When you’re talking about a neurotic individual, it’s reasonable to think of their personality as a sort of “mask” or facade that hides their true self. But when it comes to the disordered character, what you see is what you get.

Disturbed characters generally have too much self-esteem. They know what they have going for them and they equate their endowments with their identity. This is one of the main reasons their self-image can become inflated. On the other hand, disturbed characters often are frequently and chronically lacking in self-respect.

Neurotics often have damaged self-images that stem from low self-esteem. Disordered characters see themselves as superior which leads to a sense of entitlement. What’s more, disordered characters aren’t compensating for anything, they really do think they’re all that!

Some young men use the phrase “lack of self esteem”, although in fact the anxiety they experience puts them constantly centre stage in their own heads. Everyone is looking at them, only what they say and think and do matters, and what they say think and do is always visibly “worse” than what everyone else is saying, thinking and doing.

Sometimes I am struck in my work as a therapist by how many strong, talented, intelligent, creative, loving women have a tendency to live as if their lives didn’t matter.

The “Motiwake Personal Development Alarm Clock” awakens you with positive affirmations to programme you for the day. Many people use their own “Demotiwake Personal Alarm Clocks” instead. Isn’t it a better idea just to drop the programmes and relax?

One thing that strikes me at the moment in my practice is how uniquely isolated so many people are feeling — when they have exactly the same problem! Feeling isolated and judging ourselves as different, and worse than others, tends to become a self-fulfilling prophecy.