It’s an aspect of mental health that has been paid a lot of lip service over the years and yet consistently underestimated as a real cause of psychological problems. Is it because self worth is a bit too spiritual to fit our overly medicalised model of mental health? Or maybe because this same model has difficulty defining, diagnosing and medicating the issues that stem from a disrupted sense of self?
Let’s look at social anxiety for example, the most commonly diagnosed psychological disorder. If someone believes about themselves the statement “I’m no good” then they are also likely to wonder “what if others think I’m no good?” Now if we hypothetically place this individual in a social setting of 30 people, it would not be surprising if they experience emotions of fear, anxiety, apprehension and maybe even panic. Their physiological response would be commensurate understandably, and they may experience all the classic symptoms of anxiety i.e. sweating, shallow breathing, increased heart rate, changes in blood pressure, nervous energy, increases in pain and digestive systems disruptions.
On the behavioral front we can imagine they might well try to avoid the situation altogether depending on the severity of the physiological symptoms, but if they do attend we might see a range of behaviors that are characteristic of social anxiety. Some may overcompensate by talking excessively to mask their fear, while others may speak only a few words to someone well-known. Some may rely on food or alcohol to get them through while others may not be able to eat without feeling nauseous. Some may be longing to have a connection with someone else but their fear betrays them and paints their face with a look that says “stay away!”.
So what we have here in summary is an intricate and very individual response to a belief; an emotional response, and physiological response and a behavioral response. Even more distressing is the assumption that may come from misunderstanding these responses that “there must be something wrong with me”.
And why are these beliefs so powerful in propelling our whole system into a meltdown? Because essentially all the responses discussed above are designed to keep us safe when we are confronted with a threat. But “what was the threat?” you might ask. The threat doesn’t need to be a threat to physical safety to be processed as such, in fact a threat to our sense of self (in this case the belief being proven as true) is taken by our mind as highly significant because a balanced sense of self is necessary to maintain emotional, social and occupational functioning; in short it’s what holds us together.
Let’s briefly look at another example; low mood or depression. Our person in the example above is likely to experience periods of low mood, especially if something happens that makes them believe the statement “I’m no good” more strongly e.g. a relationship breakdown. It’s true that everyone may have low mood following a relationship breakdown but someone struggling with low self worth might be wondering why they hit an all time low and find it hard to cope. If this same core belief rears it’s head as an explanation for why the relationship ended, then we may very quickly see emotions of hopelessness and helplessness as a natural response, followed by a “low energy” physiological response (fatigue, low motivation, slowed metabolism) and behaviors that are consistent with a “withdraw and give up” mode.
We could go on with many other examples, and the severe harm done to self worth and mental health following complex trauma is a case in point. However, hopefully these examples have been sufficient to demonstrate the significant role that self-worth can play in two of the most prominent psychological problems. It also calls into question the already controversial over use of medication in treating anxiety and depression and further highlights the need for quality and comprehensive psychological assessment and intervention as the frontline treatment.
Illawarra Shoalhaven Psychology 