Every time you affirm your true, authentic self, every cell in your body cheers “Yes!” Every time you negate yourself or allow others to do so, it has negative biological consequences. Affirming your true self means taking action to meet your needs; expressing who you really are; thinking good thoughts about yourself and taking action to do what you really want.

Affirming yourself entails putting yourself at the center of your decision-making — something hard for codependents, who are other-focused, ignore their needs, and have trouble asserting themselves.

Negating yourself or allowing others to do so has the opposite effect. Neuroscience has substantiated the body-mind connection, revealing that hormones, neurotransmitters, immunotransmitters, and neuropeptides all respond to emotion, imagery, and thought. The powerful placebo effect is an example of how thoughts can heal. Merely talking about food can make you hungry, a sad memory or movie can make you cry, and imagining a lemon can make your mouth water. Research shows that low self-esteem is linked to stress and higher cortisol responses. Over time it affects brain structures.

It’s important to note that it’s not just the amount of stress that’s pivotal, but the belief in your ability to handle it that matters. Codependents with low self-esteem more often perceive situations as stressful – like saying “no” or asking for help – that needn’t be. However, taking such actions in the face of anxiety builds self-esteem and confidence; shunning them increases a fear response.

Self-affirming actions can be challenging for codependents. Typically, they’re disconnected from their authentic self and are preoccupied with, take the lead from, and react to others. They unconsciously don’t believe they’re important and deserving of love or respect. Some don’t feel entitled to happiness or success. Low self-esteem makes them self-critical. It’s hard for them to be proud and self-encouraging. Their shame leads to fear and anxiety about being judged, making mistakes, and failing. From being shamed as children, they may not be able to identify their needs, feelings, and wants, or believe that their feelings, opinions, or needs matter. These are all obstacles to taking self-affirming action, self-expression, decision-making, and putting themselves first.

Being loved and accepted are paramount for codependents. To ensure this, they hide who they really are and become who they aren’t. They tend to accommodate others rather than affirm their true self. They may anticipate anger, criticism, rejection, or abuse for setting limits, because that is what they experienced in childhood. As adults, due to low self-esteem they often choose partners and friends who repeat that pattern. Many even accept abuse rather than risk rejection or end toxic relationships, including friendships. Some fear being alone.

Adding to their predicament, codependents don’t realize their own power in asserting themselves. They may have had an abusive, narcissistic, or addict parent(s) and learned that their voice didn’t matter. Moreover, they were never protected and didn’t learn how to stand up for themselves.

Codependents frequently misinterpret others’ responses in a negative light. The following is an example of how expectations of others (including that they read your mind) and negative, personalized interpretations of behavior can lead to hurt feelings, which reinforce low self-esteem and feeling unlovable.

Bonnie was terribly hurt when her boyfriend Mark refused to lend her money, which he had and she needed and wanted. She took this to mean that he didn’t love or care about her. Adding to the problem, she never actually requested a loan, but presumed he should have offered anyway. The truth was that he was raised to have different beliefs about money and lending, and therefore disagreed with her expectations and her assumptions about how he should act.

After she understood his background, and even though he was empathetic to her situation, she couldn’t forgive him unless he agreed with her about what he should have done. She was surprised when I questioned why his disagreement (which clearly had nothing to do with her) meant he neither understood nor loved her and why he couldn’t both love her and disagree. These were novel thoughts that hadn’t occurred to her.

Taking self-affirming action can feel uncomfortable at first and create anxiety, guilt, and self-doubt. Plan to expect this — like soreness after using weak muscles — and know that it’s a sign that you’re doing the right thing. Give yourself credit for taking a risk. Doing so builds self-esteem and your authentic true self.

After a while, such actions feel more natural and less anxiety-provoking, until one day, you find yourself spontaneously doing them — setting limits, asking for what you want, trying something new, expressing a minority opinion, giving yourself credit, and doing more enjoyable activities – even alone. You find you have less resentments and judgments and that relationships are easier. You start to like and love yourself and enjoy the process of living.