Mrs. K. questions who she really is. Her family, her career, her entire life seem pointless. She feels anxious and broods. She sometimes screams at her children for no reason and then feels guilty. She has toyed with the idea of suicide. In contrast, Mr. M. believes that he possesses extraordinary gifts. He spends long nights writing down grandiose plans to save the world and sends his manuscripts to numerous publishers. Despite heaps of debt, he buys an expensive sports car, anticipating success. He has never felt more confident. These patients suffer from different mental illnesses–Mrs. K. is depressed, and Mr. M. is manic–but they both hold highly distorted views of themselves.

It is more than just sage advice to “know thyself,” as Heraclitus advocated in the fifth century B.C. A realistic self-image is a hallmark of a healthy mind. Ancient Greek philosophers speculated that the psyche determines behavior. Since then, numerous studies have shown that people with a faulty self-image tend to have high levels of anxiety, defensiveness, self-doubt and narcissism. Relationships, careers and happiness suffer when reality doesn’t match who we think we are.

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