Improving Self-Esteem: A Therapist’s Perspective on Perfectionism, People Pleasing, Positive Mindset, and Imposter Syndrome

When clients come into my office, one of the most common themes I hear is: “I just don’t feel good enough.”

It doesn’t matter if they’re high achievers, parents, students, or high-level executives; the underlying struggle is the same. Low self-esteem doesn’t discriminate, and it often shows up in very subtle ways.

Sometimes it looks like perfectionism, where you push yourself endlessly but never feel satisfied. Other times, it’s people-pleasing, where your worth feels tied to keeping others happy and receiving external feedback to measure success. For some, it’s imposter syndrome or the quiet fear that any moment now, everyone will realize you’re a fraud. And almost always, there’s a steady stream of negative self-talk in the background, making it hard to see yourself with compassion.

As a therapist, I want to share some experiences and insights that might help you recognize these patterns in yourself and begin to rewrite them.

The Weight of Perfectionism

Many of my clients who struggle with perfectionism describe the stress and weight of their internal performance evaluation, leading to the inevitable conclusion that it “wasn’t good enough,” which in turn creates negative bias and ruminating negative thoughts. 

That’s the trap of perfectionism: no matter how much you do, your brain convinces you it’s not enough. What perfectionism does is quietly erode your self-esteem because you’re constantly setting the bar higher than humanly possible.

What I encourage clients to do is reframe their definition of success. Instead of asking, “Was this perfect?” I invite them to ask, “Did I show up with effort and authenticity?” Often, that shift alone opens the door to self-compassion.

The Cost of People Pleasing

Perhaps the most common challenge to positive self-esteem is people-pleasing behaviors or the need for external validation. The perception that I have to perform to the standards and expectations of others’ can feel impossible based on the fact we are not even considering our own standards and expectations, along with our abilities and limitations. 

People pleasing often starts in childhood when approval and love felt conditional. Over time, it becomes a survival strategy: If I keep everyone happy, maybe I’ll be safe and accepted. This can create dysfunctional attachment styles, but that is another blog in the future.  The cost of people-pleasing is high. You lose touch with your own needs. You start equating worth with how much you do for others. And slowly, self-esteem slips away because you’ve stopped prioritizing and honoring yourself.

One tool toward managing people-pleasing behaviors is practicing boundary-setting. Identify the boundaries that you want to set and create an explanation to yourself as to “why is this so important to me?”.  Each time, you realize that the world didn’t collapse and nobody was upset or angry with you. In fact, people respected you more because of your consistency and integrity. Boundaries, I remind clients, are not rejection. They are an act of self-respect.

Living with Imposter Syndrome

Imposter syndrome is another quiet thief of confidence. I often hear clients describe promotions, awards, or compliments as if they “don’t count.”

This is the nature of imposter syndrome: it convinces you that your achievements are luck or timing rather than skill. To challenge it, I often ask clients to keep a “wins journal.” Every time a client leads a successful meeting, solves a problem, or gets positive feedback, they write it down. Slowly, those pages became evidence they can’t ignore.

Shifting Toward a Positive Mindset

Self-esteem doesn’t grow from criticism; it grows from encouragement. Yet many of us talk to ourselves in ways we’d never speak to a friend.

One exercise I use in therapy is reframing self-talk. Instead of “I’m such a failure,” we shift to “I made a mistake, but I’m learning.” It’s a subtle but powerful difference.

Gratitude is another tool. I practice daily gratitude every morning, both when I wake up and before I get out of bed.  I identify, without judging, as many things in my life that I am grateful for until I run out of thoughts for that day

Here are a few practices I often recommend:

• Self-compassion – Speak to yourself as you would to someone you love.

• Celebrate progress – Don’t wait for huge milestones. Small wins matter, and disregard self-judgment.

• Surround yourself wisely – Spend more time with people who uplift you, less with those who drain you.

• Journal your growth – Track not just struggles, but also strengths.

• Take care of your body – Sleep, movement, and nutrition deeply impact mood and self-image.

A Final Thought

If you take nothing else from this month’s blog, let it be this: you are worthy, not because of what you achieve, not because of how perfectly you perform, not because you keep everyone happy. You are worthy simply because you are here, doing what you are doing.

Low self-esteem convinces you otherwise, but the truth is: confidence grows when you stop fighting who you are and start embracing yourself, flaws and all.

FAQs about Perfectionism and Imposter Syndrome

1. What’s the fastest way to feel more confident?
Start by celebrating one small win today and begin building positive affirmations through the acknowledgement of other small wins.

2. Can therapy help with perfectionism and imposter syndrome?
Absolutely. Therapy provides a safe space to challenge those thought patterns and practice healthier ones. Oftentimes, it takes another set of eyes to call out those thoughts and behaviors.

3. How do I stop people pleasing?
Start small. Practice saying “no” in low-stakes situations, and remind yourself that boundaries are self-care, not selfishness.

4. Is it possible to completely get rid of imposter syndrome?
For many people, it never disappears entirely, but you can quiet its voice so it no longer controls you.

5. How long does it take to improve self-esteem?
It’s different for everyone. Some people notice changes within weeks of practicing new habits, while for others, it’s a gradual process over months or years. For many people, this becomes an issue of sustainability and maintenance more than a feverish effort.

If you are struggling with perfectionism, people pleasing or imposter syndrome, please don’t hesitate to reach out! We are happy to help support you through these obstacles so you don’t have to go through it alone!