Low self-esteem

People describe a running commentary. Not occasional self-doubt — a voice that is there in the background most of the day, and that speaks to them in a way they would never speak to anybody else.

They describe compliments that slide straight off. A good result explained away as luck, an easy paper, a kind examiner. A promotion that means they will now be found out sooner. People describe apologising constantly, for taking up time, for asking a question, for existing slightly too loudly in a room.

The comparisons are specific and they hurt. A cousin. A sibling. Someone from school whose life arrives daily on a screen, edited. In a lot of families there is a running commentary from outside too — about marks, about weight, about a rishta, about when someone will settle — and after enough years people describe no longer being able to tell which voice is theirs.

And there is what it quietly costs. A job not applied for. A question not asked. A relationship entered from a position of gratitude rather than choice, and stayed in for the same reason. People describe accepting less than they would ever tell a friend to accept.

Recognising yourself in a paragraph on a website is not the same as knowing what is going on. This page describes; it does not assess you, and there is nothing here for you to score yourself against.

Nobody feels good about themselves every day, and a bad patch after something genuinely went wrong is not what this is.

What a clinician pays attention to is duration and cost. A view of yourself that has been steady for years rather than since a recent knock, and that does not shift when the evidence does — good results, good work, people who clearly like you. And decisions being made by it: opportunities not taken, relationships not left, help not asked for.

It is also worth speaking to someone when it has stopped being only about confidence — when low mood has arrived alongside it, or when avoiding things has started to shrink the week.

Only a qualified clinician can tell you what is going on — a website cannot. What a page like this can tell you is that this is a real thing to bring, that plenty of people bring it, and that nobody at PHC will treat it as too small a reason to be there.

PHC is an assessment-first practice. Self-esteem difficulty very often travels with something else, so the first job is to see what is actually there.

1. An initial sessionWe ask what has been going on, for how long, and what it is costing you. Nothing is administered before this conversation.
2. Emotional assessment and symptom screeningA structured screening of emotional functioning and what you are presenting with, using internationally validated instruments. Its purpose is to decide which further tests, if any, are clinically warranted — you will not be given tests you do not need — and to separate this from low mood, anxiety or a social difficulty sitting underneath it.
3. A psychologist matched to what the assessment foundPsychologists at PHC are not assigned on availability. Assignment is based on speciality, your presenting needs and clinical fit.
4. Therapy, reviewed as it goesThe modality most often indicated is CBT, which PHC uses for anxiety, depression and negative thought patterns. Where the work is more about managing emotion and relationships, DBT may be used alongside it. Sessions are 50 minutes, in clinic at our PECHS clinic or in DHA, or online.

Confidentiality, session length, fees and choosing your psychologist are answered in full in questions people ask before booking.

• Social anxiety
• Depression
• Family difficulties
• Emotional assessment
• CBT at PHC