Working with CompassionMichael O'Sullivan is a Cognitive Behavioural Psychotherapist for the Derbyshire Healthcare Foundation Trust and a Pavilion author. Michael co-wrote Working with Compassion and here he gives us his views on what dignity means and its correlation with mental health.

What is dignity and why is it important in mental health? It is one of those words which is much used by many without much of an idea of what it means. For me, dignity is the end result of how we relate to ourselves and other people. In all of the dictionary definitions of dignity that I have come across, what occurs most frequently is the idea that people have “worth”. In life “worth” is expressed in relationships. How we see the worth in others and how we recognise our own self worth. As a mental health worker I see the dignity in the people I work with by recognising their worth.”

It goes without saying that the most important relationship you can have is with yourself. For the clients I work with, their relationship with themselves is not one where they feel self worth. Self worth matters. Relating to yourself with dignity matters. Self worth is often forgotten in contrast with its more well known “sibling” “self-esteem”. For clients in mental health services, it is often the case that their mental health problems are expressed as a lack of “self-esteem”. 


If self-esteem is better, then they feel better.

However, if we pause for a second and consider what self-esteem actually is, self-esteem is at heart “conditional”.

What do we mean by this? We mean that your self-esteem depends on “what you do, how you look what you achieve and what results you get”. If you are successful you get the result-the job, the exam grade, the weight loss.

For me, self-esteem is a “good time” in the Nottingham half marathon. If you get the result your self -esteem goes up and you feel better. So far so good. If, however, you don’t make the grade, your self-esteem goes, and you become depressed. Self-esteem is a fair weather friend. If you aren’t getting the results, it will leave you.

Self-worth is different. Self-worth recognises that you have intrinsic value.

Your value as a person is not dependent on what you have achieved. It is not seen on the outside but comes from within. Your value as a person is expressed in your humanity.

We all at some stage in our lives recognise this.

Babies are not achievers but they have value. As we go through school we begin to lose this. We are evaluated on our achievements. Our culture reinforces this.

If we don’t get the results, if we don’t look the right way, we are rejected. All of the TV programmes we watch from The X Factor to Big Brother are built on rejection.

We are taught that our worth is expressed solely in these external terms. I do not want this to sound as if it is a criticism of needing to achieve. We all need to exist in the real world.

We all need to work and produce results. However we need more.

We need to feel self-worth and to see the worth in others. We need to think how this can be put into action. When we begin to act in this way, then we will be working towards the result that really matters- to relate to ourselves and towards other people with dignity.

Michael O’Sullivan

Cognitive Behavioural Psychotherapist
Derbyshire Healthcare Foundation Trust 

Author of Working with Compassion

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