Abbey was seven years old when I met her. She was pretty shy at that first appointment at my paediatric developmental clinic, initially only looking at the ground and not responding to any questions. I always get intrigued when this happens.
Part of my brain is listening to the story the parent is telling me, trying to establish a shared understanding of their concerns, the journey so far and what the priorities might be for this family – but another part of my brain is listening for a “hook”.
Hooks are a form of motivation, a way that I can connect with and help encourage the kids I meet in the clinic. We often know the hooks for the parent or the teacher, but not the child. Parent hooks are often things like wanting their child to flourish and to gain a happier household. Teacher hooks might be wanting to understand why the child is struggling and to gain a calmer classroom.
The hooks for kids are always different to those of their parents and teachers, and we don’t spend enough time figuring out what these are before launching in with our attempts to change their behaviour. We first need to connect with them and find out why they might want things to be different too.
I started by asking Abbey if she knew why she was here to see me. No response.
Her mum, Sally, told me that Abbey was really struggling academically. Teachers said she was a joy to teach and was never disruptive or causing trouble, but they had noticed that Abbey was participating less and less in group activities. She went from often being the first to put her hand up to needing lots of encouragement to attempt an answer out loud.
This apparent lack of confidence had been impacting her in the playground too, in terms of socialising with other kids. More often than not, Abbey would just sit and watch the other kids play during breaks. Instead of increasing her participation and confidence at school, which is a big goal that we should have for all kids, Abbey was going in the opposite direction.
It was clear to me that her self-esteem was the issue here.
When we are helping kids with their self-esteem, we often make the mistake of aiming for high self-esteem. I’m sure we all grew up with kids who thought quite highly of themselves and many of us probably know adults like this too.
While that level of confidence can seem appealing, the risk with high self-esteem is that it can be really fragile. People with fragile self-esteem often really struggle with any kind of criticism or failure; they may be highly reactive and they may avoid challenges completely out of fear of failure.
What we should be aiming for in ourselves and the kids we support is stable self-esteem. While self-esteem is not set in childhood, it is built during this period and it can be difficult to shift once it’s been low for some time. Being proactive about building a strong and stable sense of self – one that can take constructive feedback on board without it destroying their self-esteem – helps children and adolescents navigate the challenges ahead of them.
Many of the kids I meet in the clinic are struggling due to their self-esteem being fragile or low, and if you are caring for a child with similar issues, all is not lost. There is a great deal that we can do as parents and professionals to rebuild and support self-esteem for our children.
Three pillars of healthy self-esteem
Even though my own daughter, Yvette, is much younger than Abbey, I am already trying to guide her towards stable and secure self-esteem. While I often say I am proud of her, I also tell her she should be proud of herself when she succeeds at something such as a puzzle or sharing.
Too many children see their self-worth being determined by the praise and acceptance of others, leading to a fragility when they are not told how great they are. It also makes them vulnerable to taking on board unfair criticism such as being told they are less than others due to their appearance or abilities. From a young age, we can help our kids to see that their opinion of themselves is more valuable than the opinions of others.
I also try to separate her efforts from who she is as a person. When a child is misbehaving, it is helpful to separate the behaviour from the child’; for example, by saying a specific behaviour is mean instead of saying the child is mean. We need to do the same when they succeed, so that children understand that our care and support is unconditional, and “good” or “bad” behaviour will not challenge our love or support of them. This protects them from feeling like they are not good enough or that they need to perform well constantly to keep us on side.
Separating the child from their behaviour when they are succeeding is called “process praise”. Instead of telling Yvette she is so smart or good at drawing, which is called “person praise”, I try to remind myself to reinforce her effort: “You worked so hard on that drawing and it looks beautiful.”
Another thing I do is make sure that Yvette knows she is valued and needed in our family. She has roles that only she does, such as helping me to shave, feeding the worms and watering the strawberries. While these might seem a bit silly or lighthearted, I’m trying to show her how important she is to the family. This is a sense that every child needs, not just for the security of their self-esteem but also for any future challenges to their mental health.
When we are really struggling, a sense of being valued and needed by others can carry us through.
The final pillar of how I try to build Yvette’s self-esteem is with what I call “sanctuaries”. All kids need them, and every day in the clinic I help build them with families. Sanctuaries are like rituals – activities we do or places that we go together that are only for joy. They have to happen frequently, consistently and be untouchable.
Families need to have sanctuaries for all members, and each child needs to have them for just themselves and each parent.
Each person needs to genuinely enjoy the sanctuary to really harness the joy within the time together. Taco Tuesdays are no good if someone doesn’t like Mexican food, and playing video games with Mum won’t become a sacred family ritual if she doesn’t enjoy them too.
The most important aspect of the chosen sanctuaries is that they are untouchable. No matter what else is going on in our lives, the sanctuary remains. It is in these really difficult moments that we can prove our unconditional love for our kids. These activities are, sadly, often the first to slip away in busy households, but they are way more important than homework and eating our vegetables. Knowing that you are enjoyed and celebrated by your family is a cornerstone of healthy development and mental health.
I still remember one of my sanctuaries with my mum, who died when I was in my early twenties. I didn’t see her much growing up because she worked three jobs, but somehow she made it to some of my extracurricular activities consistently. In primary school I was chosen to be in the boys choir. My mum would take me to rehearsals and afterwards we would walk through the park nearby to the fairy tree.
This old tree has carved and painted fairies up its trunk, and we would sit there as she told me their stories, carrying on the narrative from the previous week’s visit. Decades later, that sanctuary is a special memory of my mum. On the day we took Yvette and then Charlie home from the hospital after being born, we visited that tree to introduce them to my mum, that sanctuary echoing from my childhood into theirs.
I think these echoing memories are what many of us are aiming for with our kids, and these stories of love and connection stay with them long after we’ve gone.