Episode 3 - Taming the Inner Critic - Part One

In this episode, Rebecca discusses the neuroscientific basis for the inner critic - a runaway part of the phonological loop - how it arises, how to recognize it, and how to begin untangling from this dysfunctional aspect of a helpful, natural phenomenon that develops as we learn language as babies. This work can allow us to become free from unhelpful critical thoughts that we internalize from our environment throughout our lives.  It can allow us to be more willing to take healthy risks, to grow, and to take exciting leaps into greater things. It is also an essential tool for building the capacity for self-love and compassion, which in early episodes we have established as prerequisites for wellbeing and flourishing.

Transcript Here

Rebecca Lauderdale, MD's website
email me at rebecca@rebeccalauderdalemd.com

Tara Mohr - Playing Big
Ethan Kross, PhD - Chatter
Jill Bolte Taylor, PhD - TED Talk and book My Stroke of Insight

Amee Wayton, SLP, at Hyperfocus Solutions (ADHD Coaching for adults!)

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Music used with permission:
Intro "Death Dance" by Luftmensch
Outro "Timeless Clouds" by Luwaks

Transcript

WPF Podcast Episode 3

Taming the Inner Critic - Part 1

I am so glad you are back! I have been having lots of fun thinking of things I can teach and share that will help you flourish!  This topic is one I have found so fascinating and even better, it's one of those subjects where implementing what you learn can be life altering - no exaggeration. It was for me. There is so much great material to talk about that I’m going to divide this into two episodes, so that we can give this the attention it deserves. So, I will be talking with you about the inner critic, the critical, chattering voice in our head.  The one that can take on characteristics of our parents or other caregivers in childhood, teachers, professors, sometimes for me it has been attending physicians, senior partners - even years after I wasn’t working with them anymore.  

It’s important to know that at its foundation, the inner voice is a normal, helpful phenomenon - called the phonological loop, which I’ll explain more about - but it can get wacky and overactive and end up paralyzing us with criticism instead of helping us, because it can be a way of internalizing criticism from external sources. 

I’m choosing this as one of my first podcast topics because learning how to transform the conversations that go on in our heads is one of the first skills we need to master as we doctors begin to challenge and reinvent the systems that we work within - whether that be our local practices, our healthcare organizations, the government or insurance regulatory system, or just the simple but powerful act of transforming our own relationships to be more genuine and intimate. If we don’t learn to deal with our inner critic, it can leave us in a situation where we feel we can’t move forward - paralyzed by the voice of impostor syndrome, self-doubt, shame and anxiety. 

Back years ago when I was in the depths of burnout, this was one of those fundamental skills that helped me really start to break through the barriers I had created between myself and my dreams. Over years of harsh self-criticism, perfectionism really took hold - I felt that I had to do things perfectly, or not at all.  And that admitting fault or admitting to a weakness was just like worse than death.  Not because I actually thought I was never at fault or didn't have weaknesses, but the feeling that admitting those things to others would cause me to fall out of favor, to not be accepted by “the group” anymore. 

Many of you have probably heard of the hidden curriculum in medicine- this is the set of rules and beliefs that get transmitted during medical training that aren’t part of the formal curriculum but that get taught to us nonetheless - perfectionism, workaholism, emotionally rigid - all things that are killers of joy and killers of wholeheartedness. They directly contribute to the development of burnout, perpetuating this system that is hurting so many physicians. 

For me, the hidden curriculum got internalized and became part of my inner dialogue. It felt like admitting to imperfection would cause me to lose credibility, to lose the sense of having a right to be there, to lose a sense of belonging - which in my case wasn't so much belonging as just fitting in - the distinction being that belonging is when you’re accepted in a group as you are, without changing, and fitting in is when you change yourself to group norms in order to be accepted. 

An important aside here is that you can never truly belong with people if you don't show them who you are - no matter how open they are to accepting you - the more you practice vulnerability and learn to be open about the best and the worst parts of you, the more you feel known, and truly accepted.  

So, what I’m bringing you today in this episode and in the next are a basis of science, a framework to think about our inner dialogues, and then very specific evidence-based practices for transforming the effect that the inner critic has, and transforming these conversations in our heads that can be so paralyzing. Making friends with ourselves. Because that’s what we’re looking to do here, right? In the previous episodes I hope I convinced you that self-love is an imperative if you want to live a flourishing life, what Brene Brown calls Wholehearted living. And we want that right? It’s worth the time working on these things. 

I’ll be mainly drawing from the work of two authors - Tara Mohr, who is an author and teacher who wrote a book called Playing Big that was published in 2014; that book has had such a positive impact on me that I keep a stack of em in my office to give away. The book is about her work with professional women in just about any industry you can think of, and her passion for coaching them through the things that get in the way of Playing Big - bridging the gap between your limited ideas of what you can do, and the truth of your potential and talent and gifts.  The first chapter of the book is about the inner critic, for good reason.  It doesn't matter how much you learn, how much theoretical knowledge you acquire about how to lead and how to live authentically, you can't implement it if you have a paralyzing inner critic that you don't know how to reality check or disarm.

The other author whose work I’ll be referencing is Dr. Ethan Kross. He is an experimental psychologist and neuroscientist at the University of Michigan; he founded the Emotion and Self Control Laboratory, where he and others research the silent conversations people have with themselves.  He wrote a book called Chatter that came out early this year and which I highly recommend. I have a friend who is a speech and language pathologist and is an ADHD coach for adults and we just geeked out over this book because it has so much rich and useful and life-changing information to help the people we work with (and ourselves too). It is sooo good.  

So, I think a good place to start is by describing what I mean when I say “inner critic.”  What I’m referring to is the critical internal voice. We all have internal dialogue, its part of being a human. Even people who have been deaf all their lives have an internal dialogue, but instead of verbal thought, it’s their own version of signing language, used internally.  And internal dialogue is certainly not all negative or critical.  All humans develop the “phonological loop” as they develop language as babies and toddlers - the loop is composed of an “inner ear” that retains any words we’ve just heard in the past few seconds and an “inner voice” that allows us to repeat words in our head, for example, when we are memorizing something and saying it to ourselves internally. The phonological loop is an essential component of our working memory, and precedes our development of self control (because we have the internal conversations that tell us what to do and what not to do). As babies and toddlers, we get verbal instructions from the world, from our caregivers, and then we repeat and mimic those instructions to ourselves, and over time we internalize these messages. The messages stick with us even when our caregivers aren't present and help us develop self control.  Our inner voice thus becomes tuned by our environment. 

Another thing that the phonological loop does is run simulations.  This is the default state of our thoughts - running simulations. If you are not otherwise engaged in completing a task or a specific thought, then thinking about events in the past and how they impact the present or the future, various thoughts about the meaning of past events, fantasizing about things that are possible, wondering what would happen “if”, planning, planning, planning. We do this at incredible speeds, like 4000 words/minute.  Think about the average blog post, around 2k or 3k words, or a 60 minute speech around 6000 words.  We are thinking at 4000 words/minute. There is an incredible amount of content, of thought about ourselves and our possibilities and our interpretation of the world as it relates to us, constantly going on in our heads. 

Our inner voice, the phonological loop, also plays a big part in helping us monitor our goals. Thoughts related to achieving goals or objectives, monitoring whether we are on track or on time are among the most frequent kind of spontaneous thoughts. Our phonological loop also is integral to the process of constructing meaning from our experiences as they relate to our thoughts and beliefs - this system takes our experiences and tells stories about ourselves to ourselves. These thoughts become our beliefs about ourselves. These stories are the building blocks of our identity, our concept of self. In fact, the phonological loop is essential to our self- concept.  Not just certain things we think about ourselves, but our sense that there even IS a self that is separate from the world. 

Dr. Jill Bolte Taylor, whom many of you may be familiar with, is a Harvard-trained neuroanatomist who had a massive L brain stroke in her 30s. It obliterated her speech and language centers. She recovered and is now thriving and is quite a sought after speaker and author, and a lot of her teaching springs from this experience. She describes suddenly not having thoughts. She had perceptions, and she felt emotions, but the phonological loop was gone. She talks about having long periods of silence in her mind, hearing all the things around her but her self-talk disappeared, and very interestingly and relevant to what I’m talking about here in this episode, so did her sense of identity. She describes it as something that was frightening but at the same time blissful. She felt a sense of there being no boundary between who she was and the world around her. A couple of quotes from her: “The growing void in my traumatized brain was entirely seductive. I welcomed the reprieve that the silence brought from the constant chatter.” She says “I am a devout believer that paying attention to our self-talk is vitally important for our mental health. “

So, to state it simply, our inner talk, our phonological loop, builds our self. And remember last episode when I talked about human evolution and the biological imperative we have to belong to groups.  So one of the things that our brains are designed to pay most attention to is our status in our tribe. So our phonological loop will disproportionately internalize warnings that are designed to keep us in good standing.  

Clearly, then, there can be a major problem when we humans are exposed nearly constantly to many times conflicting criticism, which we then internalize. It can paralyze us. And not only that, change who we think we are. 

I have to say I’m a little jealous of Jill Bolte Taylor having had that experience of mental quiet - especially the way my mind was before I learned how to work with critical self-talk. I truly thought it was who I was, and assumed that meant it was fixed. But what I didn't really understand then, but that I do now, is that self is just a phenomenon.  Some of you who study meditation or nondual religious practices know this is not a new idea. It’s thousands of years old. And it certainly bears true in the science.  Our self is just a collection of thoughts. And the good news about this is that our thoughts are changeable. It’s not quick and easy, it doesn't just go away because you know about it - you have to practice - but you’ll be surprised how much change can happen in just a few weeks of practicing the skills I’ll be talking about, and after several years? It’s huge. If I were suddenly to be plunged back into the mind of myself 7 years ago, I would probably first go into shock at the barrage of criticism and negativity, but I’d also know what to do about it, and that’s what I’m here to teach you about today. 

My first experience of turning the tide of my inner critic was reading Playing Big and hearing Tara Mohr describe the ways to identify the voice of the inner critic - she defines the inner critic as having one or more of these characteristics  I’m about to describe to you. Several of them are focused on areas where women are particularly vulnerable.  If you’re not a woman, these things will still be true but may have different themes. These characteristics closely parallel and complement the research cited by Dr. Kross in his book.  In the research, one of the first steps in neutralizing your inner critic is seeing it as something separate from you, just a phenomenon. The object is not to attack it or shame it, because that’s just another form of the inner critic - the best way Ive found is to just say “ok, I see you there. Thanks for trying to help - I know you’re trying to protect me from shame or ostracism, or whatever, but I’m a grown up now, I can take care of myself. Ive got this”

 I want you to just listen and see what rings true for you. 

So , our list of inner critic characteristics, from Tara Mohr’s book Playing Big:

1. It’s harsh, rude, and mean. It talks to you in a way you wouldnt talk to someone else, certainly not someone you care about.
2. Its very binary. Black and white thinking. You’re either great or you’re awful. Your beautiful or you’re atrocious. There's not room for anything gray
3. Plays itself as the voice of reason, as if it’s a definite pronouncement of what is true, while arguing against you doing something that it deems “unreasonable” - so like you’re interested in taking on a new challenge and the voice says “your own ideas aren't enough here. Don’t put yourself out there. It’s too risky, just be reasonable.”
4. You’re not ready yet.  This is very common for women. Women tend to overprepare and underestimate their ability to perform. Research on women executives shows that they tend to pursue more education and training compared to their male counterparts before they consider applying for promotions or new jobs. I definitely have felt this one before, the feeling like, well, I’ll just go take this class or pursue this certification before I’m ready, and it’s not something that requires a new certification, but I just thought I would do better with more education first.  But after thinking more about this and practicing dealing with my inner critic, I’ve learned to reality check those impulses and make sure I’m not just pursuing more education as a way to put off taking a risk, and risk is inherent to anything new, no matter how prepared we are. 
5. The voice of “you arent good at ___” that is associated with traditionally masculine skills. Like negotiating, technical skills, financial matters, and sometimes leadership in general. You can learn whatever you need to learn. While there are certainly things you might choose not to do because they aren’t your strong suit and you’d rather do something else, this criticism will often come up as a block to you doing something you actually do want. 
6. The voice of body-perfectionism - I probably dont need to say too much for you to understand this one. very critical talk about appearance, weight, or aging. Keeps you tied up in worrying about your appearance instead of living big in the world. 
7. The tape - feels like a tape running automatically, even invading or interrupting your own thinking
8. The broken record - rehashing the same things over and over, over years or decades
9. Irrational but persistent
10. The one-two punch - the critic starts talking about one thing and then shames you for having that thought. So, for example “you have gained weight and you look awful in that dress right now, people are going to know how out of control youve been with your eating and just ugh.” and then turn right around and say “why are you so fixated on your appearance.  You’re so damn shallow” -it’s never satisfied. 
11. Takes inspiration from critical people in your life - a parent, a teacher, for me it’s also been attending physicians when I was a student or resident, or more senior partners who are very critical of others. Or an archetype - the old white guy wearing a tweed jacket. 

A worry that I had when starting to do this work was, What is going to motivate me without this inner critic? Or maybe this is just who I am? I’m never going to get anything done if I don’t have this voice “motivating me”. It’s super important to realize that this inner critic is not you . It’s very likely that you, like I had, have so internalized this voice for so very long because we are in a field that is very reliant on critical thinking and that can make criticism of ourselves so much easier, and our environments are steeped in criticism of EVERYTHING. On top of the fact that there may have been people early in your life who were very critical of you, and those voices got internalized. 

So, You might feel that you are inseparable from this voice, you may even be reluctant to want to separate from it because, again, you think that your motivation, your edge will be taken away if you aren’t on constant alert for things that are “wrong” with you and need fixing or monitoring. This kind of alertness for trouble might serve you quite well in the OR or examining patients or doing your taxes, but it is devastating when you turn it on yourself.  

My purpose in creating this podcast is to help you flourish. Not just be un-burned out. Remember I talked about Brene Brown’s work studying people who were what she called Wholehearted - people who were flourishing. Their sense of self worth was so healthy that it allowed them to live in this way that was very free, and allowed them the space to be creative and innovative and to take calculated risks that let them live the kind of whole lives that they wanted.  I said then, and it bears repeating now - you cannot do this to yourself, this kind of constant criticism, and live a life of wellbeing.  Humans don't work that way. Self love and self compassion, self respect, get run into the ground by the inner critic when it runs amok, and they are an imperative. They are a prerequisite for wellbeing and flourishing, and for your ability to fully love others (because we do judge others by the same standards we judge ourselves.  Watch next time someone you love steps out of those boundaries that you draw for yourself and see what your internal dialog does.  Or what you spontaneously say without thinking. It is quite revealing). 

Self love is also a prerequisite for taking risks, and I dont mean stupid risks - you could definitely argue that actions that are overly risky are the opposite of self love - but I’m talking about things like taking your relationships further and deeper, or changing or starting a new practice, applying for a promotion or making a proposal to your organization for a new project or endeavor, or just keeping boundaries for yourself with other people.  You have to assume a certain level of your own worthiness to do those things freely. They are involve risk - you don’t know exactly what will happen, but the potential benefit for your growth outweighs the risk, and if you value yourself and believe that you are worthy of love and belonging just as you are, you don't feel like you’re risking your belonging when you take healthy risks.  But if your worth is placed on the opinions of others, or the opinions of culture/media, or your own internalized critical voice, it will be so hard to take those leaps, those big steps in growth, because you’ll be paralyzed by the criticism. 

That critical part of our phonological loop is there to keep us from taking the risk - it begins as the internalized voice of our parents, who gave us instructions to keep us safe, but then it became a voice of critical people and culture which didn't always have our best interests at heart.  And now that we are grown-ups and can take care of ourselves, we can say “thank you” to the inner critic, and also “I don't need your help right now, I've got this.”  The point is not to wrestle with or kill your inner critic. It’s to realize that it is there as a beneficial adaptation that’s gotten out of hand.  And the same wonderful brain that protected us when we were small, we can use to learn how to re-evaluate and recalibrate our response to risk and criticism. 

So, next episode we are going to talk about some more ways that you can tame the inner critic, to loosen its grip on you, but in a gentle way, and in ways that are science based. 

Until then, try this: set aside some time when you don’t have to be mentally engaged with another task, and set a timer for whatever amount of time you’d like. Just 5-10 minutes is enough to begin to notice patterns. In that time, notice your thoughts. Don't try to change them, just pay attention.  Does your critic show up? Do your thoughts have any of those characteristics I listed above? Is it harsh or mean? Is there black and white thinking? Is a voice of supposed reason trying to keep you from doing something you want? Is there a voice of a critical person in your life? Is there a one-two punch of criticism and then criticizing yourself for the criticism? Is there perfectionism?  See if you can notice this voice and label it, “Oh, I’m hearing my inner critic right now” - this begins to separate it from your sense of who you are and help you deidentify with it. That's the first step to loosening its hold on you. We will pick up with more exercises in the next episode. 

Until then, keep being your badass self. Thank you so much for listening. I’m grateful for you and for the opportunity to share with you. It would mean a lot to me if you do find this podcast valuable, if you would share it, and also if you would give a 5 star review on itunes, because those high ratings actually help the podcast get seen more and allows me to help more people. 

In between episodes, you can find me @dr.lauderdale on instagram, or you can go to my website www.rebeccalauderdalemd.com to get on my mailing list and in exchange I will send you a couple exercises I created with a workbook and audio guides for working with the inner critic. You can also email me at rebecca@rebeccalauderdalemd.com (rebecca with two c’s)

A blessing for you as we go, from Jan Richardson

“May you be wise

To your own terrain

And know the lay

Of your own land.

May you see who you are

In all the fullness

Of your spirit

And your flesh.

May you tell it forth

Without shame

Or dismay. “

Much love to you all, have a great week