Revision

This document as of 7/19/15 is considered version 1.10. This means that while it is not exhaustive, it is readable and usable as-is. Future revisions will add to and expand upon the materials in this version.

Self-Esteems Ties to Depression

There tends¹Dr. Burns puts it even more strongly: “When you are depressed, you invariably believe that you are worthless. The worse the depression, the more you feel this way.” (Burns 53) I, however, have not found this to be my experience. While I sometimes have believed I am crippled, I have always held onto a conception of my self-worth. to be a strong correlation between depression and a sense of worthlessness. (Burns 53)

Perceptions

Dr. Aaron Beck found that depressed patients perceptions of themselves lacked those qualities they esteemed in others (Burns 53):

1. intelligence
2. achievement
3. popularity
4. attractiveness
5. health
6. strength.

4 D’s of Depressed Self-Image

Beck also suggested that a depressed self-image is characterized by 4 D’s (Burns 53):

1. Defeated
2. Defective
3. Deserted
4. Deprived.

When we are depressed we have a hard time recognizing our illogical patterns of thought. We tend to believe what these false patterns are telling us – resulting in low self-esteem. This perspective can be shared by friends, family, co-workers, even therapists as we continue to insist upon its truthfulness over time. (Burns 55)

Where Does Real, Valid Self-Esteem Come From?

The important question that must be addressed at this juncture is “What is the source of genuine self-esteem?” (Burns 56)

Burns states:

• “…you cannot earn worth through what you do. Achievements can bring you satisfaction but not happiness. Self-worth based on accomplishments is a ‘pseudo-esteem,’ not the genuine thing!…Nor can you base a valid sense of self-worth on your looks, talent, fame, or fortune…Nor can love, approval, friendship, or a capacity for close, caring human relations add one iota to your inherent worth. The great majority of depressed individuals are in fact very much loved, but it doesn’t help one bit because self-love and self-esteem are missing…only your own sense of self-worth determines how you feel.” (Burns 56-57)

In essence, Burns asks where our self-esteem comes from, suggests that it is built upon our inherent self-worth, and that it is not something that can be acquired or lost.²I think, in essence, Burns is correct, though as a Christian I would want to note that our self-worth is not a subjective but objective reality. Our worth is given to us by God  – both in the aspect of His creation of us as beautifully complex beings and also in His valuation of us so highly as the ultimate arbiter of what is valuable.

Steps to Overcoming Low Self-Esteem

Dr. Burns has three aims when helping an individual overcome their sense of worthlessness, namely: A rapid and decisive transformation in one’s (a) thinking, (b) feelings, and (c) behavior. (Burns 61)

In order to overcome low self-esteem one must set aside time daily to practice cognitive techniques. This should include utilizing Tool #1 for at least fifteen minutes each day.

On a regular basis (say every two weeks) take the Burns Depression Checklist to monitor your progress. It is easy for us to forget what we felt like in the past and to write off as insignificant the improvements we have made in mood. Using this checklist on a regular basis provides an objective means of measuring improvement in mood.

Refute Internal Critic

Our sense of worthlessness comes from an internal self-critical dialogue. We must overcome this bad habit by utilizing three steps (Burns 62):

1. Train yourself to recognize and write down³Yes, physically writing them down is very important. the negative thoughts as they come into your mind.
2. Discern why these thoughts are distorted/untrue.
3. Talk back to these thoughts with more realistic alternatives.

See Tool #1: Goodbye Internal Critic Worksheet

Mental Biofeedback

Burns suggests that a wrist counter is useful. Every time you press it, it increments its count by one. You press it every time you have an automatic negative thought (ANT) and then see your tally at the end of the day.

Initially, the number increases due to improved capturing of ANTs, then it plateaus, and then it begins to decrease.⁴The way in which this method works is not fully understood – perhaps it is simply a means of becoming more self-aware and able to challenge ANTs.

Coping Versus Moping

Asking ourselves questions such as “Am I good or bad in this role?” or “Do I have or lack this desirable characteristic?” are not helpful. (Burns 75) Instead we should break down the problem we are facing in our role or due to weakness in a characteristic into smaller components which are less overwhelming.

• Example: “Nancy’s mistake had been to view herself in a global way, making the moralistic judgment that she was a bad mother. This type of criticism incapacitated her because it created the impression that she had a personal problem so big and bad that no one could do anything about it. The emotional upset this labeling caused prevented her from defining the real problem, breaking it down into its specific parts, and applying appropriate solutions.” (Burns 78)

It can also be helpful to try to define what you mean when you identify yourself using a negative label (e.g. ‘fool’, ‘sham’, ‘stupid’, ‘bad’). (Burns 78)

Bibliography

The materials on this page are largely drawn from Dr. Burn’s book, chapter 4. See the main CBT page for a full bibliographical entry.