My pdoc said I should go back to my therapist after taking about 4 years off due to an overdose in Aug. My pdoc says I need to improve my self-esteem & that's why I should go to therapy. Well, I've been reading a book on self-esteem & intellectually I "get" all the concepts (black & white thinking, looking for the criticism in every remark or glance my way, judging myself more harshly than I would ever judge another person, calling myself ugly names, focussing on my neg. traits & behaviors, etc.)

So I excitedly took in the notes I had taken from the book to discuss with my therapist & she said my low self-esteem was a symptom of my bp & that I couldn't "think " in order to make my self-esteem better. She made it sound like I wouldn't benefit from the exercises in the book, because no matter what I'm bp & I'll always have low self-esteem as a symptom (esp. when I'm a little depressed like now). Of course, when I'm manic I feel great & don't care what other people think of me.

I'm confused. Is it not possible for me to learn to have better self-esteem? That seems like what she was saying to me--that trying to gain insight from a book won't help me change my low concept of myself.

I'm really down in the gutter here with the rats as far as my self-concept goes. Has someone managed to increase their self-concept while being bp or depressive or whatever. And how? Thanks for any help you can give me.--Suzy

[LMo]

Hi Suzy:
I'm not exactly in the same boat, but I kind of agree that while a book can help immensely, it wouldn't be as effective (for me) as therapy. Intellectually, I "get" it, too, but a) I've learned that I'm not nearly as objective with myself as my ego leads me to believe, and b) there is a difference between the "right" way to be and the "realistic" way to be. For these two reasons, I have no plans to ever ditch my T. Those are the two things that for me are irreplaceable by a book.

I'm sure that the book will be helpful, though, so I would encourage you to keep at it!

Thanks, LMo, but what am I supposed to do with my therapist to increase my self-esteem? What can she do for me or help me do for myself? I'm at a loss as to how I can improve my self-concept when it is so low. How does your therapist help you in this regard?--Suzy

[LMo]

Well, she gives me an objective opinion about the issues I struggle with. What sometimes feels catastrophic for me isn't necessarily so from an outsider's point of view. Left on our own to ruminate about our faults or flaws, it's really hard to see that we're much better off than we realize. And it's hard to recognize your own negative thought patterns over time -- I might be able to realize when I'm having a negative thought, but the *pattern* is something hard for me to see.

A good T should be able to guide you as to the "how" to increase your self-esteem. I know this isn't the specific answer you might be looking for, but I do wish you the best of luck

Part of my problem I posted somewhere else is that my husband says he no longer finds me sexually attractive due to my weight gain (50 lbs. in the last 4 years) so I proceeded to overdose, he took me to the ER once he found out what I did, but I'm feeling so bad about myself...

[LMo]

I know... I just saw that Suzy. I'm really sorry. My ex-husband was rude about my weight as well (and mind you, I was about 115 lbs at the time). It can send us reeling. My heart goes out to you. I wish I could erase his words for you

I can't help, but you have my unconditional support

[Perna]

Reading a book is not an interactive experience. The book can't respond to you either positively or negatively or any other way. Self esteem isn't about "caring" what others think of you either as you imagine when you're manic. Self esteem is being "centered" and working on Life from the inside out. Knowing who you are and being kind of like those clown punching balloons that always right themselves? Life comes at you from the outside but your inside is "weighted" when you have good self esteem and you right yourself easily/naturally.

A therapist can help with our search for ourself, for that weighted portion that we can count on that doesn't play keep away from us because it "is" us. It's a bit like target practice and the therapist is the target :-) They mirror what you're doing and what effect it is having and say "try moving over two inches to the left" and the like. Eventually you can hit the "target" every time because you have a "feel" for it/where it is. It is probably harder if you have BP since you do sometimes have a moving target through no fault of your own. But it just takes longer to figure out the quirks of your particular Self and its patterns. It's possible to hit a moving target but is admittedly harder than learning to hit a stationary one.

Thanks for caring to respond. I guess I'm feeling down tonight. I thought she was saying my low self-esteem couldn't be helped. As far as my husband, as soon as I think about it (like now) I'm crying again. I still feel like overdosing to get rid of the hurt I feel, but I know I shouldn't do that or should I? It would certainly get rid of this pain.

[LMo]

No way Suzy. I know you're in a lot of pain and my heart is breaking for you, but don't even THINK about overdosing because of this. Weight is a resolvable problem. It's not the end of the world, and it's NOT the worst thing that can happen.

It's funny Suzy - I completely 100% can relate to the catastrophic affect it's having on your self-esteem, but from the outside looking in, it's irrational to think that it's worth overdosing for.

Do you have any meds for anxiety? It would be great if you could relax and calm down and do NOT make any decisions right now while you're feeling like this.

But do NOT overdose. I'm serious Suzy.

[Perna]

No overdosing Suzy! Your husband's thoughtless comment isn't worth it. One quote I love, "I'm the right size, it's the pants that don't fit" and tell myself that over and over (I'm 125 pounds overweight (but my husband is too so we don't thrown stones at one another).

I try to be thankful to my body that it's so flexible and able to help me. Looking at it as a "friend" is beginning to pay off in how I treat it. But no matter what, your body is worth way more than you husband's personal perception of whether you're "sexy" or not to him (he's not the world's judge of what's "sexy"). That's so very narrow-minded and small!

Yeah, I have meds for anxiety--that's what I overdosed on last time--Xanax & wine. Through my mail-order pharmacy (insisted by his co.) I now have 3 mos. worth of Xanax & then after the OD my doc changed me to Trazadone & klonopin so I have 3 mos. worth of that, too. Great way to save money, but not a good idea with depressed people! I have 2 kids & my mother committed suicide so I won't do that, but for some reason I forgot my resove to not do that when my husband hurt me so I just had to get rid of the pain & hurt. I'm not there now, don't worry, just crying & feeling down & wanting to feel better & then when my therapist said I basically was doomed to feel like this for life, I went into a tail-spin.

[Perna]

I would give the "extras" back to your doc or to your therapist, ask them to dispose of or hold them for you. That would be a positive step in the direction I think you want to go? Yes, I'd give them to my T saying to her, "You're wrong! I do want to get better and I will! Take these you tailspinning impediment!" :-) Maybe not the name calling. . .

[LMo]

LOL and ditto to what Perna said!

Suzy, how are you feeling today? I wish I could bring you a cup of tea and really be there for you this morning. I really can empathize with so much of what you wrote

gentle hugs Suzy.... like the others said pls do not take a thoughtless comment to heart,

I had very low self esteem, severe depression - my marriage was pretty terrible (he used to call me a worthless piece of s..t and not worth the air that I breathed)
Therapy most assuredly improved my self-esteem. It kept improving to the point that I had enough courage to divorce my husband - he was also very ,very physcially abusive too.

I am in no way saying your husband is like that...

But the therapy helped me see myself as worth while and that I had assets - I'm not sure how therapy works but that is what it did for me - even though I was severely depressed...

I'm feeling better this morning now that my husband has left for work & I'm alone & only have my own neg. thoughts to deal with. I'm used to them. I'm going to try to do some positive things today--which in another post I recommended to someone--time to take my own advise! I've made a schedule & have included exercise, sitting under my full-spectrum light, reading & doing errands & cooking dinner in the crock pot--though the thought of food makes me axious--that's what got me to this state in the first place--overeating.

Anyway, I'll keep at the therapy & ask my therapist next time how she plans to help my self-esteem.

Thanks for all the wonderful care you all gave me. I really appreciate it. Here's to surviving another day!--Suzy

[Soidhonia]

Hello I hope things are going better for you at this time. Your therapist may be concerned that you will get intertwined in the book and get confused and grandiose in the therapy in the book, and neglect your thrapeutic therapy with your therapist. Some people with bipolar become followers of things that are not exactly positive, or get overly concerned about things that are not as beneficial in their therapy. I think if the book is helpful to you and is helpful to your standards, then you should use the exercises in the book, but ALSO see your therapist as well. for more rounded treatment. I hope the best for you there is a WRAP (wellness REcovery Action Planning) class available is some states you may like this class as well, since you are abe to follow exercises in the book you are reading. WRAP can be found on the internet and was founded by Mary Ellen Copeland. Take care Sincerely Soidhonia

Thanks for the response. Funny (not really) thing is that I've taken the WRAP through NAMI. It's been a few years. I'll have to get it out to see if I can find some "tools" to help me now. When I took the WRAP class I was pretty up so I could easily identify things that were triggers, what helped me to function better each day & I did have some goals that I had some success at.

I've always had the low self-esteem (except when manic), but as one of the posters above said my self-esteem is supposed to come from inside & not from what others think of me. That I don't know how to accomplish.--Suzy

[Milanist]

Hi Suzy,
Building up your self esteem is quite a complex thing. I am no therapist, but i too had/have a low self esteem on myself but it seems to get better by time.

Reading books about it is not bad at all, but its not the solution! applying what you learn is! Self esteem in my opinion is all a matter of thinking! What you think about yourself!

You should appreciate everything you do, even if somethimes it is not the right thing, appreciate that you try! Having a good relationship with yourself is what you should work on! If you are comfortable with yourself then there is no stopping you!

Therapists help, but there is no one way to fight your low self esteem, so do what you think helps you the most! if reading that book and applying it helps you feel better, then i think that is the right way for yourself.

The only thing is try to make it a long term thing, not just for a small time! Make sure you get to know yourself well because although this might seem to be the easyest thing it is not! For me it was one of the hardest things to do and i am still discovering things today that i did not know!

Have fun with it, take it as an adventure, a task which you need to do in life, once youve accomplished that you will be in peace with yourself and your self esteem would improve too!

I hope that i have explained myself well, if not just ask! We are all here to help you and there is no shame in asking for help.

Dont give up, it will get harder but its worth the trouble.

[Rapunzel]

Suzy, how about an update? When you went back to therapy again, did you talk about this? How are you doing now?

From your original post, I thought it sounded like your T just thought that exercises from a book wouldn't help your self-esteem as much as actual therapy. It didn't sound like your self-esteem would never improve. I love books, and I use lots of books, and I think that they help with a lot. I also 'get' what the books are saying. But when we 'get' something, that usually is a thinking mode rather than feeling mode. Self-esteem isn't intellectual. You can understand all the positive things about you and acknowledge that people think highly of you, and do all the exercises in the books, but if you don't ***feel*** it, it isn't going to do much for your self-esteem. That's what my T is trying to get me to do too, I think. Even if I talk about feelings, I often start with "I think ..." so she called me on that last week because that is thinking language, not feeling language. When I do exercises from a book, I can do the exercises and understand the concepts, but I very rarely feel it, so it's just another exercise, and if I share it with T she will make me keep doing it over and over and I'll get mad because I 'get' it already, but she's right though because I don't feel it. Does that sound like you too?

Rap