The science of self-worth (and how to boost yours)

When someone with low self-esteem receives a compliment or an award, their blood pressure can actually go up. That striking finding comes from research psychologist Marissa Franco, author of a new book on self-worth, in conversation with NPR's Mariel Segata. The reason, Franco explains, is that positive feedback contradicts how these individuals see themselves—and that misalignment creates genuine physiological distress. One study even found that when people with low self-esteem experienced positive events, they had more doctor visits months later. This counterintuitive reaction sits at the heart of what Franco calls "the paradox of self-worth": people who are truly worthy can admit when they don't feel worthy, because they're attuned to expressing their internal world as it is.

How low self-esteem rewires the brain and body

Franco explains that low self-esteem doesn't just affect how you feel in the moment—it actively amplifies negative emotions and dampens positive ones. When someone with low self-esteem experiences rejection, it hits harder and lasts longer because their brain draws on a database of negative memories that predict more of the same. Those memories don't just record the past; they forecast the future, triggering the same body states as if the original rejection were happening now.