Self-image, or the way that individuals perceive and think about themselves, has been shown to affect how that individual functions and relates to others, on a daily basis. As expected a positive self-image has been associated with a number of positive outcomes including greater self-esteem, better interpersonal relationships, better sexual functioning, less mental health difficulties, less body image concerns and greater self-efficacy or self-belief. In contrast, a poorer self-image has been shown to be associated with less effective interpersonal communication, a higher frequency of reported mental health difficulties, and lower levels of self-efficacy, among other things. This research therefore signifies that an individual’s self-image, or the way that they feel about themselves, plays a significant role in how a person lives their life.

Today a large number of individuals seek and attend psychotherapy or counselling, in order to explore and enhance their overall well-being. Psychological research has aimed to explore many aspects of what makes psychotherapy effective in order to establish what leads to a better therapeutic outcome. Much of this research has focused on exploring variables such as how the client-therapist relationship or the frequency of therapy attendance, impacts on how well an individual performs in therapy.

A recent study by psychologist, Truls Ryum and his team in Norway aimed to explore the role of self-image in psychotherapeutic treatment outcome. Based on the existing evidence suggesting that a positive self-image can have positive effects on overall functioning and well-being, Ryum and his team hypothesized that individuals with a more positive self-image would perform better in therapy than those with a more negative self-image. They also predicted that the participant’s overall self-image would improve during therapy, with those who experienced the greatest improvements, attaining more positive treatment outcomes than those with less improvement.

In order to do this Ryum and his colleagues, examined levels of self-image and psychological distress in a group of individuals with diagnosed mild to moderate levels of distress, prior to and following completion of a series of weekly psychotherapy sessions. They measured self-image using a validated psychological measure that accounts for eight distinct components of self-image: Self-emancipate, Self-affirm, Self-love, Self-protect, Self-control, Self-blame, Self-attack and Self-ignore. Psychological theory suggests that self-actions often develop in line with what a person has experienced in their life – so someone who has been mistreated a lot by those around them may report lower levels of Self-love and higher levels of Self-attack. In other words, what an individual has experienced in their lives may impact on their overall concept of themselves and influence how they feel that they should be treated. This in turn may have negative ramifications for other aspects of that person’s life, potentially including how they respond to psychotherapy.

Ryum and his team found that overall, self-image was found to improve over the course of treatment. Individuals reported an increase in levels of Self-affirm and Self-love as well as a decrease in levels of Self-blame, Self-attack and Self-ignore. Greater improvement was associated with better treatment outcome. Additionally, higher levels of Self-ignore and Self-blame predicted poorer treatment outcome in terms of psychiatric symptoms and interpersonal problems.

So what do these findings mean – well first off, they highlight the importance of considering the role of the self-image in therapeutic settings, in particular the effect that a negative self-image might have on how a person responds to psychotherapy. Ryum and his team found that a decrease in levels of Self-attack was the most important predictor for improved interpersonal problems and an increase in levels of Self-love were most associated with reductions in distressing symptoms.

Their findings illustrate that participation in regular psychotherapy appears to encourage the development of elements of a positive self-image and decrease elements of a negative self-image. In order to capitalize on the gains that already appear to be occurring for individuals’ self-image during therapy, clinical psychologists and counsellors should aim to include strategies to further boost self-image as part of the therapeutic process. As well as this, therapy professionals should consider if issues relating to an individual’s self-image are impeding on their therapeutic progress.

Similarly someone who is considering or is already engaged in psychotherapy should try to consider their own self-image and reflect on how it is influencing their current difficulties both inside and outside of therapy. Some self-image questions to consider include:

– Do you hold a positive attitude towards yourself?
– Do you feel that you mostly deserve to be treated as well as others?
– Are you often self-defeating?
– Do you expect to fail?
– Are you satisfied with who you are?
– Do you feel that you have at least some good qualities?
– Do you blame yourself for all of the bad things that happen to you?

If the above questions have prompted you to notice that you may be struggling with issues pertaining to a negative self-image, it may be advisable to discuss this with your therapist or someone who you trust in order to ensure that this issue is being acknowledged accordingly. It is critical to be mindful of how the way that we view ourselves can influence the extent to which we feel psychological distress and how we respond to treat it. Thankfully the current findings demonstrate that self-image can be ameliorated through effective psychotherapeutic practices.

Some helpful links regarding self-image:

The role of self-image as a predictor of psychotherapeutic outcome (Ryum et al., 2015)

The importance of a positive self-image (includes tips on improving your self-image)

Positive self-image relaxation exercise

Helpful link for step-by-step advice on improving self-esteem

Ms. Niamh Allen, M.A. B.Sc.

A healthy self-image predicts better psychotherapeutic outcomes

One thought on “A healthy self-image predicts better psychotherapeutic outcomes

  • January 10, 2016 at 8:03 am

    Wow another great post! I’m really enjoying this site. Thumbs up! Keep’em coming.


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