It takes time. A lot of time.
Your negative self-worth developed over years and/or decades. So it might take some time to reverse the direction and see positive ideas about yourself grow.

What made a difference for me:

• Making a list of my negative ideas about myself, taking those ideas into therapy and talking with T about it. Ultimately all those ideas (like I'm not good enough, I'm a nuisance etc.) were connected for me.
• This won't make those negative preconceptions go away. So be prepared for a lot of effort.
• I made another list where I tried to find the "opposite" ideas to those negative ones. This was a really difficult one. Talked a lot about those with T as well. At the time this felt like a shallow excercise, like going through the motions, for the sake of doing it.
• When I was in intensive inpatient treatment, I actually performed some sort of little "ritual" and threw some big stones into the nearby river - one for each of the main negative thoughts. This gave me something tangible to hold on to in times when those thoughts would return in a massive way in the sense of "I did get rid ot those thoughts, those are the echoes, that keep returning..."
  Doing this was my own idea, I just felt the need for it. Had someone told me I "had" to do this, I would have flat out refused.
• I actively tried to replace the negative thoughts with the positive ones. I collected a number of little flat stones and wrote the positive thoughts on those stones. Or I drew a symbol. Each morning I would decide which of those stones would be the "right one" for today. And I carried this stone with me during the day, each time I touched it or remembered it or during difficult situations I made an active effort to remember this positive thought about myself. With time, I found that just carrying one of those stones in my pocket was soothing and helfpul. Again, this was my own idea, what felt fitting at the moment. If I had been directed to do so, this would have brought out my stubborn side.
• With the help of my T we worked on "symbolic positive triggers" and anchoring those positive beliefs into my body memory. We did a lot of imaginative work in this area. For instance, she would ask me to imagine a situation when I felt "good" about myself. To imagine this situation, what does it feel like in my body, where do I feel it? This situation could be some every-day-activity like riding my bike without holding on to the handlebar while listening to one of my favourite songs. So opening my arms wide, thinking about my bike or this favourite song over time became positive triggers for feeling good about myself. Sounds weird, and I was very sceptical at first, but it actually does work over time. It takes a lot of reinforcing those positive cues though, over and over again.
• What made another huge impact was taking a meditation class, I was looking for a mindful based stress reduction kind of thing, and by chance ended up in a "mindful self compassion" class, because I found the teacher very impressive. This class actually taught me another set of excercises and meditations that are helpful in dealing with ourselves in a more (self)compassionate way.

Those are the steps that I've been taking over the last couple of years. I'm not saying that those might help for everyone. You probably have to find out what fits for you and develop your own ideas what might be helpful for your particular situation. Generally it helps to be proactive, to try out different things, to seek input from you T, to find out together how T can support you. Be prepared to do most of this work yourself. There is no magic potion (unfortunately). T is something like your navigator, or your guide, providing the frame, but ultimately you have to put one foot in front of the other yourself. Again and again. You need a lot of patience, since you probably won't see immediate results (at least I didn't). It helps if your T can reflect on your visible improvements from the outside, since you yourself probably won't notice at first. Also T would quite often ask me: Remember how you felt about this one last year? Do you notice a difference? Most of the time I had to admit (sometimes grundingly ) that there was a tangible difference in my self-perception. So it helps to have someone at your side who can spot the difference and point it out to you.


Over a period of a couple of years those steps (probably a few more that I can't remember right now) really helped to "re-write" my programm with negative ideas about myself. I even had to think really hard right now to come up with one or two examples of those negative ideas, because they normally don't pop automatically into my head any longer. There are still moments when they pop up, and they probably won't disappear for good. But I am able to actively contrast them with a positive idea, and since we worked a lot on those positive triggers, anchors and symbols, I am able to recall the positive feeling that's connected with the idea, and this too me really helps a lot.


Hope you'll find a way to work on your self-worth that really makes a difference for you.

c_r