I wanted to spend this part looking at the scientific literature as it relates to self-esteem. There are good tools for measuring self-esteem, such as the Rosenberg Self-Esteem Scale. Unfortunately, after reading twenty or more articles, I didn’t produce much useful information. For example, it was never clear how prevalent significant issues are with self-esteem on a global scale. Most of the studies were of Idiosyncratic groups, adolescents in Spain, women in Ethiopia, children in refugee camps, and etc. Several psychologists quoted one figure, that 85% of the general population has significant self-esteem issues. However, I could not find the source for that number and these psychologists never used it in their scientific papers but in articles they wrote for the public, such as on their practice web pages.

Even if I had found a well-supported number for people who suffer from low self-esteem, I’m not sure that would have been helpful for this article. I’m not trying to focus on people who have clinically low self-esteem, but the general population. I suspect that 100% of the population deals with this issue of self-worth in one way or another, and with a severity that is along a continuum, from insignificant to extreme.

I did find one research article, that seemed to conflict with one thing I said in my previous article, is that they estimated that people who lash out in violence toward others (I mentioned mass shooters in my previous article) did not score high on low self-esteem survey, but the opposite. They have an inflated sense of self-esteem, narcissistic if you will. A good example is the shooter in New York that went after black shoppers and the one in El Paso who went after Hispanic shoppers at a Walmart. Each touted a white-supremist perspective. While I accept that data, I think if you drilled down to a Freudian level, you would find that the heightened sense of self-worth is a compensation for a chronic low self-esteem. But I digress by discussing a small group that is not that relevant to my general point.

None of us are perfect, in body or mind. Most of us, I believe, have those secret places of doubt about our worth. I will list things that most of you will have struggled with at periods in your life.

1. Imperfect bodies. Some have a genetic pre-disposition for obesity. It is a life-long struggle to try and stay slim in a society that values slimness. Some have other features that don’t fit the societal standard for attractiveness.
2. Even if you were born with a good body, according to how society measures it, time takes that away. Wrinkles, flabbiness, and baldness or gray hair. I heard a story on NPR about an actor in Hollywood, who was getting past her prime (turning 50). One day on the Santa Monica Boulevard she was speeding in her little sports car. A police officer pulled her over. She was a habitual speeder but had never had a ticket because as soon as the officer would recognize her, and she would flirt with them, the officer—being so enamored—they would just give her a warning. But on that day, the young officer didn’t recognize her and her flirting, pulling up her skirt to expose her tight, had no effect. She got a ticket. She said she then went home and got drunk and stayed drunk for the next twenty years. I think self-esteem issues may peak with adolescence and as we enter the mid-life epoch of our lives.
3. Most of us were never as successful in business and earning money as we had hoped.
4. Some of us were never as successful as a parent as we had hoped.
5. In the areas we usually measure ourselves by, appearance, talents, work ethic, and good character, and intelligence, we have not lived up to our ideals.
6. Everyone has a lengthy list of failures that we carry. Failures in relationships, marriages, careers, and other areas.

In our self-evaluation of worth, comparisons with others become a key tool that we use, for better or worse. The problem with that tool is that we only see the best side of others, just as we are prone to only showing our best sides in public. This is one area that a Hidden Brain episode concluded that if we were most honest about our failures, we would mute the harshness of these comparisons.

There is another type of low self esteem called “The Imposter Syndrome.” Hidden Brain episode addressed this well. This is where you feel like an imposter, if people knew who you really were in your private life, they would not like you. That you don’t deserve any praise that you may receive.

I took a position at Mayo Clinic in Rochester, Minnesota in the 1990s. It was by far the greatest job I ever had. I was the only full-time headache specialist within the department of neurology. US News and World Report ranked our department as the number one neurology practice in the world. My physician colleagues, world experts in their respected field, treated me like a colleague and with enthusiastic respect.

Being Mayo Clinic, our patients came from all over the world. Many of them were CEOs, political leaders in their countries, wealthy, and famous. One day I had a famous actor on my schedule. The chair of our department asked my boss to see the patient rather than me. My boss told him that I offered the very best care for headaches within Mayo Clinic, and he was not going to remove this famous person from my schedule. This chair, a multiple sclerosis specialist and with limited knowledge about headache disorders, ended up seeing the patient.

While working in that environment, I began feeling like I was a fraud. I drove an old car, lived in a simple house, dressed in used clothes that didn’t quite fit me right. I was the sole breadwinner (at first) for a family of seven and didn’t live anywhere near the standard of my physician colleagues. I felt I did not deserve this praise with the thought, “If they only knew who I really was.”  With rich and famous patients often filling my schedule, I began having panic attacks. I could control them most of the time, but I remember once having to abruptly get up and leave a patient in the room, walking the corridors until I could get my breathing under control.

This imposter syndrome shines a light very clearly on this battle of self-worth. Can you relate to this?

Mike

(not proof-read)