Relationships can influence how a person speaks to themselves. A repeated criticism, a pattern of walking on eggshells, feeling responsible for another person’s mood, a difficult break up, uncertainty about being wanted, or the pressure to be easy to love can all leave a mark. That does not mean that every painful relationship causes low self esteem, or that a person’s choices can be explained by one belief about themselves. It can be tempting to look back and make a neat story: this is why I tolerate too much, this is why I do not ask for what I need, this is why I choose certain people. Sometimes the story is useful. Sometimes it is too simple. Relationship patterns can also involve practical dependence, culture, disability, caring responsibilities, financial pressure, trauma, safety concerns, sexuality, faith, past loss or what a person has learned was necessary to get through the day. An assessment can make space for that context. It can ask what happens before self doubt appears, what the person predicts would happen if they set a boundary, what they do to keep the peace, how another person responds and whether the relationship feels safe. The purpose is not to blame someone for staying, tell them to leave, or assume that a relationship is unhealthy because it contains conflict. If there is coercion, violence, fear, immediate danger or control within a relationship, specialist safeguarding or emergency support is more important than trying to resolve the situation through a therapy article. A blog cannot assess risk, advise a person to confront someone or make a decision about contact, disclosure or separation. CBT based therapy may be considered after assessment where clinically appropriate. It can explore the links between self critical thoughts, emotions, behaviour and relational situations. It cannot guarantee confidence, change another person’s conduct, make a relationship safe or decide what a person should do. Where behavioural work is appropriate, it is planned collaboratively with a qualified clinician. A blog is not a self directed instruction to set a boundary, disclose a feeling, stop seeking reassurance, test a relationship or have a difficult conversation alone. Pace, consent, safety and practical support matter. For related information, see self esteem support at lyceumclinic.co.uk/therapy/low self esteem/, the guide to self esteem and relationships at lyceumclinic.co.uk/guides/low self esteem relationships/ and the guide to imposter feelings at lyceumclinic.co.uk/guides/imposter syndrome cbt guide/. If distress includes crisis, thoughts of self harm or an inability to keep safe, urgent appropriate help is needed.