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A First Steps guide to

Building self-esteem and confidence

First Steps, Version 3, February 2013

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Im not good enough Im unlovable Im always getting things wrong, I must be really stupid Im not good enough Im so ugly

are just a few of the comments from people who are experiencing low selfesteem.

Using self-help tools The strategies/tools suggested in this booklet are evidence based methods of managing emotions and reducing their negative effects on our everyday life. We are all individuals and respond to situations in different ways therefore not every tool will work with everyone. For example some people find meditation and reading really relaxing, whilst for someone else this could be a cause of stress and their preferred relaxation method may be to go to the gym. There are no set rules for managing emotions. A helpful way of thinking about this could be to think is my current method working for me? If the answer is yes, then great, but if not, these strategies may be an alternative way that is more productive for you. As with any new skill, self-help can take time and practice. In the same way that reading a cookery book will not instantly make you a great cook, simply reading this material will not make you instantly happy and healthy. But with time, practice and exploration it is possible for everybody to experience emotional well-being. Self-help alone may not be adequate for everybody. If you feel that you need more support, it is important to discuss this with your GP. In addition there are a number of helpful resources at the back of this booklet or you could call our phone line/email us for more information/advice.

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What is in this booklet?

Page Introduction Different aspects of low self-esteem How low self-esteem develops How low self-esteem is maintained Cycle of low self-esteem Building self-confidence How can you break the cycle and boost your self-esteem? Changing thinking patterns Keeping a thought record Positive notebook Changing your activity to build your self-esteem and confidence Activity diary Goal setting Handling uncomfortable situations Expressing your feelings and learning to say no Taking care of yourself (relaxation, diet and exercise, sleep) Useful contacts 4 6 7 10 11 12 13 14 15 18 20 20 23 24 26 29 32

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Introduction
We all at some point in our lives feel uncertain about ourselves, lack self-confidence, have doubts about our abilities or think negatively about ourselves. However, if you find that this is how you are feeling a lot of the time and it is having an effect on your day to day life, then this booklet may be helpful to you. What is self-esteem? Self-esteem refers to the way we think and feel and value ourselves as a person. What is self-confidence? Self-confidence refers to how able we feel to get a task done. What is low self-esteem? Most people describe themselves in a negative way at some time in their lives, however if you think about yourself in this way on a regular basis, then you may have low self-esteem.

Low self-esteem is having a generally negative overall opinion of yourself, judging and evaluating yourself negatively. People who have low self-esteem generally have a rigid, negative belief about themselves. These beliefs are often taken as truths or facts about themselves, resulting in a negative impact on a person and their life

The impact of low self-esteem Low self-esteem can impact on the way that a person feels about them selves and the way that they function in everyday life. Personal impacts The person might: say a lot of negative things about themselves criticise themselves, their actions and abilities put themselves down, doubt themselves, or blame themselves when things go wrong not recognise their positive qualities find it hard to accept compliments focus on what mistakes they have made, or things they didnt do expect that things will not turn out well for them feel depressed, anxious, guilty, ashamed or frustrated

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Impacts on everyday life Reduced performance at work Not reaching full potential because of the negative value they place on themselves Avoiding challenges for a fear of failure Believing that any achievements were down to luck, rather than a result of their own abilities or positive qualities Altered relationships with friends, family or colleagues. For example: becoming overly upset or distressed by any criticism or disapproval, trying to please others, being extremely shy or self-conscious or even avoiding social contact Change in appearance. Some people may lack the motivation for personal care whilst others may try to hide their perceived inadequacies by paying significant attention to the way they look, and avoid contact with others unless they look perfect Altered food and or alcohol intake. Some people may diet whilst others may comfort eat or reach for convenience foods. Some people may use alcohol or drugs to increase their confidence, which in turn has an adverse affect on their self-esteem

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Different aspects of low self-esteem


Having negative beliefs and opinions about yourself can affect your thinking patterns and your behaviour, which can impact the way you feel both emotionally and physically. Low esteem may affect you as a person in certain different areas. Everybody is different and will react differently to low self-esteem. Seem people might notice more physical symptoms, whilst some might notice more changes in their thinking. It is common for people to notice a vicious cycle of symptoms (see page 11), but no two people will have the same experience.

Thoughts and beliefs Thinking youre not good enough Thinking other people will see you negatively Doubt your ability to do things Blame yourself for things that happen, even though it might not be your fault Be critical of yourself and say that you are too stupid, useless, unattractive, boring, etc Focus on criticism and mistakes, ignore success and strengths

Moods Anxiety Frustration and anger Sadness Guilt Shame

Physical reactions Tension Reduced sex drive Tiredness Change in appetite Sleep problems

Behaviours Difficulty saying no and communicating your needs Not meeting your own needs and trying to please others Holding back from doing things and avoiding challenges Finding it difficult to make decisions Putting pressure on yourself to do things perfectly and working too hard Shyness and avoiding meeting new people Being oversensitive

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How low self-esteem develops


The opinions and beliefs we have about ourselves are influenced and shaped by the experiences that we have had during our lives. This often (but not always) dates back to our early childhood/adolescence, but we continue to be shaped by our day-to-day experiences throughout our lives. Learning about life and ourselves is gained through different ways. We learn by observing what other people do or say and the way that we are treated by others, for example the interaction with our families, the society that we live in, the school we went to and the peers that we were/are influenced by. Other factors can also influence our self-esteem including stereotypes and the media. The following are some examples of past and present experiences which may lead to the development of low self-esteem Meeting high standards or being expected to be perfect. Not meeting someone elses expectations or standards. Constantly being criticised can also have a negative effect; this could be parents, family, peers or work colleagues who criticise and focus on your weaknesses and mistakes rather than your positive qualities Being bullied or made fun of. This can result in believing thoughts such as Im ugly or Im stupid Rejection. Feeling rejected by parents, friends, work colleagues etc. can have a significant impact on the way we feel about ourselves Difficulties in fitting in or feeling different to those around you. Feeling as though you dont fit in, especially during late childhood and adolescence can influence how we learn to view ourselves. This is a time when physical appearance may be very important to a young person. Thoughts such as Im unlikeable or Im unattractive can become real beliefs about ourselves that can become quite rigid as we get older A lack of positives. This could be growing up or living in an environment with a lack of praise, encouragement, warmth and affection. For example if a childs basic needs such as food and clothing were met, but their parents were emotionally distant or not physically affectionate, these experiences can negatively influence how a person views themselves Traumatic life events. Sometimes when families are experiencing stressful or distressing life events they may become angry, depressed and respond negatively towards each other. Perhaps a relationship breakup, health problems or bereavement have affected you. These factors can all affect self-esteem Punishment, neglect, or abuse. How we are treated in life affects the way we see ourselves. For example, if a child is unfairly punished, neglected or abused they may come to believe very negative things about themselves. The same may be true for an adult in an abusive relationship Stress or financial worries. These can also cause low self-esteem, for example by leading to thoughts that you cant cope or that you are a failure

These factors can lead people to hold certain beliefs about themselves which are called core beliefs.

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We continue to experience low self-esteem even though our circumstances have changed from the past because of the negative core beliefs we hold

Core beliefs These beliefs are strongly held beliefs about ourselves that influence what we think and how we feel. They usually influence us subconsciously and we rarely ever challenge if these beliefs are true. Common negative core beliefs are: I am not worthy I am unlovable I am not good enough I am not important I never get things right
I am not worthy

Our core beliefs also relate to how we believe the world should be and include our ethics and values. Examples of these could be: People should be courteous and polite I should always get things right Life should be fair I must not let people down

We all hold these beliefs and they are central to our being. Quite often just awareness that these core beliefs may be shaping your thoughts and feelings can be helpful in challenging your view of the situation or yourself. Our thoughts about an event or situation are often closely linked to our core beliefs and will affect a persons self-esteem and self-confidence in managing the event or situation.

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Case study Emma is taking the children to school. She turns the corner and there is a long traffic jam. Emma begins to feel stressed.

Situation Emma is taking the children to school

Event There is a traffic jam

Importance of situation/event Emma feels that she must not let the children down so must get them to school on time Core beliefs I am not good enough I never get things right I must not let people down How Emma: Feels emotionally Feels physically Thinks about future situations Behaves

Negative thoughts The children will be late, it is all my fault (personalising) The teachers will realise that I am a bad mum (jumping to conclusions) I should be able to get them to school on time (should statements)

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How low self-esteem is maintained


So far we have looked at how negative beliefs that we hold about ourselves are influenced by our experiences of life and the way that we have interpreted events or behaviours. Rules and assumptions (the shoulds and musts) What happens in our adult life is that we keep these negative beliefs going. This can be by the unhelpful rules and assumptions we place on ourselves, for example, rules could be I should always be the best at everything or I must never get close to people, and assumptions could be people wont like me if I express my true feelings or I must do everything 100% perfectly otherwise I will fail. Sometimes the rules that we place on ourselves can be unrealistic, extreme and inflexible.

Unhelpful rules The rules we place on ourselves actually stop us from testing out whether our beliefs are true as they restrict our behaviour. For example, a belief that Im unlovable means that the rule may be I must never get close to people, thus the person never actually gets the opportunity to test out whether people find them lovable or likeable. This keeps the belief going

Everyday situations Our responses to certain day-to-day situations can also serve to keep our negative beliefs going, as seen in the cycle of low selfesteem on the next page Self-fulfilling prophecy We gather information that confirms our negative self beliefs because we pay much more attention to negative events that confirm these beliefs

The impact of negative thoughts The thoughts we have tend to affect the way we behave, and the way we feel physically and emotionally

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Cycle of low self-esteem


Events from our past may be the starting point for the development of negative self-beliefs and low self-esteem, but certain situations activate these beliefs and trigger a vicious cycle of symptoms, which strengthen our negative self-beliefs. Our feelings, thoughts, and actions are closely related, and a negative change in one area can have a negative effect on another.

Cycle of low self-esteem

Past experiences Parents were overly harsh and critical when I didnt get exceptionally good school grades

Negative core belief I am worthless

Difficult situation Cancelled dinner with a friend because of work commitments

Thoughts
Im a useless and pathetic friend I dont deserve to have friends I shouldnt let people down Im always being selfish They are better off without a friend like me

Behaviours
Apologise profusely and put yourself down to friend Overcompensate when trying to make it up to friend (reschedule dinner at a time that is not convenient for you) Withdrawing and avoiding the friend for a while

Physical reactions
Tense Sweating Headache Change in appetite

Moods
Depressed Sad Guilty Confirms negative belief I was right I am worthless

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So how does the belief I am worthless get confirmed and maintained in the cycle of low self-esteem? Firstly, the negative thoughts that you are having about yourself eg. the negative self-talk are confirming your belief Im worthless. Secondly, the feeling of depression / low mood can increase negative thinking which may confirm your negative belief that you are worthless. Thirdly, all the unhelpful behaviours that are triggered by the negative thoughts mean you are acting in a way that is consistent with the belief that you are worthless, e.g. withdrawing, acting in a passive or apologetic way. By acting as though you are worthless, you will carry on thinking you are worthless, and maintain feelings of sadness, depression or guilt.

Building self-confidence
Self-confidence comes from our abilities to master skills and achieve goals that matter to us. It also comes from our sense of self-esteem, that we are able to cope with what is going on in our lives, and that we have a right to be happy. People may lack confidence in some or all aspects of their lives. How confident you feel about yourself can be seen in many different ways: through your behaviour, your body language, and how you speak for example. Below is a table which compares common confident behaviours with behaviours that are related with low selfconfidence. Do you recognise any of the thoughts or actions in yourself or other people around you?

Self-confident Asserting yourself, even if others criticise or mock you for it Having the confidence to take risks and put in the extra effort to achieve good results Being comfortable when others pay you compliments and accepting them as truths Acknowledging and being proud of your successes and achievements

Low self-confidence Changing your behaviour based on what other people think Not venturing out of your comfort zone and avoiding taking risks Dismissing compliments, and not believing in them Waiting for others to praise you on your achievements

Low self-confidence can be destructive and often shows itself as negativity, whereas selfconfident people are normally positive, and believe in themselves and their abilities.

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How can you break the cycle and boost your self-esteem and selfconfidence?
The good news is that whilst we cannot change past experiences, we can start to change the things we do in the present which are keeping the unhelpful beliefs going. We can start to challenge the negative views that we have developed about ourselves, and break the cycle of low self-esteem and self-confidence.

The first step to breaking the cycle is to become more aware of the ways that low selfesteem/low self-confidence affects you: Think about this and make some notes on your self-esteem and self-confidence and: the way you feel physically the emotions you experience the way you think the things that you do Notes:

The second step is to try to break the cycle which can be done in a number of ways: Change negative thinking patterns Challenging unhelpful thoughts and the unhelpful beliefs you hold about yourself Uncover your strengths and positives

Take action Ensure you have a balance of activities that need to be done and that you enjoy doing Set yourself achievable goals Try to tackle things that you have been avoiding Take care of yourself

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Changing thinking patterns


When things happen in the world around us, we usually have a number of thoughts about the situation and how it relates to us. We are not usually aware of these thoughts, as they often happen really quickly and unconsciously, and are often coloured by our past experiences. However, if they are quite negative and critical, it can affect how we feel about ourselves and our ability to deal with the situation. If you have negative beliefs about yourself, you can also start to ignore any positive information like strengths, achievements and compliments and may only focus on things such as mistakes, criticism and weaknesses. This acts to strengthen the negative beliefs that you may hold about yourself.

Common thinking errors Jumping to conclusions This is where we make a negative interpretation of an event, even though we do not know all the facts. My manager has asked to see me in her office. I think I am going to be in trouble. Catastrophizing An extreme form of jumping to a negative conclusion, where the importance of an event is exaggerated to become a catastrophe. I was late for work again today. My boss will be angry and as I am only bank staff, I may be laid off. I wont be able to pay my bills, so my house may be repossessed and my children and I will be homeless. All or nothing Thinking in black and white terms and not allowing for any grey areas. If I dont get this right the first time, then there is no point in doing it at all. Personalising/labelling Seeing ourselves as the cause of some negative external event or taking the view that we are to blame Katy ignored me when I said hello today. Maybe she doesnt like me any more as I didnt make her a coffee. Discounting positives Focusing on negatives and not giving praise for the positive things we do. Ok, so I got my report approved today, so what? Thats only whats expected of me. Should statements Trying to motivate yourself with should, must and ought statements places unnecessary pressure and expectations on you. These pressures are unhelpful and can lead to feelings of failure. I should be able to cope with this; I used to be able to.

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Challenging our thoughts In order to start changing the way we think about ourselves and improve our self-esteem there are a couple of strategies that you can use: Challenging unhelpful thoughts - Identify and question the critical thoughts you have about yourself Positive notebook - Helps you to look out for and identify your positive qualities

Both of these strategies aim to increase self-esteem by helping you to recognise and believe a more positive view of yourself - replacing the critical overly negative view you might currently hold.

Keeping a thought record


1. Situation: What were you doing? When was it? Where were you? Who were you with? 2. Unhelpful thoughts: What was going through your mind just before you started to feel this way? What images or memories do you have of the situation? In which unhelpful thought style did you engage (ie. all or nothing thinking, catastrophizing, etc.) 3. Helpful thoughts: What might be an alternative more helpful thought?

When trying to come up with a helpful thought, here are some tips to help you What is the evidence to support the unhelpful thought? What tells you that this thought is correct? What is the evidence that does not support the unhelpful thought? This is the hard part because it is often overlooked, but ask yourself these questions: How would someone else view the situation? How would I have viewed the situation in the past? What might I say to a friend who was in a similar situation? What is the effect of thinking the way I do? Does it help me or make me feel worse?

Now, is there an alternative, more helpful thought that could also be true to that situation

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What was I thinking just before I felt like this?

Proof that the thought is true

Other possibilities, or What I would say to a friend

What if the alternative thought is true?

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Balancing Balancing is a useful technique to try. When you have a negative, critical thought, balance it out by making a more positive statement about yourself. For example: The thought: Im unattractive, could be balanced with: my husband and children love me and always tell me that Im beautiful. Obviously this is much easier said than done, especially when we are feeling negative, and it can be difficult at first, but with practice it does get easier.

The double column technique Another technique that may help is to write down your negative automatic thoughts in one column and, opposite each one write down a more balanced positive thought.

Negative thoughts Im really not fitting in with others at work because Im unlovable and have nothing interesting to say

Balancing thoughts I have two really lovely best friends who always ask me to come out with them and phone me up once a week at least so I cant be that bad

Im unlovable

I have good friends

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Positive notebook
(based on non-direct quotes in Overcoming Low Self-esteem by Melanie Fennell) Everybody has strengths and weaknesses, but when your self-esteem is low, you can start to focus on the negatives and discount or ignore some of the positives about yourself. This keeps the cycle of low self-esteem going, as you pay more attention to the negative information which confirms your negative beliefs about yourself. A way to start to try and get a more balanced picture of yourself, which will help improve your self-esteem, is to keep a positive notebook.

Identify and list your positive qualities When you have low self-esteem, it can often be easier to list all of your negative qualities, and difficult to see the strengths you have, but here are some questions you can ask yourself to identify your positive qualities: Is there anything that you like about yourself? What are the positive achievements of your life so far, however modest? What obstacles have you overcome in your life? What would someone who cares about you say your qualities and strengths are? Might there be a grain of truth in there? What strengths and qualities do you appreciate in others? Do you have any of these yourself? What negative qualities do you not have?

It is important to list your answers however modest they seem to you. It is easy to dismiss things as insignificant when your self-esteem is low, but they are all important evidence to build a picture of all your strengths and positive qualities. . It may be useful to ask somebody who you trust to help you answer some of these questions Once you have come up with a list of positive qualities, write them in your notebook, leaving room to add new ones in the future.

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Daily recordings of positive qualities Once you have created a list of your strengths, spend time every day trying to write down three positive qualities that you have shown on that day. If three is too difficult, just writing down one is a good start. It is important not only to record the positive quality, but also some evidence of the quality. What did you do that tells you that you have this quality? This will help you remember your strengths when you look back over your notebook. This is not about doing things, to make you feel good. It is about reflecting on what you are already doing that proves your qualities. It can be helpful to consider how you felt after each piece of evidence to ensure that you are only using positive examples. E.G Always putting someone elses needs before your own may prove that you are considerate, but could also strengthen your core beliefs, that other people are more important. . Here is an example of what a daily record of positive thoughts may look like. Day Thursday Evidence of positive quality Let another driver into the queue of traffic Colleagues asked me to join them at lunch Cooked dinner for partner despite feeling tired Friday Sorted out problem for colleague at work Spoke in meeting even though felt nervous Sent friend a get well soon card Positive quality Considerate

Likeable

Caring Helpful, skilled

Determined

Thoughtful

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Changing your activity to build your self-esteem and confidence


We gain confidence and improve self-esteem by doing things. Achieving small steps can help to rebuild confidence that you may have lost, and can motivate you to try other things. Also, being active can give you a sense that you are taking control of your life. Sometimes when we are feeling bad about ourselves we may: Stop doing things we used to enjoy Avoid or put off completing tasks Withdraw from friends and family Find it difficult to make decisions Work too hard or try to be perfect

These behaviours all keep the vicious cycle going and strengthen our negative selfbeliefs. A good strategy for identifying how your current activities could be impacting on your selfesteem is by keeping an activity dairy. You can then see what changes you could make to improve your well-being, make life more satisfying, and take credit for your achievements.

Common backward thinking I will do what I enjoy when I feel better I will feel better when I do what I enjoy

Activity diary
Step 1 - What are you currently doing? The first step is to look at how you currently spend your time and to consider how satisfying you find your daily activities and routine. You can use the diary sheet on the next page. Try to record daily activities, along with ratings of how satisfying you found each activity (sense of pleasure or sense of achievement). It is important that there is a good balance between duty activities and those activities that give you a sense of pleasure and achievement.

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Activity diary Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Morning

Afternoon

Evening

What was the best part of the day?

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Step 2 What would you like to change?

Are you getting a balance between enjoyable and relaxing activities, and activities that need to be done? Can you improve your balance?

Ask yourself: if you were helping somebody with their activity diary, what changes would you recommend?

What activities give you a sense of achievement? When we feel bad about ourselves it can be difficult to feel that we are actually achieving anything at all, but this strategy can help you to see you might be achieving more than you give yourself credit for

Did negative thoughts affect your activity? Try to write them down and question them to see if you can come up with a more helpful view

Are there things that you would like to do or need to do, but feel they are unmanageable? Try breaking the task down into smaller more manageable steps, and setting yourself goals to achieve them. Each time you achieve a step it will increase your confidence, and motivate you to try the next one

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Goal setting
Most people find that working towards realistic goals is motivating and satisfying, but it is important to start off by setting the right goals. This really will have a positive impact on the success of building confidence and self-esteem. Remember, change is not always easy, and there may be slips or lapses along the way. This is normal, and so dont be put off or be hard on yourself if you find that you dont always stick to the plan!

S M A R T

Specific Measurable Achievable

By being clear about your target goal you will be able to take pride in achieving it Just wanting to build up my social life is not measurable; taking part in a dance class twice a week is. Recognise your limits, if you set goals too high you are more likely to quit and feel that you failed. Challenging yourself is great but dont expect the impossible! The goal has to make sense to you and be something you feel is worthwhile and that applies to your views and lifestyle Think when the best time is for you to fit in your goals and try not to tackle too many goals at once

Relevant Timely

Goal setting is an on-going process

E R

Evaluate Redo

Regularly look again at what has gone well or less well and why this might be the case Set new goals or adapt the ones you have. Give yourself a reward for what you achieve, even if you did not complete the goal, but gave it a good shot!

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Handling uncomfortable situations


Sometimes when people feel bad about themselves, they might think that things will turn out badly or might doubt their ability to deal with situations. This might lead to avoiding certain situations, because they predict that things will not go well. If you avoid things, it can make you feel better in the short-term as you have not had to confront your fears or anxieties, but in the long-term it keeps those negative self-beliefs going, as you never have the opportunity to find evidence to disprove them. If you find that you have been avoiding certain activities or situations that you need, or would like, to do, then try the following strategy: Draw up a list of things that you have been avoiding Order them with the most manageable task first, working up to the hardest one Picking the most manageable one, break it down into smaller more specific steps You can then start to achieve these smaller steps one by one Keep practicing each step until you feel comfortable enough to start the next one By tackling things step by step, you can start to build confidence in your own abilities. Dont forget to take credit for achieving each step, and reward yourself appropriately

Prediction of what might What actually happen? happened? If I speak up in a meeting at work then everyone will stare at me. Ill get flustered and everyone will laugh and think Im stupid I felt quite uncomfortable and nervous but everyone listened to what I said and agreed with my point and the manager thanked me for raising it

What I have concluded My colleagues dont think Im stupid and I can make useful contributions to meetings even though I still feel nervous

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Here is an example of somebody who is experiencing low self-esteem, and the different parts of her life it is affecting:

Sarah is 27-years-old. Her low self-esteem issues started when she went to secondary school, where she found it quite difficult to settle in and make new friends. She always felt shy and like the odd one out. Since then, she has always felt that she is somehow not acceptable to other people. Sarah has a small circle of friends whom she has known since university and has just started a relationship with someone whom she has been friends with for some time. Recently, Sarah has found that she has been feeling more tense and uncomfortable in social situations, especially where there are a lot of people, or people whom she does not know very well. Her new boyfriend has a lot of friends, and he is often invited to go out with others. He would like Sarah to come along with him, but she feels very anxious, which also makes her sad and frustrated, as she would really like to meet new people. Sarah thinks that others will think she is weird and boring. When she goes out, she often feels very self-conscious and thinks that nobody wants to speak to her. Sarah is also very quiet and avoids speaking up. Because of the way she feels, Sarah starts to avoid social events. This means that she stops going out as often and does not socialise with other people. As she does not interact with others, she feels rejected, which confirms her view that she is unacceptable.

She could tackle this by breaking the task down into more manageable chunks, starting with the easiest first: 1. Go out with boyfriend to an event where she knows everyone else 2. Go to an event where she only knows her boyfriend and a few other people 3. Go out to an event where the only person she knows is her boyfriend

For each step Sarah should: Before - predict what she thinks will happen After - reflect on what actually happened Each step enables Sarah to be in what she determines as an uncomfortable situation and to test if her predictions are true. (see below also) It is normal to feel anxious in many of these situations and the goal is not necessarily to feel completely comfortable. However it is enabling her to look at feeling comfortable with feeling uncomfortable. You may find that you are having negative thoughts, which are stopping you from doing these steps. You may need to challenge these to help you move forward

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Tackling things that you have been avoiding will help to test out your negative view of yourself and gain a more balanced view by building your confidence. Did you learn anything new about yourself? Did you cope better than you expected? Was the outcome better than you expected? If they didnt go so well, is there anything you can do differently next time?

Expressing your feelings and learning to say no


Expressing our feelings openly promotes a sense of well-being and freedom from tension. It helps us to recover from hurtful experiences, and also helps other people to understand what is going on inside us. There are times when displays of emotion are not helpful, but hiding or holding back our feelings, can cause tensions that affect our physical and mental health. Learning to say no in an assertive and tactful way is a difficult, but important, skill to learn. Remind yourself now and then that: You have the right to say no without feeling guilty Others have the right to say no to you Saying yes when you really mean no may reduce your feelings of self-worth It's better to say no at the time than to let somebody down later Saying yes to extra work or obligations might cause you stress Taking on too much might lower your standard of work or come at a cost to those people who are important to you It might not be such a big deal to the other person to get a no response Being respected and respecting yourself is more important than being liked

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Setting limits and saying no When someone asks for a loan, comes round uninvited, continually expects you to work late, parks in your space

How comfortable are you with assertively refusing or approaching them about it? What stops you from saying how you feel?

There are a number of reasons why people have difficulty saying no they often have thoughts such as: Saying no is rude, aggressive, unkind, uncaring or selfish People will be hurt if I say no or it will upset them If I say no, people wont like me Other people are more important Saying no is petty or small-minded I should be able to do that

The key to refusing requests and saying no is to be able to accept the following beliefs: Other people have the right to ask and I have the right to decline When you say no, you are refusing the request, not rejecting the person When we say yes to one thing, we are actually saying no to something else

When people have difficulty saying no, they usually overestimate the difficulty that the other person will have accepting the refusal. By expressing ourselves openly and honestly, it liberates the other person to express their feelings too. How do you feel when someone says no to you? Do you find that you always feel as if they are rejecting you or that they must not like or respect you? Think about what you would say to a friend if they came to you with the same situation that you are in.

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How to say no Practicing these techniques may be helpful: Direct no: Say no without apologising o No, thank you o This way is quite forceful and can be effective with salespeople or people who are being quite pushy

Reflecting no: Reflecting back the content and feeling of the request, but adding your assertive refusal at the end o I know you were looking forward to a walk this afternoon, but I cant come

Reasoned no: Very briefly, give your genuine reason for the refusal o I cant do that for you because Ive already arranged to do something else

Rain check no: Say no to the present request, but leave room for negotiation o I cant do that for you now, because I wanted to do something else, but I will do it for you next time if you can give me a bit of notice

Enquiring no: Not a direct no, but a request for more information or an alternative o Do you need that to be done for you now or can it be done later?

Broken record no: Repeat a simple statement of refusal over and over again if the requester is very persistent o Id like to be able to help you out, I just dont feel I can at the moment As I said, I just dont feel I can at the moment I appreciate what youre saying; I just cant help at the moment

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Taking care of yourself Learning to relax


How relaxation works Feeling relaxed and feeling anxious are incompatible. You can't feel them both at the same time When you are stressed, the muscles in your body tense up, which causes uncomfortable feelings, such as headache, backache, tight chest, etc. Relaxing slows down the systems in your body that speed up when you get anxious If you learn a method of relaxation and use this regularly you will be able to control anxiety more effectively There are many forms of relaxation including yoga, meditation, imagery, and many others

Relaxation is a skill It may not come naturally and has to be learnt through regular practice Make time for yourself and develop a routine which you can stick to. Aim to set aside 15 to 20 minutes a day with no interruptions or distractions

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Diet and exercise


The food you eat can play an important part in the way you feel, physically and mentally. Too much sugar, coffee or salt can cause tension and irritability. Therefore, it can be useful to look at your eating and activity patterns. A balanced healthy diet can make you feel better about yourself as well as being beneficial to your body and immune system. A balanced diet will also help your body and mind to work more efficiently. For more information, please see your GP or nutritionist.
Fruit & vegetables Bread, rice, potatoes, pasta and other starchy foods

Meat, fish, eggs, beans and other non-dairy sources of protein

Milk and dairy foods Foods and drinks high in fat and/or sugar

Regular exercise is good for us in many ways: it increases our confidence and self-esteem; it stimulates "feel good" chemicals in our bodies; it provides an outlet for tension and frustration; it relieves anxiety; helps us relax; helps us sleep better and helps to prevent physical illness, such as heart disease and osteoporosis. Choose a sport or exercise you enjoy. Please note that when first undertaking an exercise program you should consult with your GP.

Sleep
Try and get a good nights sleep every night. The amount of sleep that you need is different for everyone and can range from 5 hours upwards per night. The amount of sleep that we need often reduces as we age. Research shows that those with a poor sleep pattern are more at risk of poor mental health and poor sleep can worsen existing mental health conditions. How to get a good nights sleep People may worry about not getting enough sleep, but worrying often only makes it worse. It is easy to overestimate how much sleep you need, or not to realise it is normal to wake briefly during the night. The occasional bad patch is harmless and usually rights itself. It's generally only of concern if its been going on longer than a month. The average amount of sleep is seven to eight hours a night, but we all need different amounts, and less as we get older We pass through cycles of light and deep sleep at night. Around every 90 minutes we have a period of dream sleep (REM), which is vital for our well-being

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If we miss out on sleep on a regular basis (not caused by sleep difficulties eg. socialising, children etc) we may incur a sleep debt, making us tired and irritable, unable to concentrate or to function properly. It usually stops once the debt is paid off. However irregular sleep patterns or napping should be avoided if you are having difficulty sleeping at night

Long-term sleep problems may be both the cause or consequence of physical or mental health problems

Things that may disrupt your sleep pattern Snoring that interferes with breathing Too much stress Racing thoughts Ill-health or physical pain Emotional difficulties, including anxiety and depression Jet lag or shift work that disrupts our internal body clock Traumatic events, such as a divorce, redundancy, or bereavement Different environments e.g. going into hospital, a residential home or a hotel Medicines, such as water pills, steroids, beta-blockers, and some painkillers, antidepressants, slimming tablets and cold remedies Withdrawing from certain drugs, such as tranquillisers or antidepressants Taking street drugs such as ecstasy, cocaine and amphetamines Overusing alcohol, tobacco and caffeine

Tips to help you sleep Establish a regular routine. Go to bed only when you're tired and get up at the same time each day. Avoid napping during the day Check your sleeping arrangements. Think about comfort, temperature, light and noise levels Learn to de-stress before bed. Dismiss nagging thoughts by writing them down Have a warm bath, practise a relaxation technique, or listen to a relaxation tape. (But don't read or watch television in bed) Dont eat late. Avoid rich, spicy or sugar-rich foods, red meat and cheese. Choosing wholemeal, low-fat, magnesium-rich foods (green salads, broccoli, nuts and seeds) may encourage sleep, as may drinking hot milk and honey. Get enough exercise. Fit people sleep better Don't stay in bed. If you can't sleep, get up after 15 minutes and go through your relaxation routine again Keep a sleep diary. This helps you identify potential causes for your sleeplessness Try some reverse psychology: keep your eyes open and tell yourself to resist sleep Interrupt unwanted thoughts: repeat a soothing word to yourself. Visualise a scene or landscape that has pleasant memories for you Try out complementary remedies. Yoga, meditation, homeopathy or herbal remedies, such as lavender or valerian, may be helpful for some people Talk to your GP. Sleeping pills can present problems, but a brief course is sometimes appropriate

Night-time relaxation routine Breathe deeply, counting slowly up to four as you breathe in, hold for another four seconds and then breathe out slowly. Consciously tense and relax your muscles, in turn, starting at your toes and working up your body.
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Useful contacts

First Steps
0808 801 0325 - Monday and Wednesday 10am to 4.30pm and Thursday 11am to 5.30pm. The helpline will be open on a Tuesday following a Bank Holiday www.firststeps-surrey.nhs.uk first.steps@nhs.net

Living Life to the Full


A self-help website offering free modules on confidence building, as well as other topics, that you can work through on the internet www.llttf.com

MINDinfoLINE
0845 766 0163 - Monday to Friday, 9.15am 5.15pm www.mind.org.uk info@mind.org.uk

Books
The Surrey County Council Library has a very helpful list of self-help books that can be accessed from the following libraries: Camberley, Dorking, Epsom, Farnham, Godalming, Guildford, Horley, Oxted, Redhill, Staines, Walton-on-Thames, Woking

You can find the list at www.surreycc.gov.uk if you search Read Yourself Well. Many of these libraries also have a self-checkout option, which means you can take out a book without anyone knowing the book that you choose.

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