Self Esteem, Self Compassion and Their Role in Recovery from Addiction.

It is common to hear among recovering addicts that they suffer with low self esteem. They talk of having low self-esteem before using a substance or behaviour and often their behaviours whilst in active addiction serve to compound this feeling of low self worth. When treating addiction, we often look at ways we can raise an individuals feeling of self esteem in the hope that feeling better about themselves will prevent them from self destructive behaviours. However this article seeks to discuss the idea that it is not raising self esteem that is necessarily needed in the treatment of addictions, rather the learning and understanding of self compassion. 

What is self esteem? 

Self esteem is a judgement we put on ourselves. Whether we are worthy as individuals. Are we good and valuable and do we do estimable things? William James, an influential U.S. philosopher and leading thinker who is also known as the “Father of American psychology”, believed that self-esteem was a vital component of mental health. He stated that self-esteem was created by a person’s ‘perceived competence in domains of importance’[1] James, W. (1890). Principles of Psychology. Chicago: Encyclopedia Britannica discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd . Early sociologist Charles Horton Cooley suggested that self esteem was also influenced by ‘the ‘looking glass self’ – our perceptions of how we appear in the eyes of others’[2] Cooley, C. H. (1902). Human Nature and the Social Order. New York: Charles Scribner discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd . In a 1999 study conducted by Susan Harter looking at how individuals assess their overall worth, she found that self esteem is often ‘impacted more powerfully by the opinions of acquaintances than close others’[3]Harter, S. (1999). The Construction of the Self: A Developmental Perspective. New York: Guilford Press discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd Considering that acquaintances are less likely to know us as well as close family and friends, this surprisingly suggests that our basis for self esteem may be mistaken and ill informed. 

Pursuing self-esteem in order to achieve better mental health.

Although self esteem in and of itself is perhaps a necessary component for our overall sense of wellbeing, the pursuit of it can be problematic. For example ‘the need to feel superior in order to feel okay about oneself means that the pursuit of high self esteem may involve puffing the self up while putting others down’[4]Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd. As well as an over-emphasised sense of importance and superiority, self esteem may also pose other issues. In an assessment of ‘7 sources of self esteem in college students: academics, appearance, approval from others, competition, family support, God’s love, and virtue’, Crocker, Luhtanen, Cooper, and Bouvrette found that problems can also arise when self esteem is contingent on particular outcomes[5]Crocker, J., Luhtanen, R. K., Cooper, M. L., & Bouvrette, S. (2003). Contingencies of self-worth in college students: Theory and measurement. Journal of Personality and Social Psychology, 85, 894–908.. As Harter discovered, global self esteem assesses itself in specific domains such as ‘appearance, academic ⁄work performance, or social approval'[6]Harter, S. (1999). The Construction of the Self: A Developmental Perspective. New York: Guilford Press discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd. Because we evaluate our self esteem within categories defined by society, this may result in us neglecting certain other important skills which are necessary for success. Because often self esteem is reliant on specific outcomes, it will therefore shift and vary being intrinsically unstable. In 2005 Michel Kernis looked at the importance of stability of self esteem in psychological functioning and concluded that when self esteem was unstable it drove people ‘to obsess about the implications of negative events for self-worth, making them more vulnerable to depression and reduced self-concept clarity’[7]Kernis, M. (2005). Measuring self-esteem in context: The importance of stability of self-esteem in psychological functioning. Journal of Personality, 73, 1–37.

If not self esteem, then what? 

How can we feel worthy, valuable and good about ourselves if not by inflating our self-esteem? Before you panic and think that we are all doomed to feeling worthless and ashamed of ourselves, rest assured that research has been done into another concept that can be used to raise our feelings of worth and pride and has similar benefits to self esteem but without the problems of ‘self-evaluation, ego-defensiveness, and self-enhancement’[8]Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd. This is the idea of self compassion. ‘Whereas self esteem entails evaluating oneself positively and often involves the need to be special and above average, self compassion does not entail self evaluation or comparisons with others. Rather, it is a kind, connected, and clear-sighted way of relating to ourselves even in instances of failure, perceived inadequacy, and imperfection’[9]ibid.

How can self compassion over self esteem help in recovery from addiction?

Both self compassion and self esteem are sources of positive self regard (although one is conditional and the other unconditional), which is something that, though difficult to achieve in recovery, is vitally important to develop if we are to maintain long lasting freedom from addiction. One theory as to why self compassion is more helpful for people in recovery stems from work done by Paul Gilbert and Chris Irons when looking at whether compassionate mind training would work with people suffering with shame. Within their study they theorised that some of the differences we have been attributing to self-compassion and self-esteem could potentially be down to the fact that each one affected different physiological systems. They suggested that ‘self-compassion deactivates the threat system’[10]Gilbert, P., & Irons, C. (2005). Therapies for shame and self-attacking, using cognitive, behavioural, emotional imagery and compassionate mind training. In P. Gilbert (Ed.), Compassion: Conceptualisations, research and use in psychotherapy (pp. 263–325). London: Routledge.. In general every addict has suffered some form of trauma, either before addiction, during addiction or both. Trauma dysregulates the nervous system and causes the threat system to be on continuous high alert. If, as suggested by Gilbert and Irons, self compassion is able to deactivate this and instead activate the self-soothing system which brings feelings of secure attachment and safety, it would be a vital tool for those in recovery to have. 

If, as Kirstin Neff says, self compassion is made up of three components: self kindness, connection through our shared humanity and mindfulness, it’s easy to see how well it could be used to help those in recovery from addiction: 

Self-Kindness – this is about the ability to be understanding and caring towards ourselves instead of judging or criticising. When you are being kind to yourself, you look upon your personal flaws and inadequacies gently and attempt to understand them instead of criticise. It’s about accepting the fact that you, just like everyone else, are imperfect.

Connection in our shared humanity: this is arguably the most vital component when relating it to recovery from addiction because addicts feel isolated. Addicts, in fact, are isolated from the community and from society. Recognising that everyone fails, makes mistakes and feels inadequate from time to time can connect us to one another. In journalist Johann Hari’s widely known and referred to TED Talk titled “Everything You Think You Know About Addiction is Wrong,” he concludes, in a concise and wonderfully true way, that ‘the opposite of addiction is not sobriety, it’s connection’.‘Self-compassion sees imperfection as part of the shared human condition, so that the self’s weaknesses are seen from a broad, inclusive perspective. Similarly, difficult life circumstances are framed in light of the shared human experience, so that one feels connected to rather than disconnected from others when experiencing suffering’[11]Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd

Mindfulness: mindfulness and meditation are well known and crucial elements of most people’s recovery from addiction. They are also equally as important as the third component of self compassion. Kabat Zinn, the “Godfather of modern mindfulness” and author of the book “Wherever you go, there you are”, says “Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgmentally. This kind of attention nurtures greater awareness, clarity, and acceptance of the present-moment reality. It wakes you up to the fact that our lives unfold only in moments. If we are not fully present for many of those moments, we may not only miss what is most valuable in our lives but also fail to realise the richness and the depth of our possibilities for growth and transformation.” Eckart Tolle is another of today’s best known authors and thinkers around mindfulness. In his book, The Power of Now he firmly states, “Realise deeply that the present moment is all you have. Make the NOW the primary focus of your life.” It is this idea of being present in the moment that is so important in recovery from addiction. In order to be able to be kind, understanding and gentle towards yourself in a moment of suffering, you first need to acknowledge and be present in that suffering. That might sound obvious but you may be surprised as to how many people don’t actually take the time to feel their own pain because they are too busy self criticising, judging or, like all addicts, trying to figure out a way not to feel the pain. 

In conclusion it seems that when related to recovery from addiction, it would appear that striving for high self-esteem may in some instances be harmful and counterproductive, whereas self compassion could offer a healthier way to feel valuable, safe, accepted and secure and a valuable tool in maintaining long lasting recovery.  


References   [ + ]

1. James, W. (1890). Principles of Psychology. Chicago: Encyclopedia Britannica discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
2.  Cooley, C. H. (1902). Human Nature and the Social Order. New York: Charles Scribner discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
3, 6. Harter, S. (1999). The Construction of the Self: A Developmental Perspective. New York: Guilford Press discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
4. Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd.
5. Crocker, J., Luhtanen, R. K., Cooper, M. L., & Bouvrette, S. (2003). Contingencies of self-worth in college students: Theory and measurement. Journal of Personality and Social Psychology, 85, 894–908.
7. Kernis, M. (2005). Measuring self-esteem in context: The importance of stability of self-esteem in psychological functioning. Journal of Personality, 73, 1–37.
8, 11. Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
9. ibid
10. Gilbert, P., & Irons, C. (2005). Therapies for shame and self-attacking, using cognitive, behavioural, emotional imagery and compassionate mind training. In P. Gilbert (Ed.), Compassion: Conceptualisations, research and use in psychotherapy (pp. 263–325). London: Routledge.

The Antidepressant Power of Exercise

Depression is the most predominant mental health problem worldwide. According to the World Health Organisation (WHO) more than 350 million people suffer with depression globally. In Europe, data shows that 27% adults in the EU have mental issues, which have contributed to 55,000 people who die yearly from suicide. Twice as many people are dying from suicide compared to car accidents. [1]Vos, T., Barber, RM., Bell, B., Bertozzi-Villa, A., Biruyukov, S., Bollinger, I., …Murray, CJ.. (2013). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease study. The Lancet, 386(9995), 743-800.

In 2013, depression was the second leading cause of years lived with a disability worldwide, behind lower back pain. In 26 countries, depression was the primary driver of disability. In 2014 almost 20% of people in the UK aged over 16 showed symptoms of anxiety or depression – a 1.5% increase from 2013. 

The most common way globally to treat depression is with antidepressant medication. However, this is not the only way. In recent years there has been more and more interest directed towards understanding the effects physical exercise could have on the wellbeing of people with mental health disorders. Although this concept isn’t as new as we may think. Back in the 80s, researchers  suggested that  physical  fitness training could lead to an improved mood, self-concept, and work behaviour.

Today more and more research is indicating that exercise can also be used to treat depression. According to Dr Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School, exercise can work for some people just as well as antidepressants. Although for those with severe depression exercise may not be enough on its own, it can certainly help in conjunction with medication where medication is necessary. 

The effect of exercise:

Exercise has a biological impact on our bodies that contributes to many health benefits including heart disease, diabetes, reducing blood pressure levels and helping us get better quality sleep. When you participate in any form of high intensity exercise such as running, circuits, boxing etc you may have noticed that you feel great afterwards. This is due to the release of endorphins this kind of exercise stimulates. However, it’s not only high intensity exercise that can be beneficial. Low intensity exercise, when sustained over a consistent period of time, encourages the release of proteins call neurotrophic or growth factors. These neurotrophic proteins stimulate nerve cell growth which then make new connections within your brain chemistry resulting in an improved sense of wellbeing. According to Dr Miller, neuroscientists have discovered that depressed people have a smaller area of hippocampus in their brains. The hippocampus is the region of the brain that regulate mood. If this area is smaller, it is understood that mood is potentially harder to regulate. Therefore if exercise can result in growing the connections between the nerve cells within the hippocampus region of a depressed person, it stands to reason that it could help relieve their depression. 

How to use exercise to treat depression:

Depressed people often lack motivation to do even the most simple of daily tasks. This is because depression causes reduced energy levels, poor quality sleep, pain and changes in appetite. Exercising can then be thought of as an impossibility for many people suffering with depression. It doesn’t have to be that way though. As little as ten minutes of exercise a day can may a difference. The better you start to feel, the more likely you will increase the amount of time you spend exercising a day. Make sure that you pick something that’s sustainable and fits in with your daily routine as exercise as a treatment for depression is not a quick fix. You need to be able to commit fully to it as part of a long term treatment plan. The goal is to find something you enjoy doing and keep it up. 

References:

  1. Monica Stănescu, Luciela Vasile. Using Physical Exercises to Improve Mental Health Procedia – Social and Behavioral Sciences, Volume 149, 2014, pp. 921-926
  2. Ferrari, A.J., Charlson, F.J., Norman, R.E., Patten, S.B., Freedman, G., Murray, C.J.L., … & Whiteford, H.A., (2013). Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease study 2010. PLOS Medicine, 10(11).
  3. Evans, J., Macrory, I., & Randall, C. (2016). Measuring national wellbeing: Life in the UK, 2016. ONS. Retreived from https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/measuringnationalwellbeing/2016#how-good-is-our-health.
  4. McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016). Mental health and wellbeing in England: Adult psychiatric morbidity survey 2014. Leeds: NHS digital.
  5. Monica Stănescu, Luciela Vasile. Using Physical Exercises to Improve Mental Health. Procedia – Social and Behavioral Sciences, Volume 149, 2014, pp. 921-926

References   [ + ]

1. Vos, T., Barber, RM., Bell, B., Bertozzi-Villa, A., Biruyukov, S., Bollinger, I., …Murray, CJ.. (2013). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease study. The Lancet, 386(9995), 743-800.