Self-esteem & confidence · in person, online, Phone, Messaging
Self-Esteem Therapy
For the voice in your head that is harder on you than you would ever be on anyone else. Therapy to understand where it came from and to quieten it.
Adults and young people
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Harjeet Hayre
Integrative Psychotherapist · BACP Registered Member · NHS-experienced Reviewed September 2026 · About Harjeet
Does this sound familiar?
The inner critic never clocks off.
Compliments slide off you while criticism sticks for weeks. You apologise for things that are not your fault. You assume other people are managing life better than you are. Underneath the coping, there is a quiet certainty that you are somehow not enough.
The NHS describes self-esteem simply as the opinion we have of ourselves. With low self-esteem, we tend to see ourselves and our lives in a more negative and critical light and it often begins in childhood, shaped by the messages we received and later by stress and difficult life events. Left unaddressed, persistent low self-esteem can harm your mental health and contribute to depression and anxiety.
It is worth knowing that low self-esteem is not itself a mental health problem, as Mind points out, although it is closely bound up with them. You do not need a diagnosis to deserve help with it.
What the evidence says
The beliefs were learned, so they can be unlearned.
One of the most useful models of low self-esteem comes from the Oxford psychologist Melanie Fennell. Early experience creates a "bottom line" about the self, such as I am not good enough, which we then protect with rules for living: if I never let anyone down, I will be all right. When the rule is broken, the critic wakes up.
Therapy that works with this model has been tested. In a randomised trial, ten sessions of CBT for low self-esteem produced significant improvements in self-esteem, overall functioning and depression, with gains maintained at follow-up. Compassion-focused approaches, developed specifically for people with high shame and self-criticism, have been shown across trials to reduce self-criticism and increase self-reassurance, although the researchers themselves note the evidence base is still small.
Perfectionism deserves its own mention. A large meta-analysis of 284 studies found that both perfectionistic striving and perfectionistic worry are linked with depression, anxiety and distress. Perfectionism is not a strength with a downside. It is a pattern worth understanding.
How I work with self-esteem
Acceptance first, then the evidence.
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Person-centred space. Being accepted without conditions, week after week, is the direct counter to worth that always felt conditional. It is not a technique. It is the relationship doing the work.
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Psychodynamic exploration traces the bottom line back to where it was learned, so it stops feeling like the truth and starts feeling like a story you were told.
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CBT-informed and compassion-focused tools test the critic's claims against evidence and build a kinder internal voice you can actually hear.
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Somatic awareness helps you notice where shame lands in the body and how to settle it.
Low self-esteem rarely travels alone. If it comes with worry, see anxiety therapy; if with flatness and withdrawal, depression counselling. Many neurodivergent clients carry a lifetime of being misread as laziness or difficulty, which is why my neurodivergent-affirming therapy starts from a different premise entirely.
Often it starts in childhood, from the messages we absorbed and is then shaped by later experiences: bullying, discrimination, job loss, relationship or money difficulties, health conditions, body image and social media all feature in Mind's list.1, 2
The NHS says counselling or CBT can help.1 An Oxford randomised trial found ten sessions of CBT improved self-esteem, functioning and mood, with gains held at follow-up, although the study was small.4 Compassion-focused therapy reduces self-criticism in trials.5
It depends on how deep-rooted the beliefs are and how long they have been running. The trial above used ten sessions; longer-standing patterns usually deserve longer. We review together as we go.
Sources
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Mind (2022). About self-esteem.
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Fennell, M.J.V. (1997). Low self-esteem: a cognitive perspective. Behavioural and Cognitive Psychotherapy, 25(1), 1- 26.
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Waite, P., McManus, F. and Shafran, R. (2012). Cognitive behaviour therapy for low self-esteem: a preliminary randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 43(4), 10491057.
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Vidal, J. and Soldevilla, J.M. (2023). Effect of compassion-focused therapy on self-criticism and self-soothing: a meta-analysis. British Journal of Clinical Psychology, 62, 7081.
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Limburg, K., Watson, H.J., Hagger, M.S. and Egan, S.J. (2017). The relationship between perfectionism and psychopathology: a meta-analysis. Journal of Clinical Psychology, 73(10), 13011326.
This page is general information from a registered psychotherapist, not medical advice or a diagnosis. If you are in crisis, call 999, NHS 111 (option 2) or the Samaritans free on 116 123.
Ready when you are.
A free introductory call, no forms and no obligation. Just a quiet conversation to see whether working together feels right.