Verbalizing Your Inner Dialogue

Daniel Keeran, MSW, President, College of Mental Health Counselling

www.collegemhc.com

College of Mental Health Counseling presents:

Verbalizing Your Inner Dialogue A Cognitive Therapy Approach

http://www.collegemhc.com/

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This new generation psychological technology can improve

conditions in persons with normal or average cognitive

functioning. The cognitive mental functions give humans a

particular advantage in terms of creative solution

development.

Humans are constantly engaging in a process of internal

dialogue across a variety of subject areas. Mental distress

may be at least partly remedied by verbalizing,

understanding, and perhaps modifying the internal

dialogue.

For persons suffering from chronic dependency as well as

anxiety, depression, and relationship issues, the following

technique may be useful:

1. Invite the client to talk about what they know will improve

their situation and what could worsen their situation.

2. Identify the parts of the self as the knowing confident self

and the unknowing negative self.

3. Ask the client to verbalize each part of the self in

response to the other (like Golum in Lord of the Rings).

4. Discuss ways to strengthen the knowing confident part of

the self. This is also the observer will part of the self that is

able to evaluate and modify the dialogue and draw a

conclusion that works best.

The above technique can be easily learned, recorded

through journaling, and repeated as a core process in

therapy in order to make the inner dialogue most conscious

and useful to the client. This psychological technology can

improve conditions in persons with normal or average

cognitive functioning.

The therapeutic use of inner dialogue can focus on a

specific issue or area of mental distress and invite the client

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to have a conversation between the knowing confident part

and the negative self-doubting or unhealthy part.

Here is an example of an exchange using this inner

dialogue approach:

Client: I feel so inadequate and lacking in self-confidence.

Counselor: So, part of you feels inadequate and lacking in

self-confidence. I wonder if there is another part of you, a

knowing part, even a small part, that feels adequate and

confident about some things.

Client: Yes, there is. I moved out here on my own. I have a

job and pay my rent (client smiles).

Counselor: You are very resourceful, capable, and

independent. You can strengthen the positive, capable part

of yourself just by talking more about it. Tell me more.

In this example the counselor further supports the knowing

supportive self by adding to the dialogue. The counselor

can also invite the client to verbalize the inner dialogue

between the positive knowing part and the negative

doubting part.

Counselor: Now I want you to speak your negative

thoughts and also your positive thoughts.

An exchange with someone suffering from

depression

Counselor: If there’s a conversation inside you about the

depression, how does it go? Speak the conversation out

loud.

Client: I am a failure. Nothing I do is good enough.

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Counselor: So that is the negative part of you that feeds

the depression. There is another part of you, even if it is a

small part, that knows more and that can see the big

picture. What does that part say?

Client: I have been resourceful, independent, and self-

reliant. I pay my own rent, buy my own food, hold a job,

moved far from home, and have travelled to Europe on my

own.

Counselor: Yes. Which part of you feels better than the

other part of you: the negative part or the other part?

Working with different personality disorders

The beginning of the process is to identify the central issue

defining the personality disorder.

Personality disorders are understood as a pattern of

behaviour beginning in childhood, causing subjective

distress and affecting social and occupational functioning.

The central issue of each disorder is actually the voice of

the negative unhealthy self that is larger or stronger than

the positive confident self. The goal of therapy is to

strengthen the positive confident self and thereby relieve

mental distress. This occurs by bringing the inner dialogue

into conscious awareness and by focusing attention on the

positive healthy confident self by talking about, elaborating,

and affirming it.

The negative unhealthy self is significantly fed by negative

uncaring experiences during childhood, usually the parental

relationship. A way to strengthen the positive self is to say,

“What would you say or do if what happened to you

happened to your own child?” and “If you were the healthy

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caring adult or parent in the situation you describe, what

would you say or do for you, the child?”

This approach utilizes the person’s own cognitive ability

and sense of empathy to create and define healthy

choices.

Another approach is to say, “If you had power to change

any three things about your childhood or family when you

were growing up, what would they be?” and, “I wonder if

you can imagine how you might be different today in some

ways if things had been different as you describe.”

This approach helps the person use memory to identify

significant unresolved issues from childhood that require

healing as well as visualization in order to identify and

strengthen the positive healthy self. A key to moving

forward is to hold two opposite realities simultaneously, the

reality of loss of parental caring or other loss and also one’s

power to make healthy choices in thought and action now:

“Maybe you could not choose what happened in your

childhood, and you can choose what you do now.”

Paranoid Personality Disorder

Central issue: No one can be trusted because they want

to harm me in some way.

Common associated major negative life experience:

Loss of caring and closeness in the parental relationship

during childhood. Possibly physical or verbal abuse.

Therapeutic statements supporting the healthy self:

What happened in your childhood or your past that you

think has contributed most to your distrust of others?ood

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I wonder if part of you knows what someone would be like if

they could be trusted.

How much is your fear and distrust based on what you

think about other people? If you could allow yourself to

think differently about others, how might your fear be

affected?

How would you feel toward others if you could believe that

people are generally sincere and well-intentioned?

Schizoid Personality Disorder

Central issue: No one understands me because I am

different. I prefer to be alone.


Loss of parental caring.


When in your life did you first start feeling alone or of being

lonely?

What happened in your childhood or your past that you

think has contributed most to your desire to be alone?

I wonder how you might be different today if there had been

something different in your life when you were growing up.

What is your image of the person you want to be? Describe

this person for me.

Part of you prefers to be alone.

Another part of you has a different need or different idea

about people. What does that part say?

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Schizotypal Personality Disorder

Central issue: I have odd or delusional thoughts but I may

not recognize them as odd or delusional; no one can be

trusted. Possible abuse or abandonment experience in

childhood.


Loss of parental caring; lack of social skill development in

childhood.


Part of you thinks what you described (the odd thought) is

true, and maybe you need to have those thoughts for now.

Part of you believes no one can be trusted, and everyone

wants to harm you in some way.

There is another part of you that may have a different idea

about your thoughts and knows what you need and who

you can be. What does that part of you say?

Antisocial Personality Disorder

Central issue: I am willing to violate the rights of others to

serve my own profit and pleasure.


Lack of parental discipline during childhood; loss of

parental caring


Part of you is use to surviving on your own, believes

sometimes you must take advantage of other people to

look after your own interest, and that the end justifies the

means. Is that accurate?

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There is another part of you that feels a little guilty about

taking advantage of others to meet your own needs. What

does that part of you say?

Borderline Personality Disorder

Central issue: I don’t have control over my emotions. “I

hate you, don’t leave me.” I am afraid of abandonment.


Abuse and/or abandonment during childhood.


Part of you hates people, feels emotionally negative toward

others, and also fears being left alone by others. Who was

the first important person in your life who hurt or left you?

Another part of you, perhaps a small part, believes that you

are capable of being OK and surviving even if people leave

you. What else does that part know? Maybe that you can

manage your emotions, especially your anger?

Histrionic Personality Disorder

Central issue: I need the attention and approval of others

in order to be happy. My worth depends on my physical

attractiveness.


Childhood abuse and learning to believe that value is

associated with sexuality or external appearance. Lack of

training in healthy values and beliefs during childhood.

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Part of you believes your worth depends upon your sex

appeal and physical appearance.

There is another wiser part, even if it is a small part of you,

that knows more about you and your worth as a person.

What does that part say?

Narcissistic Personality Disorder

Central issue: My ideas and abilities are superior to those

of others.


Parental abandonment or rejection by the father.


Part of you thinks your ideas and abilities are superior,

perhaps far superior, to those of others.

Another part of you thinks you may be an imposter or feels

very inferior to others. What does that part say?

And part of you thinks others are capable of having

important ideas and abilities. What does that part say?

Avoidant Personality Disorder

Central issue: I am afraid that others will criticize me in

social situations.


Critical parenting during childhood or bullying by peers or

siblings.

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There is part of you that is afraid of criticism in social

situations.

Another part of you is able to reassure you or encourage

you. What does that part say?

Dependent Personality Disorder

Central issue: I fear being alone and must subordinate my

own needs and feelings to those on whom I rely.


Dominating parenting that makes obedience and

subservience a condition of caring.


Part of you believes you must serve others in order to be

accepted by them, and you must be accepted by them in

order to be happy.

Another, knowing part of you believes you are worthwhile

even if others do not accept you. This part wants you to be

true to yourself and to assert your own needs and feelings

even if others are displeased. What else does it say?

Obsessive-Compulsive Personality Disorder

Central issue: I must control my environment and

finances, because of my fear of chaos, disorder, or poverty.

Things, working, and financial security are more important

than people.

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Poverty or financial stress or financial loss during

childhood.


Part of you thinks you must achieve and maintain financial

security even if you must sacrifice closeness and caring in

your relationships with others. If that seems accurate,

elaborate on this a little.

Another part of you believes people and the quality of your

relationships are more important than things or even than

keeping order.

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Self Improvement

Verbalizing Your Inner Dialogue