Since my residency training (which remarkably is now more than a decade ago) I’ve been on a self-guided journey of learning in an attempt to develop even more tools to become a better clinician, but even more so on a personal level to be a better human being. In that process I’ve learned about mindfulness, Positive Psychology, emotional and social intelligence, nonviolent communication, motivation, and the central importance of meaningful and loving relationships (to learn more click here). I’ve approached this learning process in a manner similar to my formal education in two ways: 1) by focusing on reliable and truthful knowledge acquired through academic research, validation through shared human experience, and the intuitive beliefs of experts in their field (while doing my best to avoid anecdotal “evidence” and self-proclaimed gurus) and 2) by finding ways to integrate different areas of expert knowledge into a larger, practical truth.

There’s been obvious recurring themes – the necessity of relationships, the validation of positive and unpleasant emotions, the development of skills relating to being more self-aware and intentional. However, it wasn’t until recently, while reading Kristin Neff’s book Self-Compassion, that I feel that I came upon the unifying principle of mental healthiness – self-worth.

In Dr. Neff’s book, early on she makes the clear distinction between self-esteem and self-worth – they are not the same. The unfortunate products of the well intentioned but yet disastrous self-esteem movement of the 1980’s has contributed to (if not directly caused) the common observations of the generation raised in the era. Achievement-oriented but rarely good enough. Outwardly perfectionistic but inwardly ashamed, depressed, and anxious. Recognition seeking for accomplishments that aren’t meaningful. The “let’s be entertained by seeing other people screw up” celebrity train wreck fandom. Cyberbullying and internet trolls.

How did this happen? Well, the original research observed that people with high self-esteem tended to be more successful in life. This was totally true then and is still true today. Proponents of the self-esteem movement concluded that improving self-esteem would then make people more successful. Actually not a bad idea. However, where it went wrong was the approach. Most self-esteem boosting strategies are structured around the idea of making a person feel special or unique. “You should feel good about yourself because you’re so pretty, you’re so smart, you’re the best” – conditional esteem built around what follows the word “because.” The problem is that there’s always someone prettier, smarter, or better – and what do you do when you realize this or you fear that others will too? Maybe you try to be even prettier, smarter, or better which leads to perfectionism, compulsion, anxiety, and ultimately shame. How about trying to get more recognition which leads to attention seeking, people-pleasing, or superficiality? If elevating oneself doesn’t work, then you’re left with the alternative of putting others down so that on a relative scale, you’re now the better one – which leads to competitiveness, conflict, taking pleasure in others’ failures, bullying, or narcissism. So like I said, well intentioned but disastrous.

The key error made was believing that self-esteem was the source of success, but in truth high self-esteem is instead a natural byproduct of something else, something deeper – an authentic personal sense of self-worth. And here’s where it gets flipped on its head because genuine self-worth doesn’t come from what makes you extra-ordinary. It comes from an understanding of what makes you just ordinary. It’s your average humanness. It’s what makes you just like everyone else. Nobody’s perfect, including you. We are all good at certain things, not so great at others, and can improve in a lot of ways. However, what is true for all people is that everyone deserves to feel safe, secure, seen, and soothed – it’s hard wired into us from the moment we are born. Everyone should be given the opportunity for happiness. We all should be given the freedom to make choices over our own lives. We all want our lives to matter. The true source of self-esteem is not what distinguishes you from everyone else, but it’s what makes you no different than everyone else.

Building around self-worth also reverses the source of motivation from externally dependent sources, such as recognition, praise, criticism, pressure, competition – to internally driven sources – needs, feelings, ideas, curiosity, inspiration, purpose, and meaningfulness.

Okay, but how is self-worth the unifying principle behind all mental healthiness? Let’s start at the beginning, of life that is.

One of my favorite studies, the Harvard Grant Study, a remarkable 75-year plus prospective study looking at the critical factors related to living a fulfilling and successful life, shows that more than anything else the warmth of relationships in your childhood or a “corrective” loving relationship later in life best predicts broad life success, wellbeing, longevity, life satisfaction, and physical health. George Vaillant, who oversaw the middle 40 years of the study summarizes its primary conclusions in a few words – “Happiness is love. Full stop.”

Looking at Attachment Psychology and reflecting on my own experiences as a parent – it is when your children can reciprocate the least, when they are least likely to earn your love, attention, or respect – when they are helpless infants and frustrating toddlers that you are also most likely to instill deeply in them the feeling that no matter what they do – “good” or “bad,” they are inherently worthy of love, respect, comfort, freedom, opportunity, and security. I don’t find it surprising then, that if a person can leave their childhood feeling warmth (shorthand for the four S’s of attachment – safe, secure, seen, soothed) that this hard wired sense of personal self-worth sets them up to be more motivated, resilient, open, flexible, kind, empathetic, generous, thoughtful, introspective, moral, conscientious, and mindful…in other words mentally healthy. As the Grant Study also demonstrates, that if you are unfortunate in that your childhood memories were not of warmth, that at any other point in life loving another and receiving their love in return can course correct your life towards fulfillment as well. Being the recipient of a nonjudgmental, unconditional, and experiential love lays the foundation of a stable sense of self-worth.

This inherent self-worth then translates itself to a greater probability of more positive life experiences. The take home message from Brene Brown’s popular TED talk on vulnerability is that a person’s belief that they are worthy of love is what separates those that continue to have courage and grit when life is disappointing or painful. They are the ones who ultimately find joy, love, and peace. People that don’t have such a belief, that instead believe that not only do they not deserve love but when bad things happen then that’s what they deserve, they stay stuck in a cycle of self-criticism and shame and tend to live smaller lives.

What about self-worth in the context of everyday living? Positive Psychologist Martin Seligman has validated a model of “flourishing” built around five core life experiences that positively correlate to life satisfaction and wellbeing. They are: 1) positive emotion, 2) engagement (flow), 3) relationships, 4) meaningfulness, and 5) accomplishment. Of these, the strongest correlation to life satisfaction comes from having meaningful life experiences, which are defined as experiences where your strengths are utilized for the sake of something larger than yourself. In other words, when you contribute to the wellbeing of others, it in turn brings you the greatest fulfillment. But this isn’t just for philanthropists and saints. Relationships are the most common means to meaningfulness in life, which again validates your personal significance to others, which in turn is also immensely rewarding to you. Experiences of “flow” – using your highest strengths in ways that are challenging but not overwhelming, also create a uniquely immersive positive feeling, and those that experience flow frequently, also feel that their lives are more fulfilling. What meaningfulness, flow, and relationships have in common is that they require contributions from the best parts of you – a real time application of self-worth. Interestingly, just a pursuit of happiness, or an attempt to have as much fun in life as possible, doesn’t independently contribute to life fulfillment at all. So activities that make you feel happy, don’t really make your life better. However, for those that already have a sense of meaning or flow, their enjoyment of life also increases – they have more fun, they love more deeply, they are more grateful. When you are chasing pleasure it tends to leave you feeling deprived, but when you are already fulfilled, your pursuit of happiness is driven by a motivation to experience the good things in life that are well-deserved.

Abraham Maslow, Marshall Rosenberg, Edward Deci and Richard Ryan are all psychologists who have contributed to the understanding of the fundamental importance of how needs drive human motivation and behavior, and how we can achieve optimal wellbeing. Maslow describes the fulfillment of human potential as being able to self-motivate towards meeting all of our needs, from the most basic needs of safety and self-care, to the highest needs of self-actualization – in other words, how well we can take care of ourselves when appropriately motivated from within. Marshall Rosenberg eloquently integrates the interdependent relationships between needs, feelings, empathy, compassion, connection, and fulfillment. At the core of his observations are the validation of the universality of human needs and feelings, and it is this ability to empathize with what we see as being common in our shared human experience – the validation of both ourselves and others – that is key to fulfillment and wellbeing. From a more academic approach, Deci and Ryan summarize our healthy human needs as being in the domains of autonomy (our ability to make choices for ourselves), relationships (how we matter to others), and competency (validation of our strengths and abilities).

It’s not that hard to see the self-worthiness thread here, is it? So this is the foundation of our integrated healthiness. Some of us are fortunate that early in life, at least one person helped us understand this truth, and we are better off because of it for the rest of our lives. For others, this inherent truth of the universal self-worth that we all possess has been distorted. However, it can be rediscovered and nurtured, through real-time experiences that are meaningful, through relationships that are loving, and by being kind to yourself through a practice of self-compassion. And since we all change in life, no matter what, we can all grow in our ability to recognize and appreciate the significance of living our lives through these truths – We all need and deserve to feel safe. We all need and deserve to feel secure. We all need and deserve to feel seen. We all need and deserve to feel soothed.

When we recognize this in others, we become better people. When we recognize this in ourselves, we become better people. Isn’t it interesting that to become a truly special human being, that what it takes is to focus on the basics of being human?

Written by Joseph Lee, M.D.

I'm a Psychiatrist in private practice in Redondo Beach, CA. I completed both medical school and residency training at UCLA. My practice is psychotherapy based with a health-oriented focus on personal growth and wellbeing. I also teach about mental healthiness and advocate for social emotional learning (SEL) in all contexts.

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