In this paper I shall explore aspects of depression which I feel are important, such as ambivalence, hopelessness, masochism, hostility and addictive relationships, and explain some of the dynamics behind these. I shall try and show how these feelings and their defences develop from childhood.

Ambivalence

Freud realised that unconscious, ambivalent feelings towards the object, which complicate the relationship with it “is a precondition for melancholia”. (Freud, 1917:251) We have unconscious struggles due to our ambivalent feelings because of traumatic experiences in connection with the object, but these remain in “the region of the memory traces of things”. (Freud, 1917:256) The object can thus be kept good.

Bibring touches on the concept of ambivalence when he talks about ‘depersonalisation’ which develops in place of an outburst of anger. This is a defence mechanism against overwhelming tensions within the ego, (Bibring, 1953:28) presumably because of ambivalent feelings towards the object, which cannot be expressed.

Fairbairn develops Freud’s ideas of ambivalence: the child internalises his bad objects because he wants to control them and needs them “for if they neglect him, his need for them is increased.” (Fairbairn, 1943:67) This is a chilling statement in terms of the development of ambivalence because of a strong fixation to the bad object in the small child. While the object is present, the internalised bad object is modified by its better qualities, but once the object is lost, the person is then left to the mercy of the internalised bad object; if he cannot embrace the healthy mourning process, he is then left objectless. (Fairbairn, 1943:70)

An ambivalent relationship with an object can be caused by the object’s own depression, silent hostility or withdrawal, “brutally transforming a living object, which was a source of vitality for the child, into a distant figure, toneless, practically inanimate.” (Green, 1986:142) This may cause a premature disillusionment, a loss of love and meaning. “The infant has the cruel experience of his dependence on the variations of the mother’s moods.” (Green, 1986:153) These memory traces remain in abeyance within the subject and “the child’s ambivalence is structured by the fear of the loss of the object” or the loss of its love. (Armstrong-Perlman, 1991:348)

Hopelessness and Helplessness

Freud touches on this theme when he writes about the fact that in depression, the subject finds it difficult to consciously perceive what he has lost, which presumably induces a nebulous feeling of defeat and low self-esteem. “In mourning it is the world which has become poor and empty; in melancholia it is the ego itself.” (Freud, 1917:246)

Bibring defines depression as “the emotional expression of a state of hopelessness and powerlessness of the ego” (Bibring, 1953:24), which leads to a “collapse of self-esteem of the ego.” (Bibring, 1953:26) In the oral stage, frustration can lead to a feeling of helplessness, in the anal stage, feelings of powerlessness and fear of punishment may be added which can lead to a sense of guilt, remorse and too much/lack of control over aggressive impulses. In the phallic stage the fear of being defeated, ridiculed and humiliated could be incurred. “…such traumatic experiences occur in early childhood and establish a fixation of the ego to the state of helplessness.” (Bibring, 1953:39) “A predisposition to depression may be created in early childhood due to a lowering of self-esteem because of weakness, defeat, lack of attention or respect.” (Bibring, 1953:42)

Against the shamefulness of these experiences, defences are erected. In terms of the child and his bad objects, “It is obviously preferable to be conditionally good than to be conditionally bad…it is preferable to be conditionally bad than unconditionally bad.” (Fairbairn, 1943:66) This is the defence of guilt, or the moral defence. The child attempts to repair the bad object, the ‘dead mother’ (Green, 1986) and feels “the measure of his impotence after having felt the loss of the mother’s love and the threat of the loss of the mother herself.” (Green, 1986:150) This leads to a general feeling of impotence “to love, to make the most of one’s talents” (Green, 1986:148). This can cause the feeling of emptiness, so characteristic of depression.

Hostility and Masochism

As these patients have learnt to be acutely perceptive and adaptive to the needs of others, they are not in touch with their own anger. This leads to unconscious hostility and possibly masochism. Patients treat themselves as objects, directing against themselves “the hostility which relates to an object.” (Freud, 1917:252) “The patients usually succeed…in taking revenge on the original object and tormenting their loved one through their illness, having resorted to it in order to avoid the need to express their hostility to him openly.” (Freud, 1917:251) This, I think, can be the self-righteousness of the moral defence: “The ego may enjoy in this the satisfaction of knowing itself as the better of the two, as superior to the object.” (Freud, 1917:257)

Fairbairn explains that the child, who experiences a relationship with a bad object as intolerably shameful, prefers to become bad himself, to make his objects good, “he is really taking upon himself the burden of badness which appears to reside in his objects.” (Fairbairn, 1943:65) This means that the child establishes some outer security at the cost of inner confidence, the ego being left at the mercy of internal persecutors. Defences are erected, such as repression, the bad objects are banished to the unconscious, the good objects become the superego, which causes the ego to feel inadequate and guilty, leading to the moral defence: “…it is better to be a sinner in a world ruled by God than to live in a world ruled by the Devil.” (Fairbairn, 1943:66) The child blames himself: “The subject attributes the responsibility to himself, his manner of being…it becomes forbidden for him to be.” (Green, 1986:151) The child would rather die than direct destructive hostility to the outside world, because of the fragility of the object.

Hostility and Addiction

Armstrong-Perlman writes about how the frustrating, shameful, humiliating and hated aspects of these addictive, perverse and masochistic relationships are denied. “The individual is fixated to a particular form of object choice.” (Armstrong-Perlman, 1991:346), i.e. an ambivalent object found to be both exciting and rejecting, like the original object, the mother with her “duality of aspects.” (Armstrong-Perlman, 1991:347)

Conclusion

This shows that when working with depressed patients it is important to get them to a stage where they can acknowledge the ambivalence towards the original object and therapist, so that the patient can begin to dissolve the cathexis to the exciting object and accept that their wish for the loving acceptance by the original object is hopeless. They need to feel that they can survive this trauma with sadness and mourn for that which they did not receive and that this no longer means that there is no hope for the self. As Fairbairn says, the appeal of the good object, the therapist, rather than the allure of the bad object, can promote the dissolution of the cathexis of the internalised bad object. (Faribairn, 1943:74) There will be anger and ambivalence towards the therapist, who will be consistent, but will also fail the patient. The patient hopefully replaces depression with some healthy aggression towards life.

Bibliography

ARMSTRONG-PERLMAN, E.M. (1991) The Allure of the Bad Object, Journal of the British Association of Psychotherapists, No 22

BIBRING, M. D. (1953) The Mechanism of Depression, in Affective Disorders (1953) ed. P. Greenacre N.Y. International University Press.

FAIRBAIRN, R. (1943) The Repression and Return of Bad Objects (with Special Reference to the ‘War Neuroses’), in Psycho-Analytic Studies of the Personality, Routledge.

FREUD, S. (1917) Mourning and Melancholia, Standard Edition Vol XIV, Hogarth Press.

GREEN, A. (1986) On Private Madness, Chapter 7, Karnac Books, 1986.

I have worked with many clients who have experienced depression in their lives. Experiencing depression can be a lonely and frightening place to be. The following is a list of some common symptoms of depression. It is unusual to have them all, but several usually may develop.

• Frequent or persistent low mood. Things often seem ‘black’.
• Apathy, loss of enjoyment and interest in life, even for things you used to enjoy.
• Deep sadness, sometimes with weepiness.
• Feelings of guilt, worthlessness, uselessness, hopelessness and helplessness.
• Poor motivation. Even simple tasks seem difficult.
• Poor concentration.
• Sleeping problems, insomnia or early waking.
• Lacking in energy, often tired.
• Difficulty with affection, including going off sex.
• Poor appetite and weight loss. Sometimes the reverse happens with ‘comfort eating’ and subsequent weight gain.
• Feelings of constant irritability, agitation, or restlessness.
• Symptoms sometimes seem worse in the. morning.
• Recurrent thoughts of death. This is not usually a fear of death, but a preoccupation with death and dying. Some people get suicidal ideas such as “life’s not worth living”.

Depression can be triggered by traumatic and stressful changes in your life. Examples include financial worries or the loss or break-up of a relationship, redundancy or starting a new job. Life changes and life transitions can all be followed by depression.

What can help?

Depression is a complicated state of mind, with many different symptoms and causes which are unique to each individual. It can particularly affect people with low self-esteem, little confidence and negative thought patterns. They then quickly feel overwhelmed with stress and anxiety. Some people struggle with a negative self-concept and a perceived lack of self-efficacy. They may find it difficult to believe that they can influence events or achieve personal goals. During counseling and psychotherapy, it may be helpful to question and alter these negative thoughts, beliefs and behaviour patterns. This may perhaps begin to restore a healthier self-image and help to establish a new sense of potency and agency in life.

Sometimes depression can be due to unresolved grief over the loss of a loved one. Sometimes it can be due to the loss of another kind, like the loss of a previous way of life, status or health. Working through this kind of grief during counseling or psychotherapy can help a person to come to terms with a different life situation. This may lift the depression and enable the client to move on into the future.

In other cases, depression may be more deeply rooted in difficult and stressful childhood experiences like loss, neglect or abuse. Traumatic feelings may have been hidden and locked away. This can then leave a person with a sense of hopelessness, helplessness, futility or meaninglessness. In such cases the approach in counseling or psychotherapy is often in-depth, and needs to be gentle and slow and at a pace the client is comfortable with.

Anxiety is a natural reaction to a stressful situation, the fight or flight response. It may help a person to successfully deal with a difficult situation, for example at work or at school.

Only when anxiety becomes excessive and chronic, difficulties can begin. Chronic anxiety is a psychological state characterised by unpleasant feelings of uneasiness, apprehension, fear or worry. Anxiety affects the life style, job performance, self-confidence and relationships of many people. This can make it difficult to deal with stressful situations, which can create anxiety in itself. This may then lead to a vicious cycle of anxiety about anxiety.

Anxiety includes some the following conditions:

• panic attacks
• nervousness
• fear of
  • failure
  • competition
  • conflict
  • rejection
  • decision-making
  • social situations
• Phobias like for example
  • social phobia
  • claustrophobia
  • agoraphobia

These conditions can be extremely alienating. Fear of social interactions with others is often to do with feeling evaluated by others. This can become a difficult and painful problem which is sometimes chronic in nature and may cause people to withdraw or isolate themselves.

Someone who suffers from excessive anxiety might also experience it as a sense of dread or panic. Although panic attacks are not experienced by every person who has anxiety, they are a common symptom. Panic attacks can come without warning, and although the fear is generally irrational, the perception of danger is very real. A person experiencing a panic attack will often feel as if they are about to die or pass out.

Anxiety is often a future-oriented mood state in which one is ready or prepared to attempt to cope with upcoming negative events. This may suggest that there is a distinction between future vs. present dangers that divides anxiety and fear. General existential anxiety is also common.

Physical symptoms can include palpitations, chest pains, faintness, sweating, shortness of breath, hyperventilation, choking and nausea.

What can help?

Coping with anxiety can be a lonely and isolating experience. I have worked with many clients who have suffered from debilitating anxiety. With anxiety, counselling and psychotherapy needs to explore and address the underlying issues before coping strategies are put in place, otherwise improvement is only temporary or incomplete. This may include some of the following interventions:

• Providing you with a secure attachment base and emotional support through the therapeutic relationship, which provides containment.
• Helping you explore and understand your condition based on your own unique situation and history.
• Helping you explore and understand your symptoms.
• Helping you explore and understand why your condition developed.
• Helping you to face and tolerate your fears.
• Helping you to manage and understand panic attacks.
• Helping you to develop assertiveness skills, to manage your life better.

Counselling and psychotherapy can then help you to develop your own coping mechanisms in order to deal with your anxiety and strategies to overcome negative thinking patterns.

Summary

This is an article about the concept of mirroring. I shall be looking at Winnicott’s paper ‘The Mirror Role of Mother and Family in Child Development’ primarily, but also at ‘Primary Maternal reoccupation’ and ‘Ego Distortions in Terms of True and False Self’ and see how these three papers link with each other when looking at mirroring. I shall also be taking Kohut’s ideas into account when exploring the areas of responsive, distorted and absent mirroring, how they will influence the growing child and what implications there may be for therapy.

Introduction

The root of the word ‘to mirror’ means ‘to look, to wonder’. (Pines, 1982, 1) and we often wonder how we are looked at. Other people’s eyes are like pools of water which reflect our image. Narcissus tried to find himself in the mirroring pond albeit in a narcissistically self-absorbed way, perhaps not having been sufficiently mirrored by an equally self-absorbed mother. (Pines, 1982,1) The very presence of a mirror in a room causes people to be more self-aware. (Pines, 1982, 9) The need to be seen is compelling; some children may provoke parental hate in order to have negative intimacy if their parents cannot provide mirroring. Others find their reflection in “intrasubjective dialogues” as a way of making up for the lack of interpersonal play. (Bollas, 1987, 143)

Responsive mirroring

In ‘The Mirror Role of Mother and Family in Child Development’ Winnicott writes about a stage of emotional development, when the infant still perceives mother as part of himself. Therefore, if the environmental mother performs her functions of holding and handling in a good-enough way, she also presents herself as an object in such a way which will respect “the infant’s legitimate experience of omnipotence.” (Winnicott, 1971, 112) If mother mirrors him, he sees himself in her face and gets to know himself. Mother’s mirroring gaze upon her infant is thus a founding experience as it establishes a template in the infant’s ego as a site for something good and confirms the infant’s place in the world; moreover, how we have been looked at in early life may determine what we see in other people later.

However Winnicott says that this good enough mothering “is too easily taken for granted.” (Winnicott, 1971, 112) In ‘Primary Maternal Preoccupation’ Winnicott seems to me to be saying that “this state of heightened sensitivity” (Winnicott, 1956, 302) is necessary for the mother to be able to mirror her baby. He also says that “a woman must be healthy in order to…develop this state” (Winnicott, 1971, 302) as it happens at a deeply unconscious level. He says that “…if the mother provides a good enough adaptation to need, the infant’s own line of life is disturbed very little by reactions to impingements.” (Winnicott, 1956, 302)

This reminds me of what he says in ‘Ego distortions in terms of True and False Self’ about how the True Self develops. This to me is a further clue as to how responsive mirroring happens naturally as the mother “meets this infantile omnipotence revealed in a gesture.” (Winnicott, 1956 145) I believe that this can only come from her own True Self. Therefore, I think that these three papers hang together in terms of giving us a sequence of how good mirroring happens: a mother who is in touch with who she is, is more likely to achieve Primary Maternal Preoccupation and thus in turn is more able to mirror her infant and encourage the infant’s True Self to emerge, and in turn this infant when becoming a mother will be more likely to achieve primary Maternal Preoccupation, which will continue the process for the next generation.

In Kohut’s thinking “the confirming/mirroring process” is also very important. (Klein, 1987, 208) For Kohut, mirroring is a two-way process: firstly accurate empathy, i.e. knowing and absorbing what the child is feeling and communicating back recognition and acceptance of this. Secondly doing something about it. (Klein, 1987, 211 ) The child will then develop into an autonomous self, as the self-object is the child’s experience of its own power and competence. The proud smile of the parents will enhance the child’s inner security and self-worth. The glint in the parent’s eye, the shared joy that mirrors the child’s grandiosity, will indeed say: ‘You are the fairest of them all!’ but can also curb the display by adopting a realistic attitude in regard to the child’s limitations. (Kohut & Wolf, 1986, 183) The child may then not need to find ways of “getting the mirror to notice and approve” (Winnicott 1960, 114) by living a life in complete reference to the parents.

Distored mirroring

Winnicott says that the mother with a depressed face will puzzle the infant, and he will get a distorted image of himself: “Many babies, …have a long experience of not getting back what they are giving. They look and they do not see themselves.” (Winnicott, 1971, 112) Apperception then becomes perception and these babies study the mother’s face “as we all study the weather.” (Winnicott, 1971, 112) The infant, in order to make sense of mother’s face learns to predict her moods. This leads to a sense that a mirror is something to be looked at rather than looked into; Winnicott draws a parallel with how later, young people look at themselves in the mirror, perhaps touching on Lacan’s idea of being image conscious, (Benvenuto & Kennedy, 1986) firstly in terms of their own appearance and secondly in terms of what they see when they fall in love. (Winnicott, 1971, 113) Winnicott describes the patient with a depressed mother who chose a depressed nurse so that she would not steal the children away with her liveliness. (Winnicott, 1971, 115) Winnicott argues that if such a distortion of development between mother and baby occurs, the parents may get caught up in spoiling or doing therapy, rather than parenting. (Winnicott, 1956, 203) Kohut argues that faulty mirroring hinders the development of an independent, vigorous self, because mother’s need, to keep the child dependent, is predominant. (Kohut & Wolf, 1986, 193) There is a mode of being with a child, which always imposes mother’s needs, perhaps because her fragile self feels threatened by the child’s innate grandiosity. There may then be little sense of liveliness about such people, presumably aggressive feelings have been suppressed.

Lack of mirroring

I think that lack of mirroring is perhaps what Winnicott calls, “worse still the rigidity of her own defences” (Winnicott, 1971, 112) as opposed to a depressed mother. Perhaps a mother with a rigid face gives the baby the sense of never having been seen at all. This lack of the other there may even be more damaging because it is a trauma of what did not happen and may be what Winnicott means when he says “the infant might be expected to die physically, because cathexis of external objects is not initiated.” (Winnicott, 1971, 146) The infant remains isolated and suffers the fear of annihilation. “The wound the baby suffers is thus not an external lack to which he could react, but a trauma, a brokenness, which runs throughout his subjectivity” (Gomez, 1997, 88) and “the primitive agony of not being able to communicate because there seems to be no way of connecting with anyone, even oneself.” (Gomez, 1997, 89.)

In the absence of a mirroring mother the “baby slips into compliance and identifies with the negative functioning of the mother”. (Symington, 1986, 313) The baby is filled with terror, and in order to deal with this void, it internalises “the bad False Self mother functioning”. (Symington, 1986, 313). The False Self is therefore composed of the hated non-responsive aspects of the mother. This adaptation creates a feeling of closeness to mother to compensate for her distance. (Symington, 1986, 316) In fact Kohut argues that the lonely unmirrored children later suffer from profound anxiety and a loss of the sense of the continuity of the self in time and of its cohesiveness in space. Apprehensive brooding concerning the fragments of the body, may express itself by worry about health. (Kohut & Wolf, 1986, 183)

Implications for therapy

Psychotherapy is “a long-term giving the patient back what the patient brings. It is a complex derivative of the face that reflects what is there to be seen.” (Winnicott, 1971, 117) If something has gone wrong at the mirroring stage, people have no strong self-image. It is as if the client’s image needs to be held for a while by the therapist, so that he will have the strength to hold it for himself. (Klein, 1987 366/7) A “mirror transference” (Kohut, 1986, 186) will develop, which will give the client that feeling of omnipotence which he has missed out on in early ife.

Just as it is more important what the parents are, rather than what they do, so essentially a therapist needs to be able to respond from his True Self.

Conclusion

In this paper I have tried to show that for an infant to develop optimally, he needs the foundational experience of a authentically mirroring mother. Socialisation occurs “through mutual interactions with the sensitive mother.” (Zinkin, 1978, 4) However Zinkin also argues that giving babies interesting things to look at, will cause babies to focus, but including them in a social environment, helps them to relax and be more open: “…the individual emerges, always incompletely, from a matrix of communality, which is also held within the self.” (Gomez, 1997, 87) A well-mirrored child can “react to stimulus without trauma because the stimulus has a counterpart in the individual’s inner psychic reality.” (Winnicott, 1960, 147) Even Winnicott’s title of his paper on mirroring suggests that the family as a whole is an important mirroring component, in saying to the new baby: ‘You are the fairest of them all!’

Bibliography

BENVENUTO, B. & KENNEDY, R.(1986) The Works of Jaques Lacan, Chapter 2, London, Free Association.

BOLLAS, C.(1987) The Shadow of the Object: Psychoanalysis of the Unthought Known. London, Free Association.

GOMEZ, L. (1997) An Introduction to Object Relations, London, Free Association.

KLEIN, J. (1987) Our Need for Others and its Roots in Infancy, London, Routledge.

KOHUT, H. & WOLF (1986) Disorders of the Self and Their Treatment: An Outline, Chapter 7, Essential Papers on Narcissism,
ed. Andrew P. Morrison, New York University Press.

PINES, M. (1982) Reflections on Mirroring, Group Analysis 15 (2) 1-32.

SYMINGTON, N. ((1986) The Analytic Experience, Chapter 29, London, Free Association.

WINNICOTT, D.W. (1956) Primary Maternal Preoccupation, reprinted in (1958) Through Peadiatrics To Psychoanalysis: Collected Papers, London: Tavistock Publications; reprinted London Karnac (1992)

WINNICOTT, D.W. (1960) Ego Distortions in Terms of True and False Self, reprinted in The Maturational Processes and the Facilitating Environment, London, Hogarth (1965)

WINNICOTT, D.W. (1971) Playing and
Reality, London: Tavistock Publications; reprinted London Routledge (1991) Chapter 7: Mirror-Role of Mother and Family in Child Development.

ZINKIN, L. (1978)
Person to Person: The Search for the Human Dimension in Psychotherapy. Br.
J. med. Psychol., 51, 25-34

Grief and bereavement are responses to loss. Bereavement refers to the state of loss and grief to the reaction to loss. Loss is the disappearance of something cherished, often the death of a person. It may also include the loss of a relationship, the loss of a way of life, loss of employment, status or sense of safety and security. The process of bereavement and its related symptoms can also be felt in cases of other losses, like adoption, separation and divorce or loss of a country, or loss of contact with a positive support network, due to a geographical move.

Losing a loved one is a devastating experience. It often means we are in a state of complete sorrow. Sometimes the pain can be worked through with the support of family and friends and at other times professional support is required.

Every individual’s bereavement journey is different. The goal of bereavement counselling is to get you to a place where you can remember the loss with less pain, while also feeling comfortable reinvesting in your future life.

Many people, who are in the throes of a deeply felt loss, feel that they are going crazy, but grief, which is very normal, brings with it a set of common symptoms.

Physical symptoms may include some of the following:

• Hollowness in the stomach
• Tightness in the chest
• Tightness in the throat
• Oversensitivity to noise
• Breathlessness
• Weakness, lack of energy

Some of the following emotions may be experienced:

• Shock
• Numbness
• Anger
• Guilt
• Sadness
• Anxiety and Depression
• Loneliness
• Fatigue
• Helplessness
• Yearning
• Relief

You may have some of the following thoughts:

• Preoccupation with the loss
• Hallucinations
• Disbelief
• Confusion

You may experience some of the following symptoms:

• Insomnia
• Loss of Appetite
• Social Withdrawal
• Dreams of the deceased
• Avoiding reminders of the deceased
• Searching and calling out
• Sighing
• Restless over-activity
• Crying
• Treasuring objects that belonged to the deceased

What helps?

I have had many years experience of helping people with their bereavement journey, coming to terms with losses of many kinds. Grief, although normal, can manifest itself differently in different people. Some people mourn and move on easily, while others can get stuck. This may mean that grief can turn inwards into depression and despair. This can be an extremely lonely and agonizing experience.

Counselling and psychotherapy can help with:

• considering whether mourning has turned inwards, to depression and anxiety
• understanding the grieving/mourning process
• exploring areas which might restrict letting go and moving on
• helping resolve areas of conflict
• helping to adjust to a new sense of self

Healthy mourning may include the following stages:

• understanding and accepting the loss and what it means to you
• working through the difficult pain of grief
• adjusting to a different life
• letting go

Bereavement counseling helps you to cope with your loss, work through your grief and begin to heal. In my experience, grief is a very personal process, and just as each individual is unique, so too is their grieving process.

Talking about the loss can be healing and helpful and allows you to adjust to your new life with all its positive and negative changes. Any loss has to be acknowledged for us to move forward. Healing means coming to terms with the loss and bereavement, psychologically and emotionally. This means we can then allow life to continue with adaptation to change, not forgetting or wiping out the memory.

Low self-esteem is a feeling that most people experience at some point in their lives. This feeling may be transient and the individual can pick themselves up again and move on.

More deeply rooted feelings of low self-esteem are present when we cannot recognise our own value as a person. The signs of low self esteem are different for everyone. They could include some of the following:

• not feeling good enough
• not feeling likeable
• not feeling successful
• feelings of anxiety and depression
• making self-disparaging remarks
• unable to accept compliments
• difficulty saying ‘no’ to others, need to be liked
• comparing yourself negatively to others
• feeling powerless and helpless
• needing a lot of reassurance
• being easily influenced by others
• excessively seeking to please or receive praise or attention
• being withdrawn or uncommunicative
• being over-sensitive, taking things to heart
• blaming others for our own problems or failures

What helps?

I have had many years experience of helping people improve their self-esteem. Psychotherapy and counselling can help those suffering from low self-esteem and help develop a sense of self to ensure a more fulfilling life. This could include identifying and re-evaluating your negative self-beliefs, reviewing your value system, helping you to develop your own coping strategies and enabling you develop and build relationships.

In some cases low self-esteem could be as a result of a difficult past. This may need to be talked about, negative and difficult feelings and experiences worked through, to encourage a stronger sense of self and develop a stronger identity.

Self-esteem is the extent to which we value ourselves. Good self-esteem is important for us to function in the world. Our self-esteem is made up of how we value ourselves physically, i.e. our image, how we rate our abilities and talents and how we evaluate our successes and failures. It is about valuing and loving ourselves despite our human flaws and imperfections. It is about accepting ourselves just as we are. How can this happen? By taking the opportunity through talking about ourselves to a psychotherapist who will help you to relate more deeply and more fully to yourself .By improving your relationship with yourself, your relationship with others can also improve.