The self-esteem-assertiveness link: interview with Guillermo Orozco

The fact of having self-esteem problems can be reflected in many aspects of a person's social life. And one of the most reflected in conversations is the lack of assertiveness: the ability to say what is thought, even if it annoys others, maintaining a balance between respect for the interlocutor and defending one's own right to Express oneself.

People with low self-esteem generally also have assertiveness problems. Let's see how is this relationship between both elements of personality through an expert on the subject: the psychologist Guillermo Orozco.

• Related article: "Low selfsteem? When you become your own worst enemy

Guillermo Orozco: the relationship between self-esteem and assertiveness

Guillermo Orozco is a General Health Psychologist residing in Las Palmas de Gran Canaria, a city where he cares for many of his patients from his Psychological Care Center. In this interview he talks about the relationship between self-esteem and assertiveness, and how problems in these dimensions are addressed from Acceptance and Commitment Therapy.

How does having low self-esteem influence us in our relationships?

Self-esteem is the value, consideration and affection that each person feels towards himself. This assessment is independent of how we really are or how others see us. When our self-esteem is balanced, we perceive ourselves realistically and accept ourselves with our faults and virtues. This makes us feel valuable and worthy of being appreciated by others. Consequently, low self-esteem influences not only how we relate to ourselves, but also to others.

People who suffer from low self-esteem often have distorted thoughts that make them believe that that everything bad that happens around them has to do with their behavior, which makes them feel guilty constantly.

This distortion of thought also makes them believe that they do not deserve the consideration or compliments that their friends, family or even their partner give them. For this reason, they feel uncomfortable when they receive them, they downplay their importance and, sometimes, they feel rejection when showing affection. This causes a distancing between people, since the desired effects are not achieved by reinforcing the virtues or behaviors of a person. individual with low self-esteem, causing frustration and rejection in friends, family and, especially, in the couples of the people who suffer.

On the other hand, the insecurity they suffer about their behavior leads them to think that they are doing everything wrong, so they constantly strive to please and not bother other people. This can lead in many cases to very unbalanced personal relationships and great emotional dependence, since they forget their own needs to cover those of others.

To maintain coherence with their mental schemes of low personal worth, it is very common for them to associate with people who contribute to maintaining their low level of self-esteem. Their perception of not deserving anything better makes them feel "comfortable" in these types of relationships despite of the great suffering that they entail, since they are usually based on abuse and emotional imbalances constants.

Is it common for people with low self-esteem to accumulate many psychological problems simply because they are not able to express themselves freely?

People with low self-esteem do not feel respected. Obviously if I'm not worth anything, I don't respect myself and, therefore, nobody is going to respect me. People with low self-esteem measure their words so as not to disturb, they adapt to the needs of others. others and don't take their own into account. What would happen if you didn't tell your boss to stop yell at you? How would you feel if your partner constantly decides what you do together? How long could you put up with your mother controlling your vital decisions? When are you going to tell your friends that you don't like to drink alcohol?

These questions are easy for people with balanced self-esteem to answer, but people with low self-esteem tolerate constant abuse in their day by day, which becomes job stress, anxiety, anguish, social isolation, family problems, substance abuse or depression, among others.

In my practice, for example, there are countless people with low self-esteem who continue to want, often without being aware, to please their parents. It does not matter the age, the studies or the socioeconomic level, low self-esteem can affect anyone. Most of the time, when patients come to the consultation, they do not come because they have low self-esteem, but because of the problems mentioned, but after an initial evaluation, a lack of self-esteem is detected. assertiveness when it comes to relating.

An agreed definition of assertiveness would be the form of communication consisting of defending your rights by expressing your opinions and making suggestions honestly, without falling into aggressiveness or passivity, respecting others, but above all respecting your own needs.

People with low self-esteem have a hard time expressing themselves like this, therefore, they do not defend their rights, leading them to have social relationships very unbalanced in which they usually end up suffering and keeping quiet, at times, and at others exploiting and having aggressive behavior disproportionate.

In your experience treating patients, which do you think comes up first, self-esteem problems or assertiveness problems?

It is difficult to know what came before, the chicken or the egg, but what is clear is that self-esteem and assertiveness are closely related.

In my experience, people with low self-esteem don't behave assertively because they don't respect themselves, so they don't need to be respected. In fact, they do not conceive that other people treat them with respect and value them since it goes against their mental schemes, so they are unable to assume that treatment.

On the other hand, it may happen that during our childhood we do not learn to behave assertive, since it is common to encourage submissive behavior in children, in some cases, and aggressive behavior in others. others.

Over time, it is common for these behavior patterns to become rigid and we can begin to being abused or rejected by our family and friends, classmates or possible couples. This causes our self-esteem to deteriorate until we begin to believe that there is really something wrong with us and that we do not deserve the affection, affection and respect of others people.

When working from psychotherapy to intervene in cases where there are self-esteem and assertiveness problems, what is usually done?

As I mentioned earlier, when patients arrive for a consultation they do not usually come due to low self-esteem, the most common thing is that come for problems of work stress, anxiety, depression and, sometimes, with deficits in social skills and problems to be related.

The most important thing before starting a psychological intervention is to carry out a detailed evaluation of the patient through an interview and, sometimes, using specific instruments for each case. For example, the Rathus Assertiveness Test or the Rosenberg Self-Esteem Scale are very useful in situations in which we suspect that the person's problem may underlie low self-esteem or an attitude assertive

Once the evaluation is completed and the functional analysis of the problem behaviors has been carried out, cognitive-behavioral psychotherapy begins with psychoeducation. It is essential that the patient associate his low self-esteem with the way he relates to others and himself, as well as the implication that this has on his state of mind.

Once the patient knows the keys to her problem, the next objective is for the person to change their misaligned beliefs and thoughts with the guidance of the therapist. In addition to the consultation sessions, behavioral experiments are of great help for this change in attitude, which consist of that the patient is exposed to different situations of his daily life and practices behaviors that have previously been agreed upon in therapy.

The result of these practices is usually different from that expected by the patients, since they anticipate situations negative and unpleasant for them, which finally do not occur, contributing to break their mental schemes previous.

This work with the patient's thoughts is transversal to the whole therapy, it is necessary to take advantage of all the opportunities that are given in consultation to confront the distorted beliefs that people with low self-esteem have.

It is very common for these people to make internal, global and stable attributions about the bad things that happen to them (I failed the exam because I am a useless and I will never get the degree), and external, specific and unstable attributions for success (I have passed the exam because I was lucky that day). It is also important that the patient is aware of their strengths and that, little by little, they internalize them.

Finally, it is very important to do assertiveness and social skills training, since it is very common for people with low self-esteem to present deficiencies in these fields. The concept of assertiveness has become a trend nowadays, it seems that if you become an assertive person you will be successful in business and an achiever.

Not far from this idea, and being realistic, assertiveness helps us to relate to others as equals, without being below, but not above anyone either. There are numerous techniques that help move from submissive or aggressive behavior to the much desired assertive behavior.

How are Third Generation Therapies different in the treatment of these problems?

Third-generation therapies consider thoughts as one more behavior, so they focus on their functionality rather than their content. In other words, it is not necessary to change thoughts but their function and the suffering they cause us.

The Acceptance and commitment therapy (ACT), the leading representative of this group of therapies, uses an eclectic mix of metaphors, paradoxes, and mindfulness skills. Like cognitive-behavioral therapy, they also apply a wide variety of experiential exercises. and behavioral interventions, the difference here is the importance that ACT places on each person's values. That is why the main objective of these therapies is to achieve a meaningful and full life, accepting the inevitable suffering that this entails.

Many people come to the consultation with their life on pause, waiting to "cure" their emotional problems to start living. Therapies such as mindfulness and ACT strive for the person to begin to build the life they wishes from that very moment, despite the difficulties and sufferings that the disorder produces. Focus on individual values, do not avoid negative experiences, accept the inherent suffering of life, experience all the events without evaluating them as good or bad, or returning attention to the present moment, are some of the keys to third-party therapies generation.

Some acceptance and commitment therapy techniques, such as "cognitive defusion", are especially useful in cases of low self-esteem, since they help us to weaken the control that thoughts exercise over our behavior, so that, although they remain in our minds, they do not continue to be a barrier to acting based on our values.

That is to say, when the patient thinks, for example, "I am useless at my job", he may come to downplay that importance. statement by distancing yourself from its meaning and realizing that it is not reality, simply a thought based on your low self-esteem. This causes the patient to be able to face her work despite these thoughts.

Mindfulness is also very useful in cases of low self-esteem, since it helps us to focus on the present moment, and not in the past events that make us feel sad, nor in the future ones that cause us anxiety. Most of the rejections felt by people with low self-esteem do not conform to reality, and on many occasions, they avoid exposing themselves to these situations so as not to suffer. With mindfulness we learn to focus on the here and now, without evaluating or judging the present experience.

What advice do you think is important to follow so as not to fall into situations that weigh down our self-esteem?

Something that seems very simple but is of great importance, and that underlies almost all psychological disorders is that, sometimes, what you think does not correspond to what you feel. In the case of self-esteem it is very evident, on the one hand, there is the self-concept, which is the opinion that each one has of himself, that is, what do I think of myself. On the other hand, there is self-esteem, which is the affective or emotional assessment of myself. I mean, what do I feel about myself?

People with low self-esteem may have an adequate self-concept about themselves, for example, thinking that they are intelligent, but at the same time feeling stupid. Psychologists call this "emotional reasoning", and it is one of the keys to change. Realize that even if you feel that way, it doesn't have to be true.

Another key to prevent weighing down our self-esteem is not to fall into the constant comparison with other people, since the assessment we will make will always be negative for us. This will inevitably lead us to feel more miserable. The important thing is to set yourself realistic goals and constantly improve as a person in the areas you want, rewarding yourself every day with your progress.

Focusing on activities that make us happy is also very useful, as it helps us develop skills in which we can improve and evolve without feeling too much pressure. Enjoying free time also makes life meaningful and motivates us to face all the situations that make us suffer.

Although it sounds like a cliché, exercising is one of the infallible formulas to improve our mental health, and in the case of self-esteem for more reasons. Not only the well-being we feel when we do sports, thanks to the secretion of endorphins, but also the personal satisfaction of doing something for and for us, and the positive effects on our health.

Sometimes it is necessary to heal wounds from the past that weigh us down emotionally. Talking about it with friends, family, or a professional is invaluable. Learning to express our emotions and make ourselves known causes us to feel more intimately connected with other people important to us.

People with low self-esteem have a hard time saying no, as they are so focused on being accepted and valued by everyone. Putting limits on our relatives, bosses, friends or partners is very important to begin to be respected, and therefore respect ourselves.

Constantly criticizing ourselves with phrases such as "I'm worthless", "I'm a disaster", "I will never achieve anything in life", "I am always annoying", they are undermining our self-esteem every once again. Being aware of this inner voice and remedying it, being realistic with our abilities, is of vital importance to improve our self-esteem.

These are just some small tips that help prevent low self-esteem, and even greatly improve it. There are cases in which it is so deteriorated that it is already part of the maintenance of a disorder psychological, for example, anxiety, depression, inability to relate to each other, relationship problems or work stress. It is in these moments when the help of a mental health professional becomes essential.