Q – Why don’t we have better theoretical and clinical models with which to understand and treat low self-esteem issues?
A – Before I try to tackle this question, a bit of a history lesson is in order here. The clinical model already exists. It has existed for over 50 years now. And it’s not just a clinical model: it’s a comprehensive system that includes the continuum worldview <==> ideology <==> methodology <==> clinical intervention. It’s John Bowlby’s theory of attachment. It’s already here. So, maybe the more important questions are, “Why hasn’t it caught on? Why don’t people know about it? Use it on a daily basis?” Sir Richard Bowlby (John’s son) asked the same questions at a large attachment conference back in 2003 held on the UCLA campus. The answer (at least my take on an answer) to these questions might surprise you.
As noted feminist psychoanalyst Susie Orbach wrote in her 1997 paper (actually, a transcript of a talk she gave) Why Is Attachment in the Air? (Psychoanalytic Dialogue Vol 9 no 1, 1999), U.S. feminists did look at Bowlby’s theory back in the early 1970s (not long after the first volume of Bowlby’s trilogy on attachment came out in the late 1960s). It was at this point that they summarily rejected his theory because they (erroneously) felt that it carried with it the potential to bring additional oppression to women. Feminist psychology types (of which there were many men) reframed Bowlby’s insecure attachment as a “lack of self-esteem.” These early 70s feminists took the science of attachment and made it vitalistic by reframing attachment as esteem. By removing attachment from a scientific frame and putting it into a vitalistic or folk frame, it could no longer be looked at or evaluated empirically. No one has ever adequately operationalized esteem, and, as a result, you can say and do whatever you want because it can’t be adequately tested. According to noted self-esteem researcher and clinician Marilyn Sorensen (more on her work below), as of 09.09 Amazon.com listed over 160,000 books on self-esteem and over 10,000 books containing affirmations designed to “boost” self-esteem. At our Foundation, we receive several requests each year that have as one of their goals “increase self-esteem.” This really is a bogus goal because there’s no way to check empirically whether that goal has been reached . You simply cannot adequately operationalize such things as self-worth, self-regard, self-respect, self-love, etc. (which is why you can have tens of thousands of books on the subject). And even Bowlby got this and wrote (I believe in his third volume) that (and I paraphrase), “Self esteem, as an explanatory model, is simply not up to the task of explaining such things as why youth contemplate and attempt suicide. It is simply jibberish to say that youth contemplate or attempt suicide because he or she lacks esteem.” OK, you’re a tough crowd. “Give us an example of what he really said,“ you say. Lets open up Volume III and listen in as Bowlby talks about attempts to explain depression (especially sever depression) by using the concept of self-esteem:
Not infrequently the state of mind of someone severely depressed is described, or explained, in terms of loss of self-esteem. This is a concept I believe inadequate to the burden placed upon it. For it fails to make manifest that the low self-evaluation referred to is the result of one or more positively adverse self-judgments, such as, that the self is incapable of changing the situation for the better, and/or is responsible for the situation in question, and/or is intrinsically unlovable and thus permanently incapable of making or maintaining any affectional bonds.
Bowlby went on to suggest that if we persist (and by “we” he meant those 70s feminist psychology types) in framing insecure attachment as a lack of self-esteem, there will be heck to pay (blowback effectively). Well, Bowlby was right and we have tons of “esteem movement” blowback to deal with. This is a point that Orbach makes in her article (talk), and it’s a point that Daphne de Marneffe also makes in her 2004 book Maternal Desire (summary available). de Marneffe goes so far as to suggest that the self-esteem movement was about abstracting parenting out of the mother so that it could then be placed within myriad parent substitutes. As revealed in his 1979 book The Culture of Narcissism, Christopher Lasch sees the psychological process of narcissism operating in such areas of society as the self-esteem movement and what he calls “the socialization of reproduction” (chapter summary on the topic available). Finn Bowring, writing in his 2003 book Science, Seeds, and Cyborgs: Biotechnology and the Appropriation of Life, cites work by Richard DeGranpre (author of Ritalin Nation) when he suggests that the sensory overloads of modern society “and their pharmacological equivalents are increasingly targeted by adults at children as a substitute for more intensive and time-consuming forms of care [read “caregiving”], thus enabling the young to feel contentment and self-esteem without participating in formative interpersonal struggles for recognition.” What these authors are suggesting is that we are feeding our kids copious amounts of behavioral drugs and framing them as “quick and easy liquid esteem.” Liquid esteem is being rapidly substituted for “more intensive and time-consuming forms of care” (quoting Bowring from above).
By reframing Bowlby’s attachment as vitalism via the esteem movement, 70s feminist psychology types (unwittingly) opened the door for what we have today: rampant reductionism in the forms of behaviorism (i.e., cognitive-behavioral therapy would be an example here) and what Ernest Keen calls “chemical lobotomy” (i.e., feeding our kids copious amounts of behavioral drugs like Ritalin and Adderall). It continues to blow me away that parents—mothers in particular—willingly and voluntarily lead their kids to Keen’s “second coming of lobotomy”—behavioral therapy combined with behavioral drugs (see Keen’s 2000 book Chemicals for the Mind for more on this theme). Why do present day parents do this? You can “thank” those 70s feminist psychology types who kicked open the door to “liquid forms of esteem” while at the same time closing the door to Bowlby’s theory by turning it into an inane form of vitalistic gibberish. So, I “feel your pain” (with apologies to Bill Clinton) over inadequate ways of framing esteem and ineffective ways of treating low self-esteem. Rather than simply sitting in raw pain and frustration, I would suggest that you direct some of it toward those 70s feminist psychology types who sold you down the river big time. Feminists (and I’m sure there were a small minority that did like Bowlby’s theory) had their chance and they blew it. And, no pun intended, we are dealing with massive amounts of blowback now in the form of childhood obesity, teen pregnancy, substance abuse, school shootings, criminality, and the list goes on. For more on this theme, see Mary Eberstadt’s 2004 book Home-alone America—The Hidden Toll of Day Care, Behavioral Drugs, and Other Parent Substitutes.
The main reason Bowby’s theory is rejected today is because to embrace it two things would have to happen: 1) esteem as any kind of explanatory model would have to be abandoned (along with a mess load of grant proposals), and, 2) present day feminist psychology types would have to admit that their 70s counterparts really—and I mean really—screwed up (which is what Orbach, de Marneffe, Lasch, Bowring, and, to a lesser degree, Bowlby, are getting to in their respective writings).
Will esteem as an explanatory model be abandoned, and will present day feminist psychology types own up to the mistakes (and missteps) that were made back in the 70s? Simply, no. There’s way too much at stake politically. Will Bowlby’s theory ever be embraced here in the U.S. (other countries like Sweden, Canada, and Australia do embrace it) if the above two items do not happen? No way. So, am I pushing a rock up a hill worthy of Sisyphus? You bet. Will I eventually get tired? Probably will. Bowlby in his lifetime saw what destruction the esteem movement could wreak on his theory and was effectively helpless to do anything substantive about it. Hmmmm … if Bowlby couldn’t do it … what chance does our Foundation have??? But there are a few small voices out there, like Orbach and de Marneffe and Lasch and Eberstadt (conservatives and liberals alike mind you) calling for a rethinking of those 70s esteem movement decisions. Like the Katrina response, it just may be too little too late. The esteem movement has stripped us bare (relationally speaking) and now asks us to drink the Kool-Aid that would be behaviorism in its many forms, whether cognitive-behavioral therapy or behavioral drugs such as Ritalin and Adderall (drugs, according to Bowring, that are more potent than cocaine) .
Q – One follow-up question … are there any bright spots on the self-esteem horizon?
A -Yes, there’s one that I can think of. I went to a workshop on self-esteem put on by Marilyn Sorensen (mentioned above). I thought that this would be a typical workshop on esteem but it wasn’t. Dr. Sorensen made a statement that just about blew me out of the water. She said (and I paraphrase), “You cannot boost or increase self-esteem.” Yeow! And this from a self-esteem researcher and clinician. Talk about breaking away from the “party message” so-to-speak. Sorensen told us that low self-esteem is a pattern or model that often develops because of early adverse relationships, typically with parents. Sorensen told us that she suffered from low self-esteem most of her life and was able to trace its origin back to the fact that her parents lost their first baby at age six months and both went through what she called “a nervous breakdown.” Attachment researchers and clinicians who are versed in the Adult Attachment Interview (AAI) would look at this story and suggest that a form of unresolved grief on the part of Sorensen’s parents played a large role in Sorensen’s life of low self-esteem. However, these same attachment researchers and clinicians would not use such a vitalistic frame such as esteem; they would use a scientific frame such as insecure or disorganized attachment. Without knowing it, Sorensen was moving the esteem frame in the direction of Bowlby’s theory. She told us that the goal of any intervention program focused on esteem was to move a person from a pattern of low self-esteem (e.g., an insecure or disorganized attachment position) to a pattern of healthy self-esteem (e.g., a secure attachment position). She even went so far as to suggest that, like a recovered alcoholic, the old low self-esteem pattern does not go away once healthy self-esteem has been achieved. AAI types (of which I am one) would suggest that Sorensen is accurately describing what they call an “earned secure attachment position.”
Before I could point it out, another workshop participant beat me to the punch and blurted out, “You’re describing attachment theory.” Sorensen simply said, “I’ve heard that comparison before, but I simply do not have the time to look at other theories.” This got me to thinking: how many other esteem researchers and practitioners are out there that don’t buy into the vitalistic propaganda that surrounds esteem and, instead, take more of a true attachment theory approach (like Sorensen)? The next question that popped into my head was: why aren’t Bowlbian attachment types reaching out to esteem types in a bid to pull them from vitalistic ignorance over to the light of attachment theory scientism? As allude to above, part of the answer stems from the fact that this “reaching across the aisle” would trigger the process of, 1) abandoning the esteem model as too vitalistic, and, 2) owning up to the missteps that were made back in the 70s. There’s another part to the answer: attachment has been framed vitalistically in other areas beyond esteem, such as attachment parenting, RAD (reactive attachment disorder), and attachment therapy. If Bowlbian attachment types started reaching across the aisle in all of these various areas, all of their energy would be drained. “But shouldn’t Bowlbian attachment types do some aisle reaching?” you ask. The answer is a resounding yes. Our Foundation tries to do as much aisle reaching as we possibly can (this blog site would be an example) Sadly, Bowlbian attachment theory lacks public intellectuals willing to engage in this type of public education. I hate to say it but my guess is that there is a fear of going up against several huge lobbies: behavioral drug companies, insurance companies, certain feminist groups, the day care and pre-K lobby, the esteem lobby, the RAD lobby, and the list goes on. The best Bowlbian attachment types can do is to keep the light on and answer the door when those occasional travelers come along looking for answers and understanding. As a social worker friend of mine emailed me the other day …
Attachment theory actually seems more relevant today than it may have ever been in the past to me. I can see in my own life that in order to be a good caregiver of positive emotional energy to my own children that I need to be able to get that recharging from outside of myself. With the current state of our world—lack of resources, high levels of stress, etc.—it seems like it would be so much harder to get any of those things … which actually makes it so much harder to be a consistent attachment figure.
I agree. Attachment theory should be more relevant today than it ever has been in the past … but, sadly, it’s not. Lets hope that one day Bowlbian attachment theory can earn a bit of healthy esteem. For copies of the summaries mentioned in the text, click on the CONTACT US button above.