – and the messages it gives us about ourselves
3. Being human – we naturally tend to compare to others
4. Ongoing life experiences – both positive and negative
5. Our personality and thinking style – such as being a perfectionist, or more optimistic or pessimistic in our thinking (Howell, 2023, p. 63).

Low self-belief can affect our health and wellbeing in many ways, such as contributing to stress, anxiety and low mood. These in turn may affect our sleep and eating habits, or ability to exercise, and thus our general health. It can also affect our relationships and social functioning. So positive self-belief is protective for our physical and mental health!

We can improve our self-belief in many ways, including:

• Changing our thinking and underlying beliefs about ourselves, through recognising our worth is not actually about what we achieve. Quitting overly self-critical thoughts and using affirmations.
• Changing the stories we hold about ourselves, such as ‘I’m a good mother’ or ‘I am not good enough.’ Remember that no single story can cover all aspects of our life, and if we have negative stories dominating our lives (such as ‘I’m not worthy’), we can learn to re-story our lives by focussing on strengths and successes, even if they’re very small.
• Focussing on our values and acceptance. Start by considering what is important to you in life. What do you truly value? For example, under the heading of work, having a satisfying job might be important to you. Under leisure, you might value playing sport or catching up with friends. We need to then accept what is out of our control, and take action to helps create a rich and meaningful life (Harris, 2009, p 2).
• Practicing mindfulness, which involves paying attention to experience in the present moment, as opposed to being caught up in thoughts or feelings. So, if we are having a cup of coffee in the sunshine, we pay attention to the taste and smell of the coffee and the warmth of the sun, rather than getting caught up with worries or thoughts. In the same way, we can be mindful of our thoughts and feelings, noticing them, rather than getting caught up with them. Through mindfulness we can learn that thoughts and feelings come and go, that we can have more balance and experience greater calm and peacefulness.
• Focussing on positive emotions and accomplishment. There is a growing interest in the field of positive psychology, which encourages us to focus on our strengths and to use them more. If you know and use your abilities, you will find that you will be happier and more confident, and confidence in one area tends to spread into other areas! Focussing on positive emotions such as enjoyment and gratitude helps us to feel good too. Equally, enhancing relationships, finding meaning in life through our passions and a sense of purpose, and having a sense of accomplishment, can enhance our confidence and wellbeing.
• Developing self-compassion. This means you are kind and understanding towards yourself when faced by your personal failings, instead of criticising and judging yourself harshly (Neff, 2021, p. 4). In other words, apply the golden rule to yourself and treat yourself as you do others, accepting that we are all human, and applying understanding and kindness to yourself.
• Trusting yourself and use your intuition. Intuition is knowing without knowing how we know! We all have it, and it can help us feel more confident about ourselves and our decision-making. There is evidence of its value from health research, and we can enhance our intuitive skills through awareness and practice (Howell, 2013, p. 67).

References:

1. Harris, R. (2009). ACT Made Simple: An easy-to-read primer on Acceptance and Commitment Therapy. New Harbinger Publications, Oakland, USA, https://www.newharbinger.com/9781684033010/act-made-simple/?gclid=CjwKCAjw1t2pBhAFEiwA_-A-NOk4mTZUTwRoWj3xQQmAUsnGjYGt00agDHiPUX3RQVseMaO7gcfROhoC42wQAvD_BwE
2. Howell, C. (2013). Intuition Unlock the power. Exisle, NSW, https://exislepublishing.com/?s=intuition&post_type=product
3. Howell, C. (2023). The Flourishing Woman A mental health and wellbeing guide. Exisle, NSW, https://exislepublishing.com/product/the-flourishing-woman/
4. Neff, K. (2021). Fierce Self-Compassion How Women Can Harness Kindness to Speak Up, Claim Their Power and Thrive. Penguin, USA, https://self-compassion.org/fierce-self-compassion/