Some people come to therapy with a curious difficulty when they try to talk about self-esteem.

They do not think of themselves as incapable. They know they have built a great deal in their lives; they are often competent, responsible and appreciated. If I asked them to list their strengths, they could probably do it.

And yet it does not take much for all of that to suddenly lose its weight.

A comment from a manager. Someone not replying in quite the way they expected. A person seeming slightly less enthusiastic than usual. A small mistake that would probably be irrelevant to anyone else.

For a few hours, it can feel as though all the evidence they have collected in their favour has somehow stopped counting.

This is one of the forms of self-esteem I find most interesting: not necessarily believing that you have little worth, but feeling that your worth needs to be continually confirmed.

When your sense of worth always feels provisional

At first, this can seem almost paradoxical. How can I know that I am competent and still feel inadequate so easily?

Perhaps because knowing that we have good qualities and feeling sufficiently secure in our own worth are not quite the same thing.

We may have developed a realistic, even positive, view of ourselves while having learned at a deeper level that this position needs to be maintained: I need to do well, be interesting, avoid disappointing people, be desirable, be useful, not make too many mistakes.

The sense of worth is not absent. It is conditional.

As long as those conditions are being met, we may feel relatively settled. But when something challenges them, even slightly, the thought does not remain simply, I made a mistake. It can quickly become something far more personal:

Perhaps I’m not as capable as I thought.

Perhaps they’ve realised I’m not good enough.

Perhaps I don’t really deserve the place I occupy.

The problem here is rarely a lack of achievement. Quite often there is plenty of it. The problem is that success seems to have a remarkably short memory, while mistakes have a particular talent for staying with us.

The finish line that keeps moving

This may be one reason some people achieve a great deal and enjoy very little of it.

An important accomplishment brings relief, perhaps satisfaction, but it does not last long. A few days later it simply becomes what had to be done. The expected standard moves a little further ahead.

What felt difficult yesterday becomes today’s minimum.

And so we continue.

From the outside, this can look like ambition. And of course ambition may be part of it. But there is a difference between wanting to do well and needing to do well in order to feel all right about yourself.

The second makes every challenge much more expensive.

You are not simply preparing a presentation; something about your sense of self is being protected. You are not merely receiving criticism; a particular image of yourself feels at risk. You are not simply disappointing someone; somehow, their disappointment seems to say something about your worth.

Research on perfectionism describes this relationship well: when self-esteem depends too heavily on meeting high standards, a mistake can stop being information and begin to feel like a verdict.

And living continually in anticipation of a verdict is exhausting.

Perhaps the point is not to learn to value yourself more

When someone tells me in therapy, “But I know I have value,” I tend to believe them.

I do not think every insecurity hides a person who, deep down, simply “doesn’t love themselves enough”. I find that explanation too simple.

Sometimes the problem is not having a negative opinion of yourself. It is having a relationship with yourself that becomes most fragile precisely when you need it most.

When you make a mistake. When someone chooses somebody else. When you do something mediocre. When you are confused, needy, jealous or tired. When you encounter a part of yourself that does not fit the image you have worked hard to build.

Perhaps self-esteem tells us less about how we feel when things are going well and much more about how we treat ourselves when we do not particularly like ourselves.

It is a subtle distinction.

We can spend our lives trying to become a version of ourselves that is finally good enough to be beyond criticism. Or, gradually, we can develop the capacity not to abandon ourselves every time we discover that we are imperfect.

The second path is less impressive.

It is probably also more solid.

Staying on your own side

This does not mean excusing everything we do or no longer questioning ourselves. A good relationship with yourself does not mean believing you are always right.

It means being able to look at something you dislike without immediately turning it into a condemnation.

I made a poor decision can remain a statement about the decision rather than becoming I am incapable of making good decisions.

This person doesn’t want me does not necessarily have to become I am undesirable.

I wasn’t at my best today can remain one unimpressive day without the whole of our identity being put on trial.

In therapy, I often find this transition particularly revealing: how quickly a specific experience becomes a global definition of the self.

Sometimes it happens so quickly that we barely notice it.

What can actually begin to change?

Perhaps we do not need to add more evidence to the list of reasons why we should feel worthy. If the list already exists and has not been enough, making it longer may simply leave the underlying problem untouched.

It may be more useful to begin noticing the invisible conditions we have attached to our right to feel good enough.

Completing a few sentences, even just privately, can sometimes reveal quite a lot:

I can feel comfortable with myself as long as…

It would be difficult for me if other people discovered that I can also be…

When I make a mistake, what I am really afraid of is…

In order to feel like a person of value, I need to be…

There is no need to find the perfect answers. The point is to begin seeing the contract.

Then comes a second movement, and often a more difficult one: allowing ourselves small experiences in which the contract is not fulfilled, and noticing what happens.

Leaving something simply “good enough”. Accepting a compliment without immediately explaining why it is not entirely deserved. Not correcting every impression someone might have of us. Doing something we are not particularly good at. Admitting that we need something.

Not because these actions will magically improve our self-esteem.

But because, little by little, they allow us to test a different possibility: that our worth might survive even when we are doing nothing to prove it.

Becoming larger than the image we have of ourselves

Perhaps this is the part that interests me most.

Some of the suffering around self-esteem comes from trying to remain identical to a particular version of ourselves: competent, generous, strong, desirable, intelligent, independent.

But a person is inevitably more contradictory than their best definition.

We can be capable and make mistakes. Generous and sometimes selfish. Strong and need help. Intelligent and make a foolish choice. Confident in one place and vulnerable in another.

Perhaps becoming more secure does not require us to eliminate these contradictions.

Perhaps it means developing enough internal space to contain them.

And then the opposite of feeling inadequate is not necessarily feeling exceptional.

It may simply be being allowed, sometimes, to be human.

Perhaps a more stable sense of self-worth begins there: not when we have finally collected enough evidence that we are valuable, but when we no longer need to keep presenting the evidence, even to ourselves.

“But I had a normal childhood.”

It is something I hear often in therapy.

There is no abuse to talk about. No terrible event that divided life into a before and an after.

Your parents were there. They took care of the important things. You went to school, went on holidays, perhaps there was a great deal of love too.

And then, as we keep talking, other things begin to emerge.

As a child, you learned to read a parent’s face before even walking into the room, trying to work out what kind of mood you were about to meet.

When you were sad, you preferred not to say too much because there were already enough problems.

If someone was angry with you, it felt as though you had done something terribly wrong.

Being good, independent and undemanding had started to feel almost natural.

And then comes the question:

“But can this really be trauma? Nothing that bad happened to me.”

Sometimes that is precisely where the difficulty lies.

Trauma does not always take the form of a single event

When we think about trauma, it is easy to imagine something that happens: an accident, violence, a sudden loss, an experience in which fear is unmistakable.

But some experiences do not have a particular date we can circle on a calendar.

They take shape slowly, within relationships.

Not only through what someone did, but sometimes through what repeatedly could not happen.

Not being comforted when you were frightened.

Never quite knowing which version of someone you were going to meet.

Learning that certain emotions were too much, that some needs created problems, or that adapting yourself was the safest way to preserve the relationship.

When experiences like these are repeated, particularly within relationships we depend upon, they can profoundly shape the way we learn to relate to ourselves and to other people.

This is what we mean when we talk about relational trauma.

Sometimes it is easier to remember what happened than what was missing

There is a particular difficulty in recognising these experiences.

An absence does not always leave an image behind.

It is easier to remember a door being slammed than all the times no one noticed that you were frightened.

It is easier to describe an argument than years spent trying not to be a burden.

And it can be even harder when the pain existed alongside affection, protection and genuinely happy memories.

Our histories are rarely entirely good or entirely bad.

You can have been loved and, at the same time, have grown up in a relationship where some of your needs had very little room.

You can understand a parent’s vulnerability deeply and still recognise what that vulnerability required from you.

One truth does not cancel the other.

How can relational trauma show up in adulthood?

Relational trauma does not always appear as an obvious traumatic memory.

It may emerge instead in the way we enter relationships.

Noticing the smallest change in another person’s tone immediately.

Feeling responsible for their mood.

Feeling uncomfortable when you need something.

Finding it difficult to truly believe that someone can stay close even when you are angry, vulnerable, disappointed or simply not accommodating.

Sometimes it appears in the body: sudden tension, a sense of alarm that is difficult to explain, an urge to withdraw or, at the opposite extreme, an urgent need to restore connection.

At other times it can look almost like the opposite: not feeling very much at all, always coping alone, realising that you needed someone only after the need itself has passed.

None of these experiences, on their own, proves that someone has experienced trauma.

They only acquire meaning within the context of a person’s history.

Not everything is trauma

I think this is important to say.

Not every childhood frustration is traumatic. No parent can always be available, perfectly attuned or capable of responding to every need.

Growing up also means encountering limits, misunderstandings and disappointment.

The point is not to look backwards in search of everything our parents did “wrong”.

It is to ask what happened when certain experiences became repeated, pervasive and difficult to process without the support of someone else.

And perhaps, more importantly: what did we have to learn to do in order to feel sufficiently safe within those relationships?

In trauma work, this is often a much more useful question than:

“Was it bad enough?”

A child does not think: “I am adapting”

They simply adapt.

If the environment is unpredictable, they become good at predicting.

If expressing anger threatens the relationship, they may learn not to feel it.

If vulnerability does not bring comfort, independence can become a necessity long before it becomes a choice.

If love seems to depend on being good, useful or easy to manage, this may become the language through which a person continues to seek worth many years later.

There is often an intelligence in these responses.

They are not character flaws.

They are ways in which mind, body and relationship have tried to create the best possible balance under the circumstances.

Where do we begin in therapy?

Not necessarily by looking for trauma.

And certainly not by trying to convince someone that their childhood was worse than they remember it.

Sometimes we begin with the present.

With a reaction that feels disproportionately intense.

With the guilt that appears every time a boundary is set.

With the difficulty trusting someone precisely when a relationship begins to matter.

With a body that goes into alert before the mind quite understands why.

In therapy, these experiences can be approached carefully, without forcing them into a ready-made explanation.

The therapeutic relationship can also make visible something that may be difficult to describe through memories alone: how hard it can feel to need someone, to allow yourself to be helped, or to disagree without fearing that the relationship will disappear.

When traumatic memories or responses continue to become activated in the present, the work may also integrate approaches such as EMDR, attention to bodily experience and work with different parts of the self.

Not in order to search for trauma at all costs.

But to understand more clearly what, in the present, still seems to need protection.

Perhaps the question is not how bad it was

Many people spend years comparing their own history with someone who had it worse.

“I was never hit.”

“I never went without anything.”

“My parents did the best they could.”

All of these things may be true.

But pain is not measured by comparison.

Recognising what was missing does not mean blaming someone, nor does it mean rewriting childhood as though it contained nothing but pain.

It means being able to look more closely at what we had to learn very early in life.

Perhaps the question can then change.

Not:

“Did something bad enough happen for me to call it trauma?”

But:

“What did I learn about relationships, about myself and about safety while I was growing up there?”

Sometimes it is through this question that an apparently “normal” childhood can begin to tell the part of its story that, until then, had remained without words.

You know you don’t need to justify yourself.

You understand why other people’s judgement affects you so deeply. You have recognised where that need to explain yourself, reassure others, or make sure no one is upset with you comes from.

Then someone’s tone changes.

And there you are, explaining yourself again.

It is one of the most unsettling experiences of self-awareness: seeing clearly where something comes from and discovering, almost immediately, that understanding it is not yet enough to make it disappear.

Why isn’t understanding enough to change?

We tend to assume that once we understand where a behaviour comes from, we should simply be able to stop doing it.

But many of the things we learn about relationships are not learned through reasoning.

We learn them by living them.

We learn how much we are allowed to ask for, when it is safer to stay quiet, what might happen if we disappoint someone, how good we need to be in order to feel secure, and whether expressing a need will bring someone closer or risk pushing them away.

Over time, these experiences become expectations, ways of relating, and responses that can be activated very quickly.

That is why I can know perfectly well that a situation today is different and, at the very same time, feel as though it is not different at all.

Why do I keep repeating the same patterns?

What causes difficulty today did not necessarily begin as something dysfunctional.

At one point in our lives, it may have been an intelligent way of adapting.

Being highly attuned to other people’s moods may have helped in an unpredictable relationship. Asking for very little may have protected us from rejection. Doing everything well may have created a sense of safety or worth.

The problem is not that we learned these strategies.

It is that sometimes they continue to activate long after the situation itself has changed.

So we can repeat the same patterns while being completely aware that we are doing it.

And this often makes the experience even harder: the original difficulty is joined by judgement towards ourselves.

“How can I still be here, after everything I’ve understood?”

Sometimes understanding can become a defence

There is something more subtle too.

Sometimes we become extremely good at understanding ourselves.

We recognise our patterns, reconstruct our childhood experiences, and can explain why we choose certain relationships. Sometimes we can even anticipate what our therapist is going to say.

And yet we may still be observing ourselves from a slight distance.

We know that we are frightened, but it is harder to notice what is happening as the fear arrives.

We know that we seek approval, but it is much harder to tolerate the moment when we choose not to look for it.

We know that we need to set a boundary, but when we finally do, guilt appears.

In these moments, understanding is neither false nor useless.

But it can become a very sophisticated way of keeping some distance from what we are actually feeling.

The task is no longer simply to understand ourselves better.

It is to move closer to what happens inside us precisely when we try to do something differently.

Change does not happen through words alone

Psychotherapy can certainly help us make sense of our history. But the work does not necessarily end when we have found a convincing explanation.

In relational psychoanalytic work, for example, some of our ways of being with others can become visible as they emerge within the therapeutic relationship itself.

Sometimes they appear in words.

At other times, they appear in a silence that suddenly becomes difficult, in the need to reassure the other person, in the fear of disappointing them, or in the body becoming tense before we even know why.

When certain reactions are connected to traumatic experiences, therapy may also involve working with the ways those experiences continue to be reactivated in the present, integrating approaches such as EMDR where appropriate.

The point is not to replace an explanation with a technique.

It is to allow something we already understand intellectually to become, gradually, a different experience as well.

Setting a boundary and remaining there while the guilt arrives.

Not immediately filling a silence.

Asking for something without knowing what the answer will be.

Stopping, even briefly, from having to prove our worth.

It is often in these seemingly small moments that we begin to discover that what we have always done is not our only possibility.

Knowing where something comes from does not mean it is over

Perhaps, then, the question is not:

“Why am I still behaving like this if I already understand it?”

Sometimes we already know perfectly well why.

A more interesting question may be:

“What happens inside me when I genuinely try to do something differently?”

The anxiety that rises. The guilt. The urge to go back. The feeling of being selfish, cold, wrong, or simply different from the person we have always known ourselves to be.

It is there that we begin to meet what, until then, we may mostly have understood.

And slowly, an old way of protecting ourselves can stop being the only possibility.