Self-esteem – that elusive quality so vital to our wellbeing, yet due to our human fallibility so fragile amidst our need for external feedback and validation.

We live in an era of uncertainty, where a sort-of-knowing and a fear of missing out dominate. The burgeoning use of social media – tweeting, swiping and Facebook - can make the traditional concepts of sitting with one's feelings, delayed gratification, accepting our flaws and the relative meaningless of our lives almost obsolete modes of operating in the modern world.

These modes of functioning can provide an additional layer of complexity when dealing with issues of the self, when the need to numb true thoughts and feelings and restrict reality can be at the heart of a sense of insecurity and lack of confidence.

Our feelings of self-worth go hand in hand with our inherent human desire to reach our full potential. However, this need has been amplified by the media’s obsession with highlighting the concept of the ideal self – whether that be in our appearance, our partners, our homes, or our careers. This notion can often come in sharp contrast to the reality of our true selves.

The psychoanalyst Adam Phillips states: 'We are always haunted by the myth of our potential, of what we might have in ourselves to be or do…. we share our lives with the people we have failed to be. …The myth of our potential can make our  lives a perpetual falling-short, a continual and continuing loss, a sustained and sometimes sustaining rage.’

To place our self-esteem and worth on external factors and validation is to commit ourselves to the relentless cycle of continued disappointment. It can be hard to hold onto this idea in our culture of continued observation and commentary. It can be impossible to work our what really matters, when the media would rather focus on the Kardashians' new clothing line rather than the work of Malala, the Nobel Peace Prize winner.

Self-esteem and self-image are both learnt in childhood and are built on how we have been seen by others. A secure sense of self grows out of being positively recognised by our main caregivers, and a sense of feeling ‘good enough’ emerges out of positive interactions of feeling seen, accepted and valued, without the need to accommodate our actions to those who care for us. The psychoanalyst Donald Winnicott stated ‘being loved at the beginning means being accepted’. If we felt subject to criticism, abuse or were stigmatized for being ‘different’ due to our race, class or disability this may lead to feelings of inadequacy.

In adulthood, even a well-developed sense of self can be challenged by changes in circumstances, such as losing a job, bereavement, the ending of a relationship. These events can feel life-changing and threaten our worth or value in the world.

Therapy can often help put these events in perspective and help to enhance our resilience and accept our vulnerabilities. In therapy we can consider the idea of our true selves and develop more realistic and achievable outcomes for our lives. Social trends can sometimes feel at odds with the idea of long-term psychotherapy. A central feature and strength of the psychodynamic process is that it strives to consider the uniqueness of each individual and each therapeutic relationship; this in itself can feel like an empowering process, the sense of feeling fully understood and known. Through each meeting, the emotions, language and interplay hopefully allow us to feel ‘seen’ and accepted, boosting our internal self-esteem.

Therapy may help us discover that our sense of worth and possibilities for satisfaction lie in our capacity to bear with the frustrations of our failures and to consider the gap between our wants and desires and the realities of our existence. Paradoxically, in order to be fully in control of our feelings of self-worth we must learn to relinquish control of our desires and begin to tolerate life’s ambiguities.