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Silencing the Voice That Says You're a Fraud

 

By MELINDA BECK JUNE 16, 2009 wsj.com

 

....Psychologists say many of their patients are plagued by a harsh Inner Critic -- including some extremely successful people who think it's the secret to their success.

 

....

Unrelenting self-criticism often goes hand in hand with depression and anxiety, and it may even predict depression. In a study of 107 patients in the latest issue of Comprehensive Psychiatry, David M. Dunkley at Jewish General Hospital in Montreal and colleagues found that those who were most self-critical were the most likely to be depressed and have difficulties in relationships four years later, even if they weren't depressed to begin with.

 

Self-criticism is also a factor in eating disorders, self-mutilation and body dysmorphic disorder -- that is, preoccupation with one's perceived physical flaws. "We have expanded what we expect of material success and physical appearance so that it's completely unrealistic," says Robert L. Leahy, a psychiatrist and director of the American Institute for Cognitive Therapy in New York.

 

Many people's Inner Critic makes an appearance early in life and is such a constant companion that it's part of their personality. Psychologists say that children, particularly those with a genetic predisposition to depression, may internalize and exaggerate the expectations of parents or peers or society. One theory is that self-criticism is anger turned inward, when sufferers are filled with hostility but too afraid and insecure to let it out. Other theories hold that people who scold themselves are acting out guilt or shame or subconsciously shielding themselves against criticism from others: You can't tell me anything I don't already tell myself, in even harsher terms.

 

It's unclear whether women berate themselves more than men do -- or just talk about it more readily. "The issue with men is, we don't really know what they're thinking. They're trained not to admit to any qualms or emotional pains," says Marianne J. Legato, an internist and founder of the Partnership for Gender-Specific Medicine at Columbia University. But she frequently sees men suffering from the "I'm a fraud" syndrome.

 

....

Techniques from cognitive behavioral therapy can also be helpful in changing patterns of thought that have become painful....[says psychologist Katherine Muller, director of the Psychology Training at Montefiore Medical Center in Bronx, N.Y.] "People usually succeed in spite of their Inner Critics, not because of them."

 

Among the suggestions she and other experts offer for putting your Inner Critic in its place:

  • Monitor your thoughts. Jotting down your self-critical judgments -- I'm a loser, I'm stupid, I'm ugly -- in a journal or a personal-digital assistant is the first step to mastering them: That process alone may decrease the intensity and frequency. Also note the situations in which these feelings occur and see if you can spot patterns.
  • Evaluate your judgments. Define your terms and examine whether your standards are arbitrary or fair. If you think you're a "bad person," are you a bad person all the time? Are there times when you are adequate? Dr. Muller says patients often find that their views are internally inconsistent. "I'll ask, 'What does a loser look like to you?' The patient is picturing a guy in sweatpants sitting around the house drinking beer. I say, 'Is that what you did yesterday?' And he'll say, 'Well, no.' "

     

    Also, try to depersonalize what is really beyond your control. "Some people think, 'My portfolio is down 35% -- what's wrong with me?' As opposed to, 'What's wrong with the market?' " Dr. Leahy says.

  • Collect objective data. Challenge negative thoughts with hard facts. Keep a short list of your achievements on a note card and pull it out when your self-criticism threatens to overwhelm you. Or look back at your own CV and review what you've accomplished. "Focus on the fact that you made it as a scholarship student -- not that nobody asked you to dance for two years," says Dr. Legato.
  • Conviction or condemnation? Recognize the difference between thoughts that are critical and those that are constructive, suggests Therese J. Borchard, whose Beyond Blue blog on Beliefnet.com often deals with such issues. If you overeat at a picnic, thinking "I am a fat pig" is a condemnation, she says, whereas thinking "I'll try to start eating better tomorrow" is a conviction. Dr. Leahy agrees: "Your goal should be improvement, rather than putting yourself down."
  • Re-evaluate your values. Make sure that whatever you are beating yourself up about is worth striving for. Some goals, like kindness, integrity, and being self-disciplined, enhance the meaning and quality of life, whereas others only feed into your sense of defectiveness, Dr. Leahy says. "Some people think, 'I can get Botox and then I'll be lovable.' But the way to be lovable is to do lovable things," he adds.

Breaking the habit of self-criticism can pay big dividends in mental and physical health. "The way you see yourself can be challenged and changed, and it can literally create new neural pathways in your brain," says Dr. Legato. "And as your thinking improves, your immune system improves, your digestion is better, you don't compensate by overeating or drinking, and your anxiety levels go down."

 

You may find you have mental and emotional energy left over for many other things -- including helping other people feel better about themselves.

 

https://www.wsj.com/articles/SB124511712673817527

Edited by manymoretodays
access full article via google

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

  • 4 weeks later...
Posted

Yeh, very good article and thats why everytime i criticize myself i also say it is not y fault!

  • 10 months later...
Posted

you are not told enough, i'm sure, what a difference u make... Thank u for posting this!

:P LADYBUGQT :unsure:

 

Posted

Perhaps this is why CBT has not "fit" for me. I don't relate to the points in this article.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

  • 3 years later...
Posted

Alto, This goes way beyond AD's and Benzo's. I found this to be extremely helpful about a myriad of aspects of life in general.

 

Thank you,

Woof

 

PS: sorry it took me so long to get my topic vs. the forums clear. :)

If on a Benzo for a relatively short period of time, such as less than 6-12 months, one may want to consider tapering off their Benzo first (please see Will Hall's book on Harm Reduction)

 

Prior to commencing with an AD taper please consider what problems the AD is causing, as tapering is an extremely serious endeavor.   

If one has been on an AD for more than 10 yrs. please consider the potential long term negative consequences of AD withdrawal prior to tapering. (please see Drs. Healy, Glenmullen and Shipko) 

Prior to re-starting an AD taper, please do not resume tapering until all w/d sx's from any prior taper, especially CT, have resolved. 

 

2004 - Dec. 2015,  Cymbalta 20mg/d  for neck pain - Never had problems with Cymbalta.   Dec 2015, CT 20mg/d Cymbalta.  5 weeks later reinstated 20mg/d Cymbalta - without increase in CT sx's.   

Feb 2016 STARTED VALIUM 25mg/d for CT Cymbalta wd sxs.    Jan-April 2016 Held Cymbalta 20mg/d - doing pretty well (AM 3/10 anxiety and 3/10 tinnitus)

April 2016, CT Cymbalta sx's had not yet resolved and I prematurely tapered 10% q 4 wks x 3 mos.  After 3rd cut developed 10/10 wd sx's of Anxiety, Anhedonia, Anorexia, Panic attacks, dark, incresaed Valium to 28mg/d. 

November 2016, after 3 cuts, UP-DOSED all (41 beads) back up to 20mg (193 beads total) Cymbalta - from , dark to light.

VALIUM TAPER: Jan 2017 28mg to March 2019 Zero   Cymbalta has partially stabilized and helped with the Valium taper.  The only sx I have now is 3/10 Tinnitus, which I only notice when it is quiet.

http://survivingantidepressants.org/index.php?/topic/11900-woof-cymbalta-re-stabilization-after-cold-turkey-withdrawal/  Benzo Posts http://survivingantidepressants.org/index.php?/topic/11951-woof-valium-scheduling-and-dosage-with-cymbalta-wd-symptoms/

  • 3 months later...
Posted

Hi Alto

 

Thank you so much for this article !

 

I often spend my time criticizing my self.I only recently realised how much it doesn't help

 

Caitlin

  • 1 year later...
Posted

Does anyone else blame themselves for this? The thing is - I absolutely know that my PSSD symptoms due to Lexapro / Prozac are not my fault. I know that there was no way I could've predicted there'd be any lasting negative effects. I thought I was doing something that would not only benefit me emotionally but help me better a better girlfriend/friend/daughter, etc. I know that my decision to take SSRIs was brave, but I also feel so angry at myself at the same time for putting my body in jeopardy.

 

My sexuality was very important to me, and I feel so hollow inside now. Emotionally, I'm back to normal ... I know I sound depressed here, but my depression and anxiety is a lot better now, which only makes me more frustrated that I took the SSRIs in the first place. I was going through a rough time, but I should've just waited it out.

 

It's hard because I can't really talk to anyone about this since it's sexual obviously. I just feel like this piece of me is missing, and though I do blame doctors and the healthcare system, I also know that the decision was in my hands, and I made the worst decision possible because here I am in this situation. 

 

Sorry for the negativity. I guess I'm just looking for any advice or insight as to what to do when laying in bed at night blaming myself in this way. How can I move on? It'll be 5 months of this soon. I can't imagine spending the rest of my life not being able to enjoy sex with my boyfriend who I love very much.

  • ChessieCat changed the title to Blaming yourself / self blame for mistakes? Try this.
  • 7 months later...
Posted

Fantastic article,

I liked it so much .

Thanks altostrata .

i wasn't on a certain drug all the period. i took many drugs many times and for no very long period but to simplify.

--fluvoxamine maleate100 mg + amisulpride 200mg------started july 2012 and total taper in february 2015 ( 9 months without drugs then)

--sertraline 100mg -------started november 2015 and total taper (withoud reduction slowly) in november 2016( 4 months withoud drugs then).

--sertraline 100mg + quetiabine 25mg ( started in mars 2016 and for 7 months) then fluvoxamine maleate 100mg again for another 7months and after that a something like to use every drug for 14 days and for about 1.5 years.

--my last drug was trintellix 10 mg ( used it in 12/2018and total taper in 4/2019).

symptomts i have now ( bad concentration and problems in short and long memory+ bad depersonalization).

Posted

I've had an extremely harsh self-critic living in me since I was a kid.  I like this article very much and I think I need ongoing help learning to silence the critic.  

1994  Venlafaxine XR 300mg, 2003 tapered, 2004 off briefly back to 37.5 then 75mg, held, June 2019 up to  150mg, Aug.12 tapered down to 112.5mgs, Oct. 21, 2019 96mg;  Dec. 8, 2019  90mg, Jan. 8 2020 81mg, Feb. 4, 75mg; April 17, 2023 37.5mg

2003/2004? Diazepam 10mg/bedtime

2013 Lyrica 300mg to 25mg; April 6, 2020 17mg; April 28, <5mg; May 7, 2020 Lyrica 0 mg!

2013 Tramadol 50mg tablets, 200mg/day divided

2005? Trazodone 50mg bedtime, Feb. 12, 2020 40mg, March 7, 25mg; Oct 1 20mg;  0mg!

2009? Zolpidem 5mg at bedtime. Nov. 9, 2019 Zolpidem 0 mg! 

1990? Omeprazole 20mg in morning.

2010? Levothyroxine 75mcg morning

2011? Liothyronine 5mcg morning

1999? Buspirone 30mg twice a day  August 2019 15mg once a day,  Oct.21, 2019 2.5mg evening  Oct. 25, 2019 Buspirone 0 mg!

Posted

I have often gotten angry at my body and mind for not being adequate, being broken, not working the way I want, being a disappointment and even plotting to sabotage me. 

 

Citalopram: 40mg from July, 2007 to May, 2019.

                     Tapered down to 5mg between May, 2019 and August, 2019.

                     20 mg currently.

 

Mirtazapine: 30mg since October, 2019.

 

Melatonin: 6mg since January 2020.

 

Magnesium glycinate: 120mg since January, 2020.

Citalopram: 40mg from July, 2007 to May, 2019.

                     Tapered down to 5mg between May, 2019 and August, 2019.

                     20 mg currently.

 

Mirtazapine: 30mg since October, 2019.

 

Melatonin: 6mg since January 2020.

 

Magnesium glycinate: 120mg since January, 2020.

Posted
On 7/23/2019 at 4:13 AM, roxy65 said:

Does anyone else blame themselves for this? The thing is - I absolutely know that my PSSD symptoms due to Lexapro / Prozac are not my fault. I know that there was no way I could've predicted there'd be any lasting negative effects. I thought I was doing something that would not only benefit me emotionally but help me better a better girlfriend/friend/daughter, etc. I know that my decision to take SSRIs was brave, but I also feel so angry at myself at the same time for putting my body in jeopardy.

 

My sexuality was very important to me, and I feel so hollow inside now. Emotionally, I'm back to normal ... I know I sound depressed here, but my depression and anxiety is a lot better now, which only makes me more frustrated that I took the SSRIs in the first place. I was going through a rough time, but I should've just waited it out.

 

It's hard because I can't really talk to anyone about this since it's sexual obviously. I just feel like this piece of me is missing, and though I do blame doctors and the healthcare system, I also know that the decision was in my hands, and I made the worst decision possible because here I am in this situation. 

 

Sorry for the negativity. I guess I'm just looking for any advice or insight as to what to do when laying in bed at night blaming myself in this way. How can I move on? It'll be 5 months of this soon. I can't imagine spending the rest of my life not being able to enjoy sex with my boyfriend who I love very much.

@roxy65, I am welling up with emotions reading your post and also viewing some videos here on PSSD. I have been married almost 20 years and am about ready to leave as there is no sex life and only bitching and sniping. I have ZERO libido for years and it isn't fair on my husband. I have often wished that he would leave me for his own happiness's sake. Is that self-sabotage? Or selflessness? Or love? Or hate? Or just weariness?

I really am so fed up of the constant arguments and lack of respect on both sides. I don't feel any attraction to him (or anyone) and feel that we would both be better off apart.

Jan 2023: Venlafaxine XR 100 mg, Lorazepam 0.25 mg, Oestradiol 100 micrograms

Dec 2022: Venlafaxine XR 100 mg, Lorazepam 0.25 mg. HRT stopped for hysterectomy surgery 5 Dec 22 (potential clotting risk)

September 2022: Venlafaxine XR 100 mg, Lorazepam 0.25 mg, Oestradiol 100 micrograms, Progesterone 100 mg.

Apologies but I can't remember or find details at the moment, but I slowly reduced Venlafaxine and Lorazepam through 2020-2021-2022.

Jan 2022: HRT increased by GP for unknown reason to oestradiol patch 100 microg, progresterone 100 mg

June 2021: started HRT (oestradiol patch 50 microg, progresterone 100 mg). 

August 2020:  Made a 16% reduction in Lorazepam at psychiatrist's recommendation (1.25 mg) while holding Venlafaxine at 150 mg.

March 2019 - March 2020: Venlafaxine  XR tapered from  337.5 mg  to 150 mg (60% reduction), while continuing 1.5 mg Lorazepam.

March 2016 - January 2019: Mirtazapine taptered to 0, while continuing on 1.5 mg Lorazepam and 375 mg Venlafaxine XR.

Feb. 2015: 7.5 mg Mirtazapine + 1.5 mg Lorazepam + 375 mg Venlafaxine.

 

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