1. Lift Your Low Self Esteem Week 1 – Introduction to Low Self Esteem
LET’S TALK
LET’S TALK
Lift Your Low Self Esteem
Week 1 – Introduction to Low Self Esteem
Written by Rebecca Emmerson, Dec 2010
adapted from Melanie Fennell’s book “Overcoming Low Self Esteem”
with kind permission from the author

2. WELCOME House keeping: fire exits, toilets, refreshments
Introductions, who we are
IAPT Questionnaires
Rosenberg Questionnaire
Keeping safe
Congratulations on making the first steps towards making change!

3. Introduce yourself to the person next to you
Ice Breaker
Introduce yourself to the person next to you

4. Group Structure
Weekly from pm (with some groups in the day time) but not in any ‘school’ holidays
Based on the Work by Dr Melanie Fennell
Benefits of CBT effective for self esteem
Psycho-educational group not a therapy group
Not here to give you high self esteem, here to provide you with coping strategies to allow you to improve your own self esteem.
Weekly tasks
Week one effect!

5. Aims of the Course To provide an understanding of self esteem;
To gain knowledge of how low self esteem develops and is maintained;
To strengthen positive beliefs about yourself;
To encourage self acceptance;
To learn to recognise helpful and unhelpful thoughts;
To identify our Bottom Line and Rules for Living;
To provide encouragement and support in learning different ways of thinking and acting, that will help to improve self esteem;
To facilitate a supportive environment in which students may share experiences and learn from the group.
Learn various Relaxation exercises

6. What rules would you like the group to agree to over the next 8 weeks?
Group Rules
What rules would you like the group to agree to over the next 8 weeks?

7. What is your favourite food?
Ice Breaker
What is your favourite food?

8. Aims of Today’s Session
What is Self Esteem?
How does Low Self Esteem develop?
How is Low Self Esteem maintained?
How does Low Self Esteem effect us?
Introducing the CBT model
The continuum of Self Esteem
Positive Notebook Exercise
Diaphragmatic Breathing

9. Group Exercise What do we mean by Self Esteem?
What is Low Self Esteem?
Can we think of people in the media who have Low Self Esteem?

10. A definition of Self Esteem
“The overall opinion we have of ourselves, how we judge or evaluate ourselves, and the value we attach to ourselves as people.”
Melanie Fennell (1999), ‘Overcoming low Self Esteem’

11. A definition of Low Self Esteem
“(if you) feel your true self to be weak, inadequate, inferior or lacking in some way, if you are troubled by uncertainty and self–doubt, if your thoughts about yourself are often unkind and critical, or if you have any difficulty in feeling that you have any true worth or entitlement to the good things in life, these are signs your self esteem is low”
Fennell, 1997

12. How Low Self Esteem develops
Negative Early Experiences
The Bottom Line (beliefs)
Rules for Living (assumptions)
Trigger Situations
Situations in which the Rules for Living are (or may be) broken

13. How Low Self Esteem Develops - 1
Negative Early Experiences
Events, relationships:
Rejection, neglect, abuse, criticism and punishment
Lack of praise, interest, warmth or acceptance
Being the ‘odd’ one out in your family or school
The Bottom Line
Negative conclusions about yourself, based
on these experiences:
‘I am bad’, ‘I am worthless’, ‘I am stupid’,
‘I am not good enough’

14. How Low Self Esteem Develops - 2
Rules for Living
Ways you think you should behave, because you believe the Bottom Line
‘I must always put others first’, ‘If I say what I think, I will be rejected’, ‘Unless I do everything to the highest possible standard, I will achieve nothing’
Trigger Situations
Situations in which the Rules for Living are (or may be) broken
Being rejected, the possibility of failing, feeling that you might lose control

15. Group Exercise
Brainstorm early and later experiences that could contribute to low self esteem

16. Experiences Contributing to Low Self Esteem
Early Experiences
Later Experiences
Punishment, neglect or abuse
Failing to meet parental standards
Failing to meet peer group standards
Being on the receiving end of other people’s stress or distress
Belonging to a family or social group which is a focus for prejudice
An absence of good things (praise, affection, warmth, interest)
Being the “odd one out” at home
Being the “odd one out” at school
Work Place intimidation or bullying
Abusive relationships
Breakdown of relationships
Persistent stress or hardship
Exposure to traumatic events

17. How Low Self Esteem is Maintained
Activation of the Bottom Line
‘I’m stupid’
Negative predictions
‘People think I’m stupid’
Anxiety
Confirmation of the Bottom Line
Prediction left unchallenged, bottom line remains intact
Unhelpful behaviour
‘I’ll avoid the situation’
Self-critical thinking
Depression
Trigger situations
Situation which Rules for Living might be broken
‘I must not say anything as no one will want to hear it’

18. Break

19. ‘The Jelly Baby Exercise’
Split into groups and discuss how low self esteem effects:
Thoughts
Feelings
Behaviours
Physical
(split into 4 groups and take one each to discuss
Write on post it notes and place on the jelly baby!)

20. Thoughts and Feelings Thoughts Self criticism Self blame Self doubt
Negative thoughts
Discounting praise and compliments
Focuses on weaknesses and flaws
Lack of self acceptance
Feelings
Sadness
Anxiety
Depression
Guilt
Worthless
Shame
Frustration
Anger
Disabling self consciousness
Over sensitivity

21. Behaviour and Physical Symptoms
Not asserting needs
Reduced ability to speak out
Apologetic stance
Avoiding challenges and opportunities
Bowed posture - bowed head
Avoidance of eye contact
Hushed voice - Hesitancy - Shyness
Excessive drinking/smoking
Excessive eagerness to please
Being life and soul of the party
Excessive/lack of attention to appearance
Avoidance
Checking behaviours
Physical
Fatigue/Tiredness
Tension
Low Energy
Uncomfortable body sensations
Unable to concentrate
Changes in appetite and weight
Changes in sleep pattern

22. Vicious Cycle of Thoughts, Feelings and Behaviours
Situation: You have received an invite to go to a party
Thought
‘I won’t be able to cope everyone will think I’m an idiot’
Feeling
Nervous, worried
Behaviour
Decides not to go – avoids the situation

23. Group Exercise
What would someone be like if they had high self esteem?
Can we think of people in the media who have high self esteem?

24. How would the following be different if we had High Self Esteem?
Group Exercise
How would the following be different if we had High Self Esteem?
Thoughts
Feelings
Behaviours
Physical

25. Positive Cycle of Thoughts, Feelings and Behaviours
Situation: You have received an invite to go to a party
Thought
‘’I’m looking forward to meeting new people” “going to have a good time”
Feeling
Excited, happy,
Behaviour
Goes to the party

26. Self Esteem Continuum LSE HSE
“At home and socially I have low self esteem”
“In my job as Sales Manager I have High Self Esteem”
Able to move back and forth along the continuum
Self esteem varies according to the situations we are in and the people we are with
Self esteem varies throughout the life span

27. Continuum Course Objectives
LSE HSE
Not here to give you “high self esteem”
Not here to rid you of “low self esteem”
Here to provide you with skills and techniques to lift your low self esteem!
Where ever you are now the aim is to move a few steps forward
The course will allow you to move forward along the continuum and be less vulnerable to falling backwards!

28. Positive Notebook Exercise
Think of our minds as two cabinets. One holds negative information, the other positive information. The negative drawer is probably jammed full!
Keep a ‘special’ notebook. Start keeping a log of all the good/positive things that happen in your day.
The positive points you record have to be everyday things, things that happen to you or things you do that are positive. Then write down in a second column what each task says about you.
You will end up with a store of pleasurable and confidence building memories

29. Positive Notebook Tips
Buy yourself a nice notebook!
Avoid using scraps of paper as these are easily lost. Start keeping a record of all the positive things that happen to you in a day.
Decide on how many positive qualities you would like to record a day. Start small and build up.
Record everyday things that are positive. In the second column write down ‘what does this say about me?’
Future sessions will refer to this exercise!!!
Positive action
What does this say about me?
Went for a swim
Keeping healthy
Cooked a Thai meal Helping son with homework
Adventurous cook
Being a good parent
Buy flowers
Creating welcoming home
Rang a friend
Sociable friendly person

30. Deep Diaphragmatic Breathing
Relaxation
Deep Diaphragmatic Breathing
Diaphragmatic breathing, together with mental and physical relaxation, has been found to reduce high blood pressure and anxiety significantly.
Diaphragmatic breathing counteracts all the unfortunate effects of poor breathing and is one of the most useful tools in stress management. Diaphragmatic breathing is completely ‘portable’. You can use it wherever and whenever you feel stressed and no one will know you are trying to relax as all you are doing is breathing correctly.

31. Share with your partner your best achievement to date!
Closing Exercise
Share with your partner your best achievement to date!

32. Week 1 - Weekly Tasks Start Positive Notebook Exercise
Observation of people with High & Low Self Esteem, note what you think!
Diaphragmatic Breathing Exercise
Read Chapters 1, 2 and 3 of ‘Overcoming Low Self Esteem’ by Melanie Fennell for further supportive reading

33. Lift Your Low Self Esteem Week 2 – Anxious Predictions
LET’S TALK
LET’S TALK
Lift Your Low Self Esteem
Week 2 – Anxious Predictions

34. Feedback of Weekly Task
Positive Notebooks
Observations
Feedback on Week One Effect

35. Aims of Session To explain what anxious predications are
To explain how anxious predictions work
To explain link between anxiety and avoidance
Group to learn how to identify anxious predictions and the precautions they take
Group to learn how to check out anxious predictions

36. Predictions are ok
We all make predictions about things in our environment.
“If I turn the light switch off I know the room will go dark!”
We learn through this experience and adapt accordingly.

37. What do we mean by Anxious Predictions?
Group Brainstorm
What do we mean by Anxious Predictions?

38. Predictions in Low Self Esteem
When we have low self esteem we make predictions about ourselves and view them as facts.
We are referring to the fear we experience when our bottom line is activated and our rules for living are about to be broken .

39. We start generating predictions about what is going to go wrong.
This triggers anxiety
We take precautions to prevent the worst from happening.
Leads to confirmation of our bottom line!

40. The Vicious Cycle Activation of the Bottom Line Negative predictions
‘I’m stupid’
Negative predictions
‘People will think I’m stupid’
Anxiety
Confirmation of the Bottom Line
Prediction left unchallenged, bottom line remains intact
Unhelpful behaviour
‘I’ll avoid the situation’
Self-critical thinking
Depression
Trigger situations
Situation which Rules for Living might be broken
‘I must not say anything as no one will want to hear it’
Situation: You have to speak out in front of people in class

41. How Anxious Predictions Work
Overestimating the chance that something bad will happen
Overestimating how bad it will be if something bad does happen
Underestimating one’s own ability to deal with the worst, if it does happen
Underestimating outside resources

42. Anxious Predictions
Make you at risk to the things you are scared of. So you take precautions to protect yourself. Taking precautions means you never find out what would have happened and reinforces your belief
that you can’t cope.

43. What keeps anxiety going?
The “Fear of Fear” cycle:
(or worrying about symptoms)
More symptoms
Fear of fear
Symptoms of anxiety
More worry
(e.g. shaking, sweating etc.)

44. Longer term: loss of confidence Temporary relief of symptoms
The Role of Avoidance
Vicious cycle:
Longer term: loss of confidence
Fear
More avoidance
Temporary relief of symptoms
Avoidance
More fear

45. Anxiety is Normal Natural response to danger or stress
Helps us survive by preparing our bodies to deal with threat
Anxiety acts as the trigger for our bodies to release adrenaline
Adrenaline makes the body work faster and harder so it can cope with danger by either fighting or running away – ‘fight or flight’ response

46. The Anxiety Curve Anxiety levels Time
Anxiety reduces naturally over time. If you avoid things you never get to check this out
Anxiety levels
Time

47. Exercise – Split into Groups In groups discuss the following questions
1. Identify situations that trigger anxiety.
2. What do you notice happens to you when you become anxious, what feelings do you experience?
3. What goes through your mind when you begin to feel anxious?
4. What precautions do you take to avoid challenging situations?

48. Feedback to the Group your facilitator will write down your points for each question under each column
Q1.
Trigger
Q2. Feelings
Q3.
Thoughts
Q4.
Precautions

49. Can you identify your bottom line or rules for living?
“I’m stupid” “I’m worthless” “I unlovable”
Doesn’t matter at this point if you can’t
If you can, write them down for future sessions

50. Break

51. PREDICTIONS AND PRECAUTIONS RECORD SHEET
Date/Time
Situation
What were you doing when you began to feel anxious?
Emotions and body sensations (e.g. anxious, panicky, tense, heart racing) Rate 0 – 100 for intensity
Anxious predictions
What exactly was going through your mind when you began to feel anxious? (e.g. thoughts in words, images) Rate 0 – 100% for degree of belief
Precautions
What did you do to stop your predictions coming true? (e.g.
avoid the situation, safety-seeking behaviours)
Feelings
(short term)
(Long term)
27/11
Thinking about meal planned for this evening with old school friends
Anxious 80%
Worried 75%
Heart racing 80%
Nervous 65%
I haven’t seen friends for ages, wont know what to say, they will think I am boring, they will all be better than me and doing more interesting things.
Made and excuse not to go
Relief (ST)
Let self down (LT)
I am boring I don’t go out
Lonely (LT)

52. Checking out anxious predictions
CHECKING OUT ANXIOUS PREDICTIONS RECORD SHEET
Date/Time
Situation
Emotions and Body
Sensations Rate
intensity 0-100%
Anxious Predictions
Rate belief 0-100%
Alternative
Perspectives
(Use the key
questions on next sheet to
find other views of
the situation). Rate
belief 0-100%
Experiment
1) What did you do instead of taking your usual precautions?
2) What were the results?
27/11
Thinking about meal planned for this evening with old school friends
Anxious 80%
Worried 75%
Heart racing 80%
Nervous 65%
I haven’t seen friends for ages, wont know what to say, they will think I am boring, they will all be better than me and doing more interesting things. 96%
It is my anxiety that makes me think this way. 60% Whenever I have seen them in the past it has been fine and we have all got on well. 65% They are nice people and have known me most of my life. 60%
I went to meal. Really enjoyed catching up with friends, felt like no time had passed, like I had only seen them yesterday. They too were a little anxious about meeting up again.

53. Remember: key questions to help you find alternatives to anxious predictions
What is the evidence to support what I am predicting?
What is the evidence against what I am predicting?
What alternative views are there? What evidence is there to support them?
What is the worst that can happen?
What is the best that can happen?
Realistically, what is most likely to happen?
If the worst happens, what could be done about it?

54. Week 2 - Weekly Tasks Predictions and Precautions Record Sheet
Checking out Anxious Predictions Sheet
Positive Notebook
Read Chapter 4 of ‘Overcoming Low Self Esteem’ by Melanie Fennell for further supportive reading on Anxious Predictions