Emotional disorders may be roughly classified into two groups. (1) Disorders thought to be primarily of biochemical origin, such as depression and related conditions. These are generally treated with psychotropic medications, and the results are often dramatic. (2) Disorders thought to be of psychological origin, which may not respond to medication, and whose treatment is primarily psychotherapy. Of course, there are hybrid cases where both factors are involved.
Psychotherapy may be prolonged. Typically, the therapist seeks to uncover experiences in the client's past which may have impacted on one's emotions. Using various techniques, the therapist tries to correct faulty impressions and undo their effect.
While the majority of clients are satisfied with the results of therapy, there is still an appreciable number who feel that the therapy leaves something to be desired. Although the primary symptoms were relieved, they may complain of a poorly defined residual uneasiness if not frank depression, which does not respond to anti-depression medication. This may affect domestic and social relations as well as education and occupation.
While the presenting symptoms may improve, it is clear that the client is still not back to 100% emotional health, and the therapist realizes that there is little more he can do. He may begin to think of the client as having a personality disorder, albeit not well-defined. I found myself diagnosing many clients as suffering from "low self-esteem." In 1978 I wrote a book, Like Yourself, and Others Will, Too, aimed at improving one's self concept.
Conventional wisdom is that low self-esteem is generally due to poor parenting, i.e., failure of the parents to show adequate appreciation of the child, or deprivation of love due to circumstances, such as parental absence or illness. There are a host of negative occurrences that can cause a child to lose faith in oneself. Therapy may be able to reinterpret traumatic events and build self-confidence.
I tried my utmost to help people overcome their low self-esteem, but I was only partially successful.
However, I had to come to terms with my own low self-esteem. The problem here was that I could not point to any factors which I could incriminate as causative. I had a wonderful childhood, and my parents were extremely loving and caring. In addition, I had a nanny, a childless woman who "adopted" me and saw to it that I lacked for nothing. The sun rose and set on me. I was bright and succeeded at everything I did. I was a chess champion at age eight. I was specially promoted several times and graduated high school at sixteen. I should have felt on top of the world.
Instead, I felt I was unlikable. I had to do things that would make people appreciate me. I became a "people-pleaser." I did some crazy things to gain attention. My sensitivity was extreme. When I gave sermons on Saturday, I was dependent on the accolades from the worshippers. If they were not forthcoming, I was crushed. But the approval and recognition I received from my accomplishments gave me only momentary relief.
I graduated medical school with honors. I became director of the psychiatric department of the hospital I wrote many books, but nothing changed. The feelings of unworthiness ate away at my guts. This was an enigma, and there was nothing I could do to shake off this feeling.
At about age sixty, I came across a novel interpretation of a verse in Psalms (118:12) by Rav Simcha Zissel Ziev, a foremost mussar authority. Conventional wisdom is that the yetzer hara is a force created by Hashem to deter people from observing the Torah. The yetzer hara operates by tempting people to violate the Torah, and we must do battle all our lives to resist the wiles of the yetzer hara. Torah-observant people follow a life style of obedience to Hashem's dictates. One can rather easily identify the ideation wrought by the yetzer hara. When a person feels tempted to partake of non-kosher food, or to work on Shabbos, to steal, to have a forbidden relationship or to do anything that the Torah forbids, one can be aware that this is the work of the yetzer hara and one can utilize the Torah tools to resist it.
Rav Simcha Zissel's unique contribution is that in addition to tempting a person to violate the Torah, the yetzer hara may delude a person to think poorly of oneself. There is no frank violation of the Torah in this, and as with every delusion, one is taken-in by this false belief.
A poor self-image is the source of many evils. Rabbeinu Yonah says that gaavah, the worst personality trait, is a defense against a poor self-image. The person creates grandiosity to counteract his low self-esteem (Rabbeinu Yonah Al haTorah). The desire to control others is also the same. Having power over others may reduce the feeling of inferiority, and this is responsible for many marriage problems. Some people lie to inflate their ego.
Both underachievement and overachievement maybe due to low self-esteem. The underachiever lacks self confidence and resigns oneself to failure. The over-achiever seeks to prove that she/he can excel. Any grade less than 100% is taken as evidence of one's inability to perform properly.
There is a paradox of low self-esteem. Highly gifted people may have a lower self-esteem than less-endowed people.
Rav Simcha Zissel's insight explains this phenomenon. A person with meager personality strengths is not going to be given a whopper of a yetzer hora, whereas someone with great assets may be given a more powerful challenge. Hence, the more capable person may actually have deeper feelings of inferiority.
Personal achievements may not eliminate the pain of a poor self-image. One industrialist who was a pillar of the community, confided, "One wall in my house is covered with tributes and plaques. They mean nothing to me."
Indeed, the suffering we experienced and are commemorating on Tisha B'Av has its origin in a poor self image. The spies of Moses said, "We saw giants in Canaan, and we felt as tiny as locusts, and that's how we appeared to them." The Chiddushei Harim said, "The way you feel about yourself is how you assume others perceive you."
Simcha is essential for true avodas Hashem. The yetzer hara scores a major triumph by making a person feel unworthy, which deprives one of simcha.
A psychotherapist can help you deal with those reality factors that are causative of low self-esteem that I mentioned earlier, but he/she cannot help you in the battle with the yetzer hara. It is crucial that when you find yourself with feelings of unworthiness and inferiority that you remind yourself that this is the work of the yetzer hara to disable you. Use the sifre mussar to counteract this.
Always remember the words of the Talmud, "Beloved are the people of Israel, for they are described as the children of Hashem" (Pirkei Avos 3:18). The yetzer hara is at work 7-24-365 to make you forget this. Don't allow it to succeed. Pray to Hashem for His help in resisting the wile of the yetzer hara.
More divrei Torah, audio and video shiurim from Rabbi Dr. Abraham J. Twerski