How you see yourself, and how others see you

The mismatch between self-perception and how others actually see us is one of the more clinically productive findings in the literature on depressed and socially anxious clients. Depressed clients consistently rate themselves more harshly than people who know them rate them. Socially anxious clients consistently overestimate how negatively others view them. Perfectionists with grandiose self-image rate themselves more favourably than feedback would support. In every case, the gap matters.

This worksheet structures the comparison. The client writes how they currently see themselves. Then they ask two or three trusted people to write back briefly with how they see the client. The two views sit side by side and the client reads them together.

Use it with depressed clients carrying hard self-judgments that the cognitive work alone hasn’t budged. With socially anxious clients whose predictions about being judged are central to the formulation. With clients who feel “invisible” and would benefit from data showing they’re seen more accurately than they think. With perfectionists who can’t tolerate any positive feedback because it doesn’t match their internal assessment.

The clinical patterns to read. The most common one across depressed clients: the gap is wide in the direction of being more positively seen than they thought. Reading the responses aloud in session, in the words of the actual people, produces shifts that the cognitive work in session usually couldn’t. The data is in someone else’s voice.

A different pattern: clients who refuse to send the worksheet to anyone. That refusal is itself the working material. The next session’s conversation is about what makes asking for honest feedback unbearable. The refusal usually points at shame, at fear of confirmation of the negative self-image, or at an isolated support system where the client has no one to ask. Each is a different conversation.

A third, more difficult pattern: clients whose chosen others write back in unexpectedly cruel or dismissive ways. That happens, and it’s clinical information about the support system rather than the client. If your client is asking the people in their life how they see them and getting back responses that are dismissive or harsh, the formulation expands to include who’s available to them and who isn’t.

In my-cbt, the worksheet is one of the bundled system templates. Assign it carefully and only when the client has at least two reliable people to ask. The submission saves in the case file and you read the responses with the client in the next session, slowly enough that the data has space to land.