One has only to go into a prison, or at least a prison of the kind in which I used to work, to see the most revoltingly high self-esteem among a group of people (the young thugs) who had brought nothing but misery to those around them, largely because they conceived of themselves as so important that they could do no wrong. For them, their whim was law, which was precisely as it should be considering who they were in their own estimate.

With the coyness of someone revealing a bizarre sexual taste, my patients would often say to me, "Doctor, I think I'm suffering from low self-esteem." This, they believed, was at the root of their problem, whatever it was, for there is hardly any undesirable behavior or experience that has not been attributed, in the press and on the air, in books and in private conversations, to low self-esteem, from eating too much to mass murder.

Self-esteem is, of course, a term in the modern lexicon of psychobabble, and psychobabble is itself the verbal expression of self-absorption without self-examination. The former is a pleasurable vice, the latter a painful discipline. An accomplished psychobabbler can talk for hours about himself without revealing anything.

Insofar as self-esteem has a meaning, it is the appreciation of one's own worth and importance. That it is a concept of some cultural resonance is demonstrated by the fact that an Internet search I conducted brought up 14,500,000 sites, only slightly fewer than the U.S. Constitution and four times as many as "fortitude."

When people speak of their low self-esteem, they imply two things: first, that it is a physiological fact, rather like low hemoglobin, and second, that they have a right to more of it. What they seek, if you like, is a transfusion of self-esteem, given (curiously enough) by others; and once they have it, the quality of their lives will improve as the night succeeds the day. For the record, I never had a patient who complained of having too much self-esteem, and who therefore asked for a reduction. Self-esteem, it appears, is like money or health: you can't have too much of it.

Self-esteemists, if I may so call those who are concerned with the levels of their own self-esteem, believe that it is something to which they have a right. If they don't have self-esteem in sufficient quantity to bring about a perfectly happy life, their fundamental rights are being violated. They feel aggrieved and let down by others rather than by themselves; they ascribe their lack of rightful self-esteem to the carping, and unjustified, criticism of parents, teachers, spouses, and colleagues.

The twin qualities leading to self-esteem are (an allegedly) just appreciation of one's own importance and of one's own worth. Neither importance nor worth, however, are qualities to be found in nature without an appraising mind; it is the appraising mind that confers them upon their object.

Let us take importance first. There is no doubt a sense - that of the American Declaration of Independence, the supposedly self-evident truth that all men are created equal - in which everyone is important simply by virtue of drawing breath; but of course this kind of importance is not sufficient for the self-esteemist, who derives no comfort from it whatsoever. What he needs is to be more important than someone else in order to have his self-esteem. Nor is it sufficient that he should be more important than somebody else only in his own eyes, because we are all more important in our own eyes than anybody else.

Hence the self-esteemist demands the recognition of others - "respect," in the lexicon of the slum hoodlum - in order to prop up his self-esteem. Unfortunately for him, the world of others still usually insists upon some kind of achievement before according recognition: achievement in a broad sense, but achievement nonetheless. But the self-esteemist wants to skip this arduous requirement; the result is that he is an angry and bitter soul.

Similar strictures apply to the other component of self-esteem, namely the sense of worth. Clearly, a sense of worth is something that one would normally expect to be earned rather than conferred ex officio, as it were, similar to the right to a fair trial, but the self-esteemist wants to skip the stage of earning. He is like the man who resents the fact that he has not inherited enough to prevent the necessity of having to make a living for himself.

In other words, the self-esteemist wants something for nothing, and, because in his heart he knows that what he wants is impossible, he is wretched and ascribes all the many failures of his life to it. Self-esteem is therefore first cousin to resentment.

That self-esteemists mostly know that they are about as sincere as Marie Antoinette playing shepherdess is illustrated by the following: When patients pretended to confide in me that they were suffering from low self-esteem, I used to reply that at least, then, they had got one thing right: they had valued themselves at their true worth. (Of course, I used care when addressing the patients: those with higher education were less able to bear the exposure of their deception by means of irony, because their education had equipped them with stronger and more sophisticated powers of rationalization.)

Far from becoming angry, most patients - previously wretched - would begin to laugh, like those caught out in an obvious but relatively innocent attempt at a practical joke. Indeed, they were relieved: they no longer had to pretend anything, either to themselves or to others. We could then talk about the manifest deficiencies of their lives without resort to a vocabulary that acted as a smoke screen.

The problem with low self-esteem is not self-dislike, as is often claimed, but self-absorption. However, it does not follow from this that high self-esteem is not a genuine problem. One has only to go into a prison, or at least a prison of the kind in which I used to work, to see the most revoltingly high self-esteem among a group of people (the young thugs) who had brought nothing but misery to those around them, largely because they conceived of themselves as so important that they could do no wrong. For them, their whim was law, which was precisely as it should be considering who they were in their own estimate. It need hardly be said that this degree of self-esteem is certainly not confined to young thugs. Most of us probably suffer from it episodically, as any waiter in any restaurant would be able to tell us.

In short, self-esteem is but a division of self-importance, which is seldom an attractive quality. That person is best who never thinks of his own importance: to think about it, even, is to be lost to morality.

Self-respect is another quality entirely. Where self-esteem is entirely egotistical, requiring that the world should pay court to oneself whatever oneself happens to be like or do, and demands nothing of the person who wants it, self-respect is a social virtue, a discipline, that requires an awareness of and sensitivity to the feelings of others. It requires an ability and willingness to put oneself in someone else's place; it requires dignity and fortitude, and not always taking the line of least resistance.

Here I hope I will be forgiven for obtruding a little autobiography by way of illustration. For many years I believed that how a man dressed was unimportant; it was the man within that counted, not the man without. My belief excused me for being myself rather scruffily dressed, which was very easy and convenient for me in terms of effort required. But I now think that I was mistaken, for it does not follow from the fact that outward appearance is not all-important that it is of no importance at all.

The small matter of cleaning one's shoes, for example, is not one of vanity alone, though of course it can be carried on to the point of vanity and even obsession and fetish. It is, rather, a discipline and a small sign that one is prepared to go to some trouble for the good opinion and satisfaction of others. It is a recognition that one lives in a social world. That is why total informality of dress is a sign of advancing egotism.

Self-respect requires fortitude, one of the cardinal virtues; self-esteem encourages emotional incontinence that, while not actually itself a cardinal sin, is certainly a vice, and a very unattractive one. Self-respect and self-esteem are as different as depth and shallowness.