Thursday, January 10, 2013

Critical Voices

No one can be in therapy with me for very long, without my introducing the concept of critical voices, voices that we carry around in our head that tell us we’re crazy or stupid or lazy or just plain bad. These  are silent voices – not to be confused with hallucinations – that have been taken in by us at a very early age, stemming either from our understanding of how our parents or other caretakers viewed us or our own early criticisms of ourselves. They don’t have to be actual representations of what our parents said or how we truly were, just our subjective understanding. And once these voices are inside our minds, they are difficult to change, necessitating that we take in positive voices to counteract the internal criticisms.

If we’re lucky, we start out with positive voices as well, voices that tell us we’re kind or smart or good looking. But, it’s the critical voices that present the greatest problems, turning on us and making us feel guilty or anxious or depressed about our own “badness.” And those critical voices get turned on others as well as ourselves. In other words, if we see ourselves as lazy, it’s not at all uncommon for us to see others as lazy as well, so our critical voice is directed both towards the self and others.

Dealing with these critical voices being directed both inside and out, often becomes the focus of a therapy session. For example, there is Rebecca who struggles with feeling that she’s “ordinary,” “average,” which translates for her as not being sufficiently intelligent. She can recognize some of her positive assets, such as being a good wife and mother, but she dismisses these as inconsequential when measured against what she sees as her intellectual lack. Her father was a tenured professor at an Ivy League school, as well as a successful author whom the patient experienced as critical, cold, and unloving. In addition to her having taken in her father’s critical voice, she needs to see herself as intellectually deficient in order to hold onto the illusion that her father’s love would have been forthcoming if only she had been smarter.

Although not as successful, my father was also an exceedingly bright man who prized intelligence above all else, looking down at those he judged intellectually deficient. For many years I tried to win my father’s approval by reading the books he wanted me to, taking the courses he valued. In the end, however, although never seeing myself as smart as my father, I accepted that I would never be who he wanted and that it was far more important for me to live my life for me, rather than for him.

Not surprisingly, these similarities between myself and Rebecca affect the treatment process. This week, Rebecca began a session by talking about her book club and how she didn’t like the book they just read. She felt it was simplistic, not worthy of book club reading, a waste of her time. I hear the contempt oozing from every word.

“I’m thinking of dropping out of the group,” she says.

I remember several years ago dropping out of a book club when the books seemed too “lightweight.” Had I felt a similar contempt? I detested the contempt my father expressed to those he considered intellectually inferior. But was I being similarly contemptuous? Was my patient?

There is too much contempt in the treatment room - my own, my father’s, my patient’s. I respond in a way that shuts down further exploration.

“Hasn’t this been the only book you’ve felt that way about?” I ask.

Her contempt is now directed towards me. “What an odd response,” she says. “I would have expected more from you.”

I cringe internally. She has responded like both of our fathers. But she is also correct. My response was a way to escape the contempt, to make things “nice.” 

“You’re right,” I say. “But I wonder if we can look at what just happened here. Your critical voice, the voice that’s always telling you you’re not smart enough, got turned first on your book club and then on me. And it’s quite a harsh critical voice. It obviously made me uncomfortable, made me want to get away from the criticalness rather than explore it. I wonder if there’s a way to have a kinder voice, a voice that can criticize, but that can also make allowances for mistakes, that can also give you a break.”

“And give you and my book club a break too,” she adds.

“Yes, that’s true. The voice gets turned both inside and out.”

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