Abstract
In this article, we introduce a theory of worth consciousness that builds on the research from self-worth with attention to the importance of honoring birthright self-worth (BSW), which is foundational to human dignity. This new empirically testable construct, Worth-Conscious theory (WCT), concerns human worth and requires individuals to recognize and acknowledge their value and significance (i.e., worth) even when smaller (e.g., family) and larger (e.g., community and society) systems fail to support them in affirming and repairing their worth. Self-Worth is the birthright of all individuals; hence our central aim is to introduce and explain the four pillars of self-worth, which are major tenets of WCT that align with Erikson’s developmental stages. These four pillars of self-worth (self-awareness, self-respect, self-esteem(ed), and self-confidence) are instrumental in understanding clients’ life challenges, presenting issues, and how to assist them in repairing and maintaining their worth. More specifically, many clients’ mental health issues, interpersonal conflicts, and other concerns can be directly or indirectly related to the experience of negative and critical beliefs about their worth and, more specifically, that their BSW has not been affirmed or realized throughout the lifespan.
Self-Worth and self-esteem are constructs that have been studied by scholars in various ways. More specifically, scholars have considered the differences and similarities between self-worth and self-esteem, noting that self-worth is a much broader and more stable form of self-esteem that is less influenced by external factors (Crocker et al., 2006). More precisely, self-worth is reflective of one’s core beliefs about their worth and value, which tend to be stable over time. Whereas one’s self-esteem may be attached to specific situations, traits, skills, or achievements, self-worth is thought to be more consistent and less likely to fluctuate in response to one’s feelings, thoughts, and experiences (Crocker et al., 2006; Svedberg et al., 2016). In other words, high self-worth provides a buffer/protection against distress and emotional upset, thereby promoting one’s well-being, overall happiness, and life satisfaction (Crocker et al., 2006; Svedberg et al., 2016).
Although some definitions of self-worth have been empirically tested (e.g., increasing self-worth and contingencies of self-worth; see Sherman et al., 2009), other definitions of self-worth are theoretically based (e.g., inherent self-worth and spiritual self-worth). There are at least four distinct definitions of self-worth referred to in the psychological literature. First, inherent self-worth is described by Sevig et al. (2000) as self-worth that is innate in existence without being affected by factors such as race, gender, age, religion, or physical ability, as these factors are deemed irrelevant in determining an individual’s worth. Second, increasing self-worth is defined by Myers and Sweeney (2004) as the worth of an individual that is enhanced by coping effectively with challenges in life. This increase of self-worth is attributed to experiencing self-efficacy, which refers to one’s confidence in their ability to succeed and is enhanced through successful experiences (Meyers & Sweeny, 2004). Third, conditional self-worth, also referred to as having contingencies of self-worth, fluctuates based on perception of personal value or a person’s sense of success in a valued behavior. As such, self-worth is regarded as more emotional than behavioral and is generally reflected in aspects and/or contingencies that indirectly influence one’s level of self-worth (Crocker & Knight, 2005). Fourth, spiritual self-worth refers to the worth of the individual that comes from a connection to a higher power; faith, therefore, provides the foundation for self-worth (Fukuyama & Sevig, 1999). When using spirituality to cope with aging and disease, Alzheimer’s patients were found to experience a higher quality of life and better sense of self-worth (Beuscher & Beck, 2007).
The present discussion recognizes birthright (i.e., inherent) self-worth as foundational to human dignity. Although birthright and inherent self-worth are not distinctively different, we intentionally renamed the concept of inherent self-worth to birthright self-worth (BSW) to emphasize the powerful meaning that comes with the endowment of a birthright. It is the reality that our existence matters, that we are important enough to someone to be given a chance to develop until we can assume the role of being important enough to ourselves to continue the journey of becoming ourselves. Scholars have supported this notion. According to Friedrichs (2016), self-worth, grounded in dignity, is a birthright that does not need to be earned. Similarly, Brené Brown (roxannehai, 2012) reminded us that self-worth is a birthright and there are no prerequisites to worthiness. We conceptualize self-worth as being both inherent and realized (increasing) from a four-pillar framework that includes awareness, respect, esteem(ed), and confidence. These four pillars of self-worth are discussed extensively below.
To understand worth-conscious theory (WCT), we build on the research from self-worth. In support of scholars’ assertions that self-worth is a birthright and not something to be earned or lost, we maintain that the only action that can remove self-worth is to deny it. To honor our birthright of being worthy is to affirm it by developing and practicing the concepts within the four-pillars of the self-worth framework described below. Denial of self-worth can occur with naïve acceptance of the smaller and larger systems falsehood (i.e., family, community, society)—that we are unworthy (our existence is unimportant). Hence, we must recognize that the aspect of worth that comes with being a human being is inalienable and exists even when systems fail us, and the world has shown us its worst (Nussbaum, 2008).
In WCT, we posit that when we are born, we experience internal signals from our bodies that we respond to through simple communication. Our first attempts at communicating what existing feels like requires an honest reporting of what is needed (Rogers & Stevens, 1967). With continued experience, we create an internal map of what helps us remain in existence (life needs) and what makes our existence important to someone and eventually to ourselves (self-worth needs). More precisely, in the first few years of life, we experience needs (e.g., hunger, fear) that we begin mapping/signaling to our caregivers that they may or may not meet (Sullivan et al., 2011). To enhance understanding of the connection between early childhood experiences and the development and maintenance of the four pillars of self-worth, we draw from attachment theory (Bowlby, 1969), which posits that central to human development is the innate desire to seek and form attachments with others, most often with our primary caregiver. Hence, attachment theory provides a theoretical lens for understanding the important relationship between the caregiver and early childhood experiences as related to the development and maintenance of the four pillars of self-worth. According to Bowlby, children build attachment in the first year of life as they begin to form a representational model of themselves and others, based on their relationship with their mother. For example, when experiencing hunger, infants may fuss and cry until the need is met. By using these signals and consequently getting their needs met, they learn to trust their ability to signal others about what is happening in their bodies, which allows them to learn to trust their caregivers and their ability to experience what their body needs and how to communicate to get those needs met. In further support of this early signaling process, we are reminded that it is a natural process for children to act in ways that signal and/or attract attention from adults/caregivers (Gottman & DeClaire, 2001). This mapping sequence can include the message that our needs are worthy; thereby allowing us to recognize our BSW. Examples of the detrimental effects of unmet self-worth needs can be understood in the lives of orphans in Romania and China as described by Thurston (1996): Babies who are not adopted are eventually moved out of the infant room into what the foreign women call the toddlers’ room, a much larger space with six rows of eight cribs each. Staffing is minimal—three or four women for forty-eight children. The quality of care precipitously declines. It is almost impossible for the volunteers to guess the ages of the children. Many suffer such serious developmental delays that they appear and act much younger than they are. Children who have just been moved are generally placed in the middle two rows. They are given bottles but scant assistance in feeding, and the schedule is rigid. Some of the children grab their bottles and eat lustily, and some—often the same ones—demand attention, crying, spreading their arms to be held. Their eyes beg for human warmth and affection. Others are already passive and withdrawn. Their bottles lie untouched, as though they are too weak, too indifferent, or still too young to make the effort. When feeding time is over, even the unfinished bottles are collected. (p. 6)
Viktor Frankl’s work is the perfect theory in which to situate the concept of BSW. Frankl (1962) maintained that the will-to-meaning is a primary motivational force in every human being and therefore essential to healthy psychological functioning. Frankl posited that the conscious striving for meaning in life results in a dimension of human existence whereby an individual experiences values and true morality. However, when life situations frustrate the will-to-meaning, making it difficult or impossible to discover meaning in life, the individual experiences what Frankl distinctively refers to as an existential vacuum. The existential vacuum results in the individual experiencing a permeating sense of boredom and apathy in life, which leads to an aimless existence. We draw from Frankl’s work by asserting that having self-worth is a birthright and being worth conscious promotes genuine meaning in life.
Worth-Conscious theory
WCT concerns human worth and requires individuals to recognize their value and significance (i.e., worth) even when systems (e.g., family, community, society) fail in some ways to support their BSW and disallow their realized worth (self-worth that is maintained throughout the life span). If these larger and smaller systems fail to support individuals in their ability to affirm and repair their worth, they may run the risk of being unable to thrive.
WCT considers self-esteem as a self-worth-need that is reinforced in the first years of life along with three other self-worth needs: awareness, respect, and confidence. More specifically, the coconstruction of these four pillars of self-worth utilizing self-worth needs as building blocks is explained as follows.
Self-Awareness
The self-awareness pillar in WCT is built with the ability to focus attention towards and attach value to our forming identity. As we develop, self-awareness includes the ability to examine and clarify our own behavior in a way that promotes insight into how we compare to systemic standards present during the development of our self-concept. Therefore, when a baby experiences having their life needs acknowledged, they learn the importance of having awareness about self. When caregivers and/or others have awareness of the baby, care about the signals they give, and further respond to those signals by helping the baby figure out which needs they are signaling, this supports awareness within the baby about their internal world while they are learning about the relational world.
Self-Respect
Self-Respect in WCT is the ability to focus on protecting the value we experience when BSW is affirmed. Throughout our development, we can practice employing boundaries that support realized self-worth (RSW). Therefore, when the baby is unsure of what is needed and the caregiver is also unsure but does not ignore the signals (e.g., crying), and together they struggle to attend to the unknown need until it is met, the caregiver is respecting the signals.
Self-Esteem
Self-Esteem in WCT is the ability to focus on the individual value we experience in a BSW-affirming family system. As we develop, we can maintain esteem for qualities of self. Therefore, when the baby signals that they feel good by smiling or cooing, and those signals are met with a similar positive response, the caregiver shows esteem. Later, the baby may start to realize that some of their needs also coincide with the needs of the caregiver, in that they both want to be liked/loved. Feeling valued for one’s behaviors/actions is on one end of the esteem continuum and being loved no matter what is on the other end.
Self-Confidence
Self-Confidence in WCT is the ability to trust in the valuation of self as honest. It is knowing one’s BSW and experiencing self as worthy of being (BSW) and becoming (RSW) through a process of living one’s truth (Rogers & Stevens, 1967). Therefore, when the baby sends the same signals and their caregiver is aware of and respects those signals, the baby starts to experience their ability to signal and that their internal world matters. The baby can continue to listen to their body, mind, and heart and learn what is needed for “me to be me.”
To summarize, the first year begins the child’s awareness of the building blocks (made up of self-worth needs) used to coconstruct the four pillars of self-worth. It starts with the child’s ability to honestly signal what is happening in their bodies during the first year of life. Children give caregivers a simple yes/no signal about their internal state of affairs. This wires them to trust their bodies (and eventually themselves) and their ability to communicate physical, emotional, and social needs. Scholars acknowledge the importance of secure attachment during infancy and childhood (Mikulincer & Shaver, 2005), which allows for the child’s signals about needs and support to be given and received. When BSW is denied, conditions of worth may be present in the system, thereby resulting in disruption to attachment and causing long-term negative effects. Conditional building blocks replace worth-affirming building blocks used to create the four pillars of self-worth and imitation pillars, which do not aid us in trusting ourselves, are built.
Life needs and self-worth needs
In addition to self-worth needs, we have life needs, which include physiological (e.g., food, water, warmth, rest), safety (e.g., security, safety), and love and belonging (e.g., intimate relationships, friends, family needs; McLeod, 2007). WCT proposes that actualization of self-worth is happening throughout life and that esteem is one of the results from experiencing self as worthy. Life needs and self-worth needs coincide with each other. Maslow’s (1968) hierarchy of needs described which basic life needs must be met first. WCT states that both life and self-worth needs begin in our first year of life, but our self-worth needs are hard to recognize because they are invisible. Systemic failures may cause self-worth to be denied on such a small scale that initially the damage is indetectable. Self-Worth needs that are met can provide the bedrock of full human development. The four pillars of self-worth can be constructed on a solid foundation when caregivers are able to honor (affirm) the worth of others.
The four pillars of self-worth and Erikson’s psychosocial stages of development
The four pillars of self-worth develop in childhood through coconstruction between caregivers and children. Each pillar of self-worth is started with building blocks that originally belonged to caregivers. The blocks are moments of interaction where self-awareness, self-respect, self-esteem, and self-confidence are modeled and promoted. Caregiver acceptance helps children feel worthwhile (Mruk, 2013). Shared experiences with caregivers create a repertoire for using building blocks, which advance the sequential construction of each pillar. But the first pillar, self-awareness, does not have to be fully constructed before the next pillar can begin. The shared mental, emotional, and relational skills that support self-worth later become specific to the individual. The four pillars are distinctly different from each other, and all support a two-factor approach to self-worth. Self-Worth as a two-factor approach acknowledges the belief in worthiness (BSW) and the ability to take action towards RSW by building and maintaining pillars of self-worth. We have BSW and we can affirm or deny it. We acknowledge Erikson’s (1950) psychosocial stages as an epigenetic principle. In other words, children develop skills through stages, can question learning from a previous stage, and reintegrate learning from earlier stages. The resolution of one stage is not necessary to advance to the next stage (Logan, 1983). Erikson’s psychosocial stages are complementary to the sequential development of the four pillars of self-worth in WCT. We can use the stages in Erikson’s (1950) model as a guide for how the four pillars of self-worth develop in childhood and are maintained/repaired through adolescence and adulthood.
Stage 1 (birth–18 months): Trust versus mistrust
Children develop a sense of trust when caregivers provide reliability, care, and affection. In WCT, the child becomes aware of their caregivers and starts experiencing their own signals. When the child’s needs are consistently recognized by caregivers, the child begins to see they are worthy of participation in the system. Self-Awareness is the first pillar children begin coconstructing with their caregivers.
Stage 2 (2–3 years): Autonomy versus shame/doubt
Children develop a sense of control over physical skills and a sense of independence. In WCT, building the self-awareness pillar continues and the coconstructing self-respect pillar begins. The child continues to act on awareness and makes moves (i.e., looking, seeing, moving towards things and others) that are recognized as helpful or potentially harmful. Caregivers who provide honest, consistent, and gentle feedback about personal safety are sharing the early building blocks of self-respect.
Stage 3 (3–5 years): Initiative versus guilt
Children begin asserting control and power over the environment. In WCT, action taken by the child that is praised can begin the building of the self-esteem pillar, while consistent caregiving and helpful redirection will continue to add building blocks to the self-respect pillar. All interactions continue to add blocks to the self-awareness pillar.
Stage 4 (6–11 years): Industry versus inferiority
Children cope with new social and academic demands; success leads to competence. In WCT, the child can gain competency, which further builds self-esteem (Erikson, 1983) and allows for self-confidence to be experienced. This is when the self-confidence building blocks are recognized as actions that are beneficial to the individual making the decisions. In new environments, children get access to additional building blocks.
Stage 5 (12–18 years): Identity versus role confusion
Adolescents develop a sense of self and personal identity. In WCT, the adolescent becomes introspective and begins to accept and/or reject some of the building blocks as they work to confirm their own identity. Self-Awareness at this stage supports the ability to know who we are. Self-Respect operates to protect BSW and prevent denial by others. Self-Esteem remains valuable because it is the feeling of not only having BSW but also enjoying praise when BSW is acted on. Self-Confidence continues to grow during this stage as the individual continues to trust their ability to affirm BSW in self and others. The latter stages of Erikson’s development model can be considered a repetition of work done in the earlier stages (Logan, 1983). In WCT, repetition of using building blocks to strengthen the four pillars of self-worth is necessary to maintain the four pillars of worth and to affirm BSW. From a WCT perspective, if the four pillars of self-worth are not coconstructed during childhood, it may be because caregivers are unaware of their own birthright self-worth. The individual’s ability to build each of the four pillars of self-worth in WCT depends on what is happening in the family system and may reflect limitations in caregivers’ knowledge of their own BSW. Whereas the pillars represent relational experiences that are internalized, WCT utilizes a four-quadrant model to represent the affirming and denying of life needs and self-worth needs as described below.
The four quadrants of worth-conscious theory
Each of the four quadrants (see Figure 1) have distinct experiences related to affirmation or denial of self-worth. Quadrant 1 (Q1) includes the experience of not having self-worth needs affirmed with the additional challenge of life needs not being met (see Figure 2). In Man’s Search for Meaning, Frankl (1962) wrote about a mortification of normal reactions happening to humans who are routinely mistreated. Frankl’s recognition of this disturbing human experience captures the absence of the four pillars. The children in the orphanage represent one of the most devastating examples of this existence. For children who are situated in Q1, it is harder to move out of Q1 into other quadrants because they lack the resources and the skills to move a position. They are aware that life is unfair, but they have not developed enough self-awareness to know which building blocks for the pillars of self-worth are missing from their family system. Building blocks of self-worth are made of affirming moments when any of the four pillars of self-worth are being built (i.e., providing affirming responses to the child’s signals). According to WCT, these moments acknowledge or increase awareness, respect, esteem, or confidence in the child sharing the moment with a capable coconstructor. In the absence of signal affirmation, children in this quadrant may develop self-loathing and project that negative self-view onto others, they may also surrender to their plight and fall into addiction, antisocial beliefs, or other self-rejecting behavior.
Worth-Conscious theory quadrants.
First quadrant.
Caring others (e.g., teachers, uncles, aunts, or nonprofit workers) who gain the trust of children stuck in the first quadrant may be instrumental in helping them begin recognizing BSW-affirming building blocks to reconstruct the four pillars of self-worth, which can help these individuals move towards quadrant 4. However, if life needs remain unmet, the individual may move into quadrant 2 (Q2).
Q2 (see Figure 3) includes the experience of not having enough resources to consistently meet basic life needs but BSW is affirmed, nonetheless. Even when the larger system of which the family is embedded fails to recognize family members’ BSW, the members reinforce the value of their children. The children’s signals are received and valued. The parents do not pass on shame when they are unable to meet life needs consistently. A parent may need to tell their child that there is no money for school supplies, and not having enough money for the supplies is nothing for which to feel ashamed. This family is honest about the difficulties that they endure but they do not promote a loss of self-worth among members. A family with less economic resources may suffer from the lack of food and/or other resources, but they also acknowledge that they are worthy of better days. Families in Q2 do not personalize the demoralizing reality of poverty. They feel the pain of hunger, but they do not take that experience as evidence that they are unworthy of food. We want to respect that many versions of life lived in this quadrant exist around the world and we regret that we cannot capture all the variations in this paper.
Second quadrant.
The following example of restauranteur, Lidia Bastianich (Fleming, 2017), will help to illuminate Q2 experiences. Lidia was a political refugee who fled from Yugoslavia with her family in 1956. She stated that her family felt responsible to give back and desired to become part of America as soon as possible. In an interview with Lidia, summarized here, Fleming (2017) reported that her family had been forced behind the Iron Curtain after WWII, when her region of Italy (Istria) became part of Yugoslavia. Her family stuck together, both parents worked, and her grandmother raised, made, and cured all the family’s food. Although they had food, conditions were oppressive. Her family escaped and lived in a refugee camp for two years. Her family received help with the basics (house, furniture, food) once they arrived in the United States. She is grateful for the values she learned in her family. She still believes that positive energy is easier and greater than negativity.
Children raised in a system stuck in Q2 have value in their family and are taught how to look for the BSW-affirming building blocks of the four pillars of self-worth in their many life experiences outside the home. Lidia learned the value of growing, cooking, and preserving food for the family while believing in a better future. Without the care of others, children in this quadrant may not realize their potential because they may not experience fulfillment of their life needs. When community support groups offer resources, these children are already aware of the value of support. Their BSW has been honored, they have experienced mutual respect in their homes and can cocreate it at school and at work. They feel loved and oftentimes a depth of gratitude for a hand up in life—their confidence is only bolstered by being granted new opportunities to thrive. Moving from Q2 into Q4 requires advantages many take for granted, but because of a solid sense of self-worth and four well-constructed pillars, these individuals seize the chances they get to consistently satisfy life needs.
Quadrant 3 (Q3) includes many different experiences of having BSW denied, and life needs met (see Figure 4). Although space limitations prevent us from sharing all the variations of systemic conditional worth, we do provide a couple of examples below.
Third quadrant.
The denial of BSW may not be purposeful, but rather it is the result of learned behavior in a family system (Rogers & Stevens, 1967) that has practiced using conditions of self-worth instead of honoring BSW. Parents, on the right side of this quadrant, do not say no to their children’s self-worth needs, they say, “yes, but.” The distinction that is important is that some self-worth needs are acknowledged but they are acceptable only in their usefulness in building imitation pillars in the service of a counterfeit. In other words, a substitute (i.e., conditions) for BSW may have become acceptable several generations prior and therefore the counterfeit (power, success, status, or importance) is a tacitly adopted replacement for the development of RSW in the current family system. The acceptance of these conditions can alienate members of the family from each other, cause competition and/or conflict about who has worth in the system, and deny individuals’ BSW. This counterfeit of self-worth phenomenon results in adults who question their BSW and have not practiced coconstructing the four pillars of self-worth on the solid foundation of BSW. The self-denial experience of the child accepting their parents’ conditions does not enhance self-awareness, self-respect, self-esteem, or self-confidence because the condition does not promote knowing your own truth or affirming BSW.
Q3 includes a division between left side and right side Q3, which involves differences in severity of injunctions. According to Holtby (1973), injunctions are potent parental instructions and directions about “what the child is” (p. 25). In WCT, we recognize two types of injunctions: intrusive and abusive. Right side Q3 is characteristic of intrusive injunctions (see Figure 5) that create conditions that most people find acceptable, such as be pretty, be smart, be the best. These injunctions intrude on our sense of self, but they are not destructive. Intrusive injunctions, which are evident on both right and left Q3, are conditions that parents create for their child to feel a sense of worth through being what the parent wants them to be. More precisely, intrusive injunctions tell people, in a system with conditions, who they are allowed to be. Being true to the family goal of building their version of success is expected. These families have the means to pursue better opportunities in life. Life needs are met and might exceed what the family needs to keep them from dropping into an unvalued position in the larger system. The following example will help to illuminate the individual who is situated in right side Q3.
Use of intrusive injunctions.
Mateo 1 was a hard worker. He learned about the family business at an early age through his family’s use of intrusive injunctions. One of the conditions adopted in the family system was to always put the business first. His Mexican American family was upwardly mobile—they had a chance to live an easier life than that of his great grandparents. The signals for his self-worth needs were acknowledged by his parents but quickly used to build the business. He could be aware of what the business needed, respect what was good for the business, feel good (be esteemed) for helping the family business be more successful, and develop confidence in adding to the worth of the business. The profits went up and down during his childhood, which reinforced the focus on doing whatever it takes to succeed. Mateo grew up and took his place at the head of the larger and more prosperous family business when his dad retired. He believed that building the financial worth of the business was a necessary condition, worthy of sacrificing his personal life; however, he was not happy. His wife complained that he drank too much and was distracted when they spent time together, and that their kids got “pep talks” instead of heart to hearts. Mateo did not know how to help their kids build the four pillars of self-worth to honor their BSW. He knew how to show them what had been built, “a pillar of success” acceptable in a community that rewarded the value of material gain, and celebrated leaders with a spirit of rugged individualism rather than leaders who were emotionally connected. The social requirements for success fit with his family’s strong work ethic but contradicted some of the traditions key to family unity.
Characteristic of left side Q3 are abusive injunctions that most people find unacceptable (e.g., do not be different, do not be weak, do not grow up). Moreover, the family fails to honor the innate existence of BSW by using conditional building blocks. The imitation pillars on left side Q3 are often unfinished, leaving the counterfeit structure unstable (see Figure 6). One family member’s personal power may be held up as being more important than that of others. Other family members may not have the right to challenge who holds the privilege of power. Consequently, BSW may be misunderstood as the potential to gain power, so it is discouraged (at best) and disallowed (at worst). This is a confusing reality for children raised in a family where life needs are exceeded but self-worth needs are not met. These families miss worth-affirming teaching opportunities regularly. An additional negative impact of Q3 that impedes construction of the pillars is the use of double bind messages. Bateson et al.’s (1956) double bind communication refers to a dilemma in communication whereby an individual receives two or more reciprocally conflicting messages/demands, neither of which can be appropriately responded to (e.g., do not be shy, be quiet). In other words, meeting one of the demands means the other cannot be met. The classic example includes a parent who responds negatively when their child seeks their affection but when the child turns away, the parent encourages the child to return. The parent’s conflicting messages obstruct the coconstructing of pillars that affirm BSW. The following example provides a snapshot of an experience when life needs are met/exceeded but self-worth needs are unmet, and BSW is denied (i.e., left side Q3).
Use of abusive injunctions.
Jessica, 2 a European American, was born into a prominent family in the community. She upheld the family reputation and went along with the rules in the family. She received kindness from her nannies, but the family could not keep the same nanny very long, so Jessica had to readjust to a new caregiver every year or two. Her mother kept to herself and was often detached. When her father came home for weekends or local events, her parents would fight and then pretend things were fine when she walked into the room. Her father’s lack of empathy and sense of entitlement seemed narcissistic. She felt like a powerless intruder in her own home. The abusive injunction (do not be you) that Jessica internalized was from being told, “you are not the heir I wanted,” because her father wanted a son. Not allowed to share her personal life with anyone, she suffered in silence. She walked around with a list of abusive injunctions directing her sense of self: do not be you, do not be like others, do not share our story, do not be a problem. Jessica was often alone, disconnected, and surrounded by everything money could buy; she felt unworthy, but she pretended she had it all.
There are difficulties involved in moving from Q3 to Q4 that include the necessary step of becoming aware of the conditions in the family system. It can feel embarrassing to really look at the problems in one’s family history. Resistance to the shame of seeing the misuse of “good” building blocks for an unsatisfying family goal (exigencies) may keep the adult from asking the right questions. The move from the right side of Q3 to Q4 is easier when affirmation of self-worth needs have been practiced and promoted in a family that uses less damaging intrusive injunctions. These families are busy building something together, children gain building skills, even in the service of imitation pillars. The move from the left side of Q3 to Q4 may prove more difficult because of the family’s additional use of abusive injunctions and disempowerment. The children are not allowed to know why the privilege of personal or positional power is never bestowed on them.
Adults who grew up in Q3 have the economic resources to seek psychotherapy. Depending on which section in this quadrant they experienced, they may have inadequate experience with successful signaling of self-worth needs. To avoid the fear of feeling unworthy, they may use substances or repeat process addictions. If power was rationed in the system resulting in children being disallowed to experience knowing or enjoying their BSW, the adult client may not have developed the self-awareness needed to know their own BSW. They may be afraid that BSW does not exist and pretend they are important and use power to show importance in relationships.
Self-Awareness qualified by conditions (e.g., do not see, do not think about, do not talk about what is really happening) is more common on left side Q3. To further illustrate how self-awareness can be qualified, the young child starting to show awareness about a double standard in the family sees a parent agree to instructions at church about not yelling but upon returning home, the first complaint by the child is met with a loud and angry reaction. When the child offers their new awareness by sharing it, “Hey, Dad, I like what the pastor said today about not yelling to be heard.” They may further request, “Can we stop yelling at home?” An increase of the child’s awareness may be met with an abusive injunction, “Do not tell me how to run my house.” Consistent with the self-awareness pillar, this reaction sends three messages: (a) they have no positional power, (b) their awareness is not rewarded in this system, and (c) they are not worth listening to. In WCT, the child’s worth-conscious request for being more aware, wanting mutual respect, and having enough esteem for themselves to invite a happier family life experience was denied. This will decrease their confidence in signaling what they need. Gently challenging the family conditions, internalized injunctions, and the habit of using conditional building blocks are the first steps towards building self-awareness that honors BSW. Later, we discuss psychotherapy support and interventions that can assist clients in gently challenging their internalized injunctions.
Quadrant 4 (Q4) includes the experience of having consistent affirmation of BSW as children’s signals are received and valued (see Figure 7). The larger system does not fail to recognize the family members’ BSW, and members feel reinforced within both the family and larger systems. Families in Q4 are not perfect, rigid, or worried about appearances. They honor BSW unflinchingly, but they are still fallible human beings and therefore miss cues, grab the wrong blocks, and stumble while coconstructing with each other. Because they honor BSW, they are not ashamed of their mistakes, so they are able to account for errors, forgive, and rebuild on solid ground. The four pillars are coconstructed within family relationships and reinforced by enough people outside the home. Life needs are met and may even be exceeded in some families. Success may be prominent but is not a requirement, rather it is a secondary outcome of being worthy. For persons situated in Q3 who are trying to change the family pattern to live fully in Q4, conditions of self-worth are seen as no longer effective. In other words, they are enjoying being liberated from the conditions they were required to follow in their childhood. For example, conditions of childhood that required one to be fully groomed (look good before leaving the house) may no longer be followed in adulthood when the individual realizes that they do not need to dress up to go to the store. The following example portrays the experiences of adults who migrated to Q4.
Fourth quadrant.
Helena 3 knew she was different from her conservative Italian-American parents early in life, but she did not know how to talk about it. She learned to listen carefully to what her parents believed was good and she followed their lead. She loved her parents and felt valued, but she had a secret that became increasingly harder to keep. She was attracted to women, and she did not know anyone else like her. Helena was afraid that she was unworthy because she was different. She heard kids joking about queers, she also heard more serious negative judgments against someone famous who was like her, which caused her to refuse to share her story. As a young adult, she moved to a larger city and found peers she confided in. She found a psychotherapist who supported her emotional catharsis so that she no longer had to keep everything inside. Helena had been valued by her parents, she had learned to be aware, have self-respect, and she felt like an esteemed member of the family, but her confidence was low. She had to repair and rebuild her four pillars of worth with building blocks that were made of experiences in which she was being true to herself. Her new community valued her effort to experience her lived truth rather than requiring her to conform to an uncomfortable narrative written for sameness and devoid of individual and cultural diversity, and inclusivity. This new community helped her coconstruct pillars that honored her BSW. She eventually told her parents and discovered they had suspected what she could not tell them, but they were glad to know she was being her real/authentic self.
The adults who have been raised in Q4 or who migrated to Q4 because of developing better self-understanding through psychotherapy support/interventions feel solid. They are more self-aware, self-respecting, feel esteemed, and can show their confidence. They actively maintain the four pillars of self-worth through introspection; inviting honest feedback from family, friends, and colleagues; and engaging in relationship-repair practices. Q4 adults trust themselves, they look for trustworthiness in others, and they feel capable of using discernment. Self-Worth is realized (see Figure 8) through the work of staying aware, respecting self, knowing self, loving one’s strengths, and liking the ability to handle personal limitations.
Realized self-worth.
Psychotherapy clients, raised in Q3, have access to and may utilize self-help books, podcasts, and therapy to move them into Q4 (although they do not communicate it that way). Consistent with WCT, adults experiencing a Q3 childhood are more likely to present with long-term issues such as depression, anxiety, work- and personal-related stressors, relationship challenges, complex posttraumatic stress disorder, suicidality, personality disorders, and a host of other concerns that may be associated with struggling to live true within systems that do not honor their truth.
The relevance of WCT to clients of diverse backgrounds is emphasized and reflected in the multicultural experiences of individuals presented in the various quadrants (i.e., Mateo, Lidia, Helena). More specifically, we acknowledge that theoretical frameworks under construction/investigation must adequately address the treatment of diverse and underrepresented groups. The self-worth experiences of racially and ethnically diverse clients in WCT is considerably important as the denial of BSW may be at risk of being activated throughout daily occurrences of social oppression and discrimination. Similarly, WCT pays attention to how self-worth needs of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) individuals can be denied. Their right-to-truth issues may be misinterpreted as mental health issues but are better seen as BSW denial within their family and larger systems (see Figure 9).
Birthright self-worth to realized self-worth.
Families and systems that reject the child’s uniqueness and/or differences may cause the child to grow up and become an adult who is not self-accepting and therefore unable to accept differences/uniqueness in others. Sameness has kept us safer in our respective “tribes” for thousands of years, resulting in some adults believing that sameness is helpful, but diversity can be representational of a wealth of ideas for how to live and celebrate individual worth, together. Instead of having to fight each other, and feeling afraid, we can shift our energy to observing, learning, and migrating to Q4. In order to fully understand the utility of WCT and its underlying tenets, next we discuss the theoretical application of the WCT model followed by implications for clinical practice.
Theoretical application
Aspects of mental health issues that originate from a disoriented sense of self and are experienced and reinforced during childhood interactions within a family system that does not affirm BSW can be understood as one application of the WCT model. Denial of self-worth needs can include an individual’s unconscious consent to intrusive and abusive injunctions. The individual may feel complicit in unconsciously accepting any family or social injunctions (Jourard & Landsman, 1980), like thinking acceptance is not possible without achievement, or reenacting self-worth destructive beliefs and/or behaviors learned in childhood. Denial of self-worth needs can exist in the form of pretending the individual is more okay than they feel, pretending that the family counterfeits are not destructive to RSW, or a more severe loss of self-worth where the person pretends BSW is not real for anyone. WCT addresses the insensibility a client with denied BSW acquires but does not know how to name without being disloyal. Another potential application of this model is in understanding how depression, even physiologically based, may be magnified by any level of denial of self-worth. Also, that an individual’s anxiety may increase when they continue to accept a limited role in the family script where exigencies about acceptance in the system exclude BSW.
We speculate that an increase in affirmation of BSW will reduce a type of personally held psychological pain, “psychache” (i.e., an individual’s experience of an unbearable condition or reality; Shneidman, 1993, p. 51), related to suicidal ideology. We will provide more information on how affirming BSW is a counter to client suicidal ideology in future research because we believe, as suggested by Frankl (1962), that once the will to live is lost it seldom returns. A unique possibility within the model includes the rare event of someone born in a Q4 family system who, through tragedy, falls to the bottom of Q2. For example, Hy 4 found himself in a Vietnamese prison at age 18 in the late 1970s. He and four of his friends had tried to escape the country and failed. They were sent to prison for treason. He and one other older boy took the blame for “misleading the three younger friends” (Hy, personal communication, September 29, 2021), who were allowed to go home. Hy remained in prison for 11 months with no phone calls, little food, and no hopeful outcome.
At the end of his time, one of the important elder men in the “political cell room” asked to speak to him. The man praised him and his friend for not losing themselves to the awful experience. He told Hy how impressed he was by their generosity; the boys shared their food with a few others when they could. He said that when people come to prison, they become selfish, but Hy and his friend did not. Hy said, “In prison, you know who a good person is and who is not” (Personal communication, September 29, 2021). During his incarceration, he remained true to the good traditions his parents had taught him. He was self-respecting, he respected others, and he had the confidence to live his values. Hy remembers the time he spent in prison as a “great lesson;” the memory of the event still enhances his gratitude 40 years later. In sum, Hy grew up in a family situated in Q4 with enough resources because his dad had a good job and he felt valued. He dropped to the bottom of Q2 when he was thrown into prison, but his Q4 pillars remained in the service of his self-worth even when tested in the worst of life’s circumstances.
Practice implications
Within the context of clients’ presenting issues and psychotherapy goals, we encourage clinicians to consider the utility of the worth-affirming concepts within WCT. In terms of individual psychotherapy, understanding the client’s BSW and RSW, and/or denial of self-worth experiences offers substantial potential towards understanding their pain, trauma, and emotional upset. Moreover, knowing which quadrant they are currently situated in allows for a better understanding of what is needed to migrate to Q4 and live fully worthy.
Claudine 5 was traveling by car to Hot Springs, Arkansas. She mapped out the trip prior to beginning her journey. The trip involved navigating through the Ouachita mountains, which included ups and downs on twisting roads. She did not realize how disoriented she had become on the drive, she arrived in town and climbed to the top of a lookout tower. She was perplexed when she stood in front of a well-appointed sign pointing due North and it felt wrong. That cannot be North, she thought, because it did not feel like North to her anymore. She still knew her right from her left, but she had lost her sense of direction during her journey. She could not get her bearings in the unfamiliar area. According to Haley (1990), this may be a type of disoriented perception similar to the loss of sense of self that happens when we are not reoriented to our own true North, our BSW, throughout our lives.
Clients who come to therapy because they have lost their ability to navigate the challenges of life will arrive experiencing a variety of different symptoms. Even though symptoms may be biological, genetic, or systemically based, disorientation from their BSW may be at the core of each repair. In other words, a client who wants help with relief from their episodic anxiety, may be unaware that the way in which their family trained them to seek worth is no longer working (Q3). Now this person has a pattern of ignoring their need for respect from self and others. A grieving client who handles the ups and downs of life with resilience (Q4) may experience the complication of believing that God (or a higher power) abandoned them because they did something “unworthy” of protection. They may experience a complicated grieving process by attaching BSW to this tragic event, creating a condition for self-worth that is temporarily confounding.
A client who shared her sense of abandonment (left Q3) and exclaimed that she felt worthless attending family events may experience suicidal ideation. She sometimes thinks about escaping an existence where her BSW is not acknowledged. She knows people can have worth, but she is afraid she is not one of them. A gay young adult client who loves his parents and does not want to lose their love may be afraid to live his truth. Living his truth not only rejects the conditions of worth (right Q3) that his parents prefer, but also runs the risk of his parents no longer being proud of him. His decision includes affirming his BSW by being true to himself (Q4) and not to the exigencies his family practices, which may solidify his sense of self at the expense of familial acceptance.
One of the first steps a clinician using WCT will take with a client is to recognize their client’s denial of their own BSW. This may be masked by the client’s presenting condition and therefore may not happen in the first session. The denial of BSW becomes evident in how the client talks about the inconsistency between the family exigencies and the four pillars of self-worth. A clinician can look for and ask questions about how the client feels esteemed. That is, the client could be asked to reflect on accomplishments they feel proud of and whether the accomplishment was fulfilling to them or to someone else. The clinician can also ask what may cause a lack of confidence for the client. One of the pivotal assessments is around level of self-awareness. Some clients lack self-awareness and were punished for asking questions. If there is a family rule that prohibits the members from having awareness about family problems—the client may feel fearful to break the rule in session. Pausing that process and finding out more about the rules in their family system may be less stressful for this client.
Teaching clients the WCT model can be helpful in giving the client a visual of what affirming or denying BSW looks like (e.g., Figures 6 and 8). Clinicians who use moments in session to share BSW-affirming building blocks are helping to cocreate a pillar of self-awareness. Eventually, the coconstruction of the self-awareness pillar can include the exercise of inviting the client to engage in self-observation without personalization. This skill will slowly encourage the client to pay attention, see themselves in situations from a new vantage point, and to not feel afraid of seeing information that was once off-limits (Jourard & Landsman, 1980). Awareness-building techniques from other theories can be useful in this process.
Clinicians can use BSW-affirming building blocks in their work with clients. Coconstructing pillars with new building blocks can occur with existing approaches to clinical practice that embrace values and assumptions that are consistent with WCT and, thereby, could be enhanced by this new approach. For example, a person-centered approach engenders client genuineness and WCT promotes the idea that a client has genuine self-worth (BSW) as a starting point in life. Rational emotive behavioral therapy (Ellis, 1977) addresses self-disturbing thinking and from a WCT perspective, the client who believes they have no BSW is displaying a disturbing and powerful irrational belief. Ellis’s ABC theory of personality (Corey, 1991) is a model of self-disturbing thoughts that can be used to identify how a person denies BSW. Acceptance and commitment therapy includes the choice point model (Harris, 2019) to help clients move toward what they value. Choice point utilization in WCT can help a client recognize how what they value can build their four pillars of self-worth. Also, narrative therapy is useful in helping clients rewrite a narrative that is more meaningful. In WCT, a new narrative begins with learning about BSW, taking stock of the building blocks already available or needed to construct the pillars to uphold RSW. We believe the idea of BSW being an endowment bestowed on everyone is a helpful life script to use in rewriting a personal narrative about well-being.
Many theoretical approaches promote the use of values in support of client health and wellness. According to Seligman (2013), values are what we care about. As humans we can be instructed to care about things in childhood that lose value over time. WCT suggests that when we choose values, beliefs, and actions that help build the four pillars of self-worth, it is because we honor our BSW, which sustains value over time.
Clinicians will have and use the building blocks of the four pillars of self-worth strategically, will invite the client to use the blocks they bring with them, and will foster conversations about how the client uses their building blocks in the world. Together they will decide which blocks are no longer useful. The clinician will freely give the client BSW-affirming blocks to take home and try out in their relationships. Clients will be assured that they will not have to trade in all their blocks; instead, the BSW-affirming blocks will be identified and employed.
We believe that most therapeutic interventions can be employed to remedy the mental health challenges that clients with denied self-worth experience. Moreover, adding a conversation about how self-worth is denied may allow the clinician to consider how deeply rooted mental health issues coincide with the client’s denial of self-worth. The denial of self-worth may be systemic, but according to WCT, it is also one of the most personally painful experiences we can have as human beings. The belief in and experience of worthiness exists internally, relationally, and socially. These three levels offer multiple opportunities for self-worth affirmation in the life of everyone, but when BSW is denied, and feelings of unworthiness become internalized, that internal experience can become disorienting.
Limitations and future directions
The theoretical perspectives of WCT are not without several limitations. Although we have proposed a model that illuminates the four pillars of self-worth—including development and maintenance of the pillars—as well as the resulting unique experiences of self-worth needs and life needs (i.e., four quadrants), we acknowledge that the theory and its major tenets will need to be tested. We hope to prove the effectiveness of having distinctly different definitions of the four pillars of self-worth without the crossover of some prevalent definitions. We also provide some structure for recognizing how the early honest signals of children are the first building blocks in human relationships. Honoring BSW by coconstructing the four pillars of self-worth can be a mutually rewarding process that results in both individuals attaining RSW. What a parent did not get from their parents, regarding honoring BSW, can be learned at any point in life.
Moreover, BSW may be a construct that is better understood and rooted in a Western and individualistic framework. Hence, the utility of BSW may be inconsistent with collectivistic values endorsed by other cultures. Basic goodness is a concept in Buddhism about who we are in our essence. People who are not self-focused are seen as having several positive qualities rooted in pure awareness: love, compassion, wisdom, generosity, and benevolence (Maull, 2012). WCT supports that honoring BSW will allow the development of many desirable qualities if having such qualities does not become a condition of acceptance in the system.
Conclusion
To conclude, we sought to present a compelling case for WCT and its application to clinical practice. As described in Figure 1, the four quadrants of WCT provide a useful framework for understanding individuals’ experiences as related to affirmation or denial of self-worth, and the extent to which life-needs and self-needs are met or unmet. This worth-based framework may be a helpful tool to assess the presence of any conditions or counterfeits in the system, which alter an individual’s ability to recognize BSW and further disallows development of RSW through building, rebuilding, and maintaining the four pillars of self-worth. Also, clinicians can employ WCT tenets (e.g., unmet life needs, unmet self-worth needs, unconstructed or partially constructed pillars of self-worth, conditions of self-worth, abusive or intrusive injunctions, counterfeits to BSW) to assess which quadrant a client is currently ensconced and if any conditions in the quadrant have denied the client’s BSW. Following this assessment, clinicians can direct their attention to working with clients to coconstruct the needed pillars so that clients can successfully practice RSW and make progress toward entering the fourth quadrant.
We believe that WCT gives language to the experiences and mental health challenges of clients while also providing a rich foundation for case conceptualization. We maintain that the conceptual elements of WCT are coherent and worthy of empirical testing. More precisely, it will be important to test the four pillars/tenets of self-worth and the existence of each theoretical concept of self-worth. We hope that WCT will stimulate substantial research that will advance practice and inform the clinician’s collective understanding of the client’s situation and maladaptive patterns through the lens of WCT.
Footnotes
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
