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THE AUSTRALIAN JOURNAL OF CLINICAL HYPNOTHERAPY & HYPNOSIS Volume 34 Number 2 Spring 2012
19
Janine Fraser
Counsellor and Clinical Hypnotherapist. Aliate of Macquarie University, Sydney.
Abstract:
This article will address four misconceptions about self-esteem including issues around change,
performance, relationships and the use of armations. It will discuss how hypnosis can be used
to help build healthy self-esteem in clients by individualising your approach to meet the client’s
needs. Finally, how homework can be utilised as an experiential metaphor to provide the client
with a deeply eective experience to propel further change will be discussed.
Introduction
Self-esteem refers to how a person feels about his or her self. Self-esteem is
based on perception, not reality, and it can change according to situations and
time. According to Sociometer theory, the degree of self-esteem a person has
depends on how they think they are valued and accepted by others (Leary,
2005). Many people think that high-self esteem is good, and low self-esteem
is bad, but that is not necessarily the case. For example, a person with high
self-esteem may think they are intelligent, capable or witty, even if there is
evidence to the contrary (Baumeister, Campbell, Krueger & Vohs, 2003). It
has even been suggested that Adolf Hitler had high self-esteem (Baumeister,
1993), but that didn’t make him a nice person. At the other end of the scale,
a person with low self-esteem may be a good person, and be self-critical
or eected by the criticism of others. Whether the cause or consequence
of problems, self-esteem is strongly related to happiness and one of the
strongest predictors of life satisfaction. is is why it is an important issue
for hypnotherapists to address in their clinical practices. e aims of this
article are to:
t Identify and address some common misconceptions about self esteem
t Develop and provide ideas on how information about self-esteem can
be adapted for hypnotic use
t Provide examples of how to bolster self-esteem within, and between,
appointments.
Using hypnosis to help build healthy
self-esteem in clients
20
Misconception 1: Self-esteem Doesn’t Change
Everyone has self-esteem, with individual dierences on a scale of low to
high. However, self-esteem is not innate; it is learned and developed, and
it keeps changing throughout your lifespan (Baumeister, et al., 2003). e
development of healthy self-esteem can be impaired by a number of factors.
For example, the temperament an individual is born with contributes to
their response style and the emotional reciprocation they receive, thereby
inuencing the nature-nurture balance (Laible, Carlo & Roesch, 2004).
Individuals with a history of abuse and fearfulness are more likely to have
low self-esteem than their peers (Emler, 2002). is is because the self-esteem
doesn’t develop in a healthy way throughout the childhood. Also, life events,
such as interpersonal rejection, can decrease self-esteem that was previously
at a reasonable level (Leary, 2005). rough out the lifespan, when feedback
is received from events and people in our lives, self-esteem is increased or
decreased accordingly (Leary, 2005). Given a nurturing environment, low
self-esteem can be increased. For example, an Olympian is not born with
more self-esteem than you or anyone else, but they may use their talent and
encouragement they receive, to increase their self-esteem. It is important to
convey to clients the message they can feel better about themselves.
Misconception 2: High Self Esteem Leads to Good Performance
Several decades ago, many teachers and parents believed that high
self-esteem would lead to good performance in their children. is belief
fueled a movement in the 1970’s and 1980’s to improve self-esteem with
positive statements and praise about a child’s abilities (Baumeister, et al.,
2003). For example, parents and teachers would create environments where
there was no competition; therefore, children could not lose. ey would
make recurring statements such as “you can do anything you set your mind
to” (whether or not the child had talent or ability in that particular task).
ese sort of activities could go one of two ways for the children: they could
either make the child feel worse about themselves due to real or imagined
failure in the given task, and as a result, be counterproductive. Alternatively,
they could give the child an inated self-esteem that is not based on reality,
which is particularly unhelpful if accompanied by being over-indulged.
In adults, self-esteem towards tasks works a little dierently. Studies have
failed to show that high-self esteem improves performance; although, they
have shown that high-self esteem is related to persistence and perseverance
in the face of failure (Baumeister, et al., 2003). At the other end of the scale,
people with low self-esteem are more likely to give up quickly if the gap
between their reality and the desired outcome is too large. erefore, it is
Using hypnosis to
help build healthy
self-esteem in clients
THE AUSTRALIAN JOURNAL OF CLINICAL HYPNOTHERAPY & HYPNOSIS Volume 34 Number 2 Spring 2012
21
vital for the clinician to improve the perseverance of individuals with low
self-esteem by setting achievable tasks or using suggestions as stepping-
stones, before setting a more challenging task.
Misconception 3: Positive Self-Statements Can Improve Self-Esteem
Following on from Misconception 2, self-help books, movies and new-age
advocates are rife with “think positive” advice. It has long been thought
that positive self-talk (i.e. armations) can improve mood and increase
self-esteem. However, the evidence supporting armations is mixed. ere
is evidence suggesting that positive self-statements can backre and be
detrimental to people with low self-esteem, making them feel worse (Wood,
Perunovic, & Lee, 2009). is is due to the disparity between self-concept
and self-statement. Other research indicates that introducing smaller
increments of self-statement reduces the disparity between self-concept
and self-statement, thereby minimizing any harmful eects (Hames, 2011).
e reason this is mentioned is to highlight the fact that if the clinician
overestimates the client’s ability, they can unintentionally set the client up
for failure. erefore, smaller steps and increments of self-statements are not
only useful, but also necessary to build healthy self-esteem.
Misconception 4: High self-esteem predicts good relationships
Many people think that people with high self-esteem have many positive
traits. ese people are perceived as more attractive and more likeable than
people with low self-esteem (Baumeister, et al., 2003). If they were actually
more attractive and more likeable, then it would logically follow that high
self-esteem would predict better relationships than low self-esteem. However,
people with high self-esteem are more likely to behave in conceited ways or
superior ways (Baumeister, et al., 2003). Given enough time, they can drive
partners away or leave relationships for the promise of a better relationship.
Furthermore, when another person threatens their self-concept, an
individual with narcissistic self-esteem can become aggressive and retaliate
(Baumeister, Bushman, & Campbell, 2000; Heatherton, & Vohs, 2000). On
the other hand, people with low self-esteem are also at risk of acting in
ways that are detrimental to relationships (such as mistrusting partners or
phone snooping). However, studies have not shown any dierences between
self-esteem and the quality or the duration of relationships (Baumeister, et
al., 2003). When predicting relationship outcomes, there appears to be an
even playing eld for individuals with both low and high self-esteem.
When using hypnosis to help build self-esteem, the hypnotherapy
session can be divided into ve stages. Table 1 below contains a
22
general outline of a strategy that can be adapted to meet your client’s
unique needs and interests while initiating changes to self-esteem.
Table 1
General Strategy for building healthy self esteem
Stages Perceived Outcomes
Stage 1:
Expectancy
Conversationally in the pre-talk, suggest
indirectly that self-esteem is exible, that
it changes over time, and depends on the
context. is builds the expectation that the
client can experience a change.
Stage 2:
e ‘yes set’
Use the induction to build on stage 1 by
oering similar messages in the form of ‘yes
sets’. ese can be used to build agreement
and momentum towards the goal.
Stage 3:
Metaphors
Use metaphors that are aligned with the
client’s experience to further build the idea
that the client can feel better about himself
or herself.
Stage 4:
Posthypnotic Suggestions
Use posthypnotic suggestions to orientate
the client towards positive future
possibilities.
Stage 5:
Homework
Use experimental metaphors between
appointments to encourage the client to
use or develop new resources, promote new
behavior, and challenge their thinking.
Application
e general strategy for applying hypnosis to help a client with low
self-esteem involves ve stages. ese stages are described as follows, and
can be repeated from session to session.
Stage 1 involves building expectations. e therapist suggests that while
self-esteem comes from the client’s history, their current level of self-esteem
can change and can improve. In fact, their self-esteem can vary from day
to day, and time to time. Some days a person can feel so much better about
him or her self than other days. Also, self-esteem can change depending on
the company someone is with, or the task being performed. For example,
Stephanie Rice (or Ian orpe) was not born with more self-esteem that
Using hypnosis to
help build healthy
self-esteem in clients
THE AUSTRALIAN JOURNAL OF CLINICAL HYPNOTHERAPY & HYPNOSIS Volume 34 Number 2 Spring 2012
23
anyone else, but they have a talent that was nurtured, and it was this talent
that was used to build their self-esteem.
Stage 2 involves an induction. While any induction can be used, the ‘yes set’
induction can be directly tailored to build upon the self-esteem theme using
truisms. e truisms can lead towards more specically tailored suggestions
that are presented in the metaphor or metaphors. Rather than mentioning
self-esteem directly, address concepts indirectly, such as ‘pride’ or a ‘sense of
identity’. For example:
“Everyone has a sense of what they are like . . . and what they aren’t like . .
. sometimes they are right . . . sometimes they are not . . . there are people
who feel good about themselves . . . and others who put themselves down
. . . criticizing things . . . other people don’t even notice . . . and there
are people who know what they can do well . . . based on their personal
experience . . . or their accomplishments . . . and people who learn to do
things better . . . through trial and error . . . or practice makes perfect . . .”
Stage 3 involves oering hypnotic metaphors that include a specic message
for the client. Rather than oering specic examples, you could focus on
aspects of self-esteem, such as feelings of pride and accomplishments. is
can be done by either giving specic examples, or by being more permissive
and allowing the client to choose their own examples. Ideally, two or more
metaphors would be used. e following examples are two metaphors that
can be adapted to meet the client’s needs:
Metaphor 1. Self-esteem can be changed.
“Perhaps you can imagine inheriting or buying a house. e house might
be just right when you move in . . . but more likely than not . . . you may
want to change it . . . the thing to remember, is that . . . what you start
with . . . can change over time . . . if you have (inherit or buy or move
into) a house that doesn’t meet your needs . . . you can change it. You
can redecorate . . . or paint the walls, the ceilings . . . you can replace the
carpets and the drapes . . . you can renovate . . . And you may notice that
some houses need more work . . . and others need less . . . perhaps an
extension . . . an ensuite . . . a new kitchen . . . or bathroom . . . some may
need more room above . . . building up . . . adding a level . . . or build down
. . . a cellar . . . for storage . . . or space . . . or add a wing out the back . . . or
even a pool . . . renovations which may require good strong foundations . . .
on which to build. You can . . . pour or build or . . . create strong foundations
. . . made of concrete, brick or steel . . . good solid . . . strong . . . foundations
. . . so why not . . . strengthen those foundations . . . in what ever way is most
24
meaningful to you . . . so that you build a something . . . that brings you
pleasure . . . joy . . .? So go ahead . . . create a space that is pleasing to you . . .
something that gives you pride . . . go ahead . . . renovate . . .”
It is likely that more than one metaphor or message will be useful for the
client to help them move in a new direction. e house metaphor is useful
for many purposes. It can be tailored to a specic interest of the client and it
can lead to other useful messages, such as healthy boundaries and personal
growth. For example, the following is an extract of a metaphor developed
for a gardener who was depressed and had low self-esteem, and whose
relationship had recently ended.
Metaphor 2. Self-esteem can grow.
(Preamble about gardens and seasons) “it’s cold outside . . . not so much
to see or do . . . but winter is that time for a gardener to build up the soil
and nourish the garden . . . it’s winter when you prepare . . . plants . . .
crops . . . new seeds . . . and it’s winter that provides those quiet times . . .
that prepare you so well for spring . . . it’s hard to know when spring will
come . . . if it will be a day . . . a week . . . or longer . . . but soon . . .”
Stage 4 is the posthypnotic suggestions. Use posthypnotic suggestions to
orientate the client towards positive future possibilities. is is also known as
future orientation, or future pacing. In traditional posthypnotic suggestions
a hypnotherapist uses the “when X, then Y” format. When working to build
healthy self-esteem, suggestions may need to be modied into steps rather
than leaps. For a client who thinks they are unlovable, using the suggestion
“you are loveable” may backre, as the client might reject it as unrealistic,
thereby reinforcing previous failures that lead to low self-esteem. However,
introducing “you are learning” before the suggestion (e.g. “you are learning
to feel better about yourself ”) can assist the client to move in the direction of
the goal. e following is an example of posthypnotic suggestions, or future
orientation, used within the hypnotic metaphor. You will notice, this follows
on directly from the previous extract:
Posthypnotic Suggestions. e future can be better.
(Follows on from previous metaphor) “. . . very soon . . . spring will be
here . . . and with it . . . the thaw . . . and then the new growth . . . more
activity . . . more warmth . . . new life . . . and as the weather warms up . .
. and things begin to thrive . . . and get better . . . one day at a time . . . and
you can enjoy more periods . . . longer periods . . . of feeling good . . . and
growth can be easier . . . and easier . . . more exibility . . . more variety .
. . through the lush growth of spring . . . and when winter is long behind
Using hypnosis to
help build healthy
self-esteem in clients
THE AUSTRALIAN JOURNAL OF CLINICAL HYPNOTHERAPY & HYPNOSIS Volume 34 Number 2 Spring 2012
25
you . . . you can leave your garden and head for the surf (or other activity)
once more . . .”
Stage 5 is homework assignments. Homework assignments are a form of
experiential metaphor that can be used therapeutically to help a client with
low self-esteem. Homework is known to improve clinical outcomes (for
review, see ase & Callan, 2006). Homework assignments can be used
to indirectly generate a response within the client. ey can give the client
opportunity to use or develop new resources or skills; promote new behavior;
challenge their current thinking; or provide them with an opportunity for
new self-awareness.
In the following example, while working with a depressed client with two
small children, the focus of the appointment was to develop strategies
around ‘planning’. Before having children, she had a successful career as an
operations planner in a production factory. Yet, her strength had become
her weakness as a result of changes and events in her life. Due to lack of
planning, her behavior appeared erratic and without thought, which was
causing considerable emotional and nancial distress to her family; the
children were becoming dicult due to the lack of structure and interaction.
To tell her, in or out of hypnosis, to “get into a routine” or to “be a better
Mum” would have broken rapport and the suggestion would have been
rejected. Instead, she was given an experiential metaphor as a homework
task, as follows:
Example of an experiential metaphor.
e task was to watch the sunset each night through the holes in the
handles of a pair of scissor. e meaning of the task was ambiguous in
nature. erefore, the client would have to generate her own meaning.
At the next appointment, a month later, the client reported that a new
evening routine with the children had been established, she was organised
in the house, planning activities and outings, and feeling a lot better. In fact,
she reported that for the rst time in four years, she had sat with her husband
on Friday night and watched a movie.
When asked what the homework assignment had been about, she replied,
“It’s all about focus. Focus that the sun is going down, it’s time to get into
a night-time routine and get these kids organised”. Interestingly, she had
also become more structured in her daytime routines - she started planning
activities that were within her budget rather than impulsive activities that
were extravagant or poorly timed. Her new behavior reduced the stress
within the family, reduced spending, and led to improvements in her
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relationship with her husband.
is homework assignment provided her with a far more intense experience
than what could have been achieved by telling her to “get organized”. e
scissor activity matched her “out there” self-perception; it provided an
opportunity to confront her pattern of doing things without questioning why
she was doing them; it put her in touch with her strengths, and it boosted
her self-esteem. It also allowed her to integrate changes into her life easily,
without any need for analysis or self-criticism.
While optional, homework assignments that are based on direct experience
are a powerful tool to build self-esteem. ey can be designed to stretch the
client outside of their comfort zone; thereby increasing the value the client
places on the therapy (Lynn & Sherman, 2000). Ambiguous homework tasks,
where the client has to generate their own answer, ensure success (unless
the client doesn’t do them) and can, therefore, be used to build self-esteem
(Yapko, 2003). ey can be matched to the client’s personality, beliefs, or
situation, and they can successfully assist building the client’s self-esteem.
Conclusion
In conclusion, well-meaning clinicians can set their clients up for failure by
over estimating their capabilities and making suggestions that are outside
the client’s range of acceptance. Or, they can set the client up for success by
tailoring their approach to suit the client. When working with clients with
low-self esteem, it is vitally important to match all phases of the therapy
to the client’s experience. e theme, “self-esteem can change”, should be
incorporated into the pre-talk, induction and metaphors. If tailored to
meet the client’s personal experience, interests and current situation, can
be used build the message and theme. Posthypnotic suggestions provide
the opportunity for future orientation. Experiential metaphors can be used
between appointments to enhance learning, and to provide the client with a
direct experience at a deeper level than therapy can provide.
Self-esteem predicts depression, anxiety and a number of psychological
problems. Increasing people’s self-esteem does reduce these risks. Self-esteem
is strongly linked to happiness and life satisfaction. Individualizing treatment
strategies will have a signicant impact on how well clients respond to
therapy, and how change occurs in the client’s life.
References
Baumeister, R. F. (1993). Self-esteem. New York: Plenum Press.
Baumeister, R. F., Bushman, B. J., & Campbell, W. K. (2000). Self-Esteem, Narcissism, and Aggression Does Violence
Janine Fraser is
a counselling
hypnotherapist in
Baulkham Hills, Sydney.
She is well known
in hypnotherapy in
Australia thanks to her
past service on the
Board of the Australian
Society of Clinical
Hypnotherapists,
and current position
as assistant journal
editor for this
journal. She teaches
Ericksonian hypnosis
and supervises other
hypnotherapists.
She holds a Dip and
Ad. Dip of Holistic
Counselling, a Dip of
Clinical Hypnotherapy
and recently has
completed a Bachelor
of Psychology at
Macquarie University.
Using hypnosis to
help build healthy
self-esteem in clients
THE AUSTRALIAN JOURNAL OF CLINICAL HYPNOTHERAPY & HYPNOSIS Volume 34 Number 2 Spring 2012
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Result From Low Self-Esteem or From Threatened Egotism? Current Directions in Psychological Science, 9, 26-29.
doi: 10.1111/1467-8721.00053
Baumeister, R. F., Campbell, J. D., Krueger, J. I., & Vohs, K. D. (2003). Does high self-esteem cause better performance,
interpersonal success, happiness, or healthier lifestyles? Psychological science in the public interest, 4, 1-44. doi:
10.1111/1529-1006.01431
Emler, N. (2002). The costs and causes of low self-esteem. Youth Studies Australia, 21, 45-48.
Hames, J. L. (2011). Can Smaller Steps Lead to Greater Progress?: Testing the Eects of Two Types of Positive
Self-Statements on Self-Esteem and Mood. Electronic Theses, Treatises and Dissertations. Paper 4309. Retrieved
from http://diginole.lib.fsu.edu/etd/4309
Heatherton, T.F., & Vohs, K.D. (2000). Interpersonal evaluations following threats to self: Role of self-esteem.
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Laible, D. J., Carlo, G., & Roesch, S. C. (2004). Pathways to self-esteem in late adolescence: The role of parent
and peer attachment, empathy, and social behaviours. Journal of Adolescence, 27(6), 703-716. doi: 10.1016/j.
adolescence.2004.05.005,
Leary, M. R. (2005). Sociometer theory and the pursuit of relational value: Getting to the root of self-esteem.
European review of social psychology, 16, 75-111. DOI:10.1080/10463280540000007
Thase, M. E., & Callan, J. A. (2006). The role of homework in cognitive behavior therapy of depression. Journal of
Psychotherapy Integration, 16, 162. doi: 10.1037/1053-0479.16.2.162
Wood, J. V., Perunovic, W. E., & Lee, J. W. (2009). Positive Self-Statements Power for Some, Peril for Others.
Psychological Science, 20, 860-866. doi: 10.1111/j.1467-9280.2009.02370.x
Yapko, M. D. (2003). Trancework: An introduction to the practice of clinical hypnosis. Routledge.