The attitude that one has about oneself is known as self-esteem. It is probably formed very early in childhood and has far reaching consequences on how a person experiences the world. Although we are talking about self-esteem as a global concept people do usually evaluate themselves on several abilities such as: sports, academics, relationships, physical attractiveness, and so on.

Why would somebody evaluate themself?

Sedikides (1993) suggests that there are three reasons that people appraise themselves. Firstly they may want to have accurate information about themselves and so try to assess themselves. Secondly they may want to provide positive information about themselves in order to enhance how they feel. And lastly they may want to verify their existing beliefs about themselves.

The culture in which a person grows up has an important influence on what is considered important for self-esteem. For example: In collectivist cultures (such as in Africa and Asia) interpersonal relationships are stressed, while in individualistic cultures (such as the Western cultures) personal independence and material worth is stressed.

Effects of Self-Esteem

For the most part having a high self-esteem leads to positive consequences whereas having a low self-esteem has the opposite effect. This is a very simplistic statement and research suggests that there are many other factors that interplay with self-esteem to produce the consequences (Dubois & Tevendale, 1999).

Males with low self-esteem seem to be more inclined to express their anger outwardly when provoked. One might think that bullying is caused by having low self-esteem but research has shown that bullies typically have high self-esteem. Men who are prone to violence typically have a sense of superiority that their bullying behaviour "defends" when somebody disagrees.

An interesting feature of self-esteem is that it can become a self-fulfilling prophecy. We tend to choose situations and relationships that confirm our self-esteem. We also behave in a way that displays our self-esteem which elicits responses in people to confirm our belief.

Self-esteem influences how effective your immune system is. Having a very low self-esteem is related to a weakened immune system.

There is evidence that suggests that serotonin levels in the blood are related to self-esteem (Wright, 1995). Low self-esteem and low serotonin levels can be associated with impulsivity and aggressiveness.

Self-esteem and drug addiction

Low self-esteem seems to be a common theme in many addicts stories. Addicts and alcoholics often feel worth "less than" other people and excluded from society.

For many people their first experiment with drink or drugs gives them a sense of acceptance. Initially the drug might help the addict to be the life of the party, or the drink might help the alcoholic to "break the ice" with an attractive stranger in a cocktail lounge. The substance can give a false sense of power and control. While sober the addict may feel powerless over the world but when drunk or high he/she feels unstoppable and in control. Or the substance may simply numb out the emotional pain that addicts feel when sober.

Of course the effect of the drug quickly wears off and the addict is thrust back into mundane existance. The quickest way to feel powerful, sexy, and socially acceptable is to take another dose or drink. This may be a pathway to developing a psychological dependence on the substance.

Many addicts describe a sense of relief when they arrive in drug rehab and find a community of people that are accepting of them. The community in a treatment facility can be the sandbox for addicts to start learning about self-esteem and gaining a social identity that is not based on drink or drugs.

Changing self-esteem

Negative life experiences can have a negative impact on self-esteem. An addict entering detox is probably at the low ebb of life and can be expected to have incurred significant damages as a result of the addiction.

Ordinarily when our self-esteem takes a knock we use one of a multitude of mechanisms to regain it (Tesser,2001). We turn to our friends and loved ones for support, for example. An addict however is likely to have been using self-destructive mechanisms to bolster self-esteem and so might need to find new ways of gaining self-esteem as part of a drug treatment program.

Having a variable self-esteem can be quite damaging (Kernis et al, 1998) and so we should not seek to change self-esteem too quickly. The goal in treatment would be to maintain a steady improvement of self-esteem until it becomes appropriate and productive.

One way in which self-esteem can be improved by the therapist is to provide unconditional positive regard for the client. Even though the person's behaviour is unacceptable the individual is still evaluated positively and made to feel respected and accepted.

Self-esteem is not sufficient by itself to ensure lasting sobriety, but it will help the person to remain motivated in working a program of recovery after finishing drug rehab or alcohol treatment.