Mental Health

Replacing Hostile Internal Voices with Compassionate Self-Talk

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I was talking to a group of people who hear voices the other day about “self compassion” and I noticed something interesting. While just about everyone in the group had problems with voices which were hostile and disparaging, and they were often influenced by these voices into feeling bad about themselves, none of them seemed to have ever tried replacing the voice with compassionate self talk aimed at themselves.

I suspect this may be important. Most approaches to helping people with such voices have something to do with either trying to get rid of the voice, such as by taking drugs till it fades away, or trying to ignore the voice or distract attention away from it, say by listening to music or the TV. One problem with such methods is that they all involve avoiding whatever issue or emotion the voice may be bringing up. And what we know about avoidance is that we can only do that for limited amounts of time: eventually, we have to deal with what we’ve been trying to sweep under the rug.

For example, let’s say a person feels like a loser because of having few friends, being on disability, and having been recently hospitalized. A hostile voice might be happy to bring up this issue, telling the person that he or she is the scum of the earth and must die or be tortured so that justice may be served, etc. Drugs may numb out the feelings around this issue, and so quiet the voice for a bit, and ignoring the voice and distraction might help the person feel free of the voice for a short while, but none of these strategies help the person reconcile with the feelings of loss that set off the voice in the first place.

The advantage of compassionate self talk is that one can find ways of directly addressing the feelings of loss while putting a positive “spin” on it which allows the person to feel hope mixed in with the feeling of loss. The person in the above example might tell themselves something like “I’m doing my best to cope with a series of disasters, I can learn a lot from my mistakes and I might be able to do better in the future. But even when things don’t work out, I can know that it’s really my effort to do what I can that makes me a worthy person, and I can accept myself as I am at each step in this journey.”

Compassionate self talk is different from “positive affirmations” which have been shown to make people frequently feel worse when they notice they can’t live up to the affirmation. It doesn’t try to raise “self esteem” or to make the self feel stronger or more important; instead, it just notices the option of being compassionate toward the self in whatever situation in life the person may find themselves.

By taking a balanced view of the situation, the person faces and acknowledges the losses that have occurred. This means that one is no longer trying to ignore or distract from whatever negative information triggered the voices, but one is also not getting overwhelmed by negativity.

I suspect that mental health care that focused on helping people develop balanced yet compassionate self talk could prove to be much more helpful than approaches that try to get rid of, or avoid dealing with, negative emotions and voices. Such methods would be much more constructive, without being unrealistic. I suspect that negative voices would lose their influence once people are good at talking to themselves in a positive way. (I know this method often works for me when I’m having a lot of negative automatic self talk, and I think negative voices are just a variation on that.)