MANY YEARS AGO, when I was just starting out as a counseling psychologist, a woman in her 30s came to me with a problem that is not at all unique to people her age. She was distressed by the fact that her girlfriends were getting married one by one and she did not even have a prospect for a boyfriend. She was desperate to get married and have a child of her own. She was physically attractive with very fine features. She came from a well-to-do family. And she was a successful doctor. Looking at her, I was puzzled that she would have the kind of problem she claimed to have. It turned out that she did not think she was attractive at all. In fact, she actually believed other people considered her ugly.

When people have a negative opinion of themselves and come to me for counseling, I try to help them become aware of how they define themselves. I ask them to write out words or phrases that they feel best describe them. In the case of this young doctor – she described herself as “needy, ugly and fat.” She may have been needy but, objectively, she wasn’t ugly. And if she was fat, then I was a killer whale.

This young woman was totally blind to her assets and badly needed to be affirmed of her good points. I encouraged her to expand her self-definition and add positive descriptors to her list. Definitely, “needy, ugly and fat” were not all she was. For instance, she realized that she was a caring daughter and sister. She had the sophistication of a seasoned traveler. She had a way with young patients and was quite popular with them. She had flair – she was good at choosing her clothes, the colors and styles that fit her. She was intelligent – intelligent enough to pass the medical board exams. And she was actually funny – when she was not being self-conscious.

I told her to try to be more relaxed when meeting new people, to regard men as interesting creatures and potential friends, not just as prospective husbands. Expanding her self-definition probably helped her. A few years ago, I stood as a sponsor at her wedding. Today, she seems happily married and is the mother of a lovely preteen daughter.

This story underscores the impact of self-definition on a person’s self esteem. And what is self-esteem? It is nothing more than a positive self-image. We know and accept who we are. We are confident of what we are capable of. We persevere in pursuing our goals. We feel proud of our achievements. And we can effectively handle whatever criticism – constructive or otherwise – is thrown our way.

It is not enough, however, to have this realization. People around us have to acknowledge our self-image. They have to affirm our self-definition, otherwise we are plagued by self-doubt. For instance, if Maureen thinks that it is important to be pretty and smart and considers herself both, her self-worth can still be diminished if she does not feel valued by people important to her. On the other hand, even if Michael’s family and friends praise him to high heavens, he can suffer a loss of self-esteem if he thinks sports are important but he is in no way near athletic.

This reminds me of the story of a popular athlete in my country whom I will call Victor. When my husband was assistant dean for academic affairs at a Jesuit-run university a few years back, Victor informed him of his decision to quit school and become a professional basketball player. He did quit school and turned professional. I met Victor’s older sister when I visited California a few years ago. She is a school principal and holds a graduate degree. In fact, all of Victor’s siblings are professionals – medical doctors or PhDs. She told me that they were happy over Victor’s success as a basketball player and celebrity but being a family of intellectuals, they were a bit disappointed that he did not finish college. I later heard about Victor’s decision to go back to school. I suspect that the importance of academic success to his family was a factor in his decision to earn a college degree. He still plays basketball but is no longer a college dropout.

When we are young especially, we need to feel accepted and valued. We need to know from people important to us that we count, that we matter. We get our sense of self-worth BOTH from our capabilities AND the acceptance and support of the significant people in our lives. One does not compensate for the other.

This is one reason why putdowns and negative labels have such a damaging effect on people, especially our young ones. This is one reason teenagers are so vulnerable to peer pressure and group acceptance. This is one reason why I am convinced the best gift we can give others is to accept them, affirm their self-worth and help them develop their self-esteem. With self-esteem, you feel you can make all your dreams come true. Without it, you feel you are nothing.

The good news is that, as we grow older, we (hopefully) become surer of our self-definitions and we may eventually care less about what other people think of us (even the people close to us). Which is one of the gifts of old age and probably why, at age 60, I can dare to describe myself with three words which would have been unthinkable and threatening at a younger age: I am old, I am bold, and I am (fool’s?) gold.