Mental health

Can self-help be bad for you?

“Self help makes you feel worse,” BBC News has reported. It says that the growing trend of using self-help mantras to boost your spirits may actually have a detrimental effect. The news comes from Canadian research, which found that people with low self-esteem felt worse after repeating positive statements about themselves.

This experimental research on university students has found that concentrating on positive thoughts and statements made people with high self-esteem feel even better, but those with low self-esteem to felt worse and had saw their self-esteem dip.

This proposed theory seems plausible, but proving it is far more challenging. All subjective rating scales, such as those used in this study, can give a varied response among individuals. Additionally, this experimental situation has only investigated repeating mantras only, and should not be considered to be representative of other types of positive thinking. Nor is it representative of the cognitive and behavioural therapy methods used to treat a variety of health conditions. Any relationship between thinking, believing and behaviour is complex, and further research into this issue is needed.

Where did the story come from?

Joanne Wood and psychology colleagues at the Universities of Waterloo and New Brunswick, Canada, carried out this research. The study was funded by the Social Sciences and Humanities Research Council, and published in the peer-reviewed medical journal Psychological Science .

What kind of scientific study was this?

Although positive self-statements are widely believed to boost mood and self-esteem, they have not been widely studied, and their effectiveness has not been demonstrated. This experimental study sought to investigate the contradictory theory that these statements can be harmful.

The researchers had a theory that when a person feels deficient in some way, making positive self-statements to improve that aspect of their life may highlight the discrepancy between their perceived deficiency and the standard they would like to achieve. The researchers carried out three studies in which they manipulated positive self-statements and examined their effects on mood and self-esteem.

In the first study, 249 undergraduates (81% female) completed a test to measure esteem, called the Rosenberg Self-Esteem Scale, plus an online questionnaire about positive self-statements. They were given examples of positive self-statements (such as “I will win!”) and asked to estimate how frequently they used similar positive self-statements. This was measured on a scale from one to eight, representing frequencies of ‘never’ to ‘almost daily’. On another eight-point scale, participants were asked to judge whether positive self-statements were helpful on a scale of one (strongly disagree) to eight (strongly agree).

In the second study, 68 psychology students (53% female) were randomised to either repeat a positive statement (‘I am a lovable person’) or to not. The researchers classified the participants as having either low or high self-esteem (evenly distributed between both groups), depending on their score on a test called the Fleming and Courtney’s self-esteem scale.

During the experiment, participants with low and high self-esteem were asked to write down any thoughts and feelings they had within a four-minute period. Those in the self-statement group were also told to repeat the statement every time they heard a doorbell sound, with cues occurring at 15-second intervals (i.e. 16 repetitions during the four minutes).

After the writing task, the participants’ moods were assessed using two tests, the Mayer and Hanson’s Association and Reasoning Scale, and Clark’s incentive ratings test. They were then asked to estimate their self-esteem at that point in time. The researchers expected that people with high self-esteem would benefit from repeating the positive self-statement, but that repeating this statement would make people with low self-esteem feel worse.

In the third study, the participants from the second study were randomly assigned to an online study in which they contemplated the statement ‘I am a lovable person’ in either a neutral-focus or positive-focus manner. Those in the neutral-focus group were asked to consider whether or not the statement was true, but those in the positive-focus condition were asked to think about ways and times in which the statement was true. They then completed a self-report mood measure and a self-esteem measure.

What were the results of the study?

In the first study, when asked how frequently they used positive statements, 52% of subjects gave a rating of six or more out of eight, indicating frequent use. Eight per cent said that they used the positive statements almost daily, while 3% said they never used them. There was no difference between men and women in this response.

People who had higher self-esteem reported using positive self-statements more often than people with lower self-esteem. Those who used them reported using positive self-statements before exams (85%), before giving a presentation (78%), to cope with negative situations (74%), and as part of their everyday routine (23%).

Positive self-statements were generally thought to be helpful, with the participants rating their usefulness as five out of eight on average. The higher a person's self-esteem, the more helpful they found positive statements to be, with an average score of 5.93 in the high self-esteem group, and 4.48 in those with low self-esteem. The lower the participant’s self-esteem, the more likely they were to agree with the statement that positive self-statements "sometimes make me feel worse, rather than better".

In the second study, the researchers found that, based on the results of the mood Association and Reasoning Scale, those with higher self-esteem were in a more favourable mood than those with low self-esteem.

Repeating the positive self-statement did not raise the mood of people with low self-esteem to the level of those with high self-esteem. In fact, repeating the statements significantly widened the difference between the groups, i.e. those with low self-esteem felt worse than their equivalents who had not repeated the statement. Conversely, those with high self-esteem felt better if they repeated the statement compared with those who did not. A similar pattern was seen for the incentiveness ratings and self-esteem scores.

In the third study, those with an initially high level of self-esteem generally had better mood and self-esteem scores when in the positive focus group. Those with initially low self-esteem generally had similar or lower final esteem and mood scores compared with their equivalents in the neutral-focus group.

What interpretations did the researchers draw from these results?

The researchers say the results of their first study confirmed that positive self-statements are commonly used in the Western world, and that they are widely believed to be effective. However, further experiments showed that people with low self-esteem who repeated positive self-statements, or tried to focus on times when the statement was true for them, felt worse than those who did not repeat the statement or think about whether it was true or false. However, for those with high self-esteem, repeating a positive self-statement or thinking about when it was true did make them feel better.

The researchers conclude that repeating positive self-statements may benefit certain people with high self-esteem but ‘backfire’ for those with low-self esteem, who may have the greatest need for these positive statements.

What does the NHS Knowledge Service make of this study?

This experimental research among a group of Canadian university students has found that positive statements may reinforce that positivity among those with high self-esteem, and make them feel even better. But it causes those with low self-esteem to feel worse and to have lower self-esteem.

The researchers say that this theory is based on the idea of ‘latitudes of acceptance’, i.e. messages that reinforce a position close to one’s own are more likely to be persuasive than messages that reinforce a position far from one’s own. As they suggest, if a person believes that they are unlovable and keeps repeating, "I’m a lovable person", they may dismiss this statement and possibly reinforce their conviction that they are unlovable.

This theory seems plausible, but proving it is more challenging. Most of the ratings used in the later studies were subjective scales that may show considerable variability between subjects. Additionally, this study has not examined the individual’s circumstances or the reasons behind their current esteem, e.g. social/personal/academic situation, recent life events, depression, anxiety or other comorbid medical conditions.

In the first part of the study, in which researchers asked 249 people about their views on positive statements, positive statements were quite widely used and thought to be helpful. This was in a group of university students, who may be likely to think positively and make positive statements. However, it may not be representative of the population as a whole.

It should be noted that this experiment only investigated repeating mantras, and cannot be considered to be representative of other types of positive thinking. Nor is it representative of cognitive behavioural therapy, which can be used to treat a variety of medical conditions.

Any relationship between thinking, believing and behaviour is complex, and further research into this issue is needed.

NHS Attribution