Low Self-Confidence in Integrative Therapy: A Psychodynamic Take

Low self-confidence shows up in all kinds of ways—hesitating to speak up in a group, second-guessing decisions, brushing off compliments, or constantly fearing failure. It’s something many people struggle with, often quietly, and it can really limit a person’s sense of self-worth and ability to live fully. In therapy, I’ve seen how this lack of confidence isn't just about not being assertive or needing to “think more positively.” More often than not, it runs much deeper—tied to early relationships, unconscious beliefs, and long-held emotional patterns.

When I work with clients who are dealing with low self-confidence, I find that an integrative approach, particularly one that draws on psychodynamic ideas, can be incredibly helpful. It gives us a way to understand not just what’s happening now, but why it might be happening—and how to gently shift it.

Looking Back to Understand the Present

In psychodynamic therapy, we’re always curious about the past—especially early relationships with parents or caregivers. When someone grows up being criticised, ignored, or constantly made to feel like they’re not enough, they can carry that message into adulthood without even realising it. Over time, these early experiences get internalised and become part of a person’s inner world. That little voice that says “you’re not good enough”? It probably didn’t come out of nowhere.

A lot of clients I’ve worked with don’t initially connect their low self-confidence to their childhoods. They just know they feel anxious when speaking up, or that they shrink themselves in relationships. But when we start to explore their history, we often find that somewhere along the way, they learned it wasn’t safe to be themselves. They might have had to please others to stay connected or keep the peace. That’s where the roots of low self-confidence often lie—in the ways we adapt to survive, even if those patterns no longer serve us.

And then there’s shame—a powerful undercurrent in low self-confidence. Shame often keeps people locked in the belief that there’s something inherently wrong with them, and it thrives in silence. Therapy gives us a place to name it, explore it, and slowly loosen its grip. As one client once put it, “I didn’t realise how much of my life I’d spent trying not to be ‘too much’ or ‘not enough’ for other people.”

Therapy as a Space to Rewrite the Story

One of the most powerful things about therapy, especially from a psychodynamic point of view, is that it gives people a chance to rework those old stories. In integrative therapy, we don’t just sit and talk about the past (though that can be part of it). We also pay close attention to what’s happening right now—in the client’s life, in their relationships, and even in the therapy room itself.

It’s not uncommon for someone with low self-confidence to assume I’m judging them, or to hold back from saying what they really think because they’re afraid of getting it wrong. These reactions are totally understandable, and they’re also valuable clues. They often mirror how they’ve had to protect themselves in the past. As a therapist, I try to create a space where those old defences aren’t needed—where the client can experiment with being more open, honest, and assertive, and start to see that they can be accepted just as they are.

This process takes time, and that’s something I try to be honest about from the start. Confidence doesn’t come from hearing “you’re great!” a few times—it grows slowly, through repeated experiences of being seen, heard, and valued.

Using Different Tools to Support Growth

While psychodynamic work helps us dig deep, I also believe in being flexible. That’s the beauty of integrative therapy—we can draw on other approaches too. Sometimes that means bringing in CBT-style exercises to challenge negative thoughts, or using mindfulness to help someone notice and interrupt self-critical spirals.

For example, if a client has a really harsh inner critic, we might look at where that voice came from and how it’s trying (in its own misguided way) to protect them. But we’ll also practise recognising that voice when it shows up and responding to it differently—maybe with more compassion or even a bit of humour. Over time, this helps build a stronger, kinder internal dialogue, which is key for growing self-confidence.

I’ve also found that bringing attention to the body can be powerful. People with low self-confidence often hold themselves physically in ways that reflect their inner world—tense shoulders, avoiding eye contact, slouched posture. Sometimes just noticing these patterns and experimenting with different ways of holding oneself can bring a shift. It’s not about pretending or “faking confidence,” but about gently expanding what feels possible.

It’s All About the Relationship

I can’t stress enough how important the therapy relationship is when working with self-confidence issues. When someone has spent years feeling like they don’t measure up, being in a relationship where they’re seen, valued, and not judged can be a game changer.

Sometimes, that means having tough but honest conversations in the therapy room. Maybe a client avoids eye contact, or apologises constantly, or finds it hard to believe I actually like and respect them. All of that becomes part of our work together. We explore it, not to analyse or pathologise, but to understand it with compassion and curiosity.

And slowly—sometimes very slowly—things start to shift. Clients begin to take up more space in the room. They say what they really think. They realise they don’t have to be perfect to be worthy of care and respect. And those changes don’t just stay in therapy—they ripple out into the rest of their lives.

It’s worth mentioning that cultural factors can play a role too. In some families or communities, being confident might be seen as boastful, or children are discouraged from drawing attention to themselves. Therapy can help make space for these cultural dynamics, without judgment, while still supporting the client to find a voice that feels authentic.

My Thoughts

Low self-confidence isn’t something you can “fix” overnight, and there’s no quick script or worksheet that will make it disappear. But through a warm, attuned therapeutic relationship—and by looking at both the roots and the present-day expressions of low self-worth—it is possible to grow a more solid, confident sense of self.

What I love about the integrative, psychodynamic approach is that it meets people where they are. It honours the complexity of human experience and helps make sense of the layers. And most importantly, it offers hope—not just for feeling more confident, but for feeling more you.

Healing is a journey, and you don’t have to take it alone, use the get in touch form on my website or text/WhatsApp/call me…..