“I wish you self- esteem so high that you’re humble”
-Unknown

You’ve now reached a stage where you have completed your self- assessments, researched some work options and arrived at some conclusions. It’s time to set some goals. 

Mary Mueller recalls how good life was, back in 2010. She was a busy registered nurse with a satisfying career in a Toronto hospital. She constantly earned high marks on performance reviews, received raves from patients for her bedside care and even won awards for her workplace performance. 

A tonic clonic seizure changed all that overnight. One seizure begat another and actively increased to the point where they started serious interference with her life. Compounding that, her post-ictal–the recovery period immediately following a seizure—state meant that her recovery period was also compromised. Further complicating these issues was the fact that her memory was also becoming severely impaired.

“They changed my meds which made me tired and slower,” she remembers

Unfortunately the fallout from that change resulted in a series of rumours making the rounds that she was imbibing in street drugs, which affected her relationships with colleagues.

Her seizures subsequently increased to the point where her employers felt she could no longer meet their standards. Furthermore, she was reported to the College of Ontario Nurses as a safety risk. There, a psychiatrist interviewed her and declared her incapacitated. With that pronouncement her nursing registration was surrendered, stripping her of her ability to work as a nurse. 

As fast as jazz, her life had changed. The impact on her self-concept was devastating.

“It totally destroyed my self esteem,” she says. “ I felt like absolutely nothing and even hated looking in the mirror because I didn’t want to see the person I was.”

The Chinese merge the pictogram for “self” (or “zi”) with the pictogram for esteem or respect (“zun”) to create zizun. In Swahili, it’s pronounced kujistahi and in Arabic, it’s referred to al-jtibar al-dhati.

Every culture has a term for “self- esteem” although it’s meaning will vary from place to place. In her book Revolution From Within, writer Gloria Steinem turns to The Oxford English Dictionary for a definition that states “favourable appreciation or opinion of oneself.”

There’s no denying that living with an invisible disability and the stress of managing it, often hiding it, can impact self esteem. The fear of being exposed is often attached to people with low self esteem and this can be particularly impactful, especially in a workplace context.

Indeed, a 2013 study that surveyed 224 adults with dyslexia and found a causal link between concealing the disability and the amount of perceived family support received.   Furthermore, a 2010 issue of a periodical published by the National Rehabilitation Information Centre concluded that “The primary difference is additional stigmatization they face because their disability is not readily apparent. Since many individuals with invisible disabilities appear able-bodied and/or healthy they receive constant scrutiny about their disability status from family, friends, co-workers, loved-ones, and society in general.”

During her lowest moment Mueller, devastated by how she perceived her life situation, attempted suicide. At that moment, a spark materialized and she realized she needed to find a way to keep continuing.

“Part of me, even at my lowest, realized there was a need to fight and go on.”

A strength-based approach is commonly used by therapists supporting clients on the journey towards finding self esteem. While there’s many approaches to this modality, Therapistaid.com states that “people who know their strengths and use them frequently tend to feel happier, have better self-esteem and are more likely to accomplish their goals.”

You might not even be aware that you actually possess strengths but you do. You might want to start by reflecting on this strengths checklist, provided by healthvista.net. It’s important to to approach the list from the perspective of who you are now instead of who you want to become. 

Personal Strengths Checklist 

Mark the strengths that you have. Put a star by one or more strengths you want to improve on. Share this list with your health care team. 

• Kindness, or love 
• Social intelligence, or being aware of your feelings and feelings of others  
• Fairness, or treating people with respect and justice 
• Humility, or modesty  
• Self-control of actions, appetites, emotions
• Appreciation of beauty and excellence 
• Gratitude 
• Hopefulness, or having a positive attitude 
• Able to adapt, be flexible or tolerant  
• Able to cope well 
• Able to express emotions well 
• Able to express needs well 
• Assertive o Capable 
• Courageous 
• Creative
• Future or goal oriented 
• Intelligent or wise o Motivated 

Personal Strengths Checklist 

• Open-minded 
• Polite or kind 
• Realistic or practical 
• Resilient o Resourceful
• Responsible or trustworthy 
• Self-reliant or independent
• Sensitive or understanding
• Strong support system 
• Thoughtful or careful 
• Zest for life, spunky, or enthusiastic 

Strength-based Recovery 

• Strength-based practices promote resilience and self-acceptance for recovery and empowerment 
• Challenges situations that may seem hopeless or helpless and doesn’t label people or tolerate stigma 
• Builds hope from within, looking at past successes and promoting change by asking: 

1. What has worked before? 
2. What has not worked? 

 Remember that you are unique – Your strengths and weaknesses are not the same as anyone else’s strengths and weaknesses. By getting help and looking at your strengths, a realistic, specific plan can be made to work for you and your situation.  

It’s important to focus on specifics. “Kayaking isn’t a strength but athleticism and disclipline are. What makes you good at kayaking? What quality in your self enabled you to be successful in this discipline?

Gradually, Mueller began to realize she needed to take stock of her life. She began to realize that several factors, including a history of mental health issues in her family, a previous, abusive marriage and other variables had contributed to her negative feelings of  self worth. 

Little by little, she started rebuilding her life. She remarried. She returned to school. She also started taking an active role in reaching out and forging healthy alliances with the appropriate support people.

“I realized I needed help in managing my disability,” she says. “Healthcare providers helped me understand my disability and taught me management tips. For example, the importance of having a schedule: it helps me stay on top of taking my meds, but also helps me manage my sleep schedule. I also started keeping a seizure diary and learned to identify patterns and triggers.

“Had to unlearn a lot of old behaviours,” she says. “When I was younger I used to be able to multitask. I had energy. But after the diagnosis I had to learn a new way of being.

Over time, Mueller began to understand that the more ownership she felt over her disability; the more she was able to articulate what her seizures were, how and when they manifested, how they made her feel and what supports she needed, her outlook started to improve. 

Complementing this she reached out to Epilepsy Toronto to begin the process of counselling and career planning that has started to help her slowly but surely rebuild her life and clarify the next steps on her journey. 

Paying Rent on the Past 

“Self esteem is a place inside me that describes how I feel about myself,” says Mueller. “Those feelings are sensitive and raw and based on those feelings I make decisions that aren’t always good for me. 

“I tend to focus on mistakes and never on the good. But I always keep going back to the negative and that’s exhausting, having 

that low self esteem tape loop constantly running through my head is exhausting.

Solutions

“A counsellor might say, “you’ve come a long way. If someone says “thank you” or ‘You’ve done a good job,’ it enables me to brakes on that negative tape loop. 

“I find if I help someone that also helps me too. For example, someone recently had a seizure and I was able to help her home and help her feel good about herself. When I know I’m making a tangible difference it helps me feel good about myself.”

Some other techniques Mueller employs to help her manage her self esteem, include:

• Volunteering – “I love it. Feeling that connection with others helps me.”
• Dogs
• Walking
• Gardening – “Gardening is very grounding. I love getting my hands in the dirt. Nature and the beauty of outside takes me outside of myself and helps me feel real.”
• Watching movies – “I can focus on someone else and it helps stop the chatter in my head.”

Some days it’s difficult getting out of bed, but once I’m at my volunteer work, I love it, she says. “I try to remember that the next 30 minutes is going to turn into 10 hours I really love. I need to remember the good and not feeling isolated.

“Finding a few passions has really helped. You need to find something that resonates and makes you happy.”