Low Self-Esteem of Psychotherapy Patients: A Qualitative Inquiry
van Zyl, Jacob D., Cronje, Elsje M., Payze, Catharine, The Qualitative Report
In this article the story of 11 male psychotherapeutic patients with low self-esteem is told within the context of the research process. The literature suggests that the concept of "self-esteem" has a significant influence on the way an individual experiences his/her world. Therefore, the meaning that the psychotherapeutic patients associated with negative and positive labels, as it relates to self-esteem, was examined using grounded theory. The main storyline is conceptualized as follows; negative suggestion from the patient's past leads to low self-esteem which is, within his emotional problematics and by means of a negative thinking scheme, unhealthily handled. Therapy from a medical hypno-analytical perspective is used to replace negative labels by facilitating the attachment of positive meaning to his self-esteem.
Key Words: Grounded Theory, Holism, Hypnotherapy, Labeling Theory, Meaning, Medical Hypno-Analytical Approach, Negative Labels, Positive Labels, Psychotherapy Patients, Qualitative Research, Self-Esteem, Self-Esteem Induction, Understanding
Self-esteem, which is the evaluative aspect of the self-concept, and therefore the evaluation of a person's own competence, is related to accepting and approving of one's own characteristics (Berk, 2003; Plug, Louw, Gouws, & Meyer, 1997), and greatly impacts individuals' attitudes, emotional experiences, future behavior, and long-term psychological adjustment (Berk; Branden, 1969; Judge, Erez, & Bono, 1998; Rugel, 1995; Williams, 2001). It actually influences the way in which each person experiences his/her world as well as his/her aspirations and decisions to be made during important life moments such as the choice of occupation and life partner and his/her functioning in the workplace as well as decisions to take certain risks to protect himself/herself against unnecessary threats.
This study supports the view of Rugel (1995) that low self-esteem, and that which can be deduced from it, often causes the basic problems leading to psychopathology. A low or negative self-esteem and related conditions in the patient form part of the root problems, which should be addressed by the psychotherapist. Rugel indicates that this view is not new and that it is also supported by the theories of Adler, Rogers, Sullivan, Ellis, and Kohut (as cited in Rugel). It can be stated that almost all persons suffering from psychological disturbances also suffer from low self-esteem.
In psychotherapy, a patient's self-esteem is not treated in isolation, the "whole self," including self-esteem, is treated. Related concepts such as "self-image," "self-concept," "self-understanding," the "ideal self," "body image," "self-presentation," and "self-actualization" (Plug et al., 1997) are involved in the process within the context of a particular patient's emotional problems, his/her expectations of therapy, and his/her clinical history.
A review of studies done in the field of self-esteem in South Africa indicate that room exists for a qualitative study in which the meaning patients associate with negative and positive labels, as it relates to self-esteem, could be examined. The review of literature showed studies in which self-esteem, as a concept in relation to other phenomena, had been studied in various scientific disciplines such as psychology, social work, occupational therapy, sociology, and nursing. All the studies mentioned here used quantitative research as a method, highlighting the need for qualitative inquiry on meanings of labels associated with self-esteem.
Recent quantitative studies on self-esteem, in the discipline of psychology, with regards to psychotherapeutic issues include those of Blumberg (2000) on the relationship between locus of control and the impact of traumatic events; Hattingh (1999) on the arts as a therapeutic medium; Riekert (1999) on cognitive behavioural therapy for adults who were molested; and Smith (1991) on the stigmatic effects of rape. …