A negative self-image can be as unhealthy as an unrealistic or an over-the-top one, but there is a difference between healthy self-esteem and narcissism or arrogance. High self-esteem does not mean you are an egotist who feels a sense of superiority and misplaced internal pride. 

High self-esteem means respecting yourself in love, and affording yourself value and a sense of dignity. It means you think your thoughts, feelings, and ideas have worth. It's related to how you feel, inside and out. It also reflects how others see and behave around you.  If you have been in negative situations where you haven’t felt safe or valued, the associated trauma can cause low self- esteem. Also, emotionally some people are more level with stable feelings about themselves, while others are more reactive dependent on mood and life situation.

High self-esteem means generally holding yourself in positive regard. It doesn't mean you think you’re the bees knees and absolutely perfect, or that everything about you is just the best. We can have some parts that we feel need improvement or aspects we aren’t happy with, that is real life. Self-love is not denying parts of our lives where we want to do better and be better (if we can) - healthy self-respect lets you see beyond yourself and feel confident of your place in the world. It allows you to put all of your points, good, bad or middling in perspective because at your heart, you hold yourself as valuable, and can trust and respect your emotions, feelings and actions.  Good self-esteem helps you understand that everything isn't about you, and you don’t need to consider everything as a personal sleight. 

Strong self-respect lets you see beyond yourself and feel confident of your place in the world. What matters is what you concentrate on.  Your focus reflects on your actions and thinking, and the measure of grace and compassion you show to yourself, especially with those things you consider less than perfect.