*What is your expertise and how long have you been an expert in it?

 I am expert in children (ages 0-18 years), families, couples, and all relationships.  I have been expert for over 25 years on clinical staff at Cedars-Sinai Medical Center and in private practice.

*What is self-esteem, exactly?

Self-esteem as defined in Webster’s dictionary means how one values or regards themselves.  In my world of psychology, self-esteem is impacted by many factors.  How our mothers and fathers relate to us directly impacts our sense of ourselves.  For instance, if you had a father who was harshly critical of you on a repeated basis, then you (the child) take in (introject) the judgmental, harshly critical, punitive self-judge.  This is one of the many dynamics that assault a person’s self-esteem.  If, for example, you had a loving, nurturing mother, you have a good likelihood of introjecting the loving supportive aspect of your mother which fortifies your self-esteem.  Self-esteem is strengthened by our own accomplishments and achievements.  A prerequisite for building a solid foundation of self-esteem is for the individual to establish their own autonomy and independence from their parents.  Only after healthy separation is established can we truly begin to feel good about ourselves.  How we treat other people, establishing our own careers/income, and having warm, healthy relationships are all solid contributors to our evolving self-esteem.

*How does what society says is good, right, and beautiful color our self-esteem? Is this always a negative thing? Please explain.

Some of the messages in our society and current culture sabotage a person’s self-esteem.  For instance, print magazines and the media portray beauty as being thin.  Any female who had a harshly critical parent may beat herself up for not physically matching society’s image of attractive.  Society places too much emphasis on external beauty and not enough focus on internal beauty including character, values, morals, and the way we treat each other.

*How much of self-esteem is what we have internalized from outside messages (we’ve drunk the Kool Aid), and how much of it is from what we really are and feel?

I treat many patients who had “good-enough” parents.  Yet, they were mistreated badly by their peers in school.  They were excluded, teased, and bullied.  These experiences negatively affect a person’s self-esteem.  Everyone wants to belong to a group.  When kids are rejected by their peers these feelings of undesirability are internalized.  For instance, I have treated beautiful tall, thin women who could be models.  They are beautiful!  Yet, in childhood they were brutally teased and  called names for being too tall and too thin.  Many of these women are self-conscious with low self-esteem.  It doesn’t match how beautiful they look on the outside because they value themselves as “less than.”  One can have low self-esteem in one area of their life while having high self-esteem in other areas.  A person can feel genuinely great about themselves in work/career and, at the same time, feel bad about their appearance.

*How do people with high self-esteem and those with low self-esteem behave differently? Does behavior function to enhance or detract from self-esteem? How so? Please explain.

People with high self-esteem never brag or show-off.  They are not shaken if other people disagree with their point of view.  They remain clear and confident in their own ideas and opinions.  They have a sturdy core and a sunny disposition.  People who are angry, critical, and mean do not have high self-esteem.  People with low self-esteem tend to boast and put-down others.  Many people with low self-esteem apologize for their behavior when they have done nothing wrong.  This is as a defense against people being angry at them.  People with low self-esteem can’t bear to be the target someone’s anger or rage.  Some people with low self-esteem look sad and walk with a low posture.  These folks have chronic low self-esteem which can lead to depression, in some cases.

*How do people with high self-esteem and those with low self-esteem manifest behavior in any of the same ways?

Self-esteem can go in waves.  Everyone feels good about themselves and sometimes bad about themselves.  There are some parallels in the behaviors of people with high self-esteem and those with low self-esteem.  For example, people with high self-esteem are kind and generous to others – just because that’s who they are.  People with low self-esteem can be observed as kind and generous to others, but it’s because they want to be liked.  Their behavior is the same as people with high self-esteem (who are relaxed) but their motivation is anxiety driven.

*Do the people in your life affect your self-esteem? How so? Please explain and provide examples, if possible.

The goal for all people is to have a solid, sturdy self-esteem that is not shaken, nor collapses, based on how people in their lives treat them.  How we feel about ourselves should remain primary.  This is easier said than done.  When we are kind, generous, fair, and empathic to others this is the foundation of our self-esteem.  Also, our own personal and professional accomplishments build upon the foundation that is established in human relatedness.  Of course, all of us care deeply about the people in our lives.  But, when the other person’s opinion takes precedence over our own, or when we emotionally collapse under the pressure of someone else’s opinion this is a problem that needs professional help to deal with.

*How can someone begin to improve his/her self-esteem? Are there any easy exercises?

Changing one’s self-esteem requires work and a great deal of motivation.  To improve your self-esteem you must first replace the harsh self-judge with a benign self-observer.  The harsh self-judge is called the Superego.  The person has developed too much conscience, guilt, and feeling of “I am bad.”  To establish a benign self-judge, you must first turn up the volume of self-awareness.  Each time you notice yourself being hard or self-critical you need to gently shrug your shoulders and think, “Oops, there I go again.”  You are exchanged criticism with gentle acceptance.  No one is perfect.  You must accept yourself – flaws and all!

*Can changing personal appearance in healthy ways enhance self-esteem? How so? When does it become unhealthy?

Changing personal appearance in healthy ways can enhance self-esteem.  For instance, if someone accepts all of who they are except for their over-sized or crooked nose, then by all means it’s fine to have a nose-job (cosmetic surgery).  I have known many women and some men, too, who have positively impacted their self-esteem when they corrected or improved their physical appearance.  The danger or risk is with two things.  First, if they only focus on their outside appearance and neglect to also work on how they feel about themselves on the inside.  The second danger is if cosmetic surgery becomes an obsessive compulsive pattern.  I treat some women who are addicted to going under the knife to continually change their appearance.  The folks have very low self-esteem and need professional help to focus on the inside emotionally.  Just remember, self-esteem emerges and builds as a process.  It is not an overnight sensation.  Make a lifelong commitment to be kind to yourself as well as compassionate and kind to others.