Imagine two women standing in front of a mirror. One says, “I can’t stand the way I look. I’m so fat.” She feels anxious, insecure and depressed. The other one says, “I’ve gained a few pounds but it’s not the end of the world. I can relax and start my diet next week.” She feels calm and accepting of herself. The scenario is the same for both women, but their interpretation of it is significantly different because of one thing---they’re self-talk.
What we say to ourselves has a powerful impact on our emotional state, that’s why teaching clients to notice their self-talk is such an important part of therapy. Today more than ever, attachment and mindfulness-based therapies are helping clients experience emotional healing. Drawing from Mindfulness therapy, I coined the term “the art of noticing.”
Noticing helps clients pay attention to their internal monologues and understand how their negative inferences impact their emotional states. Noticing is particularly helpful when working with anxiety, depression, and eating disorders because these populations are especially prone to negative self talk. Because self-talk is so automatic, we have to help clients notice the effect it has on their moods. This is accomplished by assisting them:
- Learn the cognitive distortions
- Slow down their thinking
- Take note of negative internal monologues
- Pay attention to triggers
- Practice a non-judgmental stance
- Use effective counterstatements
- Use Socratic questioning
Helping people understand that they are responsible and in control of how they feel is key; it is also empowering. Once we learn that negative self-talk becomes a learned bad habit, we will be more inclined to spend intentional and deliberate time practicing thought replacement.
The Voice
Each one of us has a personality sub-type according to Dr. Edmund J. Bourne (The Anxiety and Phobia Workbook, 1995). I call it The Voice. These sub-types fall into 4 categories:
- The Worrier
- The Perfectionist
- The Critic
- The Victim
Each of these sub-types has their own distinct voice that perpetuates negative self-talk. Our job as therapists is to help clients recognize and change negative internal monologues, replacing them with positive counterstatements.
I find a most effective way to begin this practice is to teach clients about the Voice, and have them identify which sub-type seems to fit for them.
Next, I teach them the cognitive distortions that go along with each voice, and ask them to identify which of the thinking errors they are most prone to make. Once they have that down, they’re ready to begin paying attention to what they may never have paid attention to before; how these negative internal monologues influence what they chose to believe.
Since beliefs are the most powerful things we chose, I explain to my clients that beliefs need not be buried in stone. In other words, we can choose to modify existing beliefs if we aren’t ready to change them.
I generally provide a visual metaphor for clients as we do this exercise by using a football field as an example. I ask them to picture two opposing goal posts on the field. Next I suggest that there is a great deal of grass in between those two opposing goal posts; all that space represents middle ground. To modify an existing negative belief, or negative self talk, we have to take it down the field. We take one of their existing beliefs and the cognitive distortion that accompanies it and work on bringing it to middle ground.
It would look something like this:
Client: “I’m a total failure at relationships.”
Counselor: “Your using all or nothing thinking.”
Counselor: Using Socratic questioning: “What evidence do you have to support the belief you’re a total failure at relationships?
Client: I have no friends.
Counselor: “You mentioned two friends to me last week, and several from your past.”
Client: “I suppose you’re right.”
Counselor: “So how can we modify that belief?”
Client: “I may not be the greatest person at relationships, but I’m not a failure.”
Note that in assisting clients in developing positive counter-statements it requires that they have some degree of belief in them. It is helpful to teach Socratic questioning to help challenge negative beliefs and the self-talk that accompanies them.
The key to helping clients recognize and change their internal monologues is helping them uncover the negative beliefs that provide the fuel for them. Without addressing the core belief systems, negative attributions will persist.
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