It can be very frustrating to try and understand the relationship between drug or alcohol addiction, and a lack of self-esteem. They seem to go hand in hand, but is self-image a problem that needs to be solved in order to address addiction, or will it naturally heal when addictive behavior subsides? It seems addiction is both the cause of and the result of poor self-esteem. Breaking the cycle of this feedback loop can be difficult, but not addressing it can lead to struggles in early or mature recovery. Part of the problem is that we often try and think our way out of this situation. Many methods of self-esteem building involve addressing beliefs and perceptions. These can be very helpful, but they often lack action, which is an important tool to increase positive attitudes about ourselves. Recovery work is just that, work. A program of recovery is an experiential, not just an intellectual exercise. We can learn about shame and addiction, identify with others who have had our problem and come to a clearer understanding of the causes of these problems in ourselves, but still have difficulty being free from a negative view of ourselves. Without action, it is harder for us to accept that we have changed, so we may be unable to convince ourselves of our true worth and escape from this view. These beliefs may cause us depression, anxiety or other negative feelings. These feelings may occur often or perhaps less frequently, but they are always a dangerous time for our recovery. Low self-esteem results from an inaccurate view of ourselves that can originate in many ways. It may be the result of things we have done, things we have been told or things that have happened to us. We may have unrealistic expectations of ourselves, or an incomplete and inflated view of those we compare ourselves to. It is often easier to see the faults in ourselves but miss them in others. It may also be the case that we did not have a choice in the things that we experienced and therefore are trying to repair damage that was done by others. Finding ways to recognize when we are experiencing these negative thoughts and then identifying things we can do to counter these thoughts are important recovery skills. It is also important to have a clear understanding of the relationship between these thoughts and feelings, and the drug and alcohol addictions that we are recovering from. In addition, being able to identify beliefs about ourselves that are caused by our own actions and the ones that are outside of our control can focus our efforts on work that will help us to heal. Things we might do to boost our sense of self differ depending on if the damage is due to our own behaviors or the behaviors of others. We judge ourselves much more often and usually more harshly than we are judged by others. We also have much more information with which to make that judgment. We know everything about ourselves, both the positive and the negative, but the negative things tend to have more power because they are often secret. Our behaviors going forward and the actions we take to deal with our past are things we will continue to use to assess our character and worth. The way we handle our amends and our ongoing character defects is an important tool we use to pass judgment on ourselves and can be the beginning of our healing. How we respond to the needs of others and the role of service in our lives are ways we measure our own value. It is an important part of the information we use to come to a conclusion about whether we like ourselves or not. Would I consider someone like me a good friend? Am I trustworthy or kind? Am I a positive role model? Am I a failure? How do my actions compare with others who I consider to be good people or bad people? We have the most intimate knowledge of ourselves, and we cannot escape an assessment that contains all of these feelings and thoughts about ourselves and our behaviors. Sometimes our view of ourselves can be heavily influenced by things that have happened to us and that are caused by others or are otherwise outside of our control. Our view of ourselves can be heavily influenced by such events, and that view can be difficult if not impossible to correct with our own actions or beliefs. We may feel these events might seem insignificant to others, and we should be able to "get over it." Or we may have difficulty talking to others about the sources of our low self-worth. We may believe that our situation is not able to be healed or that our blame is too great to overcome. Our shame itself can cause us to be unable to form a healthy and realistic view of ourselves. This difficulty can be compounded by an addiction to alcohol or drugs that both provided relief from these feelings and at the same time amplified them. Learning how we process these thoughts and memories can help us to heal, and being able to identify with others in recovery from chemicals and from events outside of their control can propel us toward a place where we are able to have a clearer understanding of our true selves. Sometimes bringing these thoughts and feelings of low self-esteem to the surface can help us face them with increased safety. Whether or not we go on to address our past with professionals or peers, an understanding of the way these events impact our view of ourselves is a powerful way to begin to have a more accurate perception of our value. Finally, learning the ability to express compassion and empathy toward ourselves and others can help us heal the distorted view we may have of ourselves and boost our self-esteem. Expressing compassion toward our current selves helps us to reconsider how we view our past behaviors. Forgiveness and service can provide us with the evidence we need to change the way we judge ourselves. We can begin to form a new view of ourselves and to turn our judgment toward our actions as practiced in a program of recovery. We can also learn to express compassion for our past selves and the suffering that we may have gone through. This can help us rewrite the feelings we bring forward from those events and to lessen our feelings of shame and powerlessness. Identification with others in addiction along with compassion and empathy help us to maintain humility and a sense that we are actually recovering. It may also bring feelings of confidence that we can do this and a desire to continue with self-care. Marty O., LADC, is an addiction program manager and former counselor with the Hazelden Betty Ford Foundation. He helped develop the day treatment outpatient program in Center City and is passionate about helping others on their recovery journey. Prior to his career in addiction counseling, he worked as a trainer and motivator.