Patients suffering of depression during their
crises tend to underrate themselves; and when the crisis ends, either
spontaneously or because of therapy, they look at themselves more
optimistically. Conversely, maniacal patients tend to overrate themselves during
manic episodes. These and similar clinical observations have suggested the term
of self-esteem, that in itself is purely descriptive. Unfortunately, the
concept seemed appealing and grew by itself, became reified and in the mind of
many is causally correlated to performance, well-being and mental health: some
psychologists consider low self-esteem as a cause, rather than as a consequence
or a symptom, of depression and other psychiatric ailments. This etiological
hypothesis has been disproved by several studies, but it has proven hard or
impossible to convince its supporters to renounce it. As Paul Mc Hugh once
wrote, every now and then psychiatry is plagued by fashionable, yet wrong,
ideas, that are both harmful and difficult to abandon.

The book by Albert Ellis comments on the problem
of self-esteem and its role in psychiatric pathology from the view point of
Rational Emotive Behavior Therapy (REBT), of which he is the founder. Ellis’
main points however, are philosophical, rather than empirical. If you want a
sound discussion about the hypothesis that self-esteem may be the cause of
psychiatric diseases, this is not your book: read The House of Cards by
Robyn Dawes instead.

The title of the book is misleading: scientific
research in psychology suggests that self-esteem is a myth in the sense that it
is less relevant than it is usually hold, at least as a causal factor of
behavior and pathology, whereas Ellis’ opinion is that self-esteem is a myth in
the sense that people are overdependent on it. I suspect that a possible reason
of this discrepancy is that low self-esteem may have been overrepresented in
Ellis’ clinical experience, since depression is so common a psychiatric
disease.

 

The myth of self-esteem is quite simplistic, and
is meant to be more a self help instrument than a technical exposition of REBT.
It is essentially divided in two parts: the first is an exposition of the
principles of REBT and their relationships with self-esteem; the second an
analysis of the role of self-evaluation and self-esteem in a score of
philosophical theories. I enjoyed the latter more than the former. As one might
expect from a self help book, both parts are oversimplified, to the point of
containing misleading information: e.g. diagnosis is not discussed, so that
mild depression or anxiety performance are not discriminated from common stress
on the one hand and from major depression on the other, and the very same
discussion seems to apply to all these conditions.

REBT is a variant of cognitive and
patient-centered psychotherapies, that aims at guiding the patient to a more
benign, and less damaging self assessment. Since the correlation between
self-esteem, psychopathology and damaging behavior is modest (with the possible
exception of major depression), the whole enterprise is built up on more
fragile bases than Ellis pretends. This does not imply that REBT is not an
effective psychotherapy; indeed it is quite effective, and Ellis deserves the
credit of having been a pioneer of cognitive therapy. The apparent paradox of a
psychotherapy whose success exceeds the credibility of its theoretical basis is
solved by the numerous trials demonstrating that all psychotherapies have more
or less the same rate of success, and that inexperienced therapists, or even
lay people who lack specific training are often as effective as experienced therapists.
Thus, therapeutic success is in no way a proof of the theory on which the
therapy is based, and is largely due to other factors (e.g. the empathic human
relationship with the therapist): thus, psychological hypotheses are to be
tested by carefully conducted studies, usually outside the context of
psychotherapy. Self help books, however, occupy a no-man’s-land, where sound
research in psychology is little prized: they must be convincing, rather than
empirically sound, and mood-raising. 

 

Ellis’ theory can be stated quite simply: the
author believes that low self-esteem and the quest for high self-esteem are
both damaging; thus he suggests that people would be much better off if they
rate their achievements, rather than their selves. The take home message is:
rate your performance and your actions, not yourself as a person, for a person
cannot be rated, and should be accepted unconditionally. Moreover, try to
accept others unconditionally as well.

I do not doubt that people suffering of minor
neuroses may find Ellis’ advice rewarding: it suggests a way of using one’s
intellectual resources to combat everyday difficulties and mild symptoms. Even
in major depression, this type of psychotherapy may usefully complement a full
therapy with antidepressants. If the idea of convincing people to accept
themselves unconditionally may help depressed patients to recruit their
intellectual resources against their disease, it is probably not worth 10 mg of
paroxetine, and is quite crude a basis for a philosophical or a  psychological
theory. Ellis candidly admits that a coherent philosophy is necessary to
convince his patients; but, we may add, this philosophy must also be
simplistic, otherwise few people would appreciate it and less still could force
it to its intended usage. Indeed the lengthy enumeration of the reasons why one
should not rate a whole person (either himself or other people) is shallow:
essentially it is based on the trivial considerations that a person is not
fully reflected in his actions, and that he or she may change as time goes on,
so that any judgment is incomplete.

At least two of Ellis’ implications are frankly
misleading: that this easy-going psychophilosophy may be the basis of a true
ethic, and that self-esteem is so central an issue for people not suffering of diagnosable
psychiatric diseases. These two issues are correlated with each other since
Ellis implies that an ethical philosophy conscious of self-esteem and its
pathogenic potential is necessary because the quest of self-esteem poisons the
lives and relationships of a large majority of the population. It is hard to
believe that self-esteem is such a major problem for the general population and
I have the impression that non-depressed people find their way to
self-acceptance and self-justification by easier means than those advocated by
Ellis.  It is even harder to believe that such a simplistic philosophy may have
an appeal for people who do not suffer of some form of psychopathology. Indeed
ethic is based on the concept of responsibility, that Ellis’ theory aims to
weaken, and an important problem of scientific psychology, with extended legal
implications, is that of predicting the behavior of people, that Ellis’ theory
depicts as impossible.

 

The analysis of Ellis’ crude moral philosophy
leads us to the second part of the book, that is quite stimulating and makes a
pleasant reading. It has no pretence of scientificity, and amounts to a
simplified analysis of some aspects of famous theories. Ellis’ analyzes the
ideas of such famous thinkers as  Heidegger and Sartre, or even Jesus, to sort
out whether they practiced unconditional self-acceptance or damned themselves
by pursuing conditional self-esteem. I shall not try to reproduce all of Ellis’
reflections, but shall concentrate only on some, arbitrarily chosen.

Jesus’ ethical teaching is puzzling to Ellis:
"Back and forth, the pronouncements of Jesus go, so that it is difficult
to tell what he really believed." or "How to resolve the
contradiction that on the one hand Jesus was unjudgmental and forgiving and, on
the other hand, so punishing and damning? I really don’t know." Let us try
to solve this point. Ellis collects from Matthew’s gospel quotations that
imply: conditional self-esteem (CSE), unconditional other acceptance (UOA) and
its opposite, conditional other acceptance (COA). What he fails to realize is
that these are not all assigned to the same beings. Jesus promises that we all
shall be judged by our Holy Father, Who will therefore apply COA. Since we are
to be judged, and rewarded or punished, we better apply CSE and judge ourselves
if this prevents us from wrongdoings. We however shall not be called to judge
our peers, thus we should offer to them UOA: if we apply COA we usurp God’s
role and shall be damned. Jesus teachings amount to a coherent transcendent
ethical philosophy, at least as far as a transcendent philosophy may be
coherent, and clearly show the limits of Ellis’ pretence of drawing ethical
conclusion from a (weak) theory of psychopathology. Indeed we may rate our
actions rather than our selves, but if our actions are severely wrong
punishment will fall upon us, not upon our actions: the laws, be them human or
divine, forbid criminal actions and the judges condemn the persons who commit
crimes. Ellis’ pretence of separating the evaluation of the performance from
that of the individual may have some value as a therapeutic means to support
mildly depressed people, but does not make up a coherent ethical philosophy;
thus, why should we be interested in his comment to philosophy? The answer is
that, even if in the end Jesus is a stronger philosopher than Ellis, Ellis’
perspective gives us an opportunity to re-focus Jesus’ teachings.

Not surprisingly, Ellis enjoys oriental
philosophy much more than western philosophy: Lao Tsu, Buddha and Dalai Lama
are among his heroes. These great thinkers deserve all our respect, but I
cannot fail to notice that their moral precepts, especially their recommendations
for unconditional other acceptance, imply a judgment of our actions: are we
following the precept or not? And it is hard to judge the action and not the
actor, as Ellis pretends we should do, however cautious we want to be about the
fact that the actions do not exhaustively reveal the personhood of the actor.

 

The myth of self-esteem, as any self help book,
ends with advices and exercises for those readers who want to try the
principles of REBT on themselves. It is claimed that in a survey Ellis ranked
the second best known psychologist in the USA, beating Freud who came third.
This is hardly surprising since self help psychology manuals are often best
sellers, and Ellis wrote some seventy five of them in fifty years of
psychotherapeutical practice. Unfortunately, this amounts to writing a book
every eight months on average, and The Myth of Self-Esteem is the book
you may expect to result from such a hurried preparation.

 

© 2006 Andrea
Bellelli

 

Andrea Bellelli has an MD and
a degree in psychology, and teaches biochemistry in the Medical School of the
University of Rome, Italy.

Categories: Psychology, SelfHelp