The factors that contribute to low self-confidence combine and interact differently for each person. Your genes, cultural background, childhood experiences, and other life circumstances all play a role. But don't lose heart - although we can't change the experiences in our past that shaped us, there is plenty we can do to alter our thoughts and expectations to gain more confidence.

Some of what molds our self-confidence is built into our brains at birth. I mention these factors not to overwhelm you, but to let you know that you shouldn't blame yourself for your self-image.

Studies have shown our genetic makeup affects the amount of confidence-boosting chemicals our brain can access. Serotonin, a neurotransmitter associated with happiness, and oxytocin, the "cuddle hormone," can both be inhibited by certain genetic variations. Somewhere between 25 to 50 per cent of the personality traits linked to confidence may be inherited.

Some aspects of our behaviour also stem from our temperament. If you're naturally more hesitant and watchful, especially in unfamiliar circumstances, you may have a tendency called "behavioural inhibition." When you're confronted with a situation, you stop and check to see if everything seems the way you expected it to be. If something appears awry, you're likely to move away from the situation.

Behavioural inhibition is not all bad. We need some people in the world who don't impulsively jump into every situation. If you're a cautious and reserved person, self-confidence may have eluded you. But once you understand yourself you'll be able to work with your temperament and not fight it.

A number of individual experiences can lead to feeling completely unsure of yourself or even worthless. Here, I'll discuss a few.

Gender, race and sexual orientation. Scores of studies show women are socialised to worry more about how they're perceived and, therefore, to take fewer risks. Racial and cultural background and sexual orientation can make a difference, too.

Lack of self-confidence can come from not knowing the "rules" of the confidence game. For example, if we think we have to feel confident in order to act confidently, we set ourselves up for failure.

Perfectionism is another form of faulty thinking that contributes to low self-confidence. If we believe we have to have something all figured out before we take action, those thoughts can keep us from doing the things we value. Even learning and understanding what confidence is and isn't, as you're doing in this chapter, is a big step toward boosting it.

Many media messages are designed to make us feel lacking. Companies that want to sell you products usually start by making you feel bad about yourself, often by introducing a "problem" with your body that you would never have noticed otherwise.

Now that social media has become ubiquitous, the messages hit closer to home. It's easy to believe that everyone around you has the perfect marriage, a dream career, and supermodel looks to boot. But remember: what people post online is heavily curated and edited. Everyone has bad days, self-doubt and physical imperfections. They just don't trot them out on Facebook!

It's common for anxiety and depression to go hand-in-hand with self-confidence issues. If you've already been diagnosed with an anxiety disorder or depression and are working with a therapist, you could bring in your workbook and perhaps go through it together.

Barbara Markway, Ph.D, is a psychologist with over 23 of experience

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