Well, it can be. I have a client who always puts others first - and its ruining his life! He wants to value himself and feel self-confident - but whenever he puts his needs before those of his family, fiends or colleagues - or even thinks of so doing - he immediately feels guilty. So I suggested that he first accept that he will feel guilty when he puts himself first - and then choose to put himself first and feel the guilt anyway. Which is fine as far as it goes - but it's a difficult instruction to follow. No one finds it easy to choose uncomfortable or painful feelings which you may have spent a lifetime trying to avoid.