One begets the Other: The Importance of a Child’s Self-esteem for Good Mental Health
Ryeng, Korger and Martinussen(2013) define self-esteem as an emotional evaluation of valuing our self-confidence, knowledge of own potentials, the capacity to accept mistakes and good sense of individual limitation. High level of self-esteem is related with joy, life satisfaction, physical fitness and positive mood.(Dubois &Tevendale, 1999). Hence, love and self-esteem are the basic fundamentals of good health.
Mental illness is a condition that causes serious disorders to thinking, behavior and how one interacts with people. Mental health problems develop into mental illness when individuals don’t cope effectively (“Mental illness”, p.2). Whereas low self-esteem develops when individuals start devaluing their self; feeling of being unloved and negative thoughts about one’s life.
During mental health clinical rotation, I interviewed a patient aged 14, with the complaint of catatonic schizophrenia. She was not able to move or respond and her speech was limited. Discussion revealed that she experienced reduction in her daily activities after an accident. Three months back she injured her left foot.
Upon history taking I came to know that she belonged to a middle class family and her father had a strict behavior while her family had conflicts. She verbalized that she had been physically abused by her father and also peer-victimized. Her fellows discussed negative things like friendships with boys etc. Consequently she withdrew herself from her peers, and kept herself socially isolated, festered an aggression towards her siblings and parents which was a start of substance abuse (Chalia). She got low self-esteem and tried to attempt suicide as she thought that she was a low performer as compared to other siblings who always got positions academically.
This entire situation indicates that during development of self-esteem and self-identity in adolescence, parent-child relationship is an utmost factor. In our culture, the main issue arises during this period as parents always compare their child with others. When children evaluate their competences and skills they might feel inferior. They develop negative self-esteem and negative thoughts towards themselves. As a result, maladaptive outcomes could be observed like depressed mood, more vulnerable to psychiatric problems and a decrease in creative skills.
In developing psychopathology, a number of risk factors and causes are considered. During adolescence, child starts to spend most of the time with his/her surroundings such as with peer group, family members in home and school (Lin et al.,2008). During this duration, if an individual encounters difficulty with relationships such as parent-child relationship, peer relation, low academics performances, socio-economic status, lacking trust in one’s self, unhealthy life style choices, depression, violence, substance abuse, major life stressor and stigma to mental illness, then they develop a low self- esteem. All these issues lead to worsening of the mental and physical wellbeing (Donnellan, Trzesniewski, Robins, Moffitt & Caspi, 2005).
As it has already been discussed that the subjected patient belonged to a low socio-economic background and was having major life stressors from her family and peers. Although she was not a low performer in her academics but in comparison with her sibling she was not able to maintain good grades. Basically three main outcomes are observed; firstly internalizing of trouble includes anxiety and depression; secondly, external problems include hostility and aggression; thirdly, unsafe health behaviors like substance abuse (Mann, Hosman, Schaalma& de Vries, 2004). As in my patient’s case, her parents don’t compare their daughter with others directly, but she faced similar issues.
Her father expected her to be as active as other siblings. In our society, pessimistic stereotype, misunderstanding, myths and people’s behavior towards mental illness directs individuals to self-stigma and social isolation, which causes disruption in career of victim and family (“Mental illness”, p.4). Before psychiatric problem the patient was very creative in art and sketching, but over time her skill decreased and she started substance abuse (Chalia).
Lin et al.(2008) describes that an inappropriate family functioning and family disputes in society have a major role in developing depression among adolescences. Furthermore, depression is parallel to low self-esteem. The subjected patient also faced such family conflicts and she looked depressed and mute.
Maslow’s hierarchy of needs is based upon basic requirement of humans which describes different levels. In its 4th stage self-esteem needs and self-concept is discussed. He classified it into lower and higher levels. Respect, identification, appreciation, dignity, status and attention counts in lower while in higher level, self-respect, such as feeling confident, freedom, achievement and mastery are included.
Inferiority and low self-esteem are caused when these are not fulfilled. Therefore, person exhibits behaviors like withdrawal, feeling incomplete, not compatible, and depressed, negative self-image, feeling inferior and taking interest towards negative events of life (Boeree, 2006). Connecting these scenarios with the subjected patient who lacks confidence, is unable to achieve good rewards from parents as well as friends, and always feel inferior to her siblings.
Moreover, low self-esteem has negative impact on one’s life. To avoid such effects, we should teach coping strategies to patients and family to maintain self-esteem. As a student nurse it is our duty to encourage patients to verbalize fear and concerns, maintain therapeutic communication and also reinforce strengths. Positive self-concept and behavior helps to cope up with impact of negative influences.
Reinforce positive self-evaluation to deal with life’s challenges. When people encounter mental illness, they should give holistic care, give counseling, CBT and involve them in group activities so that they get opportunities to interact with others. Involve patients to set a goal and focus on it. As my patient was fond of art and drawing,we will encourage her to participate in similar activities. When they encounter negative thoughts then teach a technique, such as saying aloud, ‘‘stop and go away’’.
On family level, educate the family to give social support, teach them to value their child, and give unconditional positive regards. The best way is to spend more time with kids so that they feel secure (Young & Hoffman,2004). When patients get social support they are more likely to reduce factors like self-stigma, loneliness and hopelessness. At the community level policies should be made that discourage bullying at school level, conduct awareness sessions on promotion of mental health to clear stereotypes and myths related to mental illness.
In conclusion, self-esteem is an important factor in one’s life for healthy survival. Due to devaluing self, one feels inferior and this insecurity leads to negative self-esteem. Thus a person ends up with social isolation, aggression, self-stigma and hopelessness. To avoid these consequences and to build positive self-esteem and identity we should focus on different interventions discussed above.
Boeree,C.G.(2006).Abraham Maslow. Retrieved from
Donnellan, M. B., Trzesniewski, K. H., Robins, R. W., Moffitt, T. E., &Caspi, A. (2005). Low Self-Esteem Is Related to Aggression, Antisocial Behavior, and Delinquency. Psychological Science. doi:10.1111/j.0956-7976.2005.01535.x
Dubois, David L., and Heather D. Tevendale. ‘Self-Esteem In Childhood And Adolescence: Vaccine Or Epiphenomenon?’. Applied and Preventive Psychology 8.2 (1999): 103-117.
Lin, H., Tang, T., Yen, J., Ko, C., Huang, C., Liu, S., & Yen, C. (2008). Depression and its association with self-esteem, family, peer and school factors in a population of 9586 adolescents in southern Taiwan. Psychiatry and Clinical Neurosciences. doi:10.1111/j.1440-1819.2008.01820.x
Mann, M. ‘Self-Esteem In A Broad-Spectrum Approach For Mental Health Promotion’. Health Education Research 19.4 (2004): 357-372.
Ryeng, Marianne S., Jane Kroger, and Monica Martinussen. ‘Identity Status And Self-Esteem: A Meta-Analysis’. Identity 13.3 (2013): 201-213.
Stapinski, Lexine A. et al. ‘Peer Victimization During Adolescence: Concurrent And Prospective Impact On Symptoms Of Depression And Anxiety’. Anxiety, Stress, & Coping 28.1 (2014): 105-120.
Young, E. L., & Hoffman, L. L. (2004). Self-esteem in children: Strategies for parents and educators. National Association of School Psychologists, 85-90.
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