Distressed about your self-image? Of course, no one wants to make you feel worse, but have you ever considered the possibility that your very own behavior might--just might--be causing you to have a low opinion of yourself?
Twenty years ago, when I first became a doctor, no one ever complained of a lack of self-esteem, or of hating him- or herself. Now scarcely a week goes by without a patient making just such a complaint and presenting it to me as if it were my job to rectify matters. And whenever anyone says to me, "I don't like myself, doctor," my heart sinks and I feel an urge to reply, "Well, that makes two of us." Of course, I say nothing of the kind. Instead I offer bland reassurances that I scarcely recognize as my own as they leave my mouth.
Last week a young man came to me in distress about his self-image. His mother agreed that he had a low opinion of himself. It was this low opinion, the pair of them said, that had led him to beat up his girlfriend, who was pregnant at the time and subsequently had a miscarriage.
"It couldn't be the other way around, could it?" I asked.
"What do you mean?" the young man asked me.
"That your behavior caused you to have a poor opinion of yourself?"
This possibility was firmly rejected. The idea that low self-esteem could ever be justified was too revolutionary to be entertained, even for a moment.
Does recognition of the need for self-esteem represent a true advance in human understanding, or is it, on the contrary, evidence of a widespread and shallow narcissism? Is it an explanation of our failings or an excuse for them?
People who complain of low self-esteem often do so in the same way that people who fear they are suffering from Alzheimer's disease complain of a failing memory. A faculty of mind is alleged not to be functioning properly. And just as a working memory is a precondition of most human activities, so is self-esteem deemed to be necessary. For without it, the will is paralyzed, and one cannot make the most of one's abilities.
But is a lack of self-esteem, either congenital or acquired, a deficit like memory loss, to be cured, if possible, by doctors and psychologists, by pills and psychotherapy? I am not referring to the temporary loss of self-esteem that occurs in severe forms of depression, in which a person of usually blameless conduct expresses unrealistic feelings of guilt and unworthiness. I mean the lack of self-esteem that is permanent and is allegedly responsible for all manner of ills.
A lack of self-esteem is not necessarily pathological, nor is its presence necessarily desirable. Indeed, when self-esteem is not accompanied by any accomplishment or personal quality, it is a serious failing. I recall a 24-year-old prisoner who told me with great pride that he was the father of nine children by six women, not one of whom did he help in any way whatsoever, financial or emotional. His prowess in procreation was the source, or one of the sources, of his evident self-satisfaction; and he said that he intended, as soon as he was able, to demonstrate his prowess once more, regardless of the consequences to others. His self-esteem would be boosted accordingly.
It might be said, of course, that his apparent self-esteem was only a mask for a deeper-seated lack of it; in psychology, much is the opposite of what it seems.
Thus, his macho swagger and his boastfulness were, in fact, a psychological defense mechanism against profound uncertainty and insecurity. After all, the fathering of so many children at so young an age is not much of an achievement when viewed in any light but that of disappointed self-love.
But if excessive self-confidence and self-esteem are to be taken to indicate their opposite at a deeper level, are we also to take expressions of a lack of self-confidence and self-esteem as evidence of a deep-seated megalomania and self importance? Some biographers of famous men think so. Charles Darwin's modesty, diffidence, and social reclusiveness, for example, are now thought by many to have been a clever disguise for his almost psychopathic ruthlessness and determination to succeed. His painfully elaborate politeness was the means by which he exploited others and put them off their guard.
Certainly it requires a degree of self-importance even to complain of a lack of self-esteem. It is not a complaint one is likely to hear among Zairean goatherds, for example. And those people who do complain of it are often seeking reassurance that, despite their failures, which as often as not are brought about by their unwise conduct, they remain worthwhile people.
The idea that everyone should have self-esteem in the same way that everyone should be able to repeat a seven-digit number, or should know the time of day and date, is a corollary of the psychological doctrine of the Real Me.
Now the Real Me has very little connection with the merely Apparent Me--the me that loses its temper, exceeds the speed limit, gets drunk, has affairs, makes a mess of work, can't express itself properly, is never grateful, and generally behaves in a less than optimum fashion. This is only the Apparent Me, a less real and substantial being altogether than the Real Me. Unfortunately, people insist on judging by the Apparent Me.
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