Low self-esteem is a view of oneself as inadequate, "not good enough," or lacking in some way. Low self-esteem can contribute to depression and anxiety, to passivity and inactivity, to unsatisfying relationships, and to a constricted and unhappy life.

Cognitive-behavioral models propose that individuals with low self-esteem often set unrealistic and excessive standards for themselves, which can lead to chronic failure and feelings of inadequacy. Individuals with low self-esteem also tend to over-focus on their weaknesses and minimize their strengths. Some individuals with low self-esteem behave like social chameleons, suppressing their true feelings and beliefs and instead doing what they perceive as acceptable to others.

To treat low self-esteem, cognitive-behavior therapy teaches the individual who has excessive standards to identify and modify them, including by carrying out experiments to test beliefs like, "Unless I always do things perfectly, I will be miserable." Therapy can teach the individual who over-focuses on weaknesses and minimizes strengths to shift those behaviors. Therapy can teach social chameleons skills that will allow them to begin to overcome obstacles to attending to and validating their feelings, and to begin acting in ways that express important feelings and personal values.

Expressing yourself assertively means communicating your feelings directly and respectfully. Some people have difficulty being assertive in certain situations or with certain people (for example, asking the boss for a raise). Others have difficulty being assertive in nearly all situations. Some people who have difficulty with assertiveness find themselves saying "yes" when they really want to say "no," discounting their own needs and prioritizing those of others, and doing what others expect and want instead of what they themselves would prefer. These individuals are passive instead of assertive. Others who have difficulty with assertiveness tend to be aggressive and demanding rather than assertive, and still others use manipulative or indirect strategies rather than expressing their wishes directly and assertively. None of these unassertive styles is usually effective or satisfying, and all can contribute to anxiety, resentment, depression, and difficulties in relationships and work.

Cognitive behavior therapy helps the unassertive person identify and pinpoint his difficulties with assertiveness, identify and change beliefs (such as, "If I speak up, he will get angry and yell at me") that contribute to assertiveness, and learn and practice skills for expressing oneself appropriately and assertively.

The word stress can refer both to internal psychological states of feeling anxious, pressured, burdened, overwhelmed, unhappy, and similar, and to external events or situations that contribute to those internal states, such as demanding work responsibilities, financial burdens, or family problems. Stress of both sorts is ubiquitous; we all experience it at times.

If stress becomes overwhelming or causes huge suffering, cognitive-behavior therapy can help. Interventions that cognitive-behavior therapists use to treat stress include using brainstorming and other problem-solving strategies to solve external situations that are overwhelming or unmanageable, pinpointing and changing cognitions (such as "I can't handle this situation") and behaviors (e.g., working nonstop without breaks or assistance) that can feed stress, and improving self-care, such as establishing regular routines for exercise, sleep, and socialization.

Procrastination involves making a plan to do something but not carrying out the plan as scheduled. It means putting things off until later. Procrastination can lead to anxiety, and to inability to complete important tasks, including activities such as socializing, work and school assignments, and household maintenance. Procrastination can have significant consequences, and can lead to failure at school and work, and to the loss of important relationships. People procrastinate for many reasons, including worry and anxiety, feelings of inadequacy, fears of making a mistake or failing, perfectionism, fears of being controlled or dominated by other people, and depression.

Cognitive-behavior therapy can help a person who struggles with procrastination understand the causes of the problem in order to guide its treatment, respond to maladaptive thoughts that feed procrastination, and learn skills to break through procrastination, including skills to set concrete, specific, and realistic goals, to break tasks down into small manageable pieces, to make dates with others to do things together, and to establish incentives to carry out agreed-upon tasks.

Insomnia involves difficulties falling or staying asleep. All of us experience insomnia at times, but for the person who experiences it frequently or chronically, insomnia can take a major toll in quality of life, mood, energy, and productivity.

The cognitive-behavioral model of insomnia emphasizes the roles of dysfunctional thoughts about sleep, maladaptive sleep habits, physical arousal, and the daytime consequences of sleep loss. Cognitive-behavior therapy helps the insomniac improve sleep quality, quantity, and consistency by optimizing cognitive, behavioral, biological, and environmental factors known to affect sleep. Treatment components include education to correct misunderstandings about sleep, learning to challenge thoughts (often anxiety-related) that interfere with sleep, modifying the sleep schedule to maximize drowsiness at bedtime and alertness in the morning, removing disruptions in the sleep environment, relaxation training, and changing habits that interfere with sleep. Sometimes insomnia is part of another disorder, such an anxiety or mood disorder; when this is the case, treatment for these problems may be needed in order to overcome insomnia.

For some people, major decisions, such as accepting a job offer, and even minor ones, like deciding where to have dinner, can be extremely difficult. The individual may get "stuck" and feel completely unable to make a decision. He may develop the belief that he is incapable of making decisions or solving problems. The person may avoid decision-making whenever possible, letting others make important decisions or postponing decisions for long periods of time, sometimes even years. This passivity can contribute to an unsatisfying, unrewarding life, can cause the person to feel ineffective, and may even place him or her at risk for becoming depressed or developing an anxiety disorder.

Cognitive-behavior therapy helps the fearful decision-maker take an active stance toward life by teaching skills to generate and evaluate alternatives to problems, and to choose and implement concrete solutions to those problems. Therapy also helps the person identify and test maladaptive cognitions about decision-making, such as, "If I make the wrong decision, something really bad will happen and I wonÌt be able to cope with it." Therapy can enable the anxious decision-maker to acquire skills and confidence in making decisions and solving problems that can be maintained well into the future.

Grieving the loss of a loved one is one of the most difficult and stressful human experiences we all encounter. Although the grieving process is natural and necessary, it can also be a painful and confusing mixture of reactions that can last an extended period of time.

Cognitive-behavior therapy educates people about the experiences and process of grief, and teaches people helpful strategies to understand, sort through, and cope in a healthy way with the strong emotions and reactions they are experiencing. Cognitive-behavior therapy can also help people to adjust to the life changes that result from their loss and protect them from subsequent problems with mood and anxiety.

Anger is a natural human emotion. However, many people have difficulty managing the intensity and frequency of their angry reactions. They may also say or do things during a peak of anger that they later regret.

Cognitive-behavior therapy can help people better understand their angry reactions and learn coping strategies to change thoughts and behaviors in order to reduce angry behavior and feel more in control. Sometimes people who have problems controlling anger tend to ignore early warning signs of irritability and resentment until they are out of control. For these individuals, learning to monitor irritability and resentment and to use these feelings as cues to take action to get their needs met, including by speaking up effectively and assertively with others, can help them reduce and eliminate angry outbursts.