Source: WSJ Health Journal
Silencing a Voice That Says You’re a Fraud
By Melinda Beck
A physician starts playing a harsh mental tape in her head every time a new patient calls: What if I make the wrong diagnosis? I’m a terrible doctor. How did I get into medical school?
An executive loses his job and despite 25 productive years, he tells himself: I’m a loser. I can’t provide for my family, and I’ll never be able to again.
An eminent scholar is offered a top post in the Obama administration and his first reaction is: They must have made a mistake.
If these real-life examples sound familiar, you may have a caustic commentary running in your head, too. 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.
An Inner Critic can indeed roust you out of bed in the morning, get you on the treadmill (literally and figuratively) and spur you to finish that book or symphony or invention.
But the desire to achieve can get hijacked by harsh judgment and unrelenting fear. “There’s a healthy version and an unhealthy version,” says Daniel F. Seidman, a clinical psychologist at Columbia University Medical Center in New York. In some cases, he says, “people may achieve a lot, but they are totally miserable about it.”
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.
