Why Affirmations Work: What I Practiced in the Mirror

By Natacha Montemuino, MD  ·  3 minute read  ·  Issue #8

I'm 8 years old, standing in front of the medicine cabinet in the pink-tiled bathroom of my childhood home in Queens, NY. I'm looking at myself in the mirror pinching my nose, starting with the bridge between my eyes and working down to the tip, the way my mother just showed me.

She's right next to me, patiently demonstrating the correct technique for a second time. Calling me by my nickname, she says, "Tashoo, pinch your nose like this every day," and smiles in approval.

As I recall this moment, I can't help but wonder why I never pushed back. I was a rebellious child who always asked questions and had to understand things that didn't make sense.

But for this particular exercise, I just did as I was told, which my mother loved, of course.

This is how I developed the habit of pinching my nose whenever I looked in that mirror.

What seemed like an innocent little habit was slowly reinforcing a subconscious message that there was something wrong with my nose in its natural state and that it needed to be squeezed to better conform to conventional beauty standards.

Over time, that message transformed into the belief that "I’m not enough.”

I didn't realize this was happening, because like a typical 8-year-old, I was focused on the things that brought me joy, like playing with my friends and watching my favorite cartoons. But later on, during an awkward adolescence struggling with acne and braces, I remember disliking my reflection in the mirror.

Perhaps it was the nose pinching. Perhaps it was feeling fat compared to my friends. Perhaps it was a combination of those things and several others.

All I knew when I looked in the mirror of that pink-tiled bathroom was that I didn’t like what I saw. I had negative thoughts about myself, and without knowing it, I was practicing them.

What was actually happening

What you repeatedly practice, like a skill or a thought, can physically change your brain by strengthening its neural pathways. This process is called neuroplasticity. It's how your brain builds new connections and adapts.

But neuroplasticity is a double-edged sword. The same ability that supports learning new skills, rehabilitation, and healthy aging can also reinforce harmful states like chronic pain and addiction.

This means your brain gets better at whatever you keep doing or thinking, whether it's positive or negative.

Every time I looked in that mirror and thought "I'm not enough," I was strengthening that neural pathway, and my brain got better at believing it.

So instead of repeating an unhelpful thought, you can choose to repeat a helpful one.

The two tools that make affirmations work

In the last edition of this newsletter, I shared that to feel comfortable with visibility, you have to accept and love yourself exactly as you are. My story is an example of the opposite, of me rejecting my reflection in the mirror.

If you struggle to see yourself, your value, and your worth when you look in the mirror and immediately have self-critical thoughts, you're doing the same thing, and the two tools I promised you are how you change that.

The first tool is cognitive reframing, which comes from cognitive behavioral therapy, developed by the psychiatrist Dr. Aaron Beck at the University of Pennsylvania. Reframing is the practice of catching an unhelpful thought and replacing it with one that's more helpful, or at least neutral. It starts with the simple truth that your self-critical thoughts are not facts.

So when you look at your reflection in the mirror and a thought like "I’m not enough" comes to mind, you challenge it with two questions. Is it true? Where is the proof? Most of the time, the only proof is a thought you've had so many times that it feels true. Then you ask what else could be true, and you choose a supportive answer you want to repeat. Maybe it's a childhood story you're still holding on to. Maybe you're enough exactly as you are.

The second tool is mirror work, which comes from the late Louise Hay, the iconic transformational teacher, author, and founder of the publishing company Hay House. Mirror work is the practice of looking directly into your own eyes in a mirror while you repeat positive affirmations out loud. The practice helps you overcome your inner critic and is the most effective way to learn to love and accept yourself.

Some people think affirmations are fluff and don't work. But every time you reframe a thought or repeat an affirmation, you're practicing a helpful thought, and through neuroplasticity, your brain strengthens the neural pathway for that thought, the same way my brain strengthened an unhelpful one every time I looked in that mirror as a kid.

With practice, choosing a helpful thought gets easier, and eventually it becomes automatic. That's how these two tools can change the thoughts you repeat and, over time, believe about yourself.

Self-worth is the internal belief that you have value, are enough, and are worthy of love and belonging, and you build it from the inside out. That's why building high-stakes communication skills starts with doing the inner work first.

Self-worth also gets built through action. Every time you keep a commitment you made to yourself in private, or do the thing you're afraid to do, you collect undeniable proof that you are who you say you are. Affirmations work best when you pair them with that kind of action, because that's what makes them true.

What unhelpful thought about yourself have you repeated the most?

Reply and tell me. I read every response, and I love hearing from you.

See you in two weeks.

Dr. Natacha

Sources

Beck Institute. History of Beck Institute (Aaron T. Beck and the development of cognitive therapy). https://beckinstitute.org/about/history-of-beck-institute/

Louise Hay on mirror work: https://www.louisehay.com/what-is-mirror-work/

Gazerani P. The neuroplastic brain: current breakthroughs and emerging frontiers. Brain Research. 2025;1858:149643. https://doi.org/10.1016/j.brainres.2025.149643