Thought provoking post, an interesting topic. I understand what you're getting at....I'm hard enough on myself as it is, so to say that I'm "lacking" something, you're thinking it puts more pressure on that. However for me, my lack of confidence is not a symptom of my anxiety, it IS most definitely one of the multiple factors that led to an anxiety disorder developing. My lack of confidence has been present in greater or lesser degrees for years. Years. Finally when increased work stress, family issues, and hormones reached a boiling point, the confidence issue certainly played a role in finally tipping things over into a full fledged anxiety disorder. And because I can only work to manage these stressors....I cannot remedy ongoing issues with extended family, I cannot resolve all the work stuff, I must find a different part of the equation to work on to improve my anxiety levels. One of these is working on the hormone issue with my primary care doctor. Lexapro played a role in alleviating the anxiety induced depression. But to really get a handle on the chronic anxiety, then yes, I PERSONALLY (I won't speak for anyone else) Do need to work on my confidence, on my self-esteem.
A couple of other interesting points to ponder though:
1) Studies suggest that higher self-esteem doesn't actually decrease rates of depression (not sure about anxiety, haven't read any data) Sometimes in fact more depression can be found. Because higher self esteem may lead to certain expectations out of life that people expect and may not neccessarily get, which can lead to dissatisfaction. That there has been such a high premium placed on self esteem in raising kids that it leads to a sense of entitlement. So more of it isn't always better. This may sound contradictory....but what I'm saying is that for some people low self esteem IS a cause and not a symptom, and for other people it may not play a role at all.
2) It's important to realize that we're not perfect. nobody is. We DO need to think about personality traits and thought processes that exacerbate our anxiety and actively work to improve them. We're not always successful. We don't achieve these goals in a day or week, sometimes not a month or more. And that's ok. but it's part of the process. The same goes for people with physical health ailments. It's not someone's FAULT they have asthma, But they need to acknowledge that there are ways of limiting exacerbations. It's not about faults or deficiencies. It's about the fact that we humans are a work in progress, and sometimes we can work to find ways of alleviating our anxiety which is to our own benefit. And if we can't do so ourselves, this is where a qualified therapist comes in. Medications can be very important but they are only one part of the equation.....that's true of mental and physical health disorders.