Christian Jonathan Haverkampf, M.D.

Abstract – Many people suffering from depression or other mental health conditions feel that low self-confidence is at the root of many of their problems. Self-confidence is primarily a feeling, and while it is usually a signal or symptom of the underlying condition, it can be a valuable topic in psychotherapy in its own regard if part of a more complete treatment approach.

Low self-confidence is a result of a disconnect with oneself, which can be countered effectively with improved communication with oneself and others. Objectives in therapy can be to build a better sense of self and greater efficacy in communicating with others. In most cases, this resolves the patient’s preoccupation with self-confidence and helps to get a greater sense of confidence in interactions with others, ultimately making self-confidence a ‘non-issue’.

Keywords: self-confidence, psychotherapy

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Introduction. 3

Direction. 3

Self-Belief 4

Self-Image. 4

The Perceived Lack of Self-Confidence. 5

Disconnection from Oneself and the World. 5

Values, Interests and Aspirations. 6

Imagination. 6

‘Doing’ Self-Confidence. 6

Changing Focus. 7

Happiness. 7

References. 9


Self-Confidence is quite simply a feeling of having confidence in one’s interactions with others and with oneself. It is often part of feeling more secure about the world and oneself. Particularly in patients with difficult attachment patterns in the past, self-confidence can help feel safer in the world. Thus, self-confidence as a theme can be quite helpful in therapy, as long as it is not seen as a separate psychological entity or the root of the patient’s problems.

Self-confidence is often seen as the holy grail of psychotherapy in the belief that the right amount of confidence in oneself will help the patient to overcome depression and anxiety virtually automatically. More confidence in oneself, of course, helps people in many situations in life, and also provides an emotional lift, which is desired in many mental health conditions. This also requires building a better feeling about oneself generally. The way to get there is through adaptations to the thought and communication patterns, which then usually translates into better feelings about oneself and the world in general. This also makes the view of the future more positive, which can provide additional motivation.

Self-confidence can also alter the motivation to engage in activities. It has even been shown in strategic communication games that self-confidence can lead to greater, and in cases of overconfidence also to lower, welfare (Bénabou & Tirole, 2002). In sports, a meta-analysis has revealed that both cognitive anxiety and self-confidence are significantly related to competitive sport performance. (Woodman & Hardy, 2003)

To find more self-confidence, the first steps are to find out what is truly meaningful and valuable to oneself, because this connects one with the part of oneself which remains relatively stable over time, can elicit positive emotions and connects one with a better vision of the future. Most importantly, however, it provides an opportunity to connect more firmly with oneself, which provides a better sense of oneself and better reasons to confide in oneself. This approach has been described more specifically in works on communication-focused therapy (CFT) which has been developed by the author and described in the treatment of depression (Haverkampf, 2017b), anxiety and panic attacks (Haverkampf, 2017a), social anxiety (Haverkampf, 2017d), OCD (Haverkampf, 2017c) and many more. Unfortunately, communication processes are not as much a focus for therapy as one would like.


While it is true that higher confidence in one’s ability to get somewhere increases the sense of control and self-directedness, knowing where one is going is important as well. If where you are going is an extension of your values, you will also have more self-esteem, because you feel more valuable about yourself. What is valuable is usually explored and discovered through one’s interactions with the environment. (Haverkampf, 2010)

Often, patients suffering from burnout, reactive depressions, and other conditions which are triggered by difficulties with the environment, particularly the workplace and a relationship, have lost the sense of a meaningful direction. Objectives and goals are merely reduced to keep functioning, while aspirations for the future become blurry and are deemphasized in the efforts to avoid the pain of having expectations that cannot be met. The problem, however, is not that one has expectations and aspirations for the future, but that one loses track of what is valuable and meaningful to oneself. Even the idea of thinking about one’s own wants and needs becomes painful, leading to a tendency to shy away from the question altogether.


Central to the feeling of self-confidence is the capability for self-belief, what an individual believes about the own abilities and attributes. Biology has an influence on feelings and emotions, but how one feels about oneself is also determined by the messages one gets from the environment one lives in. The interactions with the parents, at school, college and in the workplace, as well as the messages received from the media, for example, have a large influence on the beliefs people hold about themselves.

Self-belief can make a difference. In a study on gymnastic programs, it was that self-concept and performance are both determinants and consequences of each other. (Marsh, Chanal, & Sarrazin, 2006) However, in a study on self-belief in novice surgeons the effect seemed to be smaller or non-existent. (Maschuw et al., 2008) Some of the differences may be due to the very different activities and settings. In any case, while self-belief might be more helpful in everyday life in some situations than in others, it is beyond doubt that it does have an effect on people’s sense of mastery over their own life, which can have an effect on the decision which activities to engage in and on the quality of their lives in general.

Mental health conditions can have an influence on one’s mood, which also impacts how one feels about oneself, as well as on the information one gets about oneself. Depression and other mental health conditions can lower one’s sense of self-efficacy and the ability to pursue one’s values and interests. In rarer cases, they can also lead to an inadequately high sense of self-belief and self-confidence, as in the case of mania where one might feel able to change the world in a day or be invincible.


The image one has about oneself is really a collection of perceptions, as well as a sense of the information streams in one’s brain. The latter part may sound strange, but our sense of self is largely how we perceive the information streams in ourselves. Since communication is the underlying mechanism that maintains life, the ability to reflect or have a sense for the communication processes inside oneself, as well as in one’s interactions with the world, is what gives humans a sense of self and agency.

The information about one’s personality, character traits, values, talents, and so on comes out of the information one receives about oneself, particularly emotions and the feedback from others. But also, the knowledge one has about things, whether acquired autonomously or from others, contributes to one’s own judgment on how one compares at a task. Mental health conditions, such as depression, can alter one’s judgment by making it more biased to the end of the negative spectrum, while a manic state could tilt it to the unhelpful positive side. The self-image is thus less a collection of objectifiable facts than an aggregate of feelings and emotions, themselves aggregates of vast amount of information, with some perceived facts thrown it. To improve the self-image thus requires working with various information sources, and even more importantly, the feeling about the feelings, one’s reflection of the flows of information and their sources.

The Perceived Lack of Self-Confidence

Many people believe they lack self-confidence. They often see it as a reason for their problems and their inability to lead happy and fulfilled lives. This means they perceive a deficit, the feeling that something important is lacking, even if they cannot identify what it is. The deficit is often seen as a significant hindrance in one’s life, a reason why one cannot attain his or her goals in life. Interestingly, when one asks people who think they suffer from low self-confidence what their values, interests, goals and aspirations are, there is only a vague reply, if at all.

Thus, building self-confidence first requires connecting with oneself in a meaningful way. ‘Meaningful’ here implies that one tunes in to new information, which should also have the potential to bring about a change. Often, individuals do not open fully to important sources of information, because they can seem harmful and fear inducing. Here it is important to remember, however, that gaining greater insight into oneself in the long-run reduces anxiety and fear rather than increasing it. This does not require greater self-confidence but only more knowledge about communication processes, which should be one objective in a therapeutic setting. In the process, a patient should learn that ‘self-confidence’ as a separate entity or feeling does not actually exist. It is how one views it that changes how one feels about it.

Disconnection from Oneself and the World

My work with clients over many years has lead me to believe that perceived low self-confidence is really a disconnection from one’s inner self and the world around. Feeling less confident is caused by feeling oneself less in general. Negative emotions, or a greater focus on negative thoughts and emotions, can reduce one’s sense of efficacy in the world and lead to a perceived lower self-confidence, however, this is also basically a disconnect from the information about one’s strengths and positive emotions. In sum, a lack of self-confidence is caused by a communication problem, a partial or general disconnect between the thought and emotional patterns that give rise to a perception of the self and the information that could provide the details.

Values, Interests and Aspirations

Through our interactions with the world around us and the thoughts in us we develop a map of what is important to us and its essence, the values we hold. Our values and basic interests can provide a stable and solid direction for the paths we choose and the decisions we take in life.

If we do what is important to us and which is in sync with our values, we are important to ourselves. A problem is that many people are afraid to look at their interests in values out of fear that this might change their life in an uncontrollable and radical way. They acknowledge that they might be far off their optimal path, but do not want to change direction. However, change should be gradual and knowing more about one’s values and interests makes the world and the sense of oneself a more, rather than less, stable place.


An important question is to ask the patient what she would do if she had the self-confidence she is looking for. Many people have never thought about this before, but imagining the future is actually a very effective antidote to the world without it.

‘Doing’ Self-Confidence

Self-Confidence is a feeling you get when you do the things that inspire self-confidence. The things we imagine that we would do once we have self-confidence are actually the things that could help instill self-confidence. So instead, do the things you plan on doing after you feel self-confident, and you will build self-confidence. The more self-confidence is no longer an issue, the more self-confident you are.

How to get there? In the short run ‘positive thinking’ may help, but in the long-term one really has to examine one’s values, needs, wants and aspirations. In the long-run, only if you do the things that are in line with your values and meet your needs and wants and help you attain your aspirations, will you do something that can instill self-confidence. You will become more proficient and skilled in it, and this also builds self-confidence. Self-confidence arises out of life-experience.

How one makes decisions and how one communicates with the environment has to fit one’s style and the things one wants to achieve. It also reflects on oneself as a person and the sense of self humans have. If you have a stable sense of who you are, how you make decisions and of yourself in general, your emotions and behavior will be more stable as well. This again builds self-confidence and a stable sense of who you are.

Changing Focus

What helps in times of change is to focus on the things that remain constant, the basic parameters (Haverkampf, 2018), including one’s values and primary interests, aspirations and sense  and feeling of self. Having a stable sense of self helps in the face of sudden change, whether positive or negative change. Winning the lottery has ripped many from their comfortable paths and left them worse off psychologically and financially in the long- and even medium-term. Building self-confidence and lasting happiness means setting one’s course on what makes happy. Often, however, this does not require changing life from one day to the next, but changing perspective and focus, because our thoughts reflect the perspective we take and what we focus on; and the emotions and one’s mood are strongly influenced by one’s thoughts.


So, what are these stable components and how can one learn about them? You know what you are interested in because doing it feels god over the long run. Your values are what you get emotional about when they are valuated. If there are not many emotions attached to something it may be something your environment wants you to do, but which is not that important to you. You learn about these things by communicating with yourself. Many people have gotten out of touch with themselves because they think their values and interests have changed. But the truth is that they do not change much over time, if at all, because they are too closely linked with who we are and our sense of self. When we follow these basic parameters, the chance of being happy is greatest. Value orientation, for example, has been described to increase or maintain happiness in the face of factors that can decrease it. (Hellevik, 2003)

Self-confidence is therefore about doing things one enjoys. Feeling good is a prerequisite for building self-confidence because it attaches good feelings to what one does and thinks, and thereby also to oneself. It is important in the process of building greater self-confidence.

Dr Jonathan Haverkampf, M.D. MLA (Harvard) LL.M. trained in medicine, psychiatry and psychotherapy and works in private practice for psychotherapy, counselling and psychiatric medication in Dublin, Ireland. The author can be reached by email at jo****************@gm***.com or on the websites and


Bénabou, R., & Tirole, J. (2002). Self-confidence and personal motivation. The Quarterly Journal of Economics, 117(3), 871–915.

Haverkampf, C. J. (2010). A Primer on Interpersonal Communication (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.

Haverkampf, C. J. (2017a). Communication-Focused Therapy (CFT) for Anxiety and Panic Attacks. J Psychiatry Psychotherapy Communication, 6(4), 91–95.

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Haverkampf, C. J. (2017d). Communication-Focused Therapy (CFT) for Social Anxiety and Shyness. J Psychiatry Psychotherapy Communication, 6(4), 107–109.

Haverkampf, C. J. (2018). The Basic Parameters (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.

Hellevik, O. (2003). Economy, values and happiness in Norway. Journal of Happiness Studies, 4(3), 243–283.

Marsh, H. W., Chanal, J. P., & Sarrazin, P. G. (2006). Self-belief does make a difference: A reciprocal effects model of the causal ordering of physical self-concept and gymnastics performance. Journal of Sports Sciences, 24(1), 101–111.

Maschuw, K., Osei-Agyemang, T., Weyers, P., Danila, R., Dayne, K. Bin, Rothmund, M., & Hassan, I. (2008). The impact of self-belief on laparoscopic performance of novices and experienced surgeons. World Journal of Surgery, 32(9), 1911–1916.

Woodman, T., & Hardy, L. (2003). The relative impact of cognitive anxiety and self-confidence upon sport performance: A meta-analysis. Journal of Sports Sciences, 21(6), 443–457.

This article is solely a basis for academic discussion and no medical advice can be given in this article, nor should anything herein be construed as advice. Always consult a professional if you believe you might suffer from a physical or mental health condition. Neither author nor publisher can assume any responsibility for using the information herein.

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