Inner Critic of the Spoonie: Fibromyalgia and Self-Talk, what we say to ourselves matters

We all have an inner critic—the voice of doubt. The voice persistently, loudly, and glaringly directs our attention and processing toward what we do wrong. To problems, faults, deficiencies, deficits, and inadequacies. Sticky, shameful areas. Those of us with chronic pain, fatigue, and other invisible idiopathic disorders, syndromes, and diseases, are in danger of developing a destructive inner critic.

Our body responds to our inner critic by withdrawing. Shoulders round in, gaze drops to the floor, our head rounds down towards our knees as if we are trying to crawl within ourselves to escape.

It feels like being beaten down from the outside in. Every interaction is lacking. It reminds you of your deepest insecurities about how you present to others and your value in this world. When self-criticism becomes too loud, we can spend too much time focusing on negative thoughts and encourage our brain to make us feel small.

The inner critic is the voice inside your head that analyzes your behaviors, actions, and feelings, tapping into your deepest anxieties. It can take on the qualities and characteristics of a powerful judge, parent, or mentor. Though harmful and limiting, the "voice" can seem protective, purposeful, and wise. We often let it play on repeat, turn up the volume, and tune out the present moment. It can become so familiar and constant that we barely hear anything else. It can say things like,

You'll never be good enough
You should just quit
No one could ever love you
You always say the wrong thing
You are so stupid
You are ugly
It's all your fault
Nobody likes you
You'll never be able to help yourself
You have so many problems
You are such a burden
Your _______________ is worse than anybody else's
You should be ashamed of yourself
Why do you waste your time trying
Everything is a mess because of you

I could go on and on. I am sure you have some you could add to this list. Our inner critic has been shown to impact cognitions (the way we think), affect (positive/negative mindset), interpersonal goals (our social relationships), and behavior.¹ Therefore, we need to pay attention to what we say to ourselves. Let's look at the components of the inner critic.

Inner Critic Operations- Covert and Destructive

Not rooted in Experience

The inner critic repeats the same old demands and degradations, ignoring the present situation in an authoritative, mean (picture any bully A-Hole) voice. In fact, it works against you in the present by preventing you from really being able to experience it. It's hard to process what's in front of you when you have a loud voice making you feel like a 2-foot-tall pile of poop in your ear. It's difficult to feel around the shame and guilt that are triggered. We are too worried about protecting ourselves.

Non-nuanced

Everything is generalized with the inner critic's voice. Words like "always" and "never" are used to overgeneralize in a predictable, simplistic tone with no room for exceptions. It will bring up guilt about something that happened in the past or create fear about something that is going to happen in the future that you cannot change.

Not situation-specific

It is liable to show up at any point in time. Failures or shortcomings usually trigger it, but it can show up in response to something good, like a compliment, or for no reason at all. It can make it difficult to feel at ease and can keep showing up time and time again.

No moral authority

This piece is really important to grasp. So write it down. Your inner critic does everything in its power to prevent you from constructive behavior. "It blocks processes that contribute to developing values, ideals, realistic self-assessments, and openness towards others."²

Dysfunctional

The inner critic always makes you feel worse. It will stunt your potential, create continuous stress and pressure, and, sadly, prevent you from living your best, full life. When your criticism runs through your mind, your body and face tense and your breathing becomes heavy; you will feel more anxious, depressed, dissatisfied, and dejected.

Inner Critic Awareness

The first step is always creating awareness. As I mentioned earlier, our inner critic often becomes so loud we just let it run on auto-pilot. So the first step is to listen and note when your inner critic is running things and what your inner critic, in particular, is saying. So grab a notepad for a day and start t pay attention to what you say to yourself throughout the day. You may wake up, and your inner critic is the first to greet you with something like,

"Way to hit the snooze button again instead of getting out of bed. You are so lazy! You'll never move up at work because you can't get out of bed on time." It feels like a punch in the gut, a slap in the face, and kills all motivation, confidence, and value.

Sometimes our inner critic only shows up in certain situations. When we have to cancel plans when we are about to sign up to learn something new, when we are out in social situations or others. Notice and write down when these situations occurred, what the inner critic said, and how it made you feel.

We can immediately become disgusted when we first see the inner critic for what it is. It's like seeing a monster living inside us all along. While it's good that we are gaining awareness, we don't want to shriek away from it in horror, suddenly ashamed of our own thoughts. Our inner critic takes the form of negativity and painful experiences, anyone who has abused us or made us feel small.

Their words are etched and echo in the critical voice, not the authentic voice. So distance yourself and know that this voice can be made tiny. Try not to judge your inner critic, as that only encourages more doubt, shame, and negative internal dialogue. Instead, be curious! Imagine you are a scientist recording data. Just observe and track your inner critic. Don't worry; we will work on shifting it later. But we need to understand when and why we become critical first.

Here's a great chart that describes the difference between the inner critic voice and true experiencing.²

Fibromyalgia's Role

Researchers still do not agree on what causes fibromyalgia. Still, studies can reveal associations and relationships between personality traits and emotional states that can impact how we feel about ourselves and our place in the world. Please know I am not saying that these characteristics cause fibromyalgia or are a symptom of it. One systematic review published in 2018, which examined all of the research on fibromyalgia and personalities, found that measurements and scales of personalities that were used and the qualifying criteria for fibromyalgia varied wildly.³ Additionally, when they only looked at individuals with fibromyalgia who didn't have anxiety or depression, the rates of personality traits were the same as those without fibro.³ But, many Spoonies have anxiety and/or depression and may not be treating it yet, so I think it's important to cover this.

So remember, they are still debating what causes fibro, how to classify and test for it, and deliberating on what are all the symptoms and how best to treat them; meaning, this may or may not apply to you.

Nevertheless, considering how devastating and overwhelming fibromyalgia can be, it's not surprising that we struggle psychologically. Evidence shows that Spoonies have higher rates of negative affect (emotional distress like anger, contempt, disgust, guilt, fear, nervousness, and poor self-concept),

neuroticism (tendency toward anxiety, depression, self-doubt, and other negative feelings), perfectionism, stress, anger, and alexithymia (problems with feeling and regulating emotions and impulsivity).⁴

All of these characteristics can contribute to a hostile, powerful inner critic.

Other personality traits like high harm avoidance (worrying, pessimism, shyness, and being fearful, doubtful, and easily fatigued) and low self-directedness (struggle with purpose, direction, and reliability), negative self-image and body perception, low self-esteem, and self-efficacy found in women with fibromyalgia also impact what we tell ourselves.⁴

Lastly, living with an invisible illness that has been stigmatized and invalidated until fairly recently shapes how we feel perceived by others, also influencing and supporting our critical inner voice.

Now it's important to keep in mind that just because studies find higher rates overall does not mean you personally fit this psychological mold. But, because data suggests many of us do, I think it deserves a discussion. If you resonate with these traits and states, please don't start beating yourself up! I share this with you so that you understand YOU ARE NOT ALONE. The great news is if you have a personality trait that is not serving you, you can change it! Research published in 2019 in the American Psychological Association states that personality traits are relatively stable but can be changed with consistent effort.⁵ So, with awareness, learning, redirection, and growth, we can work to change that voice! With a personality change will come a host of other benefits. So, stay with me, and I'll explain what to look for in more detail.

When Our Inner Critic Shows Up

Performance

Often, our inner critic is, as I described earlier, like a judge presiding over our every move, ready to administer punishment any time we fall short. The stronger the perfectionist you are, the worse this becomes. Whenever you fall short of your idea of "perfection," your inner critic gets a chance to take center stage. The "Not good enough" mistake-focused comparison critic never allows you to be satisfied. This can feel very comforting and even supportive, and often what we view as "pushing ourselves" and the reason for our success. While it may motivate us in the short term, eventually, never being satisfied leads to exhaustion and unhappiness. No one is perfect, and without mistakes, we'd never learn. I will go into more detail later about how to work with your inner critic.

Body Image & Self-Esteem

What do you tell yourself when you look in the mirror? What do you think when someone compliments you? How valuable do you feel? When a chronic illness like fibromyalgia or Chronic Fatigue Syndrome comes along, it can change many things. We may have less energy or the ability to exercise or cook healthy meals. We may seek comfort in food. We may put on a few pounds or have always struggled with our weight. But what do we tell ourselves those pounds represent? How do we feel when we think these thoughts? This may be a problem whenever we get dressed, see people, or become intimate with our partner. It may be a loud voice that talks quite often.

Fear & Avoidance

We tell ourselves not to try something or do something because we can't, or it would cause us harm. We withdraw, avoid, and possibly even catastrophize what could or would happen if we took a certain action. It surfaces as mistrust in others or ourselves and can almost sound like an actual alarm. However, you can usually tell the difference. Our body is wired to protect us from harm, which is necessary if we are to survive. But, we can also start to tell ourselves we are not good enough, people don't like us, or we will never succeed at a task, which can create feelings of fear and insecurities that isn't helpful for our survival.

When our inner critic runs the show, it can impact our relationships, our performance and achievements, our energy level, mood, and self-esteem. In addition, self-criticism is linked to depressive symptoms, eating disorders, and social anxiety disorders.⁴ So, how do we tune it down?

We drown it out with self-compassion! Compassion, forgiveness, & emotion-based therapies have been shown to effectively reduce the inner critic and increase positive emotions and self-regard.⁶⁷⁸ So, how can we switch the script from critical to compassionate?

Compassion

We have already taken the first steps of becoming aware of what it's saying and when. By creating awareness, you begin to notice that this voice exists and has power because we listen to it and react based on its message. However, it is tough to stop it from popping up or ignore it, so instead, we will provide ourselves with an alternative message. Let me give you an example.

So let's say that inner critic always pops up when you decide to start going to the gym. As you change into your workout clothes, you catch a glimpse of your reflection in the mirror. Your mind recalls a fit model from a commercial you saw earlier or your co-worker who's an avid gym-goer, and you stack your reflection (in your mind, of course) right next to yours.

The inner critic starts in, "Look at you. You look so ridiculous in those clothes. You can't work out. When you walk into that gym, everyone will look like that model, and you will look so out of place. Do you want people to laugh at you? You look much better in those oversized jammies. Just go put those on. Let's go lay back on the couch where no one can make fun of you."

What a nasty, negative tone we can take with ourselves! So the first step after you hear this is to recognize the inner critic for what it is. This is not your conscience protecting you from harm! This self-doubt and fear will hold you back if you let them. Remember, we have a choice!

Next, we give ourselves what we need. We take on the tone of a caring friend, coach, mentor, or loving, supportive family member, and we talk back. It sounds like this.

"Hey, I know you don't look the way you want to right now, but comparing yourself to others isn't going to help. You have challenges that no one knows a thing about. You even signed up for the gym and bought this outfit is a win. Remember how good you felt when you bought it? We knew this would be hard, but we want to have more energy for our kids and become stronger. Everyone at the gym is focused on themselves, and I need to focus on myself and my goals. After I get this workout in today, I will feel much better about myself. I can do this." (Or something motivating & positive like that)

Now, you might be thinking, but what if I don't believe that compassionate stuff? What if I really believe my inner critic to be right?

That's completely normal! When we first try to change our internal narrative, it can be difficult to come up with positive, compassionate things to say. It can help actually to put yourself in a friend's shoes. How would you respond to your friend if they were putting themselves down? Eventually, with practice, the compassionate voice becomes more natural. Sometimes it replaces the negative thoughts, but in some areas, you might find that the inner critic is always triggered. The key is to continue to offer yourself a compassionate perspective.

Our inner critic is not helpful and actually works against us. It holds us back from ongoing development and growth. We might think it's right because we have been listening to it for so long, but it is, in fact, a distorted view of reality. When it is allowed to operate unchecked, we can be at risk for depression, anxiety, and other disorders. Overall, it diminishes our quality of life and holds us back from connection and deeper meaning and focusing on the things that bring us joy.

If you want a better picture of how compassionate you are to yourself, take this free assessment from Dr. Kristen Neff, one of the lead psychologists studying self-compassion.

Take the Self Compassion Test

3 Components of Self-Compassion

Dr.Neff has identified three distinct areas we want to work on regularly.⁸ She defines them as:

Self-kindness

"Being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical."

Common humanity

"Perceiving one's experiences as part of the larger human experience rather than seeing them as separating and isolating."

Mindfulness

"Holding painful thoughts and feelings in balanced awareness rather than over-identifying with them."⁹

So, when our inner critic surfaces during tough times, we respond with something kind. First, we remind ourselves that we are normal, and many people struggle with pain and failure. And finally, we remind ourselves that we can let our thoughts come and go, but they do not have to define who we are, how we feel, or what we do.

Steps to Increase Your Self-Compassion

Unfortunately, there's no magic pill that turns off our negative voice and turns up positivity and compassion. But, there are some quick, simple, yet highly effective exercises that, when practiced regularly, can help you change your internal dialogue. Here are just a few suggestions you might want to try.

Meditation Exercises

Help by bringing you at one with humanity and focusing on the greater purpose; connecting with nature, gratitude, acceptance, and setting aside judgment can strengthen our ability to be reminded of these truths when our inner-critic wants to tell us otherwise.

Writing & Journaling Exercises

Writing out the words of the inner critic and seeing them on paper can help you learn to see them for what it is. An unhelpful running narrative that isn't based on truth. A narrative that you can choose not to listen to while creating an alternative, more positive, and supportive voice. Answering questions that help you create this motivational, compassionate voice with your own personal touch will make you more likely to listen to it.

Working With Emotions & Therapy, Counseling, or Coaching

Self-help workbooks and emotional work with audio guides can be very helpful for some people in learning to identify why our inner critic becomes triggered or how to redirect when anger, resentment, and jealousy rear their ugly heads and distract us from healthy thoughts. If you feel stuck, a health coach can help you find the light. If you think you might have depression, anxiety, or unaddressed trauma, reach out to your doctor, therapist, or counselor in your area. If unsure, you can always check out MentalHealth.gov to find help.

Ready to Practice Turning That Inner Critic into Self-Compassion?

GOOD FOR YOU!

There's a bunch of FREE meditations and writing exercises available for download at the fantastic Dr. Kristen Neff's website self-compassion.org. That you can check out here:

Self-Compassion Guided Practices and Exercises

In Summary

We all have an inner critic, a negative voice that cuts us down and makes us feel bad. Rather than try to quiet this voice, we need to work to build more self-compassion for ourselves and more interconnectedness with our experiences and the experiences of others around us. Don't let your inner critic run unchecked instead, begin building awareness and exercising to build a counter voice that speaks to your values, dreams, true beliefs, and goals. You deserve to be nice to yourself! If you'd like to work with me individually on your inner critic, sign up for your free 1-1 coaching session today!

References

Zuroff, D. C., Sadikaj, G., Kelly, A. C., & Leybman, M. J. (2016). Conceptualizing and Measuring Self-Criticism as Both a Personality Trait and a Personality State. Journal of personality assessment, 98(1), 14–21. https://doi.org/10.1080/00223891.2015.1044604
Stinckens, N., Lietaer, G., & Leijssen, M. (2013). Working with the inner critic: Process features and pathways to change. Person-centered & Experiential psychotherapies, 12(1), 59-78. https://doi.org/10.1080/14779757.2013.767747
Conversano, C., Marchi, L., Rebecca, C., Carmassi, C., Contena, B., Bazzichi, L. M., & Gemignani, A. (2018). Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review. Clinical practice and epidemiology in mental health : CP & EMH, 14, 223–232. https://doi.org/10.2174/1745017901814010223
Galvez-Sánchez, C. M., Duschek, S., & Reyes Del Paso, G. A. (2019). Psychological impact of fibromyalgia: current perspectives. Psychology research and behavior management, 12, 117–127. https://doi.org/10.2147/PRBM.S178240
Bleidorn, W., Hill, P. L., Back, M. D., Denissen, J. J., Hennecke, M., Hopwood, C. J., ... & Roberts, B. (2019). The policy relevance of personality traits. American Psychologist, 74(9), 1056. https://doi.org/10.1037/amp0000503
Werner, A. M., Tibubos, A. N., Rohrmann, S., & Reiss, N. (2019). The clinical trait self-criticism and its relation to psychopathology: A systematic review–Update. Journal of affective disorders, 246, 530-547. https://doi.org/10.1016/j.jad.2018.12.069
Offenbächer, M., Dezutter, J., Vallejo, M. A., & Toussaint, L. L. (2015). The role of forgiveness in chronic pain and fibromyalgia. Forgiveness and Health, 123-137.
Vallejo, M. A., Vallejo-Slocker, L., Rivera, J., Offenbächer, M., Dezutter, J., & Toussaint, L. (2020). Self-forgiveness in fibromyalgia patients and its relationship with acceptance, catastrophising and coping. Clinical and experimental rheumatology, 38 Suppl 123(1), 79–85.
Neff, K. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and identity, 2(2), 85-101.

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