If I am not for myself, who is for me (Ethics of the Fathers 1:14).
Every human being appreciates approval. We naturally desire to hear good things about ourselves and to have our feelings of worth confirmed.
Those totally dependent on the approval of others for a sense of self-worth, however, have a different story. An analogy will explain the difference. We all need oxygen in order to survive. A healthy person derives sufficient oxygen from breathing air. Someone with an impairment of the heart or lungs may require constant inhalation of pure oxygen, and any interruption may cause serious damage and even death.
In usual daily activities, we generally obtain affirmation of ourselves via two routes: our own accomplishments and the love, recognition, and appreciation that we receive from family and friends. Together, they provide us with an adequate feeling of self-worth. For a person whose ego is seriously impaired and who feels inwardly impoverished, they do not suffice, and the constant need for outside approval places the fragile ego in jeopardy. Even momentary lapses may not be tolerable.
Hillel said it well: "If I do not have a good feeling about myself, there is no one who can give it to me," which means that total dependency on external sources for affirming self-worth is unrealistic. The supply can never meet the demand.