The Trouble With Self-Esteem. Another of psychotherapist Lauren Slater’s provocative New York Times Magazine pieces. She argues that the central assumption that impaired self-esteem is related to social ills like crime bears reexamining. For example, the assumption that people with antisocial tendencies (“sociopaths”) have a hidden, unconscious sense of defectiveness and shame, which has been a tenet of the psychoanalytic formulation of sociopathy, has not been borne out in close research and clinical examination of antisocial individuals. Perhaps that’s the basis for the longstanding recognition that psychotherapeutic treatment of sociopaths is virtually never successful?
Slater hints at a broader theme — that impaired self-esteem may in fact be in general healthier and more ‘normal’, that inflation of self-esteem may in fact be a root of behavioral and emotional problems. Readers will recall I’ve written before on the notion that depression may be a more realistic way of seeing things, closely akin to this notion. It is not a novel idea; the inventor of modern psychology a century ago knew it too. Witness Freud’s oft-quoted pronouncement that the aim of psychoanalysis was not to turn unhappy people into happy ones, but rather to turn neurotic unhappiness into plain old ordinary unhappiness. In psychotherapeutic work, we get into trouble when we try to preserve our clients’ self-esteem as an end in itself. People are good enough without our help at defending against the painful-self-examination that is necessary for successful change, and I am fond of saying that, in therapy, one must expect to “feel worse in order to do better.”
Slater suggests that
“maybe self-control should replace self-esteem as a primary peg to reach for. I don’t mean to sound Puritanical, but there is something to be said for discipline, which comes from the word ”disciple,” which actually means to comprehend. Ultimately, self-control need not be seen as a constriction; restored to its original meaning, it might be experienced as the kind of practiced prowess an athlete or an artist demonstrates, muscles not tamed but trained, so that the leaps are powerful, the spine supple and the energy harnessed and shaped.”
I heartily agree. I have long written and taught that impulse dyscontrol and disinhibition, with both physiological (“nature”) and psychodynamic (“nurture”) aspects, are the neglected step-children in much psychopathology. Psychiatric and psychological schemas have in general failed to see them as primary problems in their own right, and failed to develop targeted treatment approaches to these problems. The DSM-4 “impulse disorder” diagnoses are largely ignored; even when patients qualify for such diagnoses, their problems with self-control are attributed to other classes of pathology (e.g. depression) instead. We fail to recognize them at our peril, because the conditions of modernity are combining to erode our capacity for self-control both biologically and psychosocially. The emphasis on enhanced self-esteem may be largely a distortion of a narcissistic society with an increasingly pathetic and alarming focus on image and superficiality.
