Self-esteem therapist online: therapy for low self-esteem and imposter feelings

What is low self-esteem, and is it the same as low confidence?

The NHS defines self-esteem as “the opinion we have of ourselves”, and says that when it is low we tend to see ourselves and our lives in a more negative and critical light^[1]. Everyone has spells of this: the Centre for Clinical Interventions notes that everyone is, at some point, uncertain about themselves or doubts their abilities, and that the problem is when you often think of yourself as not good enough, a failure or unlovable^[2]. It describes these as deep-seated beliefs that are “often taken as facts or truths” about who you are^[2].

Confidence is related but narrower. healthdirect, the Australian Government’s health service, explains that self-confidence relates to your ability to do a certain thing, and that it is normal to feel confident in some areas of life and less so in others^[4]. So someone can be confident at work and still judge themselves harshly as a person.

You do not need a diagnosis to get help: the NHS says you do not need a diagnosed mental health condition to get talking therapies^[7].

What are the signs of low self-esteem?

healthdirect lists these signs^[4]:

• often saying negative things and being critical about yourself
• focusing on your negatives and ignoring your achievements
• thinking other people are better than you
• thinking you don’t deserve to enjoy yourself
• finding it difficult to accept compliments
• avoiding challenges for fear of failing
• finding it difficult to make friends

The Centre for Clinical Interventions adds patterns many people recognise from daily life: brushing a compliment aside as “all luck”, working extremely hard to make up for a lack of skill they believe they have, being upset by any criticism, and bending over backwards to please others^[2]. The NHS notes that people with low self-esteem often feel they have to say yes to others even when they don’t want to^[1].

How is low self-esteem linked to depression and anxiety?

The link runs both ways. The NHS warns that living with low self-esteem can harm your mental health and lead to problems such as depression and anxiety^[1]. The Centre for Clinical Interventions explains that a negative view of yourself is also a symptom of depression, and that in clinical depression low self-esteem can be a by-product of the low mood; its 2005 workbook says that “the research has shown that when depression has been treated successfully, low self-esteem is no longer a problem”^[2]. It also names low self-esteem as a risk factor for depression, persistent suicidal thoughts, eating disorders and social phobia^[2].

The Centre encourages seeing your doctor or a mental health professional if you have had five of the depression symptoms it lists, including low mood or loss of interest, on most days for two weeks or more^[2]; our page on depression explains the options. If worry or fear of being judged is the bigger part, see anxiety and stress. If you are having thoughts of harming yourself, use the crisis numbers in the box at the top of this page now.

Why does low self-esteem keep going?

The NHS says it often begins in childhood, when the message that you are not good enough is the one that stays with you, and that stress, difficult life events such as illness or bereavement, and personality can also play a part^[1]. healthdirect adds being bullied, too much criticism and too little support from parents or carers, neglect or abuse, and comparing yourself with others on social media^[4].

What keeps it going is often what you do now. The NHS explains that avoiding difficult situations may feel safe in the short term but backfires, because it reinforces your doubts and teaches you that the only way to cope is to avoid things^[1]. The Centre for Clinical Interventions describes personal rules such as “I must do everything 100% perfectly, otherwise I will fail” or “People won’t like me if I express my true feelings and opinions”^[3]. Living by them means you never test whether the feared outcome would happen, and when a rule is broken, the reaction is often harsh self-criticism, which feeds the belief again^[3].

Is imposter syndrome the same as low self-esteem?

The sources describe them differently. A 2013 article in the American Psychological Association’s gradPSYCH magazine describes the impostor phenomenon, first described by psychologists Pauline Rose Clance and Suzanne Imes in the 1970s, as occurring “among high achievers who are unable to internalize and accept their success”: they put their achievements down to luck and fear being unmasked as a fraud^[6]. It is not an official diagnosis listed in the DSM, but impostor feelings are “generally accompanied by anxiety and, often, depression”, and it tends to go hand in hand with perfectionism, either putting tasks off or over-preparing for them^[6]. The article says individual therapy can be extremely helpful for many people with impostor feelings, and quotes Imes saying a therapist can give you tools to break the cycle of impostor thinking^[6]. On Bliss Therapy, 45 psychologists list self-esteem, and you can name impostor feelings in your first message so they know what you want to work on.

How can I build self-esteem myself?

The NHS suggests starting by noticing the negative beliefs you hold about yourself and writing them down, then writing evidence that challenges them, and keeping a list of at least five positive things about yourself somewhere you can see it^[1]. It also suggests^[1]:

• recognising what you are good at
• spending less time with people who bring you down
• being kind to yourself, and thinking what you would say to a friend
• learning to be assertive
• starting to say “no”
• setting yourself a challenge, such as joining an exercise class or going to a social occasion

NHS Every Mind Matters teaches a three-step method for unhelpful thoughts, “catch it, check it, change it”, and says not to worry if you cannot change a thought, because there are no right or wrong answers^[5]. healthdirect adds forgiving yourself for mistakes and avoiding comparing yourself with others^[4]. For a longer programme, the Centre for Clinical Interventions has a nine-module self-help workbook on improving self-esteem, written by its clinical psychologists^[2].

Our guidance: pick one small thing you have been avoiding, such as giving an opinion in a meeting, and notice what actually happens, rather than what you predicted.

When should I see someone about low self-esteem?

healthdirect says that if low self-esteem does not improve and is affecting day-to-day activities, it is important to seek help, from your doctor or from a mental health professional such as a psychologist^[4]. The NHS makes a similar point: low confidence now and then is normal, but when low self-esteem becomes a long-term problem it can harm your mental health and your daily life^[1].

What does therapy for low self-esteem involve?

The NHS names counselling and cognitive behavioural therapy (CBT) as talking therapies that can help^[1]. In the CBT approach, as the Centre for Clinical Interventions sets it out, you work on the unhelpful thinking and behaviour that keep low self-esteem going day to day: predicting the worst, self-criticism, and avoidance^[3]. Its programme then moves on to accepting yourself, adjusting unhelpful rules and assumptions, and developing more balanced core beliefs^[2]. You can read more about the method on our online CBT page.

If a harsh inner critic is the main problem, some therapists use compassion-focused therapy; our page on it explains how it works.

How many sessions? We found no NICE guideline for low self-esteem on its own, so there is no official course length. If you also have depression or an anxiety disorder, NICE’s guidance for those conditions may apply, and our pages on them give its usual number of sessions. Our guidance: agree a goal and a review point with your therapist after the first few sessions.

Can I see a self-esteem therapist online?

It is an option the NHS itself uses: it runs talking therapies over the phone, on video, and as online courses, as well as face to face^[7]. The Centre for Clinical Interventions notes that people with low self-esteem can find it hard to speak up for themselves^[2], and being at home may make a first session easier for some; that is our view, not a research finding: we found no NHS or NICE statement comparing live video therapy for low self-esteem with meeting in person. Every Bliss Therapy session takes this form, a 50-minute video call, with prices from €30 (about £25).

How do I get help where I live?

In most countries, a family doctor is a sensible first step: they can tell you what is offered locally and what is covered. You can also go straight to a private therapist, in person or online. Bliss Therapy is one online option: you book a psychologist directly, without a referral, from €30 (about £25), with 23 languages spoken between them.

In the UK. The NHS says you can refer yourself for talking therapies for low self-esteem, or talk to a GP first and be referred^[1]. In England, to self-refer you must be registered with a GP and be at least 18 (or 16 in some areas)^[7]. For the other routes, see how to find a therapist in the UK.

In the US. A primary care provider can do a first mental health check and refer you to a mental health professional, and your insurer can tell you which local providers your plan covers^[9]. Every Marketplace plan covers psychotherapy and counselling, though the exact benefits depend on your state and plan^[12]. FindTreatment.gov is SAMHSA’s confidential, anonymous search for mental health treatment^[10], and the free National Helpline, 1-800-662-4357, gives referrals and information at any hour^[11]. In a crisis, call or text 988^[13].

How do I choose a self-esteem therapist?

If you go private in the UK, the NHS advises making sure the therapist belongs to a professional body^[1], and its talking therapies page adds that the body should be accredited by the Professional Standards Authority^[7]. One question the UK Council for Psychotherapy proposes is what experience and training the therapist has with your issue, and it reminds readers that deciding not to carry on after a first meeting is fine^[8]. For low self-esteem that matters more than usual, because the urge to please the person in front of you can make it hard to say a therapist is not right. Our guidance: ask how they would work with self-criticism and people-pleasing, and how you would both know it is helping. On Bliss Therapy you can ask that in a first session, which is free with 20 psychologists there, and moving on to another profile afterwards needs no explanation. For the difference between psychologists, counsellors and psychiatrists, see who does what.

Self-esteem therapy on Bliss Therapy

45 psychologists on Bliss Therapy list self-esteem as an issue they work with. A 50-minute online session starts from €30 (about £25), the middle price is €50 (about £42), and 20 offer a free first session. 36 of them list CBT, 21 person-centred therapy and 18 psychodynamic therapy, and 9 list compassion-focused therapy.

• You pick your therapist yourself: every profile shows their methods, languages and fee.
• 20 offer a free first session, which gives you a low-pressure way to practise saying what you need, and to move on if it does not feel right.
• You pay per session, with no subscription, and book online.
• Between them they speak 23 languages, so you may be able to talk about how you see yourself in your first language.

Sessions are one-to-one. No therapist can promise you confidence; what therapy offers is time and a method to work on how you see yourself. If low self-esteem comes with depression, thoughts of self-harm or a crisis, start with a doctor or the crisis numbers on this page: Bliss Therapy is not a crisis service and does not diagnose or prescribe.

Our therapists are based outside the UK and the US, so they are unlikely to appear on UK registers, and their sessions are unlikely to be covered by US health insurance. Ask any therapist about their training and their registration in the country where they practise. For prices across the market, see what online therapy costs.