While many of us are clear and forceful about expressing our feelings and meeting our goals, traditionally, women have not been encouraged or conditioned to do so. Sigmund Freud famously asked, “The great question that has never been answered, and which I have not yet been able to answer, despite my thirty years of research into the feminine soul, is “What does a woman want?” (Sigmund Freud: Life and Work by Ernest Jones.)

Here, he was referring to psychological theory, wondering about the dynamics at work in female development. Freud and his colleagues generally had more trouble understanding women than men, and many psychologists think he was mistaken about some crucial issues relating to the female psyche and sexuality.

Above and beyond cultural influences, more women than men suffer from low self-esteem, problems in the realm of self-respect, appreciation, self-compassion, and self-love. They have difficulty paying attention to their own feelings. Some are even unaware, much of the time, of how they feel or what they want.

Although there can be many reasons for this, often it has to do with what I call signal interference. Imagine an old radio, the kind that requires you to turn a dial to tune into a station’s signals. If you turn too far one way or the other, you might get interference from another station’s signal. Other times, another, stronger or closer signal overwhelms the one you want. Sometimes the signal comes in too faintly, so you can hardly hear it.

Women can feel they are not as important as others. Your sense of self can be compromised by the pressures put on you to put others first. Some may have grown up around family members who were self-centered, troubled, or took up “all the oxygen in the room.”  A child of an alcoholic parent, for example, learns to become watchful, looking for signs of “which” mom (or dad) was making an appearance—the benign one or the drunk one.

While such people become good at reading others’ feelings, it is often at the expense of knowing one’s own. We are like radios that tune into other stations more easily than our own. Or, if someone else’s “signal” is louder, it interferes with hearing our own.

For example, it has been discovered that people with disordered eating patterns often have trouble knowing when they are really hungry or not. They will rely on external cues, rather than internal ones, to tell them when and even what to eat.

In a brilliant series of experiments in the late 1960s, Columbia University psychologist Stanley Schachter designed situations in which subjects were asked to do tests of memory. That was a ruse. Instead, the real variable that was being investigated was their eating behavior. The subjects were randomly assigned to two groups. Both groups were offered a plate of cookies when they had completed the memory task. The difference was that Group A had a clock on the wall reading the real time—late afternoon. Group B’s clock gave a false time—later and closer to dinner.

Subjects who reported themselves as overeaters were likely to eat cookies when the false, later time was on the clock. “Normal” eaters ate the same number of cookies regardless of the time. Schachter concluded that the latter group relied on internal cues of hunger, while the “overeaters” looked to external cues instead. “It’s close to dinner—I must be hungry,” they said to themselves, in other words.

Schachter was able to replicate his results in many other experiments with different designs. Since then, as other kinds of eating disorders like anorexia and bulimia have exploded, therapists have found that these patients too are estranged from their own feelings. While eating disorders afflict a wide range of people with many different histories, I have found that female anorexics, for example, may be the daughters of particularly self-centered or narcissistic mothers. These women do not help the child develop a strong, independent sense of self, because they see their daughters as extensions of themselves. This can be confusing and damaging for the child. Instead of learning to pay attention to her own feelings and desires, she is treated by her mother as if she feels the way the mother wants her to. She is punished or ignored if she expresses emotions and needs that the mother does not recognize in herself.

While it well known that people with eating and weight disorders suffer from low self-esteem, it is probable that their poor self-image and lack of a cohesive sense of self preceded and even caused the problem. The consequences of eating disorders, being over- or underweight, and various other health problems, exacerbate the problem further.

In relationships, too, this sets the stage for all kinds of problems. If we are unable to “tune in” to our own station, we are constantly being overwhelmed by the signals from others. Sometimes this causes us to behave as if our own needs don’t matter. A common instance of this is a woman who will have sex with a man who seems to really want to, without truly considering whether or not she wants to.

In more general terms, when a woman like this gets involved with someone who has a very strong sense of self, she can be dominated by his feelings even if he is not trying to do so. Simply by being able to attend to his own signals and express them, he has an “advantage.” Often these women are even attracted to narcissistic partners since they have had so much experience denying their own needs. It feels just like “home” to them. These relationships can even be outwardly “successful,” as long as the woman does not learn to acknowledge her true self. But they come at quite a cost.