Would you believe that I can spot low self-worth and poor shame tolerance even in a child as young as three? It’s true. Sometimes it is obvious. I have worked with three- and four-year old children who say things like: “I’m no good,” and “I’m a bad kid.” These children can even engage in self-harm, such as biting, scratching or hitting themselves. Often these incidents occur after they have been corrected or disciplined. But other signs of low self-worth are more subtle and often missed by parents and clinicians.
Low self-worth and poor shame tolerance start young, as we can see in these children. I believe it is important to address these issues as soon as they arise, because if not explored and corrected, they can lead to engrained habits of self-loathing, which results in anxiety, depression and other emotional and relationship problems in adolescence and adulthood. Low self-worth and shame are the CORE CAUSE of all emotional and behavioral problems in children and adults — shame is what we call a “trans-diagnostic” emotion.
I have written extensively about these topics in my Self-Acceptance Psychology concept and book. If a person learns to internalize feelings of inadequacy and unworthiness, they can develop poor shame tolerance. This leads to unhealthy blame-shifting strategies in relationships — ways of managing shame by defensively passing the blame and shame to others (Other-Blaming), being highly self-critical (Self-Blaming), or Blame Avoiding.
It is sad that even young children show that they have already developed a self-image that includes a very low opinion of themself, with lots of Self-Blaming and self-criticism.
Let’s take a look at a typical case that I see to exemplify how to identify the emotional struggles that underlie behavioral problems in young children. (This case is a composite case and is not a real client.)
Identifying Shame in Young Children
Alex’s parents set up an appointment for concerns about Alex’s behaviors at daycare that had recently gotten him expelled. He shows normal behaviors for a four-year-old most of the time, but once in awhile he seems to explode in anger, mostly at daycare.
Behaviors began at age three, when daycare reported Alex hitting other children, dumping bins of toys and “trashing the classroom.” At daycare he has had incidents of throwing toys, kicking, and hitting adults that have extended for 45 minutes. These tantrums and aggression usually occur when asked to do something he does not want to do. He has been “dis-enrolled” from two daycares because of behavioral issues, one on the first day of attendance. His mother is concerned because he is supposed to enter kindergarten this fall and may not meet behavioral requirements.
Alex’s behavior is described by teachers and parents as an inability to following rules, with oppositional and disruptive language and behaviors. He is also easily frustrated and cannot tolerate being directed or corrected. He sometimes refuses to listen, but can usually stay on task with schoolwork. Alex can become hostile and mean. He namecalls his mother (“You are stupid”), is hostile to any authority figures, is bossy and moody. Behaviors are better one-on-one, and worse in classroom and group settings.
When I dive below the behaviors and ask about his self-image, parents note he has low self-worth. They report he often feels like the bad kid (“I’m going to have a bad day at school today”) and feels labeled and stigmatized.
He has anxiety symptoms such as variable fears with heights and swings, fearful with age-appropriate risk taking, was fearful of being on a pontoon boat, engages in overthinking, and seems easily upset.
In what seems like a completely different set of behaviors, Alex sometimes also has what could be labeled social anxiety symptoms that include dissociation or blanking out in group settings and fears of new settings. He sometimes complains of stomach ache, gets odd pains at group events and can become overwhelmed in social settings. He complains of sickness to get out of going to school.
Sadly, Alex has already at the age of four been diagnosed by his pediatrician and another clinician as having “ADHD, anxiety and ODD.”
Look Beyond Behaviors to Emotions
When working with parents I advocate they be conscious parents — mindful to pause and reflect on the emotional cause of a child’s behaviors. So let’s reframe some of these situations using the paradigm of shame intolerance. A child who has learned at a very young age to internalize feelings of shame and unworthiness does not have the cognitive and emotional skills to manage this heavy emotion. Instead, they learn to react — with Other-Blaming (anger, oppositional behaviors, defiance) Avoidance (withdrawing, fears of risk taking, social anxiety, fears and phobias, etc) or Self-Blaming (self-loathing, fears of failure, depression, etc.).
For Alex or other children, the shame spiral can begin with simple daily incidents. Let’s say his older sister bosses and criticizes him for some small mistake. Alex feels shame because he feels unfairly picked on and then, as any young child will, impulsively gets angry. Parents punish him for his anger, perhaps by shaming him for being a “bad boy.” He feels guilty for his behavior and may blame himself (Self-Blaming). Over time this internalized shame may become uncomfortable, so he also alternates with Other-Blaming, which appears as defiance and oppositional behaviors, difficulty being corrected, hostility toward authority, tantrums when directed, etc. He is then punished and shamed for these Other-Blaming behaviors, so feels more shame. Then he may internalize the shame some more and label himself as a problem child. Clear results, such as getting kicked out of school or daycare, then confirms these feelings of being a “bad kid.”
While parents and adults often adopt largely one blame-shifting strategy, children frequently alternate between them. They may lash out in anger and Other-Blaming (“She is the one who started it!”) or self-loathing (“I’m a bad kid. I can never do anything right.”) or Blame Avoidance (Isolating, avoiding relationships, not trying new skills, not playing with peers.) This may be confusing to clinicians and parents, who should look beyond these behaviors for the emotions that drive them.
Consider these behaviors and how to reframe them based on poor shame tolerance:
FEAR OF NEW SETTINGS:
After Alex’s behaviors got him kicked out of one daycare he went to another daycare, where on the first day he froze at the door, screamed “I don’t want to go to this school.” That day he kicked and hit teachers and was removed from this school, too. I believe this is because he has fears of failure. Because he has been disciplined in the past so often, he has already learned to dread new situations — where he may be criticized, lose his temper, and “fail.” He dreads more labeling as “the bad kid,” so he now has anxiety about situations where this may occur.
DIFFICULTY BEING CRITICIZED, DIRECTED OR EVEN JUST TOLD WHAT TO DO
When a child has a tantrum or aggression, notice what happened just beforehand. Often they were asked to do something and this triggers feelings of failure. I had a young child say that even being reminded to brush her teeth made her feel stupid, as if she should already remember to do this task.
SHAME TRIGGERS IN PARENTING/TEACHING STYLES
For Alex, poor behaviors at school started in the past year when a new teacher arrived in his pre-kindergarten class. I have no idea how this teacher interacted with Alex, but I suspect that she probably used more shame-based styles of punishment, For a child with low self-worth and sensitivity to being shamed, even a mildly harsh or shaming style of behavior control can trigger feelings of inadequacy, then fear, then perhaps escalating into anger or tantrums. As I note in another blog in my recommendations for parenting, even the simple act of asking “Why did you do that,” can trigger feelings of being judged and rejected that may trigger a child into reactive fear and anger. Many common disciplinary tactics used by teachers and parents are inadvertently shame-based.
SHAME TRIGGERS IN SOCIAL EXCLUSION AND PUBLIC SHAMING
The policy at pre-school was to remove Alex to the office when he misbehaved. I suspect that teachers also used public shaming, such as with “clipping” systems that publicly identify which children are acting out. All young children recognize the error of their ways when they calm down and they feel guilty. They know what they did was inappropriate. This is healthy as it teaches children to self-correct and engage in more socially acceptable behaviors. Additional or heavy-handed public shaming can be excessive and lead to unhealthy levels of guilt and shame.
STATEMENT OF LOW SELF-WORTH OR DEFEATED BEHAVIORS
Alex will state “I’m bad at school,” and appears to have low self-worth and self-labels as a problem child. When he loses at a game, he often becomes downcast and sad. An inability to lose gracefully at a game can be normal for young children, but if distress over this is escalated or chronic, this can be a sign of low self-worth or self-worth that is contingent on success, achievement and external praise.
POOR SOCIAL SKILLS AND SOCIAL ANXIETY
Alex has poor social skills with peers, is too abrupt at joining groups, and is easily embarrassed. Peers find him annoying, as he adopts repetitive behaviors or jokes. Poor social skills can be a sign a child is over-eager to get peers to like them. Their anxiety comes out in intense, anxious, and inappropriate behaviors that can be off-putting.
FEARS OF FAILURE AND RISK TAKING
Alex is often cautious with new experiences and I often see this in children beyond what is age appropriate. I saw one girl who struggle to even do simple deep breathing exercises because she feared “getting it wrong and being laughed at.”
Young children should be reasonably afraid of new experiences that may be dangerous, such as going down a slide or jumping off a dock into a lake. Healthy fear keeps us safe. But excessive fears of risk taking can be a sign of fear of failure. A child has already learned that if he tries a new skill and struggles or fails, he will harshly criticize himself. The solution he chooses is to avoid that self-shaming and not to try at all.
HYPER-VIGILANCE TO THREAT
Children who are feeling uncertain or fearful exhibit this with what is called hyper-arousal and hyper-vigilance to threat. They are “on guard” for danger. Often in children this shows up as a hyper-sensitivity to sensory inputs. In other words, they are sensitive to sounds, touch, smells, sights. In response to these experiences, they may develop somatic symptoms, such as stomach aches, headaches, fatigue, poor sleep, or just vaguely feel unwell. They may dislike certain foods based on texture or smell. Loud sounds or crowds may overwhelm their nervous system.
This hyper-vigilance means they may struggle to focus and concentrate in school classrooms which are usually very loud and also involve possible “social threat” from peer rejection or judgment.
HOSTILITY TOWARD OTHERS
Just as in adults, children externalize anger. They feel angry at themselves, but instead lash out at others to displace this emotion.
POOR EMOTIONAL REGULATION
All children struggle with managing “big” emotions because they lack cognitive control. A major task of parenting is helping children learn to regulate their emotions. However, children who struggle with low self-worth live in a world of fear, dread and anxiety. Nearly any situation is a possible threat — playing with friend may mean they could get teased, learning to ride a bike may bring feelings of failure, losing a game may bring feelings of unworthiness. A child living in constant fear of shame is a child who will be anxious and hyper-vigilant — leading to even worse emotional regulation.
ENTITLEMENT, GLOATING, BEING A POOR LOSER, QUITTING TASKS AND ACTIVITIES
It should be obvious by now in this discussion that these behaviors are indicative of poor shame tolerance. Certainly children will have these behaviors to some degree, but watch for excessive frequency or high levels of reactivity in these situations, such as quitting the soccer team after only one practice. One test I use with children: Ask them “What are you good at?” If they struggle to give any answer, they are likely more of a Self-Blamer. If they have lots of things they are good at it might be a sign they are more of an entitled Other-Blamer. You can also ask: “What are you not good at?”
FEAR OF MAKING A DECISION
One child I worked with struggled to make even simple decisions of whether to do a puzzle or play game. When we explored this, she noted that she gets distressed because “I don’t want to make the wrong decision.” She also noted that “Mom wouldn’t like my decision.” A child who has been judged and over-corrected is often excessively concerned about gaining mom’s approval or overly worried about offending others. A person with low self-worth has already engaged in repeated experiences of rejecting themselves, making them highly eager for approval from others or eager to avoid rejection. Hence, even making a minor decisions leads to paralysis as they weigh the outcomes — “Will someone judge and reject me for this decision?” Over time this leads to a child and, later an adult, who loses sight of her own sense of self, her own needs and values, and has little ability to set boundaries with others.
Kids who engage in Self-blaming often are people pleasers who are overly responsible, rigid, over-achieving and highly compliant to authority figures. While this may appear to be good — this is an easy child to parent — the child is highly anxious inside.
INTERVENTIONS FOR PARENTS AND THERAPISTS
1. Do not get caught up in the diagnostic game of trying to put a label on a child. I’ve had children come in with various diagnoses from other clinicians: ADHD, Oppositional-Defiant Disorder, Reactive Attachment Disorder, Bi-Polar Disorder and others. These labels focus on specific behaviors: Does the child struggle to focus in school? Or does he throw tantrums? Or does he get overly emotional? The behaviors are merely symptoms, if you will, of deeper emotional issues, usually around the emotion of shame.
2. And certainly do NOT medicate a child for what is almost certainly just a feeling of low self-esteem. Correcting parenting and teaching approaches, and perhaps play and behavioral therapy, can be very helpful and should be tried first, second and last. A child who feels bad or ashamed of themselves is NOT suffering from a “chemical imbalance” that needs to be medicated. They need skills to feel better about themselves. Medication will only confirm for the child he is “different” and “flawed”, worsening his self-worth issues.
3. Parents and therapists can work to develop the child’s growth mindset, for example by praising hard work vs. praising achievement.
4. Watch for inadvertent ways you exacerbate a child’s shame: Avoid asking “Why did you do that?” Or “What were you thinking?” Rather than ask why, get the child to consider alternatives. Ask: What else could you have done? Or: I wonder how Johnny felt about it when you threw the rock at his head?
5. Work on improving your emotional attunement. Look past the behaviors and ask: What is my child feeling right now? They you will know how to parent. Soothe and help him manage his feelings. Correct the behaviors later if you must — although most kids already know what they did wrong and you probably can skip this step!
6. Use Reflective Listening to improve a child’s sense of being heard, seen and valued. Even if a child is angry, honor that emotion. Emotions are signals and can be helpful ways to self-protect.
7. Model healthy shame tolerance yourself: Exhibit that you can fail gracefully, learn new skills without fear of embarrassment, admit fault and apologize.
8. Recognize that all children have a fundamental fear of being rejected by parents. They fear the loss of attachment connection to you and this will trigger anxiety, emotional dysregulation, and behavioral problems. Harsh parenting will merely increase the likelihood that your child will be fearful of your rejection, then develop poor shame tolerance, leading to Other-Blaming, Self-Blaming and Blame Avoidance.
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