“I stink, you don’t want to hug me.” 

Adam and I were stood at the bottom of Yeldall’s iconic driveway. Driving to work early one morning I’d noticed movement in the bushes and stopped to investigate. Soon enough Adam emerged from where he’d slept the night, right there in the shrubbery. 

I knew Adam well from his time on the programme the year before. Initially he stayed sober but a Christmas relapse led to months spent in and out of hospital and sleeping-rough in garages and sheds. Adam would later say he stood there “broken, beaten, and with nothing left of self or material things”.

“I stink, you don’t want to hug me.”  

Those words communicated more than Adam’s need for a hot shower and some fresh clothes. They expressed the shame of a man whose sense of self-worth was shot to pieces. It was too late to abort the hug. It was already happening. And I don’t remember a smell. I just remember a man who desperately needed to know he was loved and accepted – just as he was. 


The more time I spend with those who are struggling and, to be honest, in my own head, the more I become convinced of two things.

Firstly, that a sense of self-worth is more than a ‘nice to have’. It’s not. It’s a key building-block for emotional wellbeing, healthy relationships, and professional success. In turn, a strong sense of inadequacy/shame/worthlessness will leave us vulnerable to things like depression, anxiety, addiction, and eating disorders.

Secondly, that the world we inhabit is fiercely hostile to the formation and maintenance of a healthy sense of self-worth. Of course, social media and the faux sense of ‘connection’ it creates whilst simultaneously pitching your true-self against everyone else’s best-self, can do great harm. The hostility, however, goes way beyond the advent of social media. It’s rooted in the disconnection we increasingly experience from one-another (community), the environment and the spiritual realm – a powerful unintended consequence of the process of modernization.

Modernization itself is a multi-faceted notion, which encompasses the industrialization of work; the shift from villages to towns and cities; the replacement of the small community by the society; the rise of individualism; the rise of egalitarianism; and the rationalization both of thought and social organization.

Steve Bruce, God is Dead, 2

The negative impacts of modernization (and there have, of course, been many positives) have been turbo-charged by the dominance of an economic system which, whilst yielding great benefits, has fostered a ‘life-as-competition’ worldview within which we measure our value by comparison with our neighbours. Whether the outcome is a win for us, or a defeat, we always lose. In the areas where we come-up short, we find yet more evidence to diminish our sense of self-worth. In the areas where we ‘win’, we are duped into building our sense of self-worth on a fragile foundation.


In Spanish classes I’ve been warned about so-called ‘false friends’. Spanish is particularly dangerous for the native English speaker in this respect because there are so many cognates (words which sound and mean the same thing in both languages) which make it easy for us to guess the right translation in lots of situations. Embarazada is a good example. It sounds like the English word ‘embarassed’ but means ‘pregnant’.

When it comes to self-worth we need to be aware of what psychologists call contingent or conditional self-worth, a dangerous ‘false friend’. Gabor Maté explains:

Self-esteem is not what the individual consciously thinks about himself; it’s the quality of self-respect manifested in his emotional life and behaviours. By no means are a superficially positive self-image and true self-esteem necessarily identical. In many cases they are not even compatible. People with a grandiose and inflated view of themselves are missing true self-esteem at the core… The greater the void within, the more urgent the drive to be noticed and to be ‘important,’ and the more compulsive the need for status. By contrast, genuine self-esteem needs nothing from the outside… I don’t need to be right or to wield power, to amass wealth or achievements. 

Gabor Maté, In the Realm of Hungry Ghosts, 246

Whilst we quite rightly affirm one-another’s efforts, performance, accomplishments, and a whole host of character qualities and the attitudes/actions which they produce, we need to recognize the fragility of a sense of self-worth built on anything contingent. Such emblems of worth are like a pair of knock-off trainers. They might look the part and make you feel good, but they’ll soon fall apart. 

What’s on this list? Academic performance, personal popularity, physical appearance, fulfillment of religious or cultural expectations, parental reputation, social-media virility, virtues and vices, status, intelligence, achievement, and much more.

These things impact upon our lives in a multiplicity of ways, but they do not speak to our essential value as people. That needs to be found in the same place as it is for the woman whose mental illness means she’s unable to work, the teenager coming to terms with a physical disability, or the newborn fighting for his life in an incubator.


The big road junctions of Santa Cruz, Bolivia, the city where we live, function like a drive-thru bazaar. In any given week you’ll have the opportunity to buy drinks, snacks, newspapers, flowers, bread, toilet paper, cleaning products, desserts, and electronic accessories. There are season specials, with orchids on Mother’s Day, roses on Valentine’s Day, and flags galore on Independence Day. Guys will wash your windscreen. Circus performers will entertain you with with fire-juggling, tightrope-walking, and sword-swallowing. And in the midst of all of that, you’ll be presented with an array of people soliciting your financial ‘collaboration’.

One of the more unusual sights at the lights over recent months has been that of young Venezuelan men offering you Venezuelan Bolívars (which have been rendered worthless by hyperinflation which exceeded 1,000,000% in 2018), in exchange for whatever loose change you are willing to share. The Bolívar, like all currencies today, is fiat money. It’s not underpinned by a physical commodity, such as gold. Rather, its value is determined by the people who interact with it and the level of their confidence in its issuing government.  

Self-worth operates much like a fiat currency. Whilst we will likely all affirm the proposition that every human life is of immeasurable inherent worth, what we really feel about ourselves is very largely determined by our interactions with others, particularly during early childhood. We come to love ourselves, and, as a result, are able to love others, to the measure that we ourselves have been loved, respected, appreciated, protected, esteemed, and valued. 

Like a sculpture, we are shaped by countless impacts. Some, like rejection and abuse, are heavy blows with enough blunt force to split us apart. The vast majority are light touches which, imperceptibly over time, finesse the contours of our self-image, positively or negatively. 

The sobering truth is that we each have incredible power to build-up and dismantle one-another’s sense of self-worth. And with that great power comes great responsibility – especially towards children, whose sense of self-worth is highly sensitive to external inputs, and those whose self-image has been undermined by childhood adversity.


What does all of this mean for addiction care? Might it be that effective help to discover a sense of true self-worth is the greatest gift we can give to those who are struggling to untangle themselves from the grip of addiction? 

At the very least, a concern with self-worth should be at the heart of this work. More specifically, in the context of recovery community like a rehab or day programme, we need to focus on three things:

Firstly, on creating communities which provide the space and help required for the individual to develop an awareness of their self-image and the people/relationships, and experiences, which have shaped it. If we are serious about this process we will put 1-1 work front-and-centre. We will also recognize that it takes time.

Secondly, we need to focus on creating communities which, in countless different ways, out loud and implicitly, communicate to their members that they are loved – and are worthy of being loved. Such a goal will have an impact on everything from how we relate to our clients to how we maintain our premises. It will mean our clients feel heard, appreciated, encouraged, respected, and accepted. It will mean our communities value conversation, eye-contact, vulnerability, and anything else which affirms and builds-up. It will mean we lovingly speak truth to one-another, sometimes say ‘no’, and make the effort to call each other out when we rely too heavily on false friends.

Thirdly, we need to focus on creating communities which point each person to the ultimate source of human value, and to a relationship with the personal God whose unconditional love and empowering presence will, if we let it, utterly transform our self-image.  

“God knows us and calls us by name as well. We are not strangers or aliens to God. We are each and all God’s beloved… The One who calls us beloved is also the one who knows us so intimately and well that even the number of hairs on our heads is known. To remember who creates us and recreates us, who calls us again and again, who knows us completely, and who loves us unconditionally is to be prepared, as Jesus was, for all that is to come… We belong to God who claims us as beloved children and holds us close in the embrace of strength and love.”

Rueben P. Job, A Guide to Prayer for all who Walk with God, 333-334.