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Self-Esteem The Anxiety Behind Exceptionalism Keven Duffy LCSW on December 29, 2025 in The Subplot Feeling special is often treated like a sign of confidence. Some people with advanced dementia show sudden, brief returns of clarity near the end of life—speaking, remembering, reconnecting. But having a strong need to feel exceptional isn’t really empowering—and can actually be a sign of low self-worth.