The Central Role of Self-Esteem for Persons with Psychosis

Abstract

The overall purpose of this article is to examine the role that self-esteem plays in the lives of individuals experiencing psychotic disorders. Particularly, and following the work of Harry Stack Sullivan, the expression of love as a necessary foundation for self-esteem is explored to assess its significance during and after onset of illness. Initial positive interpersonal relationships and displays of love by the caregiver during infancy may remain embedded within the infant's psyche, thereby having a profound and lasting protective effect during and after onset of illness, contributing to positive internalizations of self-worth and self-esteem in the face of experiences of failure, rejection, and discrimination. When a foundation of love and positive self-regard are not in place, their development may be required as an early step in the process of recovery for individuals with schizophrenia, challenging practitioners to go beyond the formal therapeutic boundaries in which they were trained. An example of one woman's experiences of recovery are used to illustrate the processes that may be involved in re-establishing this foundation of love.

Recovery? That's all about self-esteem, right? (Man with schizophrenia)

ACKNOWLEDGMENT

Partial funding for this research was provided to Denise M. Frank from the Blackner Stone Family Fund, Palm Beach, Florida. We report no competing interests.

Notes

¹All of these excerpts were reprinted, with Ms. Johnson's permission, from e-mails she has sent to Dr. Davidson over the previous 4 years.

Additional information

Notes on contributors

Denise M. Frank

Denise M. Frank, Ph.D., is a theoretical psychologist and currently a research fellow at the Institute for Social Innovation, Fielding Graduate University, in Santa Barbara, California. Her research interests include understanding the development of self-esteem in persons with schizophrenia spectrum disorders.

Larry Davidson

Larry Davidson, Ph.D., is Professor of Psychology at the Yale University School of Medicine, where he directs the Program for Recovery and Community Health.