Shame, self-loathing and low self-esteem: assessment and treatment !

WEBINAR on 9th July 2022

Shame based disorders are unique conditions characterised by symptoms from both the depressive and the anxiety spectrum; the treatment therefore requires a creative and comprehensive approach that undermines all these mixed and complex symptoms.

We view internal shame and self-loathing as the very foundation for low self-esteem which in itself poses a challenge and demands  a more holistic understanding of what it actually is…  is it a poor and very rigid evaluation of the self ? Is recent neuroaffective research corect in asserting that the amygdala highjacks the system in a social crisis ? Or is it also an overhelming sense of vulnerability around significant others.. perhaps all these factors play a crucial role. All covert and surface level difficulties will be explored during the workshop.

NA-CBT alongside the most recent CBT technology bring such an important contribution to the overall understanding and the treatment of shame and low self-esteem (LSE). CBT treatment protocols distinguish Depression from LSE and the “NeuroAffective” approach as well as the “Oxford model” (which we will be exploring in some depth during the workshop) are by far the best equipped treatment programmes for such conditions. One of the principle questions we shall try to answer right away is perhaps the most obvious: what are main maintenance mechanisms we need to understand and focus on during treatment ?

In any case.. How does low self-esteem affect us?

In a snapshot, one of the problems with thinking that we are not good enough is that we start to behave as if it’s true. Low self-esteem often changes an individual’s behaviours by forcing acts that confirm the person isn’t able to do anything and is not managing tasks very well. When one experiences internal shame, low esteem and low confidence (all inter-connecting domains) one would hide him-herself away from social situations, he/she might stop trying new activities or might even avoid challenging situations. In the short term, avoiding challenging situations makes you feel a lot safer. In the longer term, this avoidance can actually backfire because it reinforces your underlying self-doubt and fear of fitting in. It teaches you an unhelpful life rule that the only way to cope is by avoiding things. It may be important to mention that this is not necessarily ‘social anxiety’, which makes such conditions so difficult to diagnose or fit into a strict DSM (or ICD) type criteria.

Living with shame and LSE can harm your mental health because it leads to various other problems such as deeper states of depression, addiction or eating disorders.. over time, one tends to develop many unhelpful habits, such as over-eating, smoking, or drinking too much, as a way of coping.

The Oxford model for LSE and NeuroAffective-CBT

More links about NeuroAffective-CBT are provided on this site; however in regards to the LSE approach developed at Oxford – Melanie Fennell and her colleagues from Oxford University (one of them being Mark Williams founder of Mindfulness Based Cognitive Therapy), have long established themselves as leaders in the field of CBT for low confidence and low self-esteem. The team has developed effective treatment programmes described as the “Oxford model” which will be discussed in some depth during the workshop alongside the NA-CBT approach.

The workshop therefore provides a solid practical and theoretical introduction to the neuroaffective and underlying mechanisms that maintain such complex conditions and offers detailed interventions that  disrupt the maintaining vicious cycles.


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