The self-esteem-assertiveness link: interview with Guillermo Orozco

We interviewed Guillermo Orozco, psychologist expert in self-esteem problems.

Having self-esteem problems can be reflected in many aspects of a person's social life. of a person's social life. And one of the most common is a lack of assertiveness: the ability to speak one's mind, even if it bothers others, while maintaining a balance between respect for the interlocutor and the defense of one's own right to express oneself.

People with low self-esteem generally also have assertiveness problems. Let's see how this relationship between both elements of the personality is through an expert on the subject: psychologist Guillermo Orozco.

Guillermo Orozco: the relationship between self-esteem and assertiveness

Guillermo Orozco is a General Health Psychologist based in Las Palmas de Gran Canaria, the city where he attends many of his patients from his Psychological Care Center. In this interview he talks about the relationship between self-esteem and assertiveness, and how problems in these dimensions are addressed from Acceptance and Commitment Therapy.

How does having low self-esteem influence our relationships?

Self-esteem is the value, consideration and affection that each person feels for him/herself. This esteem is independent of how we really are or how others see us. When our self-esteem is balanced, we perceive ourselves realistically and accept ourselves with our faults and virtues. This allows us to feel that we are valuable and worthy of being appreciated by others. Consequently, low self-esteem influences not only how we relate to ourselves, but also to others.

People who suffer from low self-esteem usually have distorted thoughts that make them believe that everything bad that happens around them has to do with their behavior, which makes them feel guilty constantly.

This distorted thinking also makes them believe that they do not deserve the consideration and compliments that their friends, family or even their partner give them. As a result, they feel uncomfortable when they receive them, downplay their importance and, on occasion, feel rejected by displays of affection. This causes a distancing between people, since the desired effects are not achieved by reinforcing the virtues or behaviors of an individual with low self-esteem, causing frustration and rejection in friends, family and, especially, in the partners of the people who suffer from it.

On the other hand, the insecurity they suffer about their behavior leads them to think that they do everything wrong, so they constantly strive to please and not to bother other people. This can lead in many cases to very unbalanced personal relationships and of great emotional dependence, since they forget their own needs to cover those of others.

In order to maintain coherence with their mental schemes of low personal worth, it is very common for them to relate to people who contribute to maintain their low level of self-esteem. Their perception of not deserving anything better makes them feel "comfortable" in such relationships despite the great suffering they entail, since they are often based on constant emotional abuse and imbalance.

Is it common for people with low self-esteem to accumulate many psychological problems simply because they are not able to express themselves freely?

People with low self-esteem do not feel respected. Obviously if I am worthless, I don't respect myself and, therefore, no one will respect me. People with low self-esteem measure their words so as not to annoy, they adapt to the needs of others and do not take into account their own. What would happen if you do not tell your boss to stop yelling at you? How would you feel if your partner constantly decides what you do together? How long would you put up with your mother controlling your life decisions? When will you tell your friends that you do not like to drink alcohol?

These questions are easy to answer for people with balanced self-esteem, but people with low self-esteem tolerate constant abuse in their day-to-day lives, which turns into work stress, anxiety, anguish, social isolation, family problems, substance abuse or depression, among others.

In my practice, for example, there are countless people with low self-esteem who continue to want, often without being aware of it, to please their parents. Regardless of age, education or socioeconomic level, low self-esteem can affect anyone. Most of the time, when patients come for consultation, they do not come for having low self-esteem, but for the problems mentioned above, but after an initial evaluation, a lack of assertiveness in relating to others is detected.

An agreed definition of assertiveness would be the form of communication consisting of defending your rights by expressing your opinions and making suggestions in an honest way, without falling into aggressiveness or passivity, respecting others, but above all respecting your own needs.

People with low self-esteem find it very difficult to express themselves in this way, therefore, they do not defend their rights, leading them to have very unbalanced social relationships in which they usually end up suffering and keeping quiet, sometimes, and in others exploiting and having disproportionate aggressive behaviors.

In your experience treating patients, what do you think comes first, self-esteem problems or assertiveness problems?

It is difficult to know which came first, the chicken or the egg, but what is clear is that self-esteem and assertiveness are closely related.

In my experience, people with low self-esteem do not behave assertively because they do not respect themselves, so they do not need to be respected. In fact, they do not conceive that other people treat them with respect and value them as it goes against their mental schemes, so they are unable to assume such treatment.

On the other hand, it may happen that during our childhood we do not learn to have an assertive behavior, since it is common to encourage submissive behaviors in children, in some cases, and aggressive in others.

Over time, it is common for these behavior patterns to become rigid and we may begin to suffer abuse or rejection by our family and friends, classmates or potential partners. This causes our self-esteem to deteriorate until we begin to believe that there is really something wrong with us and that we do not deserve the affection, love and respect of others.

When working from psychotherapy to intervene in cases where there are problems of self-esteem and assertiveness, what is usually done?

As I mentioned earlier, patients do not usually come for low self-esteem when they come for consultation, they usually come for problems of work stress, anxiety, depression and, sometimes, with a deficit of social skills and problems in relating to others.

The most important thing before starting a psychological intervention is to carry out a detailed evaluation of the patient by means of an interview and, sometimes, using specific instruments for each case. For example, the Rathus Assertiveness Test or the Rosemberg Self-Esteem Scale are very useful in situations in which we suspect that the person's problems may underlie low self-esteem or a non-assertive attitude.

Once the assessment has been completed and the functional analysis of the problem behaviors has been carried out, cognitive-behavioral psychotherapy begins with psychoeducation. It is essential that the patient associates his low self-esteem with the way he relates to others and to himself, as well as the implication this has on his mood.

Once the patient knows the keys to his or her problems, the next objective is for the person to change his or her beliefs and maladjusted thoughts with the guidance of the therapist. In addition to the sessions in consultation, behavioral experiments are of great help for this change of attitude, which consist of the patient being exposed to different situations of his daily life and practicing behaviors that have been previously agreed upon in therapy.

The result of these practices is usually different from the one expected by the patients, since they foresee negative and unpleasant situations for them, which in the end do not occur, contributing to break their previous mental schemes.

This work with the patient's thoughts is transversal to the whole therapy, it is necessary to take advantage of all the opportunities that are given in consultation to confront the distorted beliefs that people with low self-esteem have.

It is very common for these people to make internal, global and stable attributions about the bad things that happen to them (I failed the exam because I am useless and I will never get my degree), and external, specific and unstable attributions for the successes (I passed the exam because I was lucky that day). It is also important that the patient is aware of his or her strengths and that, little by little, he or she internalizes them.

Finally, it is of great importance to train in assertiveness and social skills, since it is very common for people with low self-esteem to have deficiencies in these fields. The concept of assertiveness has become a fashion nowadays, it seems that if you become an assertive person you will be successful in business and a winner.

Not far from this idea, and being realistic, assertiveness helps us to relate to others as equals, without being below, but not above anyone. There are numerous techniques that help to move from submissive or aggressive behavior to the much desired assertive behavior.

How do Third Generation Therapies differ in the treatment of these problems?

Third generation therapies consider thoughts as just another behavior, so they focus on their functionality rather than their content. In other words, it is not necessary to change thoughts but their function and the suffering they cause us.

Acceptance and Commitment Therapy (ACT), the main representative of this group of therapies, uses an eclectic mix of metaphors, paradoxes and mindfulness skills. Like cognitive-behavioral therapy, they also apply a wide variety of experiential exercises and behavioral interventions, the difference here is the importance that ACT gives to the values of each person. That is why the main objective of these therapies is to achieve a meaningful and fulfilling life, accepting the inevitable suffering that this entails.

Many people come to consultation with their lives on hold, waiting to be "cured" of their emotional problems to start living. Therapies such as mindfulness and ACT strive for the person to start building the life they want from that very moment, despite the difficulties and suffering that the disorder causes them. Focusing on individual values, not avoiding negative experiences, accepting the inherent suffering of life existence, experiencing all events without evaluating them as good or bad, or returning attention to the present moment, are some of the keys to third generation therapies.

Some techniques of acceptance and commitment therapy, such as "cognitive defusion", are especially useful in cases of low self-esteem, as they help us to weaken the control that thoughts exert over our behavior, so that, although they remain in our mind, they do not continue to be a barrier to acting on the basis of our values.

That is to say, when the patient thinks, for example, "I am useless at my job", he/she can remove the importance of that statement, distancing him/herself from its meaning and realizing that it is not reality, but simply a thought based on his/her low self-esteem. This results in the patient being able to cope with his or her work despite these thoughts.

Mindfulness is also very useful in cases of low self-esteem, as it helps us to focus on the present moment, and not on past events that make us feel sad, nor on future events that make us feel anxious. Most of the rejections felt by people with low self-esteem do not conform to reality, and often avoid exposing themselves to these situations to avoid suffering. With mindfulness we learn to focus on the here and now, without evaluating or judging the present experience.

What advice do you think it is important to follow in order not to fall into situations that can damage our self-esteem?

Something that seems very simple but is of great importance, and that underlies almost all psychological disorders is that sometimes what you think does not correspond to what you feel. In the case of self-esteem it is very evident, on the one hand, there is the self-concept, which is the opinion that each one has of himself, that is to say, what I think of myself. On the other hand, there is self-esteem, which is the affective or emotional evaluation of me. That is, how I feel about myself.

People with low self-esteem may have an adequate self-concept about themselves, for example, thinking they are intelligent, but at the same time feeling stupid. Psychologists call this "emotional reasoning," and it is one of the keys to change. Realize that even if you feel that way, it doesn't have to be true.

Another key to prevent our self-esteem from being weighed down is not to fall into constant comparison with other people, since the assessment we will make will always be negative for us. This will inevitably lead us to feel more miserable. The important thing is to set realistic goals and constantly improve as a person in the areas you want, rewarding yourself every day with your progress.

Focusing on activities that make us happy is also very useful, as it helps us to develop skills in which we can Excel and evolve without feeling too much pressure. Enjoying free time also makes life meaningful and motivates us to face all the situations that make us suffer.

Although it sounds cliché, exercise is one of the infallible formulas to improve our mental health, and in the case of self-esteem for more reasons. Not only the well-being we feel when we do sport, thanks to the secretion of endorphins, but also the personal satisfaction of doing something for us, and the positive effects on our health.

Sometimes it is necessary to heal wounds from the past that weigh us down emotionally. Talking about it with friends, family or a professional is invaluable. Learning to express our emotions and making ourselves known makes us feel more intimately connected to others who are important to us.

People with low self-esteem have a hard time saying no because they are so focused on being accepted and valued by everyone. Setting limits for our family members, bosses, friends or partners is very important to start being respected, and, consequently, to respect ourselves.

Constantly criticizing ourselves with phrases such as "I am worthless", "I am a disaster", "I will never achieve anything in life", "I am always annoying", undermine our self-esteem more and more. Being aware of this inner voice and remedying it, being realistic about our capabilities, is of vital importance to improve our self-esteem.

These are just some small tips that help to prevent low self-esteem, and even to improve it to a great extent. There are cases in which it is so deteriorated that it is already part of the maintenance of a psychological disorder, for example, anxiety, depression, inability to relate to others, relationship problems or work stress. It is in these moments when the help of a mental health professional becomes essential.